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Table 1 Characteristics of patients with gastrointestinal cytomegaloviral infection

From: Patient characteristics, clinical manifestations, prognosis, and factors associated with gastrointestinal cytomegalovirus infection in immunocompetent patients

 

Immunocompetent (n = 56)

Immunocompromised (n = 117)

P

Age, year (mean ± SD)

73.0 ± 13.9

48.6 ± 16.4

<.0001

Male gender

31 (55.4%)

72 (61.5%)

0.44

Immunocompromised conditions

 HIV infection

0

34 (29.1%) CD4 (median 19, 1–187)

 

 Transplantation

0

24 (20.5%)

 

 Cancers receiving chemotherapy

0

21 (17.9%)

 

 Autoimmune diseases

2 (3.6%) (not receive steroid, immunosuppressant)

30 (25.6%)

 

 Inflammatory bowel diseases (CD = 3, UC = 8)

1 (1.8%) (not receive steroid, immunosuppressant)

10 (8.6%)

 

 Other conditions requiring corticosteroids

 

8 (6.8%)

 

a10 patients had two underlying conditions

Medications

 Corticosteroids

0

70 (40.5%)

 

 Chemotherapy

0

21 (18.0%)

 

 Immunosuppressive agents

0

44 (37.6%)

 

Underlying diseases

 Diabetes mellitus

20 (35.7%)

21 (18.0%)

0.010

 Large vessel atherosclerotic diseases

21 (37.5%)

14 (12.0%)

< 0.0001

 Chronic kidney disease

13 (23.2%)

28 (23.9%)

0.917

 • Stage 3

 • Stage 4

 • Stage 5

6 (46.2%)

1 (7.6%)

6 (46.2%)

6 (21.4%)

5 (17.9%)

17 (60.7%)

0.244

 Cirrhosis

2 (3.6%)

4 (3.4%)

>.99

 • Child-Pugh A

 • Child-Pugh B

 • Child-Pugh C

0 (0%)

1 (50%)

1 (50%)

1 (25%)

3 (75%)

0 (0%)

0.269

Status conditions at diagnosis

 Clinical Setting

  

0.024

 • Outpatient

 • Inpatient

 • Intensive care

23 (41.1%)

21 (37.5%)

12 (21.4%)

69 (59.0%)

38 (32.5%)

10 (8.6%)

 

 Bacteremia

4 (7.1%)

11 (9.4%)

0.776

 Systemic inflammatory response syndrome

29 (52.7%)

53 (45.7%)

0.39

 Respiratory failure

20 (35.7%)

25 (21.4%)

0.04

 Inotropic drugs

19 (33.9%)

10 (8.6%)

<.0001

 Acute renal failure

22 (39.3%)

26 (22.2%)

0.02

Presentation

 Median presenting duration, days (range)

1 (1–60)

10 (1–210)

0.0015

 GI bleeding

40 (71.4%)

45 (38.5%)

<.0001

 Diarrhea

18 (32.1%)

63 (53.8%)

0.007

 Abdominal pain

9 (16.1%)

39 (33.3%)

0.018

 Fever

27 (49.1%)

66 (56.4%)

0.369

 Severe ileus

4 (7.1%)

3 (2.6%)

0.215

 Perforation

1 (1.8%)

3 (2.6%)

>.99

 CMV at other organs

0 (0%)

8 (6.8%)

0.055

Investigations

 CMV viral load (n = 112)

 • Median (range, IQR)

370 (0–85,599, 4951)

2736 (0–2,988,940, 27,074)

0.010

 • CMV VL = 0

11/27 (40.7%)

11/85 (12.9%)

0.002

Location involvement

 Esophagus

4 (7.1%)

14 (12.0%)

0.430

 Stomach

10 (17.9%)

32 (27.4%)

0.173

 Duodenum

1 (1.8%)

11 (9.4%)

0.106

 Jejunum

1 (1.8%)

4 (3.4%)

>.999

 Ileum

13 (23.2%)

27 (23.1%)

0.984

 Colon (rectum not included)

33 (58.9%)

70 (59.8%)

0.910

 Rectum

14 (25.0%)

31 (26.5%)

0.834

Endoscopic findings

 EGD

N = 14

N = 45

 

  Ulcer

13 (92.9%)

37 (82.2%)

0.671

  Inflammatory mucosa

6 (42.9%)

25 (55.6%)

0.406

  Mass

2 (14.3%)

0 (0%)

0.053

 Colonoscopy

N = 40

N = 80

 

  Ulcer

33 (82.5%)

55 (68.8%)

0.108

  Inflammatory mucosa

26 (65.0%)

53 (66.3%)

0.892

  Mass

4 (10%)

4 (5.0%)

0.301

 Balloon-assisted enteroscopy

N = 1

N = 2

 

  Ulcer

1 (100%)

2 (100%)

 

  Inflammatory mucosa

1 (100%)

2 (100%)

 

  Mass

0 (0%)

0 (0%)

 

Treatment and outcomes

 Medications

  • Ganciclovir

36/51 (70.6%)

105/114 (92.1%)

0.0003

  • Valganclovir

3/51 (5.9%)

15/114 (13.2%)

0.278

  • Surgery

6/51 (11.8%)

9/114 (7.9%)

0.424

  • None

13/51 (25.5%)

5/114 (4.4%)

<.0001

 Median duration of treatment, week (range)

3 (0–6)

3 (0–28)

0.003

 Death in 6 months

  

0.047**

  • in 1 month

11/51 (21.6%)

16/114 (14.0%)

 

  • in 6 months

20/51 (39.2%)

25/114 (21.9%)

 

 Mucosal healingc

  • in 6 weeks

6/9 (66.7%)

7/20 (35%)

0.226

  • at or after 6 weeks

8/9 (88.9%)

16/19 (67.9%)

> 0.99

  1. a Ten patients had two underlying condition including 4 with glomerulonephritis undergoing renal transplantation, 3 with hematologic malignancies undergoing bone marrow transplantation, one with HIV and ITP, one with ulcerative colitis and autoimmune hemolytic anemia, and one with malignant thymoma and myasthenia gravis
  2. blog-rank test
  3. conly the patients who did not have underlying gastrointestinal disease