Relationship between cytomegalovirus cells and survival in acquired immunodeficiency syndrome patients.
OBJECTIVE
To determine whether cytopathic changes due to cytomegalovirus (CMV) in human immunodeficiency virus-infected patients are prognostic.


METHODS
Three-month mortality was compared in three groups: 36 patients with positive CMV cytology, 38 with negative cytology but culture positive, and 40 with no evidence of CMV. Bronchoalveolar lavage, Papanicolaou-stained cytocentrifuge smears were quantitated using an average of two slides per case. Additionally, coinfection with Pneumocystis carinii and Cryptococcus neoformans was evaluated.


RESULTS
There was a statistically significant increase in mortality at three months in CMV cytology-positive patients versus those with no evidence of CMV. Ten patients had quantitative CMV counts of less than 2, with a median survival of 3.0 months (range, 0.3-13.0); seven patients had counts of 2 or 3, with a median survival of 5.5 months (0.4-13.5); and 11 patients had CMV counts greater than 3, with a median survival of 7.2 months (0.3-14.0). There was no significant difference between the groups. Coinfection was P Carinii (12) or C neoformans (2) showed no difference from patients without coinfection (chi2 = 0.81).


CONCLUSIONS
The presence of CMV cytopathic changes is associated with poorer survival, but an increased number of CMV-infected cells is not related to higher mortality.
Lemert
C M
CM
Department of Pathology, University of Cincinnati Medical Center, Ohio, USA.
Baughman
R P
RP
Hayner
C E
CE
Nestok
B R
BR
D017088:AIDS-Related Opportunistic Infections / Q000473:pathology / Q000821:virology*; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000401:mortality*; D003587:Cytomegalovirus / Q000302:isolation & purification*; D003586:Cytomegalovirus Infections / Q000150:complications* / Q000473:pathology; D006801:Humans; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis