Natural history of cytomegalovirus infection in a series of patients diagnosed with moderate-severe ulcerative colitis

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 followup,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 flareup despite remission;it seems that the virus is not responsible for the disease relapse.