Analysis on clinical features and influencing factors of ulcerative colitis complicated with cytomegalovirus infection

LIU Jiaxin; ZHANG Li'na; ZHAO Guihong; SU Rong; YANG Jiali; WANG Fang; YANG Shaoqi

doi:10.3969/j.issn.1674-3806.2025.07.08

Abstract：Objective To analyze the clinical features and influencing factors of ulcerative colitis(UC)complicated with cytomegalovirus(CMV)infection.Methods The clinical data of 228 patients with UC who were admitted to Department of Gastroenterology,General Hospital of Ningxia Medical University from January 2018 to June 2024 were retrospectively analyzed.The patients were divided into CMV-positive group(22 patients)and CMV-negative group(206 patients)according to their CMV infection results.The general data,laboratory indicators,endoscopic manifestations,treatment plans and effects were compared between the two groups.The influencing factors of UC complicated with CMV infection were explored through multivariate logistic regression analysis.Results The proportions of the patients with fever,receiving hormone therapy in the past 1 month,receiving antibiotic therapy in the past 1 month as well as with deep chisel-like ulcer and irregular ulcer as the morphological characteristics of mucosa in the CMV-positive group were significantly higher than those in the CMV-negative group(P＜0.05).The proportion of the patients with normal mucosa in the CMV-positive group was significantly lower than that in the CMV-negative group(P＜0.05).There were significant differences in disease severity and Mayo endoscopic score distribution between the two groups(P＜0.05).The levels of hemoglobin(Hb)and albumin(ALB)in the CMV-positive group were lower than those in the CMV-negative group,and the levels of neutrophil-to-lymphocyte ratio(NLR),erythrocyte sedimentation rate(ESR)and C-reactive protein(CRP)in the CMV-positive group were higher than those in the CMV-negative group,with statistically significant differences between the two groups(P＜0.05).There were no significant differences in the proportions of the patients receiving treatments of biological agents,immunosuppressants and surgery between the two groups(P＞0.05).Compared with those in the CMV-negative group,the proportion of the patients receiving treatments of glucocorticoids in the CMV-positive group was higher,and the proportion of the patients responding effectively to the glucocorticoid treatment in the CMV-positive group was lower,with statistically significant differences between the two groups(P＜0.05).The results of multivariate logistic regression analysis showed that deep chisel-like ulcer was an independent risk factor for UC complicated with CMV infection[OR(95％CI)=35.513(3.932-320.759),P=0.001],and higher Hb level was an independent protective factor for inhibiting UC complicated with CMV infection[OR(95％CI)=0.951(0.912-0.991),P=0.016].Conclusion Patients with severe UC are susceptible to complication with CMV infection.Hb level and deep chisel-like ulcer observed under endoscope are significantly associated with CMV infection.Clinicians need to strengthen the monitoring of such patients and give antiviral therapy promptly to improve the prognosis.