S1853 Race Is a Risk Factor Predictive of Cytomegalovirus Infection in Patients With Ulcerative Colitis: A Nationwide Population Cohort Study

Introduction: Patients with inflammatory bowel disease (IBD), are at an increased risk for developing cytomegalovirus (CMV) infections. IBD patients with CMV have poorer outcomes with greater healthcare utilization, such as increased length of stay and total healthcare charges. The prevalence of CMV is higher in patients with ulcerative colitis (UC) compared to Crohn’s disease (CD). However, predictors of developing CMV in UC patients have not been adequately evaluated. Thus, our study aims to assess the influence of demographic factors, such as race, on the incidence of CMV infection in patients with UC. Methods: A retrospective population-based cohort study using the Healthcare Cost and Utilization Project (HCUP)’s National Inpatient Sample (NIS) from 2016 to 2020 was performed. Using International Classification of Diseases-10 diagnostic codes, we assessed adult inpatients with a diagnosis of UC without a concurrent diagnosis of CD. Bivariate analyses were performed to compare the demographics of patients with and without CMV. A multivariable logistic regression was then performed to identify demographic predictors of CMV. Results: A total of 624,930 patients with UC met inclusion criteria, of which 3,130 (0.5%) had a diagnosis of CMV. On bivariate analysis, patients with CMV were younger (mean 50.31 vs 58.11 years, P < 0.001) and were more likely to be Hispanic (12.5% vs 7.7%, P < 0.001) or Black (11.8% vs 9.7%, P < 0.001) than those without CMV. On multivariable analysis controlling for demographic factors and steroid use, CMV infection was associated with younger age (OR 0.97 per year, P < 0.001) and chronic steroid use (OR 2.32, P < 0.001). Black (OR 1.48, P < 0.001) and Hispanic (OR 1.78, P < 0.001) patients were significantly more likely to have CMV than White patients. Patients living in an area of the top quartile of median income were more likely to have CMV than those in an area of the bottom quartile (OR 1.42, P < 0.001). Risk for CMV was greater in those with private insurance than Medicare (OR 1.61, P < 0.001). Conclusion: In hospitalized patients with UC, those who are Black or Hispanic have a substantially higher risk than those who are White for having an infection with CMV. In addition, patients with younger age, from higher socioeconomic areas, with private insurance, and with chronic steroid use are at escalated risk of having CMV infections. Given that UC patients with CMV have poorer outcomes with greater healthcare utilization, further studies are warranted to elucidate the underlying cause of these disparities.