Cytomegalovirus antigenemia in acquired immunodeficiency syndrome patients with untreated cytomegalovirus retinitis.
OBJECTIVE
To determine the frequency of cytomegalovirus (CMV) viremia in patients with acquired immunodeficiency syndrome (AIDS) and untreated CMV retinitis using conventional cell culture isolation and the sensitive CMV antigenemia assay.


METHODS
We examined 24 AIDS patients with ophthalmologic diagnosis of untreated CMV retinitis and 24 AIDS patients without present or past retinitis (control patients) from three medical centers between September 1992 and March 1994. Cytomegalovirus antigenemia was detected by an indirect peroxidase staining in 300,000 cytocentrifuged neutrophils, using a mixture of murine monoclonal antibodies directed against the pp65 lower matrix protein of CMV.


RESULTS
Positive antigenemia was demonstrated in eight (33.3%) of the 24 retinitis patients and in none of the 24 control patients (P < .001). Only two of the eight antigenemia-positive patients had a concurrent positive CMV isolation from blood leukocytes by conventional cell culture assay.


CONCLUSIONS
These results emphasize the risk of extraocular disease in AIDS patients with CMV retinitis because the virus is often present in peripheral blood leukocytes. The CMV antigenemia assay may be a simple and rapid means of identifying those patients with unilateral retinitis at highest risk of developing CMV retinitis of the fellow eye or of visceral CMV disease if intravitreal injections or implants are used as sole treatment for CMV retinitis.
Pannuti
C S
CS
Division of Infectious Diseases, Hospital do Servidor Publico Estadual de São Paulo, Brazil. cpannuti@usp.br
Kallás
E G
EG
Muccioli
C
C
Roland
R K
RK
Ferreira
E C
EC
Bueno
S M
SM
Do Canto
C L
CL
Villas Boas
L S
LS
Belfort Júnior
R
R
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis* / Q000188:drug therapy; D000328:Adult; D000911:Antibodies, Monoclonal; D000914:Antibodies, Viral / Q000276:immunology; D000956:Antigens, Viral / Q000032:analysis*; D000998:Antiviral Agents / Q000627:therapeutic use; D002469:Cell Separation; D002478:Cells, Cultured; D003587:Cytomegalovirus / Q000276:immunology / Q000302:isolation & purification*; D017726:Cytomegalovirus Retinitis / Q000175:diagnosis* / Q000188:drug therapy; D005260:Female; D015774:Ganciclovir / Q000627:therapeutic use; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D009504:Neutrophils / Q000166:cytology / Q000821:virology*; D014766:Viremia / Q000175:diagnosis* / Q000188:drug therapy
D000911:Antibodies, Monoclonal; D000914:Antibodies, Viral; D000956:Antigens, Viral; D000998:Antiviral Agents; D015774:Ganciclovir