Advances in Diagnosis and Treatment of Cytomegalovirus Gastrointestinal Infection in Immunocompetent Adults

Guo Lin Dai; Chu Tian Wu; Shao Hui Tang

doi:doi:10.11648/j.ijg.20210501.13

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Advances in Diagnosis and Treatment of Cytomegalovirus Gastrointestinal Infection in Immunocompetent Adults

Guo Lin Dai, Chu Tian Wu, Shao Hui Tang

Published in International Journal of Gastroenterology (Volume 5, Issue 1)

Received: 4 January 2021 Accepted: 15 January 2021 Published: 22 January 2021

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Abstract

Cytomegalovirus (CMV), a kind of human herpes virus, is highly prevalent globally. It was believed that CMV posed a considerable risk only in newborns and immunocompromised individuals in the past, but there are increasing reports that CMV caused adverse outcomes in immunocompetent adults. The gastrointestinal canal (especially colon) is one of the usual sites of cytomegalovirus infection. Moreover, severe CMV gastrointestinal disease can lead to considerable mortality. Male, age ≥55 years, immunomodulatory comorbidities (such as kidney failure, pregnancy, diabetes mellitus, or non-hematological malignancies without treatment) and the need for surgical intervention are factors that are not favorable to survival. When patients have unfavorable risk factors for survival or serious complications, antiviral treatment should be administered. Targeted antiviral therapy with intravenous ganciclovir or valganciclovir was suitable for severe CMV disease in immunocompetent adults before the advent of new and safer anti-herpesvirus drugs. Although there are many simple ways to detect the presence of CMV, most of them cannot distinguish between latent infection and active disease, which makes clinical decision-making difficult. CMV gastrointestinal disease has no specific clinical and endoscopic manifestations, and the diagnosis is to a large extent dependent on histopathology and tissue CMV polymerase chain reaction technology. Quantitative testing of tissue CMV DNA is a useful diagnostic tool, but further research is needed to explain the quantitative value, such as obtaining a viral load cutoff to decide whether to apply antiviral therapy.

Published in	International Journal of Gastroenterology (Volume 5, Issue 1)
DOI	10.11648/j.ijg.20210501.13
Page(s)	18-25
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Cytomegalovirus, Immunocompetent Adults, Gastrointestinal Infection, Diagnosis, Treatment

References

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APA Style

Guo Lin Dai, Chu Tian Wu, Shao Hui Tang. (2021). Advances in Diagnosis and Treatment of Cytomegalovirus Gastrointestinal Infection in Immunocompetent Adults. International Journal of Gastroenterology, 5(1), 18-25. https://doi.org/10.11648/j.ijg.20210501.13

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ACS Style

Guo Lin Dai; Chu Tian Wu; Shao Hui Tang. Advances in Diagnosis and Treatment of Cytomegalovirus Gastrointestinal Infection in Immunocompetent Adults. Int. J. Gastroenterol. 2021, 5(1), 18-25. doi: 10.11648/j.ijg.20210501.13

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AMA Style

Guo Lin Dai, Chu Tian Wu, Shao Hui Tang. Advances in Diagnosis and Treatment of Cytomegalovirus Gastrointestinal Infection in Immunocompetent Adults. Int J Gastroenterol. 2021;5(1):18-25. doi: 10.11648/j.ijg.20210501.13

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@article{10.11648/j.ijg.20210501.13,
  author = {Guo Lin Dai and Chu Tian Wu and Shao Hui Tang},
  title = {Advances in Diagnosis and Treatment of Cytomegalovirus Gastrointestinal Infection in Immunocompetent Adults},
  journal = {International Journal of Gastroenterology},
  volume = {5},
  number = {1},
  pages = {18-25},
  doi = {10.11648/j.ijg.20210501.13},
  url = {https://doi.org/10.11648/j.ijg.20210501.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijg.20210501.13},
  abstract = {Cytomegalovirus (CMV), a kind of human herpes virus, is highly prevalent globally. It was believed that CMV posed a considerable risk only in newborns and immunocompromised individuals in the past, but there are increasing reports that CMV caused adverse outcomes in immunocompetent adults. The gastrointestinal canal (especially colon) is one of the usual sites of cytomegalovirus infection. Moreover, severe CMV gastrointestinal disease can lead to considerable mortality. Male, age ≥55 years, immunomodulatory comorbidities (such as kidney failure, pregnancy, diabetes mellitus, or non-hematological malignancies without treatment) and the need for surgical intervention are factors that are not favorable to survival. When patients have unfavorable risk factors for survival or serious complications, antiviral treatment should be administered. Targeted antiviral therapy with intravenous ganciclovir or valganciclovir was suitable for severe CMV disease in immunocompetent adults before the advent of new and safer anti-herpesvirus drugs. Although there are many simple ways to detect the presence of CMV, most of them cannot distinguish between latent infection and active disease, which makes clinical decision-making difficult. CMV gastrointestinal disease has no specific clinical and endoscopic manifestations, and the diagnosis is to a large extent dependent on histopathology and tissue CMV polymerase chain reaction technology. Quantitative testing of tissue CMV DNA is a useful diagnostic tool, but further research is needed to explain the quantitative value, such as obtaining a viral load cutoff to decide whether to apply antiviral therapy.},
 year = {2021}
}

