Cytomegalovirus Colitis in Inflammatory Bowel Disease The Eternal Debate: Foe or Innocent Bystander?

Authors

  • Maham Bushra, MD Division of Gastroenterology and Hepatology, University Health Network, University of Toronto, Toronto, Ontario, Canada
  • Parul Tandon, DO, PhD, FRCPC Division of Gastroenterology and Hepatology, University Health Network, University of Toronto, Toronto, Ontario, Canada

DOI:

https://doi.org/10.58931/cibdt.2025.3245

Abstract

Key Takeaways:

•  The prevalence of CMV infection among patients with IBD ranges from 2 to 29%, with a higher prevalence in those with UC compared to CD.

•  Immunohistochemistry and tissue PCR, or both, are the recommended tests for diagnosing active CMV colitis.

•  CMV may be an active pathogenic participant in cases with a high density of CMV and severe disease activity. Thus, we recommend testing for CMV colitis in patients with a severe inflammatory burden who are not responding to conventional IBD therapy.

•  Patients with low CMV viral burden can likely be treated with immunosuppression alone, while patients with high viral density or medically refractory disease should be treated with antiviral therapy.

Author Biographies

Maham Bushra, MD, Division of Gastroenterology and Hepatology, University Health Network, University of Toronto, Toronto, Ontario, Canada

Dr. Maham Bushra is currently a PGY-4 Gastroenterology resident at the University of Toronto (Toronto, Canada). She received her medical degree from the University of Toronto (2021) and completed her core Internal Medicine training at the University of Toronto in 2024. Upon completing her gastroenterology residency, Dr. Bushra is planning to pursue an advanced clinical fellowship in Inflammatory Bowel Diseases.

Parul Tandon, DO, PhD, FRCPC, Division of Gastroenterology and Hepatology, University Health Network, University of Toronto, Toronto, Ontario, Canada

Dr. Tandon is a gastroenterologist and clinician scientist at the University Health Network (UHN) in Toronto, Ontario and an Assistant Professor at the University of Toronto. He is also an adjunct scientist at ICES Central. He received his medical degree from Michigan State University and completed his Internal Medicine residency at the University of Ottawa and Gastroenterology residency at the University of Toronto. He further pursued a clinical and research fellowship in Advanced Inflammatory Bowel Diseases at the Mount Sinai Hospital in Toronto, Ontario, while completing a PhD in clinical epidemiology at the Institute of Health Policy, Management, and Evaluation, University of Toronto. He graduated from the Elliot Philipson Clinician Scientist Training Program at the Department of Medicine, University of Toronto, and the Clinician Investigator Training Program accredited by the Royal College of Physicians and Surgeons of Canada. His research interests include the care of inflammatory bowel disease (IBD) in racial and ethnic minorities, including immigrants navigating new healthcare systems. Dr. Tandon holds the David & Elyssa Feldberg and Family Professorship in IBD Research at UHN.

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Published

2025-09-23

How to Cite

1.
Bushra M, Tandon P. Cytomegalovirus Colitis in Inflammatory Bowel Disease The Eternal Debate: Foe or Innocent Bystander?. Can IBD Today [Internet]. 2025 Sep. 23 [cited 2025 Sep. 28];3(2):23–27. Available from: https://canadianibdtoday.com/article/view/3-2-Bushra_et_al

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