Antiviral therapy improves surgery-free survival in UC patients

Antiviral treatment for colonic cytomegalovirus (CMV) infection significantly improves short- and long-term surgery-free survival in patients with ulcerative colitis (UC), according to the results of a small-scale study.

Patients in treated and nontreated groups had similar demographic variables. Patients who received antiviral therapy had significantly improved surgery-free survival within 30 days and lasted 70 months (p<0.01).

On the other hand, both treated and nontreated groups showed similar rates of hospitalization, rehospitalization and mortality (p>0.05). Furthermore, there was no significant between-group difference in any of the clinical outcomes based on viremia status.

In total, 1,478 patients who had colon biopsy and were tested for CMV during 1990–2013 were identified from the Cleveland Clinic pathology database. Forty-one UC patients were selected after inclusion and exclusion, of whom 24 (58.5 percent) received treatment and 17 (41.5 percent) did not.

The authors compared 14 demographic data and four clinical outcomes (surgery-free survival, hospitalization, rehospitalization and mortality) between treated and nontreated patients. They also compared the same outcomes in patients who received treatment based on their viremia status.

“The frequency of CMV colitis in steroid-refractory inflammatory bowel disease has been reported to range from 15.8–34.0 percent. Infected patients are more likely to become hospitalized, have longer lengths of stay and higher mortality rates,” the authors said.

“Current data are limited to small scale studies and showed conflicting result regarding the role of antiviral therapy,” they added.