Epstein-Barr virus status and subsequent thiopurine exposure within a paediatric inflammatory bowel disease population

Rachel E. Harris, Vikas Hegde, Lee Curtis, Vikki Garrick, Lisa Gervais, Lawrence Armstrong, Caroline Delahunty, Andrew Eccleston, Ghassan Al-Hourani, Diana M. Flynn, Victoria Merrick, Andrew R. Barclay, Rachel Tayler, Richard Hansen, Richard K. Russell

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)358-362
Number of pages5
JournalJournal of Pediatric Gastroenterology and Nutrition
Issue number3
Publication statusPublished - 1 Sept 2021


  • children
  • Epstein-Barr virus
  • immunomodulator therapy
  • inflammatory bowel disease

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Gastroenterology


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