Ali Haider, MBBS1, Muhammad Haris Latif, MD2, Shahzad Zafar, MD3, Atta Ur Rehman, MBBS4, Vinesh Kumar, MD5, Anum Khakwani, MD6, Sheraz Ahmad Tariq, MBBS4, Mohmammad Hamza, MD7, Abdul Qadeer Khan, MBBS8, Salman Ayub Jajja, MD9, Adil Mushtaq, MBBS10, Bisher Sawaf, MD11 1Nishtar Medical University, Multan, Multan, Punjab, Pakistan; 2SSM St Mary's Hospital, St. Louis, MO; 3Howard University Hospital, Washington, DC; 4Nishtar Medical University, Multan, Punjab, Pakistan; 5New York Medical College - Saint Michael's Medical Center, Kearny, NJ; 6Charleston Area Medical Center, Charleston, WV; 7Guthrie Medical Group, Cortland, NY; 8Mayo Clinic, Scottsdale, AZ; 9NYMC-LANDMARK MEDICAL CENTER, Providence, RI; 10Akhtar saeed medical & dental college, Lahore, Punjab, Pakistan; 11University of Toledo Medical Center, Toledo, OH Introduction: Cytomegalovirus (CMV) colitis is an important differential diagnosis in patients with Crohn’s disease, especially those presenting with severe or steroid-refractory flares. Tissue-based CMV PCR or immunohistochemistry remains the diagnostic gold standard, but endoscopic procedures are invasive, costly, and may be contraindicated in critically ill patients. Plasma or blood CMV DNA testing offers a non-invasive and rapid alternative. However, the diagnostic performance of this modality in Crohn’s disease patients with suspected CMV colitis is not well established. Methods: We conducted a single-arm diagnostic meta-analysis of four studies encompassing 641 observations. A random intercept logistic regression model was used to pool sensitivity, specificity, and diagnostic odds ratio (DOR). Heterogeneity was assessed using tau² and I² statistics. The area under the summary receiver operating characteristic (ROC) curve (AUC) was calculated using a bivariate random-effects model to assess overall diagnostic accuracy. Results: The pooled sensitivity of plasma/blood CMV DNA was 66.1% (95% CI: 46.4%–81.4%) and specificity was 86.0% (95% CI: 82.7%–88.8%). The diagnostic odds ratio was 13.68 (95% CI: 4.83–38.69), indicating strong diagnostic discrimination. The AUC was 0.859, reflecting excellent overall accuracy. Heterogeneity was moderate to high for sensitivity (I² = 82.0%) and negligible for specificity (I² = 0%). Positive likelihood ratios ranged from 3.6 to 5.3 across individual studies, while negative likelihood ratios ranged from 0.16 to 0.63. Discussion: Our findings suggest that plasma or blood CMV DNA testing has high specificity and moderate sensitivity for diagnosing CMV colitis in Crohn’s disease patients. This modality may serve as a valuable non-invasive screening tool, particularly in acutely ill patients where endoscopy is not feasible. However, due to its limited sensitivity, a negative blood CMV DNA test does not exclude CMV colitis, and clinical correlation with tissue-based testing remains essential. Further studies are needed to refine diagnostic thresholds, explore viral load cutoffs, and determine optimal clinical integration.
Disclosures: Ali Haider indicated no relevant financial relationships. Muhammad Haris Latif indicated no relevant financial relationships. Shahzad Zafar indicated no relevant financial relationships. Atta Ur Rehman indicated no relevant financial relationships. Vinesh Kumar indicated no relevant financial relationships. Anum Khakwani indicated no relevant financial relationships. Sheraz Ahmad Tariq indicated no relevant financial relationships. Mohmammad Hamza indicated no relevant financial relationships. Abdul Qadeer Khan indicated no relevant financial relationships. Salman Ayub Jajja indicated no relevant financial relationships. Adil Mushtaq indicated no relevant financial relationships. Bisher Sawaf indicated no relevant financial relationships.
Ali Haider, MBBS1, Muhammad Haris Latif, MD2, Shahzad Zafar, MD3, Atta Ur Rehman, MBBS4, Vinesh Kumar, MD5, Anum Khakwani, MD6, Sheraz Ahmad Tariq, MBBS4, Mohmammad Hamza, MD7, Abdul Qadeer Khan, MBBS8, Salman Ayub Jajja, MD9, Adil Mushtaq, MBBS10, Bisher Sawaf, MD11. P3210 - Non-Invasive Diagnosis of CMV Colitis in Crohn’s Disease Using Blood CMV DNA: A Meta-Analysis, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.
