FREQUENCY OF CYTOMEGALOVIRUS COLITIS IN PATIENTS HOSPITALIZED WITH ACUTE FLARES OF ULCERATIVE COLITIS
DOI:
https://doi.org/10.70520/kjms.v18i3.686Keywords:
Cytomegalovirus, Ulcerative colitis, Acute flare, Opportunistic infection, ColitisAbstract
Objective: To determine the frequency of CMV colitis among patients hospitalized with acute UC exacerbations and to assess its association with flare severity and recurrence.
Methods: This prospective cross-sectional study enrolled 275 consecutive adults aged 16–75 years admitted with acute UC flares to the Department of Gastroenterology, Hayatabad Medical Complex, Peshawar, from October 2022 to April 2023. Flare severity was classified according to Truelove and Witts’ criteria. All patients underwent flexible sigmoidoscopy within 72 hours of admission, with 2–3 rectosigmoid biopsies obtained for histopathology. CMV colitis was diagnosed on demonstration of typical viral inclusions with hematoxylin–eosin staining or positive immunohistochemistry. Associations with age, sex, severity, and relapse frequency were analyzed using chi-square or Fisher’s exact test.
Results: The mean age of patients was 49.6 ± 15.8 years, with 56.7% males. Flare severity was mild in 42.2%, moderate in 32.7%, and severe in 25.1%. CMV colitis was confirmed in 22 patients, yielding a prevalence of 8.0%. The prevalence was significantly higher in patients with moderate-to-severe flares compared with mild flares (p = 0.01), and in those with four to six prior relapses (p = 0.01). No statistically significant associations were observed with age (p = 0.83) or sex (p = 0.11).
Conclusion: Approximately one in twelve hospitalized patients with acute UC flares had CMV colitis, with strong associations observed in moderate-to-severe disease and in patients with multiple prior relapses. These findings highlight the importance of routine CMV screening in high-risk groups, particularly in resource-limited settings.
Keywords: Cytomegalovirus; Ulcerative colitis; Acute flare; Opportunistic infection; Colitis
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