초록내용은 다음과 같습니다.

6th Congress of ECCO (European Crohn's and Colitis Organization), Feb 24-26, 2011, Dublin, Ireland.

The Prevalence and Efficacy of Ganciclovir on Steroid-Refractory Ulcerative Colitis with Cytomegalovirus Infection: A Prospective Multicenter Study

You Sun Kim, MD, PhD.^1,* Young-Ho Kim, MD, PhD,^2,* Joo Sung Kim, MD, PhD,^3,* Jae Hee Cheon, MD, PhD,^4,* Byong Duk Ye, MD, PhD,^5,* Sung-Ae Jung, MD, PhD,^6,* Young Sook Park, MD, PhD,^7,* Chang Hwan Choi, MD, PhD,^8,* Byung Ik Jang, MD, PhD,^9,* Dong Soo Han, MD, PhD,^10,* Suk-Kyun Yang, MD, PhD,^5,* Won Ho Kim MD, PhD.^4,*

Department of Internal Medicine, ¹Inje University College of Medicine, ²Sungkyunkwan University School of Medicine, ³Seoul National University College of Medicine, ⁴Yonsei University College of Medicine, ⁵University of Ulsan College of Medicine, ⁶Ewha Womans University School of Medicine, ⁷Eulji University College of Medicine, ⁸Chung-Ang University College of Medicine, ⁹Yeungnam University College of Medicine, and ¹⁰Hanyang University College of Medicine, and ^*IBD Study Group of the Korean Association for the Study of Intestinal Diseases, Korea

Aim: It remains controversial whether or not cytomegalovirus (CMV) infection in patients with active ulcerative colitis (UC) reflects a non-pathogenic colonization or a pathogenic disease warranting anti-viral therapy. The aim of this study was to determine the prevalence of CMV infection in patients with active UC and the therapeutic efficacy of ganciclovir against CMV infection in patients with steroid-refractory UC.

Materials and Methods: A prospective, multicenter study was conducted in 72 patients with moderate-to-severe UC who were treated with intravenous steroids. The presence of CMV was evaluated serologically and histopathologic examination, including immunohistochemical staining. In patients with steroid-refractory UC, CMV infections were treated with intravenous ganciclovir. In patients with steroid-responsive UC, steroid therapy was continued irrespective of CMV infection.

Results: The evidence of CMV infection was found in 31 patients (43%) with moderate-to-severe active UC. In patients with steroid-refractory UC, the CMV infection rate increased to 67% (14/21). No significant clinical and endoscopic differences existed between patients with and without a CMV  infection; however, the amount of steroids used during the flare-up period was significantly higher in patients with a CMV infection (p=0.013). Eleven of 14 patients (79%) with steroid-refractory UC and a CMV infection improved with ganciclovir treatment. CMV infections in the steroid-responsive group (17/31), however, did not require ganciclovir therapy.

Conclusions: CMV infection is frequently observed in patients with moderate-to-severe UC, especially steroid-refractory UC. Ganciclovir was very effective in patients with steroid-refractory UC who had CMV infections. However, in steroid-responsive UC patients, CMV infection would be considered as a nonpathogenic bystander.

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