Cytomegalovirus viremia in dried blood spots is associated with an increased risk of death in HIV-infected patients: a cohort study from rural Tanzania

Summary Objectives The objectives of the study were to assess the utility of dried blood spots (DBS) for the detection of cytomegalovirus (CMV) antibody and viremia in a resource-poor setting, to study the prevalence of CMV antibody and viremia in HIV-infected patients with access to antiretroviral...

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Bibliographic Details
Published in:International journal of infectious diseases 2012-12, Vol.16 (12), p.e879-e885
Main Authors: Brantsæter, Arne B, Johannessen, Asgeir, Holberg-Petersen, Mona, Sandvik, Leiv, Naman, Ezra, Kivuyo, Sokoine L, Rollag, Halvor, Bruun, Johan N, Kvale, Dag
Format: Article
Language:English
Subjects:
Adult
AIDS-Related Opportunistic Infections - drug therapy
AIDS-Related Opportunistic Infections - mortality
AIDS-Related Opportunistic Infections - virology
Antibodies, Viral - blood
Antiretroviral Therapy, Highly Active
Cohort Studies
Cytomegalovirus
Cytomegalovirus - immunology
Cytomegalovirus - isolation & purification
Cytomegalovirus Infections - drug therapy
Cytomegalovirus Infections - mortality
Cytomegalovirus Infections - virology
Dried blood spots
Female
HIV
Humans
Infectious Disease
Male
Predictive Value of Tests
Pulmonary/Respiratory
Regression Analysis
Risk Factors
Rural Population
Seroprevalence
Survival
Tanzania - epidemiology
Viral Load
Viremia - virology
Young Adult
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Summary:Summary Objectives The objectives of the study were to assess the utility of dried blood spots (DBS) for the detection of cytomegalovirus (CMV) antibody and viremia in a resource-poor setting, to study the prevalence of CMV antibody and viremia in HIV-infected patients with access to antiretroviral therapy (ART) in Tanzania, and to relate CMV viremia to outcome. Methods DBS were prepared from 168 ART-naïve patients at baseline. Demographic, clinical, and laboratory data were obtained from patient records. CMV antibody was analyzed by chemiluminescent microparticle immunoassay and viremia by quantitative PCR. Results All patients were CMV-seropositive. At baseline 38 (22.6%) had detectable CMV viremia and 14 (8.3%) had a CMV viral load ≥200 copies/ml. In 135 patients available for follow-up, CMV ≥200 copies/ml was an independent risk factor for death with a hazard ratio of 5.0 (95% confidence interval 2.1–11.9) after adjusting for confounders. Symptoms compatible with CMV disease were common with viremia ≥200 copies/ml and CD4+ T cell counts
ISSN:1201-9712
1878-3511
DOI:10.1016/j.ijid.2012.08.003