A Clinical Significance of Assessing Cytomegalovirus Infection Status in Patients With Ulcerative Colitis

cases because of its high specificity. Although CMV infection has been reported as a risk factor for poor outcomes in two prospective multicenter studies by the IBD Study Group of the Korean Association for the Study for Intestinal Diseases, there is little data concerning the relationship between CMV antigenemia assay results and clinical outcomes. In the present study, the authors retrospectively evaluted the usefulness of the CMV antigenemia assay in predicting clinical prognosis in UC patients in a single academic center. Of 146 patients hospitalized for an exacerbation of moderate-to-severe UC, 43 patients who had undergone the CMV antigenemia assay at the time of admission were included. Twelve of the patients had CMV antigenemia, and 8 (66.7%) were diagnosed with CMV colitis by endoscopic biopsy. Of the 31 patients with negative CMV antigenemia assay results, 4 (12.9%) had CMV colitis. CMV antigenemia was significantly associated with CMV colitis (P=0.001). The sensitivity and specificity of the CMV antigenemia assay for CMV colitis were 66.7% and 87.1%, respectively. Regarding the clinical course, there was a significant association between CMV antigenemia and refractoriness to corticosteroid therapy (P =0.002). Eleven of 12 (91.7%) patients in the CMV antigenemia-positive group, and 12 of 31 (38.7%) patients in the CMV antigenemia-negative group had refractoriness. In addition, the titer of the antigenemia assay showed a tendency to be higher in patients with steroid-refractory UC than in those with the steroid-responsive UC (P =0.058). Multivariate analysis revealed that steroid refractoriness was significantly increased in CMV antigenemia-positive patients (adjusted OR, 7.73; P =0.030), and in A Clinical Significance of Assessing Cytomegalovirus Infection Status in Patients With Ulcerative Colitis