title: Quantitative cytomegalovirus (CMV) antigenaemia during antiviral treatment of AIDS-related CMV disease.
abstract: In order to assess the value of quantitative measurement of cytomegalovirus (CMV) antigenaemia as a marker for the guidance of antiviral chemotherapy in the AIDS setting, 33 patients with CMV complications and showing at least 20 pp65-positive polymorphonuclear leucocytes per 2 x 10(5) cells, received either ganciclovir or foscarnet as induction and maintenance therapy. Antigenaemia was assessed every 1-4 weeks. During acute-phase antiviral therapy, a significant decrease of CMV antigenaemia (>50% of pretreatment levels) paralleled clinical improvement in 2-7 weeks in 32 of 33 subjects. In ten of 24 evaluable patients followed up during a further 4-12 months, disease relapses occurred concurrently with an increase of CMV antigenaemia in seven cases, while three cases of relapsing retinitis did not show a significant increase in antigenaemia. All patients with recurrent disease had a favourable response to further treatment, including halted clinical progression and significant decrease in antigenaemia. In HIV-related CMV disease, periodic monitoring of quantitative CMV antigenaemia proves useful in evaluating response to antivirals, in guiding therapeutic management and in predicting disease relapses.
authors.affiliation: Department of Clinical and Experimental Medicine, University of Bologna, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Manfredi
authors.forename: T
authors.initials: T
authors.lastname: Lazzarotto
authors.forename: P
authors.initials: P
authors.lastname: Spezzacatena
authors.forename: P
authors.initials: P
authors.lastname: Dal Monte
authors.forename: A
authors.initials: A
authors.lastname: Mastroianni
authors.forename: O V
authors.initials: OV
authors.lastname: Coronado
authors.forename: F
authors.initials: F
authors.lastname: Chiodo
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy* / Q000276:immunology; D000328:Adult; D000956:Antigens, Viral / Q000032:analysis*; D000998:Antiviral Agents / Q000627:therapeutic use; D015415:Biomarkers; D003587:Cytomegalovirus / Q000276:immunology*; D003586:Cytomegalovirus Infections / Q000188:drug therapy* / Q000276:immunology; D005260:Female; D017245:Foscarnet / Q000627:therapeutic use; D015774:Ganciclovir / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D010750:Phosphoproteins / Q000032:analysis* / Q000302:isolation & purification; D014763:Viral Matrix Proteins / Q000032:analysis* / Q000302:isolation & purification
chemical_list: D000956:Antigens, Viral; D000998:Antiviral Agents; D015415:Biomarkers; D010750:Phosphoproteins; D014763:Viral Matrix Proteins; C065418:cytomegalovirus matrix protein 65kDa; D017245:Foscarnet; D015774:Ganciclovir