BACKGROUND Gastrointestinal (GI) cytomegaloviral (CMV) infection is common among patients with immunocompromised status; however, data specific to GI-CMV infection in immunocompetent patients are comparatively limited. METHODS This retrospective study included patients diagnosed with GI-CMV infection at Siriraj Hospital (Bangkok, Thailand) during 2008-2017. Baseline characteristics, presentations, comorbid conditions, endoscopic findings, treatments, and outcomes were compared between immunocompetent and immunocompromised. RESULTS One hundred and seventy-three patients (56 immunocompetent, 117 immunocompromised) were included. Immunocompetent patients were significantly older than immunocompromised patients (73 vs. 48.6 years, p < 0.0001). Significantly more immunocompetent patients were in the ICU at the time of diagnosis (21.0% vs. 8.6%, p = 0.024). GI bleeding was the leading presentation in immunocompetent, while diarrhea and abdominal pain were more common in immunocompromised. Blood CMV viral load was negative in significantly more immunocompetent than immunocompromised (40.7% vs. 12.9%, p = 0.002). Ganciclovir was the main treatment in both groups. Significantly more immunocompetent than immunocompromised did not receive any specific therapy (25.5% vs. 4.4%, p ≤ 0.01). Six-month mortality was significantly higher among immunocompetent patients (39.0% vs. 22.0%, p = 0.047). Independent predictors of death were old age and inpatient or ICU clinical setting. Treatment with antiviral agents was the only independent protective factor. CONCLUSION GI-CMV infection was frequently observed among immunocompetent elderly patients with comorbidities or severe concomitant illnesses. GI bleeding was the most common presentation. Blood CMV viral load was not diagnostically helpful. Significantly higher mortality was observed in immunocompetent than in immunocompromised patients, but this could be due to more severe concomitant illnesses in the immunocompetent group.

中文翻译：

---

具有免疫功能的患者的患者特征，临床表现，预后以及与胃肠道巨细胞病毒感染相关的因素。

背景胃肠道（GI）巨细胞病毒（CMV）感染在免疫功能低下的患者中很常见。然而，免疫活性患者中GI-CMV感染的特异性数据相对有限。方法这项回顾性研究包括2008-2017年在泰国曼谷Siriraj医院诊断为GI-CMV感染的患者。比较了有免疫能力和免疫功能低下的基线特征，表现，合并症​​，内窥镜检查结果，治疗方法和结果。结果纳入了173例患者（56例具有免疫能力，117例免疫功能低下）。具有免疫功能的患者的年龄明显大于免疫功能低下的患者（73岁对48.6岁，p <0.0001）。诊断时ICU中有更多具有免疫能力的患者（21.0％对8.6％，p = 0.024）。胃肠道出血是免疫功能最主要的表现，而腹泻和腹痛在免疫功能低下更为常见。血液CMV病毒载量在免疫能力上显着高于免疫功能低下（40.7％vs. 12.9％，p = 0.002）。更昔洛韦是两组的主要治疗方法。没有接受任何特异性治疗的免疫能力明显高于免疫受损的患者（25.5％对4.4％，p≤0.01）。具有免疫功能的患者六个月的死亡率显着更高（39.0％比22.0％，p = 0.047）。死亡的独立预测因素是老年和住院或ICU临床情况。用抗病毒药治疗是唯一的独立保护因素。结论在具有免疫功能的合并症或严重伴随疾病的老年患者中经常观察到GI-CMV感染。胃肠道出血是最常见的表现。血液CMV病毒载量对诊断没有帮助。与免疫功能低下的患者相比，免疫功能高的患者死亡率要高得多，但这可能是由于免疫功能高的患者伴有更严重的伴随疾病。