Cytomegalovirus (CMV) polymerase chain reaction profiles in individuals with advanced human immunodeficiency virus infection: Relationship to CMV disease

• Published in: The Journal of infectious diseases 2002-06, Vol.185 (12), p.1717-1722
• Main Authors: Nokta, Mostafa A., Holland, Fiona, De Gruttola, Victor, Emery, Vincent C., Jacobson, Mark A., Griffiths, Paul, Pollard, Richard B., Feinberg, Judith E.
• Format: Article
• Language: English
• Subjects: Acyclovir - analogs & derivatives; Acyclovir - therapeutic use; Adult; AIDS; AIDS-Related Opportunistic Infections - diagnosis; AIDS-Related Opportunistic Infections - virology; Biological and medical sciences; Case-Control Studies; Cytomegalovirus; Cytomegalovirus - genetics; Cytomegalovirus infections; Cytomegalovirus Infections - diagnosis; Cytomegalovirus Infections - etiology; Cytomegalovirus Infections - virology; Disease risk; Epidemiology; HIV; HIV Infections - complications; HIV Infections - drug therapy; HIV Infections - virology; Human viral diseases; Humans; Infectious diseases; Major Articles; Male; Medical sciences; Miscellaneous; Multivariate Analysis; Polymerase Chain Reaction; Predictive Value of Tests; Predisposing factors; Preventive medicine; Risk Factors; Valine - analogs & derivatives; Valine - therapeutic use; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1086/340651

Cytomegalovirus (CMV) disease is a common complication of patients with advanced human immunodeficiency virus infection. The aim of the present study, based on a case-cohort design, was to determine the predictive value of follow-up and baseline qualitative plasma CMV polymerase chain reaction (PCR) values for CMV end-organ disease in 378 patients (158 who progressed to CMV end-organ disease and 220 who did not develop CMV disease). These patients are part of the full AIDS Clinical Trials Group 204 multinational study (1227 patients), a randomized, controlled trial that compared the effects of valacyclovir with those of acyclovir for CMV disease prevention. Baseline PCR positivity was a significant risk factor for CMV disease progression (relative risk [RR], 1.81; 95% confidence interval [CI], 1.09–3.00). In multivariate analyses, time-updated PCR positivity was strongly associated with progression to CMV end-organ disease (RR, 4.42; 95% CI, 2.87–6.81). Change in cumulative PCR status was informative for the risk of subsequent CMV disease.