Area Editoriale
OBJECTIVE: The clinical significanceof cytomegalovirus (CMV) reactivation complicating ulcerative colitis (UC)patients has been uncertain. It has therefore remained undetermined whether ornot CMV reactivation should be treated in UC patients under immunosuppression.The aim of the study was to clarify the natural history of CMV reactivation inUC patients. METHODS: Sixty-nine UC patients with moderate to severe activitywere enrolled in the study. All of the patients were treated with prednisolone,and/or immunosuppressants such as cyclosporine A. We sequentially monitored CMVreactivation every 2 wk up until 8 wk using the CMV antigenemia (Ag) assay and plasmaquantitative real-time polymerase chain reaction (PCR) assay for CMV. RESULTS:Immunoglobulin (Ig) G for CMV was positive in 48 patients (69.6%) and negativein 21 patients (30.4%). CMV was reactivated in 25 patients out of the 48seropositive patients (52.1%) during the study period. The CMV Ag and PCRvalues were low and none of the patients showed any evidence of CMV infectionon biopsy specimens by hematoxylin and eosin staining. While gancylovir (GCV)was not used except in two patients, clinical outcomes including rates ofremission and colectomy were not significantly different among the CMVreactivation-positive, -negative, and CMV IgG negative groups. Furthermore, CMVdisappeared without GCV in most of the CMV reactivation-positive patients. CONCLUSIONS:CMV is frequently reactivated in active UC patients; however, it disappearswithout antiviral agents. Therefore, antiviral therapies should not benecessary for most UC patients with only CMV reactivation as long as CMV Agvalues are low.Leggil'articolo