A longitudinal study of cytomegalovirus infection in human immunodeficiency virus type 1-seropositive homosexual men: molecular epidemiology and association with disease progression.
Cytomegalovirus (CMV) isolates from 234 asymptomatic human immunodeficiency type 1 (HIV-1)-positive men were analyzed for molecular relatedness using junctional hybridization. Of isolates shed simultaneously at two or more body sites, 36% from 22 men were different. Of 180 isolates collected from 67 men over 15 months, different strains were isolated serially from 27 men (40%), most from semen. After follow-up of 58 months (mean), the relative hazard of HIV infection progressing to AIDS was 1.8 (95% confidence interval [CI], 0.9-3.7) for men shedding the same strain of CMV and 3.0 (95% CI, 1.4-6.1) for men shedding different strains compared with men not shedding CMV in semen. The prevalence of CMV-specific IgM was higher in men shedding different versus same CMV strains (32% vs. 18%; P = .244). Thus, presence of multiple CMV strains in HIV-1-positive homosexual men is associated with progression to AIDS, possibly via activation of HIV-1-infected CD4 cells.
UCLA School of Public Health.
C T
CT
Leach
R
R
Detels
K
K
Hennessey
Z
Z
Liu
B R
BR
Visscher
J P
JP
Dudley
J D
JD
Cherry
D015331:Cohort Studies; D003587:Cytomegalovirus / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000453:epidemiology / Q000209:etiology* / Q000382:microbiology; D004279:DNA, Viral / Q000032:analysis; D006679:HIV Seropositivity / Q000150:complications*; D015497:HIV-1; D006716:Homosexuality; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009693:Nucleic Acid Hybridization; D015995:Prevalence; D015183:Restriction Mapping; D012661:Semen / Q000382:microbiology
D004279:DNA, Viral