Prevalence of CMV infection in children with acute severe colitis
Research type
Research Study
Full title
A retrospective, observational study identifying the prevalence of colonic cytomegalovirus infection in patients with ulcerative colitis suffering from acute severe colitis at Sheffield Children’s Hospital
IRAS ID
250640
Contact name
Priya Narula
Contact email
Sponsor organisation
Sheffield Childrens NHS Foundation Trust
Duration of Study in the UK
0 years, 7 months, 1 days
Research summary
Ulcerative Colitis (UC) is an autoimmune condition affecting the large bowel causing inflammation, abdominal pain and bloody diarrhoea. It is rare in children but increasing in incidence. Acute severe colitis (ASC) (a severe flare of UC) in children is associated with more complications including higher rates of surgery and death. Steroid therapy is the main treatment option and those who do not respond to steroids have worse outcomes. Cytomegalovirus (CMV) is a virus that usually causes at most a flu-like illness and then stays dormant in the body. Most UK adults have previously been infected with this virus, usually in childhood, without any long term problems. However, in adults with UC and ASC the incidence of colonic CMV infection is up to 1/3 of steroid resistant cases compared to <5% of responsive cases. In adults, published literature suggests that proven gut CMV infection (suggestive of active gut disease) contributes to steroid resistance and poorer outcomes.
ECCO (European Crohn’s and Colitis Organisation) guidelines for management of ASC in UC in children recommend that all children with steroid resistant colitis should be tested for CMV infection and if positive, treated. Viral infections like CMV are more common in children and there is little information regarding the rate of CMV infection in children with severe colitis nor whether this leads to poor response to steroids and other complications. The treatment for CMV infection is costly, toxic and has a significant side effect profile. More information on the role of CMV infection in paediatric severe colitis is needed to ensure we are providing the best possible care.
We are undertaking a retrospective cohort study looking at children over the last 5 years with ASC in our hospital and will re-examine histology specimens for CMV infection, to establish a rate of CMV infection in ASC in children.REC name
South Central - Oxford A Research Ethics Committee
REC reference
19/SC/0324
Date of REC Opinion
25 Jun 2019
REC opinion
Favourable Opinion