Cytomegalovirus Viremia as a Risk Factor for Mortality Prior to Antiretroviral Therapy among HIV-Infected Gold Miners in South Africa

摘要: BACKGROUND: Cytomegalovirus (CMV) viremia has been shown to be an independent risk factor for increased mortality among HIV-infected individuals in the developing world. While CMV infection is nearly ubiquitous resource-poor settings, few data are available on role of subclinical reactivation HIV. METHODS: Using a cohort mineworkers with stored plasma samples, we investigated association between DNA concentration and prior antiretroviral therapy availability. RESULTS: Among 1341 (median CD4 count 345 cells/µl, 70% WHO stage 1 or 2, median follow-up 0.9 years), 70 (5.2%) had at baseline; 71 deaths occurred. In univariable analysis baseline was associated three-fold increase (hazard ratio [HR] 3.37; 95% confidence intervals [CI] 1.60, 7.10). After adjustment count, HIV viral load (N?=?429 complete data), attenuated (HR 2.27; 95%CI 0.88, 5.83). Mortality higher (?1,000 copies/ml vs. no viremia, adjusted HR 3.65, 95%CI: 1.29, 10.41). Results were similar using time-updated viremia. CONCLUSIONS: High copy number, male adults South Africa relatively early disease. Studies determine whether anti-CMV mitigate high number would lifespan warranted.