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Steroid use, red blood cell transfusion associated with CMV colitis
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Among immunocompetent adult patients, steroid use and red blood cell transfusion within 1 month of colitis diagnosis were independent risk factors for cytomegalovirus colitis, according to recent study findings.
“Although [cytomegalovirus (CMV) colitis] has typically been described in immunocompromised patients … there have been several descriptive case series among immunocompetent hosts,” researchers from Sungkyunkwan University School of Medicine in Seoul, South Korea, wrote in Clinical Infectious Diseases. “However, data regarding risk factors for development of CMV colitis and clinical characteristics in immunocompetent hosts have not yet been reported.”
The researchers conducted a case-control study to determine risk factors for CMV colitis in immunocompetent adults. They identified 51 individuals admitted and diagnosed with CMV colitis from January 1995 to February 2014 at Samsung Medical Center in Seoul. The control group consisted of two age- and sex-matched individuals for each patient who had a clinical diagnosis of colitis. The researchers reviewed electronic medical records to obtain the patient data.
The 51 patients with CMV colitis had a lower median BMI than the controls and lower white blood cell counts, hemoglobin levels and albumin levels. More patients with CMV colitis had received antibiotic therapy and/or antacid treatment compared with controls. A higher proportion of patients with CMV colitis also had a history of steroid use: 54.9% vs. 2.9%. More patients with CMV colitis had undergone red blood cell transfusion within 1 month: 34 patients vs. two patients. More patients with CMV colitis also had renal disease/hemodialysis, neurologic disease and rheumatologic disease.
In an adjusted multivariate analysis of underlying diseases, renal disease/hemodialysis, neurologic disease and rheumatologic disease had no association with CMV colitis, but a history of steroid use (OR=15.38; 95% CI, 2.49-95.08) and red blood cell transfusion (OR=46.12; 95% CI, 90.15-232.34) were associated with CMV colitis. In a second adjusted analysis of drug use and ICU care, the only significant variables were a history of steroid use (OR=9.95; 95% CI, 1.95-46.66) and red blood cell transfusion (OR=30.85; 95% CI, 5.7-167.06).
“The present study is the first to identify risk factors for CMV colitis in immunocompetent hosts, and our findings may provide useful information for clinicians regarding their approach to these patients,” the investigators wrote.
Disclosure: The researchers report no relevant financial disclosures.
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