Year 2022 / Volume 114 / Number 5
Original
Impact of Epstein-Barr virus infection on inflammatory bowel disease (IBD) clinical outcomes

259-265

DOI: 10.17235/reed.2021.7915/2021

Andrea Núñez Ortiz, María Rojas Feria, María Dolores de la Cruz Ramírez, Lourdes Gómez Izquierdo, Claudio Trigo Salado, José Manuel Herrera Justiniano, Eduardo Leo Carnerero,

Abstract
Objective: to evaluate the role of Epstein-Barr virus (EBV) on the intestinal mucosa in the evolution of inflammatory bowel disease (IBD). The risk factors for EBV infection and the frequency of EBV-associated lymphoproliferative disorders in IBD patients were also investigated. Methods: intestinal biopsies of IBD patients with available EBV status determined by Epstein-Barr-encoding RNA (EBER) in situ hybridization were identified in the Pathology Database of our center. Clinical information, including phenotypic characteristics of IBD, previous treatments, diagnosis of lymphoma and patient outcome were reviewed in all cases. Results: fifty-six patients with IBD (28 Crohn’s disease, 27 ulcerative colitis and one unclassified colitis) were included. EBV in intestinal mucosa was positive in 26 patients (46 %) and was associated to a lymphoproliferative syndrome in one case. EBV positivity was associated with severe histological activity (52 % vs 17.2 %; p 0.007), the presence of a lymphoplasmacytic infiltrate (50 % vs 33.3 %; p 0.03) and active steroid treatment (61.5 % vs 33.3 %; p 0.03). Multivariate analyses only found an association between EBV and lymphoplasmacytosis (p 0.001). Escalation in previous treatment was significantly more frequent in the EBER+ group (53.8 % vs 26.7 %; p 0.038). No cases developed lymphoma during follow-up. Conclusions: EBV on the intestinal mucosa is associated with a poor outcome of IBD and the need for escalation of therapy. Lymphoplasmacytic infiltrate is associated with EBV infection. EBER+ patients used steroids more frequently compared with EBER- patients. No EBER+ patients developed lymphoma during follow-up.
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Núñez Ortiz A, Rojas Feria M, de la Cruz Ramírez M, Gómez Izquierdo L, Trigo Salado C, Herrera Justiniano J, et all. Impact of Epstein-Barr virus infection on inflammatory bowel disease (IBD) clinical outcomes. 7915/2021


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Publication history

Received: 21/02/2021

Accepted: 15/07/2021

Online First: 28/07/2021

Published: 06/05/2022

Article revision time: 93 days

Article Online First time: 157 days

Article editing time: 439 days


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