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P124. Frequency of opportunistic virus infections in patients with inflammatory bowel diseases in Moscow region

E. Volchkova, E. Belousova, E. Kudryavtseva, E. Velikanov

Moscow Regional Clinical and Research Institute (MONIKI), Moscow, Russian Federation

Objective: To study the rate of opportunistic herpes virus infections in IBD patients treated with or without immunosuppressive agents.

Materials and Methods: The total of 78 IBD patients were examined in the period of January-October 2010. In 72 patients UC of different extension was diagnosed: proctitis – 2 patients, left side colitis – 39, pancolitis – 31 (m:f = 37:35, mean age 37±4.3 years, range 20–72 years). In 6 patients CD (4 with terminal ileitis, and 2 with ileocolitis) was defined (m:f = 3:3, mean age 28±1.6 years, range 20–43 years). Patients were treated with different drugs: 5-ASA, prednisolone, azatioprine and cyclosporin A). Serologic markers of herpes virus group were evaluated by enzyme immunoassay, blood and tissue (colonic mucosa) virus DNA was detected by PCR method.

Results: See the table.

InfectionsEnzyme immunoassayBlood PCRTissue PCR
Cytomegalovirus (CMV)IgG 59 patients
IdM 12 patients
DNA 2 patientsDNA 8 patients
Herpes simplexIgG 51 patients
IgM 8 patients
Herpes simplex 2IgG 9 patients  
Herpes simplex 6IgG 23 patients  
Epstein-Barr virus (EBV)IgG 51 patients
IgM 12 patients
DNA 1 patientDNA 11 patients
Varicella-zoster virusIgG 40 patients
IgM 5 patients

Active CMV and EBV infections were found in 11.5% and 14.1% of patients, correspondingly (by presence of virus DNA in blood and colonic mucosa). These patients received long-term treatment with immunosuppressive agents. In all these patients steroid-resistance or steroid-dependence were noted. In patients who received only 5-ASA, different latent virus infections were found without DNA detection. Two patients showed combined CMV and EBV infection.

Conclusion: Incidence of active opportunistic herpes virus infections in IBD patients, receiving immunosuppressants is high in Moscow Region and forms 23%, CMV and EBV being predominant. We believe that it will be helpful to examine IBD patients on opportunistic virus infections before immunosuppressive drugs.