High prevalence of an active human cytomegalovirus infection in patients with colonic diverticulitis

Abstract

Background Diverticulitis affects 10% of the western population and is characterized by microscopic inflammation of the colon. Increasing evidence suggests that human cytomegalovirus (HCMV) is an important pathogen in various inflammatory diseases. We hypothesized that HCMV contributes to the progression of diverticulitis, especially in immunocompromised patients in whom HCMV is a significant pathogen. Objectives To determine if HCMV is associated with diverticulitis and with an increased frequency of diverticulitis complications. Study design We examined the prevalence of an active HCMV infection in 23 patients with diverticulitis. Serum samples were analyzed for the presence of HCMV-IgG and HCMV-IgM antibodies in 11 of these patients. Immunohistochemistry was used for detection of HCMV early antigens in intestinal paraffin tissue sections obtained from the diverticulitis patients. Results HCMV-early proteins could be detected in intestinal cells in 16/23 (69.6%) patients with diverticulitis. All of the 11 patients with serum samples were HCMV-IgG positive and 2 of these were also HCMV-IgM positive. Conclusion Active HCMV infection is frequently associated with diverticulitis and could contribute to the inflammatory process characteristic of diverticulitis.