Archive for November 27, 2016

Clinical presentation and risk factors for cytomegalovirus colitis in immunocompetent adult patients.

Clin Infect Dis. 2015 Mar 15;60(6):e20-6.

Ko JH1, Peck KR1, Lee WJ1, Lee JY1, Cho SY1, Ha YE1, Kang CI1, Chung DR1, Kim YH2, Lee NY3, Kim KM4, Song JH1.

Author information

1Division of Infectious Diseases.

2Division of Gastroenterology.

3Department of Laboratory Medicine.

4Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

Abstract

BACKGROUND:

Cytomegalovirus (CMV) colitis is a common manifestation of CMV end-organ disease, which has typically been described in immunocompromised hosts. Recently, it has been noted that this also occurs in immunocompetent patients. To gather relevant data about clinical presentation, prognosis, and risk factors for development of CMV colitis in immunocompetent hosts, we analyzed all cases that occurred during a 19-year period at our institution.

METHODS:

A case-control study was performed to identify risk factors for CMV colitis in immunocompetent hosts. Electronic medical records of individuals who were admitted and diagnosed with CMV colitis between January 1995 and February 2014 at a tertiary care university hospital were reviewed. Two non-CMV colitis patients who were age- and sex-matched were selected as controls for each case.

RESULTS:

A total of 51 patients with CMV colitis were included in this study along with 102 control patients. Certain conditions including renal disease on hemodialysis, neurologic disease, rheumatologic disease, intensive care unit admission, and exposure to antibiotics, antacids, steroids, or red blood cell (RBC) transfusions within 1 month of diagnosis of colitis were associated with CMV colitis on univariate analysis. Among these, steroid use and RBC transfusion within 1 month were identified as independent risk factors for developing CMV colitis on multivariate analysis. The 30-day mortality rate was 7.8% without any attributable mortality.

CONCLUSIONS:

Steroid use and RBC transfusion within 1 month of the diagnosis of colitis were independent risk factors for development of CMV colitis in immunocompetent hosts

PDF

http://cid.oxfordjournals.org/content/60/6/e20.full.pdf+html

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November 27, 2016 at 7:46 pm

The immune response to human CMV.

Future Virol. 2012 Mar 1;7(3):279-293.

La Rosa C1, Diamond DJ.

Author information

1Division of Translational Vaccine Research, Beckman Research Institute of the City of Hope Comprehensive Cancer Center, Duarte, CA 91010, USA.

Abstract

This review will summarize and interpret recent literature regarding the human CMV immune response, which is among the strongest measured and is the focus of attention for numerous research groups.

CMV is a highly prevalent, globally occurring infection that rarely elicits disease in healthy immunocompetent hosts. The human immune system is unable to clear CMV infection and latency, but mounts a spirited immune-defense targeting multiple immune-evasion genes encoded by this dsDNA β-herpes virus.

Additionally, the magnitude of cellular immune response devoted to CMV may cause premature immune senescence, and the high frequencies of cytolytic T cells may aggravate vascular pathologies.

However, uncontrolled CMV viremia and life-threatening symptoms, which occur readily after immunosuppression and in the immature host, clearly indicate the essential role of immunity in maintaining asymptomatic co-existence with CMV.

Approaches for harnessing the host immune response to CMV are needed to reduce the burden of CMV complications in immunocompromised individuals

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3539762/pdf/nihms429188.pdf

November 27, 2016 at 7:44 pm


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