Abstract

Epstein-Barr Virus Status and Subsequent Thiopurine Exposure Within a Pediatric Inflammatory Bowel Disease Population

J Pediatr Gastroenterol Nutr. 2021 Sep 1;73(3):358-362. doi: 10.1097/MPG.0000000000003197.

Rachel E Harris 1, Vikas Hegde 2, Lee Curtis 3, Vikki Garrick 3, Lisa Gervais 3, Lawrence Armstrong 4, Caroline Delahunty 5, Andrew Eccleston 6, Ghassan Al-Hourani 7, Diana M Flynn 3, Victoria Merrick 8, Andrew R Barclay 3, Rachel Tayler 3, Richard Hansen 3, Richard K Russell 8

 
     

Author information

  • 1Department of Paediatrics, Sheffield Children's Hospital, Sheffield.
  • 2School of Medicine, University of Glasgow.
  • 3Department of Paediatric Gastroenterology, Hepatology and Nutrition, Royal Hospital for Children, Glasgow.
  • 4Department of Paediatrics, University Hospital Crosshouse, Kilmarnock.
  • 5Department of Paediatrics, Wishaw General Hospital, Lanarkshire.
  • 6Department of Paediatrics, Dumfries and Galloway Royal Infirmary, Dumfries.
  • 7Department of Paediatrics, Forth Valley Royal Hospital, Larbert.
  • 8Department of Paediatric Gastroenterology and Nutrition, Royal Hospital for Sick Children, Edinburgh, UK.

Abstract

The use of thiopurine therapy in Epstein-Barr virus (EBV)-naïve inflammatory bowel disease (IBD) patients remains controversial due to a risk of EBV-associated complications. We evaluated EBV status and outcomes within our paediatric IBD population over an 8-year period; finding that 217 of 409 (53%) screened patients were seropositive for EBV at IBD diagnosis; that thiopurines were used in 189 of 217 (87%) seropositive and 159 of 192 (83%) seronegative patients (P = 0.22); and that 7 of 192 (4%) previously seronegative patients subsequently tested positive for EBV with 6 of 7 (86%) patients having concurrently recorded thiopurine use. All six patients continued thiopurine with/without a period of cessation; no EBV-associated lymphoproliferative disorders/serious complications were recorded within our cohort. A significant proportion of our patients would not receive thiopurine therapy should their use be avoided in EBV-negative patients (47%) or seronegative males (30%). The small but significant risks of thiopurine treatment must be balanced against the potential benefits of successful IBD management; further research into this is required.

© Copyright 2013-2024 GI Health Foundation. All rights reserved.
This site is maintained as an educational resource for US healthcare providers only. Use of this website is governed by the GIHF terms of use and privacy statement.