Effects of Cytomegalovirus Infection and Antiviral Therapy on Prognosis of Patients With Ulcerative Colitis:A Meta-analysis / 胃肠病学

ABSTRACT

Background:Ulcerative colitis(UC)patients are the high risk population of cytomegalovirus(CMV)infection. CMV infection may aggravate the disease progression of UC,and the prognosis of UC patients with CMV infection may be improved by antiviral therapy. Aims:To systematically evaluate the effects of CMV infection and antiviral therapy on prognosis of UC patients. Methods:PubMed,Cochrane Library,Embase,CNKI,Wanfang,SinoMed and VIP database were retrieved to collect the case-control studies studying the effects of CMV infection and antiviral therapy on prognosis of UC patients. Meta-analysis was conducted by RevMan 5.3 software. Results:Twenty case-control studies were enrolled. Meta-analysis showed that UC patients in CMV infection group were more serious(OR=1.62,95% CI1.13-2.33),and had larger intestinal lesions(OR=0.63,95% CI0.43-0.92),higher risks of steroid dependence/resistance(OR=6.13, 95% CI1.98-19.00)and colectomy(OR=1.64,95% CI1.14-2.36). Antiviral therapy for UC patients with CMV infection significantly improved the early clinical remission rate(OR =2.08,95% CI1.03-4.17),decreased risk of colectomy(OR=2.12,95% CI1.06-4.22). Conclusions:CMV infection can aggravate the progress of UC,enlarge the extent of intestinal lesion,increase the risks of steriod dependence/resistance and colectomy. Antiviral therapy significantly improves the early clinical remission rate,and decreases the risk of colectomy.