Clinical features of Epstein–Barr virus in the intestinal mucosa and blood of patients with inflammatory bowel disease
Jin-Qiu Zhou1, Li Zeng2, Qiao Zhang1, Xin-Yao Wu1, Meng-Lan Zhang3, Xing-Tao Jing4, Yu-Fang Wang2, Hua-Tian Gan1
1 Department of Geriatrics Medicine and the Center of Inflammatory Bowel Disease, Sichuan University, Chengdu, Sichuan, China
2 Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
3 Department of Pathology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
4 Department of Otolaryngology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
Dr. Yu-Fang Wang
Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu-61004, Sichuan
Source of Support: None, Conflict of Interest: None
Background: The role of Epstein–Barr virus (EBV) in inflammatory bowel disease (IBD) remains to be elucidated. The aim of this study was to investigate the presence of EBV in the blood and intestinal mucosa of patients with IBD and evaluate the association between EBV positivity and IBD.
Methods: Patients with IBD, hospitalized between January 2015 and April 2018, were enrolled. The EBV-DNA load in blood samples from each subject was analyzed by quantitative real-time polymerase chain reaction. EBV-encoded small-RNA 1 (EBER-1) was detected by in-situ hybridization in intestinal mucosa tissue sections of patients with IBD.
Result: EBV-DNA was detected in 48 out of 568 patients with IBD (8.4%), and EBER-1 positivity was detected in 27 of these patients (56.3%). Refractory IBD and severe mucosal inflammation were more common in patients with detectable levels of EBER-1 than in those without; the number of EBER-1-positive cells positively correlated with mucosal inflammation (P value < 0.05). Age (≥60 years old) and use of azathioprine were risk factors for EBV infection. There was no significant difference in clinical remission rate and surgical rate between the EBER-1 positive group and EBER-1 negative group, antiviral group and the non-antiviral group, among IBD patients who tested positive for EBV-DNA.
Conclusion: Elderly patients with IBD, treated with azathioprine, are more susceptible to EBV positivity. Further, EBV mucosal detection correlated with the severity of mucosal damage and refractoriness, but not prognosis.