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P647 EBV and CMV status in children with IBD at diagnosis: a case control study

S. Gatti*, R. Annibali, P. Coccia, P. Pierani, C. Catassi

Università Politecnica delle Marche, Department of Pediatrics, Ancona, Italy

Background

The cause of inflammatory bowel disease (IBD) remains to be established. Evidence has linked viral infections in childhood with the subsequent risk of developing IBD. Furthermore Epstein-Barr virus (EBV) and Cytomegalovirus (CMV) have both been implicated in re-activation of IBD

Methods

We report a case-control study of 20 newly diagnosed IBD children, naïve to treatment and enrolled between 2011 and 2013 and 20 matched controls, with the aim to assess the influence of EBV and CMV exposure on later development of IBD. Controls were children newly diagnosed with solid tumors and not exposed to chemotherapy, living in the same area and matched for age and sex. Clinical data and serology for EBV (VCA IgG and IgM, EBNA IgG) and CMV (IgG and IgM) were recorded.

Results

In children with IBD (mean age: 9.3 years, 9 with Crohn's disease [CD]) rate of previous exposure to EBV and CMV at diagnosis was 50 and 20 % respectively. In controls children (mean age: 9.2 years, 10 Ewing's Sarcoma, 3 neuroblastoma, 3 rhabdomyosarcoma, 2 teratoma, 2 brain tumors) seropositivity for both EBV and CMV was not different ( 65 and 35% respectively). In patients with IBD matched odds ratios for previous exposure to EBV and CMV were 0.33 (95% CI 0.1-0.9) and 0.5 (95% CI 0.32-1.01), respectively. Furthermore 4/8 IBD patients developed EBV infection after starting immunosuppressive treatments. No CMV infection or re-activation was recorded during the follow-up.

Conclusion

These findings provide no support for the hypothesis that exposure to EBV and CMV predisposes to the later development of IBD. Overall we found a 50% seropositivity for EBV in a newly diagnosed IBD population, comparable to previous reports [1] [2] and to our control population. Furthermore we described an high rate of IBD patients developing EBV infection after starting immunosuppressive treatment.

References:

[1] Love KA, Henderson P, Garrick V, (2014), Epstein-Barr virus status may be especially important in paediatric IBD populations

[2] Linton MS, Kroeker K, Fedorak D, (2013), Prevalence of Epstein-Barr Virus in a population of patients with inflammatory bowel disease: a prospective cohort study