In a new study, researchers found that patients with inflammatory bowel disease (IBD) maybe five times more likely than the general population to develop viral infections.
The infections can lead to hospitalization or permanent organ damage.
The research was conducted by a team Saint-Antoine Hospital and elsewhere.
The team analyzed almost 2,700 IBD patients in a Paris referral center to understand the respective roles of IBD activity and drugs in promoting systemic serious viral infection (SVI).
The study identified IBD and thiopurines (a class of immunomodulators used to treat an estimated 60% of IBD patients) as the main drivers of infection.
Despite the highest risk of infection being seen in young patients between the ages of 18 and 35, a three-fold increased incidence of severe viral infections was observed in IBD patients of all ages.
The study also found a concerning link between thiopurine use and a number of harmful infections.
Whilst IBD patients receiving no treatment were at a similar risk level to the general population, patients treated with immunomodulators were found to be six times more likely to develop an SVI.
The most common SVIs developed by IBD patients were identified as Epstein-Barr virus (EBV), which is associated with a range of diseases such as glandular fever and Hodgkin’s Lymphoma, and cytomegalovirus (CMV), an infection which can pose a risk to unborn babies.
A link was also found between thiopurine use and EBV-induced hemophagocytic lymphohistiocytosis (HLH), an aggressive disease associated with high mortality rates.
With a third of patients estimated to be stopping thiopurine use due to adverse side effects, these new findings underline the need to find novel therapeutic approaches to tackle IBD.
The team says doctors need to be aware of the substantially increased risk of SVI in patients with IBD, which had previously remained unclear.
Young IBD patients are the most vulnerable to the development of SVIs. Their risk is further elevated by the inhibiting effect of the immunosuppressive drugs they are treated with.
The lead author of the study is Professor Laurent Beaugerie, from the Department of Gastroenterology.
The study is published in the United European Gastroenterology Journal.
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