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* = Presenting author

P362 Anti-virus treatment against CMV in patients with ulcerative colitis by the PCR monitoring for mucosal CMV-DNA

M. Tanaka*, T. Takagi, Y. Toyokawa, Y. Hotta, K. Uchiyama, Y. Naito, Y. Itoh

Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Department of Molecular Gastroenterology and Hepatology, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 6028–566, Japan

Background

CMV reactivation is known as important exacerbating and refractory factor of the ulcerative colitis (UC), however the criteria of therapeutic intervention has not been established and the clinical significance of CMV reactivation remains controversial. In this study, we investigated the usefulness of anti-virus treatment for the CMV-positive UC patients based on colonic mucosal CMV-DNA PCR.

Methods

In this retrospective study, we used the clinical database including a cohort of 23 patients (total number of measurement is 32 times) with colonic mucosal CMV-DNA PCR positive at a single centre, Kyoto Prefectural University of Medicine between 2010 and 2015. Clinical parameters (age, sex, disease extent, and disease activity [CAI Lichtiger index] on admission) were evaluated in 23 patients (32 cases). Anti-virus treatment was performed with 20 patients coincident with induction therapy of UC (treatment group), whereas 12 patients were treated with induction therapy of UC alone (non-treatment group). Treatment group includes 5 patients with positive of antigenemia and 11 with negative of antigenemia.

Results

Clinical parameters such as age, sex, disease extent, and disease activity on admission showed no difference between 2 groups. Rate of remission by induction therapy and colectomy is no significant between 2 groups. The improvement of CAI was an average of 3.0 in a treatment group, and 3.08 in a non-treatment group.

Conclusion

It was suggested that the additional anti-CMV therapy based on the diagnosis of colonic mucosal CMV-DNA PCR could not contribute the induction to remission with UC patients. Not only mucosal PCR but also other methods, such as serum CMV antigenemia, might be necessary for the diagnosis of CMV infection intending to start induction therapy for UC patients.