Risk factors of cytomegalovirus infection or reactivation in ulcerative colitis patients: a Meta-analysis / 中华实验和临床病毒学杂志

ABSTRACT

Objective@#To explore the risk factors of cytomegalovirus (CMV) infection or reactivation in ulcerative colitis (UC) patients.@*Methods@#We performed a search at the databases of Pubmed, Cochrane, Embase, CNKI, Wanfang, SinoMede and VIP up to March 2017. A search strategy was constructed by using a combination of the following words "inflammatory bowel disease or IBD" or "ulcerative colitis or UC" and "cytomegalovirus or CMV" . Literature was screened according to the inclusion and exclusion criteria and statistics was analyzed using RevMan 5.3 software provided by Cochrane collaboration network and analyzed using Stata 12.0 software to evaluate publication bias.@*Results@#After searching and screening, we included 18 case-control studies finally. Meta-analysis showed that the risk of CMV infection or reactivation in severe UC was 1.45 times that in mild to moderate UC and the risk in whole colon was 1.54 times that of patients with left colon and rectum with the pooled OR values as 1.45 (1.02-2.05) and 1.54 (1.05-2.27). The risk of CMV infection in middle-aged patients with UC was higher than that in young patients with the pooled MD values of 4.60(2.13-7.07). The therapies with glucocorticoid and immunosuppressive agents such as azathioprine, cyclosporine and methotrexate were high risk factors of CMV infection or reactivation in UC patients, with the pooled OR values as 3.87 (2.70-5.53) and 2.07 (1.29-3.32), but the duration of UC, treatment with 5-Amino salicylic acid/salazosulfapyridine (5-ASA/SASP) and infliximab had no statistically significant correlation with the CMV infection or reactivation in UC patients, with the pooled OR values as -1.20 (-2.64-0.24), 0.94 (0.61-1.42) and 1.50 (0.65-3.44).@*Conclusions@#In patients with severe UC, whole colon lesions and the therapy with glucocorticoid and immunosuppressive agents were the risk factors of CMV infection or reactivation. The risk of CMV infection or reactivation in middle-aged patients was higher than that in young patients.