Cytomegalovirus viremia, mortality, and end-organ disease among patients with AIDS receiving potent antiretroviral therapies.

摘要: Objective: To determine the association of cytomegalovirus (CMV) viremia with CMV disease and death in patients AIDS. Design setting: Prospective, observational cohort study conducted at a university hospital. Methods: A 190 subjects AIDS who were seropositive had no history or evidence longitudinally evaluated for signs symptoms plasma DNA polymerase chain reaction (PCR) whole blood hybrid capture. Results: total 187 least 1 visit following entry. At baseline, median CD4 + cell count HIV RNA level 110/μL (range = 3-620/μL) 47,973 copies/mL ( 750,000 copies/mL), respectively. Highly active antiretroviral therapy (HAART) use increased from 87.5% during 1st year to 98.5% by end study. During follow-up 334 days, 16% (30) died 2 (6%) developed disease. No deaths attributable disease; 4 prior death. Baseline viral load final significantly independently associated mortality. Detectable PCR was an independent predictor even after adjusting (P 0.038). In contrast, capture did not predict The assays neither collectively nor individually found be few cases Conclusions: CMV, detection predictive provided additional prognostic information on risk all cause-mortality beyond that obtained testing alone. Detection AIDS, particularly those low counts, provides rationale optimization consideration pre-emptive anti-CMV therapy.