Brief Article
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World J Gastroenterol. Feb 7, 2011; 17(5): 633-638
Published online Feb 7, 2011. doi: 10.3748/wjg.v17.i5.633
Natural history of cytomegalovirus infection in a series of patients diagnosed with moderate-severe ulcerative colitis
Valeria Criscuoli, Maria Rosa Rizzuto, Luigi Montalbano, Elena Gallo, Mario Cottone
Valeria Criscuoli, Mario Cottone, Dibimis (Biomedical Department of Internal and Specialist Medicine), “V.Cervello” Hospital Palermo, University of Palermo, Palermo 90143, Italy
Maria Rosa Rizzuto, Elena Gallo, Institute of Pathology.“V.Cervello” Hospital Palermo, Palermo 90143, Italy
Luigi Montalbano, Division of Gastroenterology, “V.Cervello” Hospital Palermo, Palermo 90143, Italy
Author contributions: Criscuoli V and Cottone M planned, conducted the study and drafted the paper; Montalbano L performed proctoscopy and rectal biopsies; Rizzuto MR examined histologic specimens; Gallo E performed PCR assay; all authors approved the final version of the paper.
Correspondence to: Valeria Criscuoli, MD, PhD, Dibimis (Biomedical Department of Internal and Specialist Medicine), “V.Cervello” Hospital Palermo, University of Palermo, Via Imperatore Federico 70, Palermo 90143, Italy. vale.cic@libero.it
Telephone: +39-91-540614 Fax: +39-91-7305218
Received: August 25, 2010
Revised: October 26, 2010
Accepted: November 2, 2010
Published online: February 7, 2011
Abstract

AIM: To evaluate the natural history of human cytomegalovirus (HCMV) infection in a series of 28 ulcerative colitis patients in whom the search for HCMV was positive.

METHODS: A series of 85 patients with moderate-severe ulcerative colitis flare-up were evaluated for a HCMV search by performing a haematoxylin and eosin stain, immunohistochemical assay and nested polymerase chain reaction on rectal biopsies. Among 85 screened patients (19 of whom were steroid resistant/dependant), 28 were positive for HCMV; after remission the patients were followed up clinically and histologically.

RESULTS: Among the 22 patients with complete follow-up, in 8 (36%) patients HCMV-DNA persisted in the intestinal specimens. Among the HCMV positive patients, 4 (50%) experienced at least one moderate-severe flare-up of colitis without evidence of peripheral HCMV. Among the 14 HCMV negative patients, 3 with pouches developed pouchitis and 5 out of 11 (45%) experienced a colitis flare-up.

CONCLUSION: Our preliminary results suggest that HCMV may remain in the colon after an acute colitis flare-up despite remission; it seems that the virus is not responsible for the disease relapse.

Keywords: Ulcerative colitis; Cytomegalovirus; Natural history; Polymerase chain reaction; Outcome