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TY  - JOUR
T1  - Advances in Diagnosis and Treatment of Cytomegalovirus Gastrointestinal Infection in Immunocompetent Adults
AU  - Guo Lin Dai
AU  - Chu Tian Wu
AU  - Shao Hui Tang
Y1  - 2021/01/22
PY  - 2021
N1  - https://doi.org/10.11648/j.ijg.20210501.13
DO  - 10.11648/j.ijg.20210501.13
T2  - International Journal of Gastroenterology
JF  - International Journal of Gastroenterology
JO  - International Journal of Gastroenterology
SP  - 18
EP  - 25
PB  - Science Publishing Group
SN  - 2640-169X
UR  - https://doi.org/10.11648/j.ijg.20210501.13
AB  - Cytomegalovirus (CMV), a kind of human herpes virus, is highly prevalent globally. It was believed that CMV posed a considerable risk only in newborns and immunocompromised individuals in the past, but there are increasing reports that CMV caused adverse outcomes in immunocompetent adults. The gastrointestinal canal (especially colon) is one of the usual sites of cytomegalovirus infection. Moreover, severe CMV gastrointestinal disease can lead to considerable mortality. Male, age ≥55 years, immunomodulatory comorbidities (such as kidney failure, pregnancy, diabetes mellitus, or non-hematological malignancies without treatment) and the need for surgical intervention are factors that are not favorable to survival. When patients have unfavorable risk factors for survival or serious complications, antiviral treatment should be administered. Targeted antiviral therapy with intravenous ganciclovir or valganciclovir was suitable for severe CMV disease in immunocompetent adults before the advent of new and safer anti-herpesvirus drugs. Although there are many simple ways to detect the presence of CMV, most of them cannot distinguish between latent infection and active disease, which makes clinical decision-making difficult. CMV gastrointestinal disease has no specific clinical and endoscopic manifestations, and the diagnosis is to a large extent dependent on histopathology and tissue CMV polymerase chain reaction technology. Quantitative testing of tissue CMV DNA is a useful diagnostic tool, but further research is needed to explain the quantitative value, such as obtaining a viral load cutoff to decide whether to apply antiviral therapy.
VL  - 5
IS  - 1
ER  -

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Author Information

Guo Lin Dai

The First Affiliated Hospital, Jinan University, Guangzhou, China
Chu Tian Wu

The First Affiliated Hospital, Jinan University, Guangzhou, China
Shao Hui Tang

The First Affiliated Hospital, Jinan University, Guangzhou, China

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APA Style

Guo Lin Dai, Chu Tian Wu, Shao Hui Tang. (2021). Advances in Diagnosis and Treatment of Cytomegalovirus Gastrointestinal Infection in Immunocompetent Adults. International Journal of Gastroenterology, 5(1), 18-25. https://doi.org/10.11648/j.ijg.20210501.13

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ACS Style

Guo Lin Dai; Chu Tian Wu; Shao Hui Tang. Advances in Diagnosis and Treatment of Cytomegalovirus Gastrointestinal Infection in Immunocompetent Adults. Int. J. Gastroenterol. 2021, 5(1), 18-25. doi: 10.11648/j.ijg.20210501.13

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AMA Style

Guo Lin Dai, Chu Tian Wu, Shao Hui Tang. Advances in Diagnosis and Treatment of Cytomegalovirus Gastrointestinal Infection in Immunocompetent Adults. Int J Gastroenterol. 2021;5(1):18-25. doi: 10.11648/j.ijg.20210501.13

