Crohn's & colitis 360 · 2026
Genetic proof of herpesviruses CMV, EBV and HHV-6 in intestinal biopsies from patients with inflammatory bowel diseases: prevalence and disease characteristics.
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Zhang Chengcheng Christine, Klemm Sarah, Schnitzler Paul, Gauss Annika
Аннотация
BACKGROUND: While the clinical relevance of cytomegalovirus (CMV) for inflammatory bowel disease (IBD) patients remains controversial, the role of related Epstein-Barr virus (EBV) and human herpesvirus 6 (HHV-6) is unknown. The aim of this retrospective study was to determine the prevalence of CMV, EBV, and HHV-6 DNA in the intestinal mucosa of IBD patients, and to identify potential risk factors and associations with disease characteristics.
METHODS: Any IBD patient who underwent endoscopy with mucosal biopsy for virologic assessment at Heidelberg University Hospital from December 2018 to September 2020 was eligible. DNA of CMV, EBV, and HHV-6 was determined by polymerase chain reaction.
RESULTS: A total of 230 patients were included (123 male, median age 37 years). Ulcerative colitis was diagnosed in 146 patients (63.5%), Crohn's disease in 78 patients (33.9%), and unclassified IBD in 6 patients (2.6%). The prevalence of CMV was 6.1% (n = 14/230), 25.7% for EBV (n = 59/230), and 8.7% for HHV-6 (n = 20/230). Detection of EBV DNA was associated with longer hospitalization (P = 0.001), steroid treatment (P = 0.004), higher CRP levels (P = 0.04), and higher disease activity (P = 0.02). Histological evidence of inflammation (P = 0.03) and ulcers were also detected significantly more often in EBV-positive patients (P = 0.001). JAK-inhibitor treatment was associated with CMV infection, while HHV-6-positive patients were treated more frequently with azathioprine/6-mercapotopurine or steroids.
CONCLUSIONS: The study reveals that the prevalence of EBV in the intestinal mucosa is high in patients with IBD and correlates with disease activity and severity, while HHV-6 is associated with specific immunosuppressive therapy.
METHODS: Any IBD patient who underwent endoscopy with mucosal biopsy for virologic assessment at Heidelberg University Hospital from December 2018 to September 2020 was eligible. DNA of CMV, EBV, and HHV-6 was determined by polymerase chain reaction.
RESULTS: A total of 230 patients were included (123 male, median age 37 years). Ulcerative colitis was diagnosed in 146 patients (63.5%), Crohn's disease in 78 patients (33.9%), and unclassified IBD in 6 patients (2.6%). The prevalence of CMV was 6.1% (n = 14/230), 25.7% for EBV (n = 59/230), and 8.7% for HHV-6 (n = 20/230). Detection of EBV DNA was associated with longer hospitalization (P = 0.001), steroid treatment (P = 0.004), higher CRP levels (P = 0.04), and higher disease activity (P = 0.02). Histological evidence of inflammation (P = 0.03) and ulcers were also detected significantly more often in EBV-positive patients (P = 0.001). JAK-inhibitor treatment was associated with CMV infection, while HHV-6-positive patients were treated more frequently with azathioprine/6-mercapotopurine or steroids.
CONCLUSIONS: The study reveals that the prevalence of EBV in the intestinal mucosa is high in patients with IBD and correlates with disease activity and severity, while HHV-6 is associated with specific immunosuppressive therapy.