The impact of latent cytomegalovirus infection on the disease behaviour in patients with ulcerative colitis

Abstract Background Cytomegalovirus (CMV) infection has been associated with steroid-refractory disease and risk for colectomy in patients with Ulcerative Colitis (UC). We aimed to study if patients with latent CMV infection more often needed systemic steroids, immunomodulators, biologics and surgery than patients negative for CMV infection. Methods From the national IBD register (SWIBREG) all patients with UC (n = 404) treated at Umeå University Hospital in Sweden, and who were tested for CMV infection were included. A latent CMV infection was defined if a patient had at least one positive serology and/or a positive PCR for CMV. A retrospectively medical chart review between the years 2006 and 2019 was performed to check for medical therapy and surgery due to UC. Results One hundred and thirty-one patients (32%) had at least on one occasion been tested for CMV infection and of these patients, 88 (67%) had evidence of a latent CMV infection. There were no differences in the use of systemic steroids, in the use of immunomodulators/biologics or in colectomy rate between patients with latent CMV infection and patients with no infection (table). There were no differences between patients with latent CMV infection vs. no infection in median faecal calprotectin (FC) levels the first five years after diagnosis (302 vs. 457 µg/g; p = 0.301) or at the last recorded FC test (62 vs. 82 µg/g; p = 0.317). Conclusion Patients with latent CMV infection do not differ from CMV negative patients in the use of medical therapy for UC nor in colectomy rate.