RESUMO
Background:Cytomegalovirus [CMV] infection is common in individuals with inflammatory bowel disease [IBD] and is responsible for relapse, increased severity, and poor outcome if left untreated. Ganciclovir is the mainstay of treatment but data regarding its use, mode of administration, and duration of treatment is poorly described. We reviewed the practice of treating CMV colitis with different regimes of ganciclovir at a district NHS hospital to compare the clinical outcome
Methods: 35 patients with IBD and concurrent diagnosis of CMV infection were evaluated. The parameters studied were clinical outcome in term of clinical response, length of hospital stay, readmission, or colectomy with three different regimes of ganciclovir, in addition to treatment for IBD
Results:35 patients with IBD [ulcerative colitis = 23, Crohn's disease = 5, Indeterminate colitis = 7] and positive diagnosis of CMV infection were studied. Clinical outcome with two weeks of intravenous [IV] ganciclovir regime was superior than one week of IV ganciclovir and two weeks of oral Valganciclovir in term of clinical response on day 15 [95.8% vs 74%, 24.3%, respectively p = 0.45] and colectomy rate within 3 months [6.25% vs 27.3%, vs 25%, respectively]
Conclusion CMV colitis is associated with poor outcome in patient with IBD if left untreated. 2 weeks IV ganciclovir was associated with a better outcome than 1 week of IV treatment or oral treatment