Copy | Download

@article{10.11648/j.ijg.20210501.13,
  author = {Guo Lin Dai and Chu Tian Wu and Shao Hui Tang},
  title = {Advances in Diagnosis and Treatment of Cytomegalovirus Gastrointestinal Infection in Immunocompetent Adults},
  journal = {International Journal of Gastroenterology},
  volume = {5},
  number = {1},
  pages = {18-25},
  doi = {10.11648/j.ijg.20210501.13},
  url = {https://doi.org/10.11648/j.ijg.20210501.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijg.20210501.13},
  abstract = {Cytomegalovirus (CMV), a kind of human herpes virus, is highly prevalent globally. It was believed that CMV posed a considerable risk only in newborns and immunocompromised individuals in the past, but there are increasing reports that CMV caused adverse outcomes in immunocompetent adults. The gastrointestinal canal (especially colon) is one of the usual sites of cytomegalovirus infection. Moreover, severe CMV gastrointestinal disease can lead to considerable mortality. Male, age ≥55 years, immunomodulatory comorbidities (such as kidney failure, pregnancy, diabetes mellitus, or non-hematological malignancies without treatment) and the need for surgical intervention are factors that are not favorable to survival. When patients have unfavorable risk factors for survival or serious complications, antiviral treatment should be administered. Targeted antiviral therapy with intravenous ganciclovir or valganciclovir was suitable for severe CMV disease in immunocompetent adults before the advent of new and safer anti-herpesvirus drugs. Although there are many simple ways to detect the presence of CMV, most of them cannot distinguish between latent infection and active disease, which makes clinical decision-making difficult. CMV gastrointestinal disease has no specific clinical and endoscopic manifestations, and the diagnosis is to a large extent dependent on histopathology and tissue CMV polymerase chain reaction technology. Quantitative testing of tissue CMV DNA is a useful diagnostic tool, but further research is needed to explain the quantitative value, such as obtaining a viral load cutoff to decide whether to apply antiviral therapy.},
 year = {2021}
}

Copy | Download

TY  - JOUR
T1  - Advances in Diagnosis and Treatment of Cytomegalovirus Gastrointestinal Infection in Immunocompetent Adults
AU  - Guo Lin Dai
AU  - Chu Tian Wu
AU  - Shao Hui Tang
Y1  - 2021/01/22
PY  - 2021
N1  - https://doi.org/10.11648/j.ijg.20210501.13
DO  - 10.11648/j.ijg.20210501.13
T2  - International Journal of Gastroenterology
JF  - International Journal of Gastroenterology
JO  - International Journal of Gastroenterology
SP  - 18
EP  - 25
PB  - Science Publishing Group
SN  - 2640-169X
UR  - https://doi.org/10.11648/j.ijg.20210501.13
AB  - Cytomegalovirus (CMV), a kind of human herpes virus, is highly prevalent globally. It was believed that CMV posed a considerable risk only in newborns and immunocompromised individuals in the past, but there are increasing reports that CMV caused adverse outcomes in immunocompetent adults. The gastrointestinal canal (especially colon) is one of the usual sites of cytomegalovirus infection. Moreover, severe CMV gastrointestinal disease can lead to considerable mortality. Male, age ≥55 years, immunomodulatory comorbidities (such as kidney failure, pregnancy, diabetes mellitus, or non-hematological malignancies without treatment) and the need for surgical intervention are factors that are not favorable to survival. When patients have unfavorable risk factors for survival or serious complications, antiviral treatment should be administered. Targeted antiviral therapy with intravenous ganciclovir or valganciclovir was suitable for severe CMV disease in immunocompetent adults before the advent of new and safer anti-herpesvirus drugs. Although there are many simple ways to detect the presence of CMV, most of them cannot distinguish between latent infection and active disease, which makes clinical decision-making difficult. CMV gastrointestinal disease has no specific clinical and endoscopic manifestations, and the diagnosis is to a large extent dependent on histopathology and tissue CMV polymerase chain reaction technology. Quantitative testing of tissue CMV DNA is a useful diagnostic tool, but further research is needed to explain the quantitative value, such as obtaining a viral load cutoff to decide whether to apply antiviral therapy.
VL  - 5
IS  - 1
ER  -

Copy | Download