Cytomegalovirus retinitis and viral resistance: 3. Culture results. CMV Retinitis and Viral Resistance Study Group.
OBJECTIVE
To evaluate the relationship between blood and urine cultures for cytomegalovirus and clinical outcomes in patients with cytomegalovirus retinitis.


METHODS
Prospective epidemiologic study of 108 patients with newly diagnosed cytomegalovirus retinitis. Blood and urine were cultured for cytomegalovirus at diagnosis of retinitis, at 1 month and 3 months after diagnosis, and every 3 months thereafter.


RESULTS
Of the patients, 80.6% were found to have either a positive blood culture or urine culture for cytomegalovirus at the time of diagnosis of retinitis, and a positive blood culture at diagnosis was associated with an increased mortality (odds ratio = 1.91, P = .012). Follow-up cultures were positive in approximately 20% of patients, and the rate was constant over time. The development of a positive blood or urine culture during follow-up correlated with the occurrence of cytomegalovirus retinitis in the contralateral eye in those patients with unilateral disease at diagnosis (odds ratio = 5.74, P = .001).


CONCLUSIONS
Patients with cytomegalovirus retinitis and positive blood cultures for cytomegalovirus have a poorer prognosis.
Jabs
D A
DA
Department of Ophthalmology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. dajabs@welchlink.welch.jhu.edu
Enger
C
C
Dunn
J P
JP
Forman
M
M
Hubbard
L
L
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy / Q000401:mortality / Q000821:virology*; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D015142:Baltimore / Q000453:epidemiology; D001769:Blood / Q000821:virology; D000077404:Cidofovir; D003587:Cytomegalovirus / Q000187:drug effects / Q000302:isolation & purification*; D017726:Cytomegalovirus Retinitis / Q000188:drug therapy / Q000401:mortality / Q000821:virology*; D003596:Cytosine / Q000031:analogs & derivatives / Q000627:therapeutic use; D004352:Drug Resistance, Microbial; D005260:Female; D005500:Follow-Up Studies; D017245:Foscarnet / Q000627:therapeutic use; D015774:Ganciclovir / Q000627:therapeutic use; D006801:Humans; D008297:Male; D063065:Organophosphonates; D009943:Organophosphorus Compounds / