Systematic Reviews
Copyright ©The Author(s) 2016.
World J Gastroenterol. Jan 21, 2016; 22(3): 1321-1330
Published online Jan 21, 2016. doi: 10.3748/wjg.v22.i3.1321
Table 1 Eligibility criteria for inclusion
Diagnosis of IBD, according to international guidelines
English language
Prevalence and/or diagnostics CMV infection or intestinal disease reported
Minimal sample size 10 patients
Table 2 Prevalence by definition of cytomegalovirus-infection
DefinitionStudies, nMedianRange
Tissue PCR[22-25]411%1%-32%
HE or IHC[33,34]28%5%-11%
HE and IHC[35,36]219%12%-27%
IgM or HE or IHC2[37,38]29%5%-13%
Antigenemia or Tissue PCR[39]1NANA
Serum PCR[40]184%-
(HE and IHC) or tissue PCR[41]14%-
Tissue PCR 10 copies/µg; OR histology OR Antigenemia[42]154%-
Antigenemia (2 tests: C7-HRP OR C10/C11) OR histology[43]19%-
Antigenemia or blood PCRquantitative[44]136%-
IgM or serum PCR or HE[45]178%-
IgM or tissue PCRqualitative or HE[46]116%-
IgG and (blood culture, antigenemia or histology or IgM or urine culture)[47]16%-
IgM or serum PCRqualitative or feces PCR[48]15%-
Inclusions: HE[49]113%-
Active infection: tissue PCR[50]113%-
Active replication: (HE or IHC) and antigenemia[51]136%-
Blood dissemination: (viremia, antigenemia, RNAemia) or (viremia or tissue culture)[52]116%-
Total: 21Total: 36
Table 3 Prevalence by definition of cytomegalovirus-intestinal disease
DefinitionStudies, nMedianRange
HE or IHC1,2[38,44,53,54]46%2%-29%
Tissue PCRquantitative > 10 copies/mg[56,57]234%30%-38%
Serology and (IHC or antigenemia or serum PCR or tissue PCR)[58]16%-
HE or IHC or tissue PCR[51]133%-
(Pp65 antigenemia or tissue PCRquantitative) and IHC and intestinal symptoms[39]1NA3-
IHC positive when inflammation present[52]11%-
Total: 8Total: 13
Table 4 Prevalence by definition of cytomegalovirus-reactivation
DefinitionStudies, nMedianRange
IgM or HE or PCR1[60]110%-
Serum PCR in IgG positive patients[61]10%-
Antigenemia or plasma PCR[62]136%-
Total: 3Total: 3
Table 5 Test characteristics different diagnostic tools for cytomegalovirus
SerologyFast, quantification possibleSystemic, not proving intestinal disease;98%-100%96%-99%
AntigenemiaFast, quantification possibleSystemic, not proving intestinal disease labor intensive60%-100%83%-100%
Serum PCRFast, quantification possibleSystemic, not proving intestinal disease65%-100%40%-94%
HE Histology (gold standard?)Specific, proofs intestinal diseaseSlow; low sensitivity10%-87%92%-100%
Histology with IHCSpecific, proofs intestinal diseaseSlow93%92%-100%
Tissue PCRQuantification possibleCut-off point unclear, uncertain clinical significance65%-100%40%-100%
Stool PCRQuantification possibleLittle experience83%%93%
Viral CultureVery specificVery slow45%-78%89%-100%
Rapid Vial cultureVery specificLittle experience68%-100%89%-100%