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Clinical relevance of the plasma load of cytomegalovirus in patients infected with HIV—A survival analysis
Author(s) -
Aramă Victoria,
Mihăilescu Raluca,
Rădulescu Mihaela,
Aramă Sorin Ştefan,
StreinuCercel Adrian,
Youle Mike
Publication year - 2014
Publication title -
journal of medical virology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.782
H-Index - 121
eISSN - 1096-9071
pISSN - 0146-6615
DOI - 10.1002/jmv.24027
Subject(s) - asymptomatic , viral load , medicine , human cytomegalovirus , cytomegalovirus , virology , betaherpesvirinae , immunology , sida , proportional hazards model , viral disease , gastroenterology , virus , herpesviridae
To investigate whether asymptomatic cytomegalovirus (CMV) viraemia impact the course of human immunodeficiency virus (HIV) infection, this study evaluated the effect of CMV replication on progression of newly‐diagnosed HIV infected individuals towards AIDS events and death. In a 3‐year prospective study on co‐infected patients, clinical, immunological, and virological tests were performed in a national reference hospital quarterly. CMV viraemia was quantified by RoboGene® HCMV DNA Quantification Kit (Analytik Jena, Germany), on ABI Prism® 7000 Sequence Detection System (Applied Biosystems, USA). One hundred and five patients were enrolled with a balanced sex distribution and a median age of 30.7 years. Median CD4 + cell count at enrollment was 164/mm 3 and median HIV RNA 4.6 log 10 copies/ml. Detectable CMV viraemia was found in 25.7% of the patients. Kaplan–Meier analysis showed progression of HIV infection to be significantly increased in those with active CMV replication and/or low CD4 + cell count. Cox regression indicated the risk of developing new AIDS events was 2.6 times greater in patients with detectable CMV viraemia versus those without (CI95% 1–6.6; P = 0.04). Also in multivariate analysis, the overall risk of progression to AIDS events or death was 3‐fold higher in those with detectable CMV viraemia (CI95% 1.3–6.7; P = 0.008) and 2.3‐fold higher if CD4 + cell count was below 100/mm 3 (CI95% 1–5.1; P = 0.04). In these young Romanian HIV‐seropositives, active CMV replication increased morbidity, even when treated with combination antiretroviral therapy. Further studies are needed to evaluate if serial quantitative CMV‐DNA levels might correlate with non‐infectious inflammation‐related risks in patients with HIV and active CMV infection. J. Med. Virol. 86:1821–1827, 2014 . © 2014 Wiley Periodicals, Inc.