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M9610609.TXT
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1996-01-30
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Document 0609
DOCN M9610609
TI Evidence of active cytomegalovirus infection in clinically stable
HIV-infected individuals with CD4+ lymphocyte counts below
100/microliters of blood: features and relation to risk of subsequent
CMV retinitis.
DT 9601
AU MacGregor RR; Pakola SJ; Graziani AL; Montzka DP; Hodinka RL; Nichols
CW; Friedman HM; Department of Medicine, University of Pennsylvania
School of; Medicine 19104, USA.
SO J Acquir Immune Defic Syndr Hum Retrovirol. 1995 Nov 1;10(3):324-30.
Unique Identifier : AIDSLINE MED/96027800
AB To determine the frequency and significance of cytomegalovirus (CMV)
viremia and viruria in HIV-positive subjects with low CD4+ lymphocyte
counts but with no clinical indications for culture, we studied 100
consecutive clinically stable subjects with CD4+ cells < or =
100/microliters of blood who agreed to culture of blood and urine. Serum
was tested for CMV antibody, p24 antigen, neopterin, and liver enzyme
concentrations, and patients were offered funduscopic examination.
Subjects' records were reviewed an average of 9.1 months after
enrollment for evidence of subsequent CMV retinitis. Three of the
original cohort proved ineligible because of CD4+ count >
100/microliters; CMV antibody was present in 96% of the remainder.
Isolation of CMV from blood was uncommon (2 of 93 seropositive subjects)
whereas viruria occurred in 51.6%; likelihood of having a positive urine
culture was significantly related to the subject's absolute CD4+
lymphocyte count: 60% for those with CD4+ < or = 50/microliters, vs.
26.1% for those with CD4+ 51-100/microliters. Neither serum p24 antigen
nor neopterin was predictive of CMV in urine or blood. No subjects
submitting to ophthalmologic exam had unsuspected CMV retinitis.
Subsequent development of retinitis correlated with CMV viruria on
entry: 13.5% if urine-positive, 1.9% if negative (p = 0.029; Fisher
exact test).
DE Adult Antibodies, Viral/ANALYSIS Biopterin/ANALOGS & DERIVATIVES/BLOOD
Cohort Studies Cytomegalovirus/IMMUNOLOGY/ISOLATION & PURIF
Cytomegalovirus Infections/DIAGNOSIS/*ETIOLOGY Cytomegalovirus
Retinitis/DIAGNOSIS/*ETIOLOGY CD4 Lymphocyte Count Enzymes/ANALYSIS
Female Follow-Up Studies Human HIV Core Protein p24/BLOOD HIV
Infections/*COMPLICATIONS/IMMUNOLOGY/URINE Liver/ENZYMOLOGY Male
Middle Age Risk Factors Support, Non-U.S. Gov't Support, U.S. Gov't,
P.H.S. Urine/VIROLOGY Viremia/DIAGNOSIS/*ETIOLOGY JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).