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Review
. 2021 Jul 21;27(27):4276-4297.
doi: 10.3748/wjg.v27.i27.4276.

Viral infections in inflammatory bowel disease: Tips and tricks for correct management

Vincenzo Craviotto  1 , Federica Furfaro  1 , Laura Loy  1 , Alessandra Zilli  1 , Laurent Peyrin-Biroulet  2 , Gionata Fiorino  1 , Silvio Danese  1 , Mariangela Allocca  1
Affiliations
Review

Viral infections in inflammatory bowel disease: Tips and tricks for correct management

Vincenzo Craviotto et al. World J Gastroenterol. .

Abstract

Over the past decades, the treatment of inflammatory bowel diseases (IBD) has become more targeted, anticipating the use of immune-modifying therapies at an earlier stage. This top-down approach has been correlated with favorable short and long-term outcomes, but it has also brought with it concerns regarding potential infectious complications. This large IBD population treated with immune-modifying therapies, especially if combined, has an increased risk of severe infections, including opportunistic infections that are sustained by viral, bacterial, parasitic, and fungal agents. Viral infections have emerged as a focal safety concern in patients with IBD, representing a challenge for the clinician: they are often difficult to diagnose and are associated with significant morbidity and mortality. The first step is to improve effective preventive strategies, such as applying vaccination protocols, adopt adequate prophylaxis and educate patients about potential risk factors. Since viral infections in immunosuppressed patients may present atypical signs and symptoms, the challenges for the gastroenterologist are to suspect, recognize and diagnose such complications. Appropriate treatment of common viral infections allows us to minimize their impact on disease outcomes and patients' lives. This practical review supports this standard of care to improve knowledge in this subject area.

Keywords: Crohn’s disease; Inflammatory bowel diseases; Opportunistic infections; Standard of care; Ulcerative colitis; Viral infections.

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Conflict of interest statement

Conflict-of-interest statement: MA received consulting fees from Nikkiso Europe, Mundipharma, Janssen, Abbvie and Pfizer; FF received consulting fees from Amgen, Abbvie and lecture fees from Janssen and Pfizer; LP-B reports personal fees from Merck, Abbvie, Janssen, Genentech, Mitsubishi, Ferring, Norgine, Tillots, Vifor, Hospira/Pfizer, Celltrion, Takeda, Biogaran, Boerhinger-Ingelheim, Lilly, HAC-Pharma, Index Pharmaceuticals, Amgen, Sandoz, Forward Pharma GmbH, Celgene, Biogen, Lycera, and Samsung Biosepsis; GF received consultancy fees from Ferring, MSD, AbbVie, Takeda, Janssen, Amgen, Sandoz, Samsung Bioepis, Celltrion; SD served as a speaker, consultant and advisory board member for Schering-Plough, Abbott (AbbVie) Laboratories, Merck, UCB Pharma, Ferring, Cellerix, Millenium Takeda, Nycomed, Pharmacosmos, Actelion, Alfa Wasserman, Genentech, Grunenthal, Pfizer, AstraZeneca, Novo Nordisk, Cosmo Pharmaceuticals, Vifor and Johnson and Johnson. VC, AZ and SB have no conflicts of interest to declare.

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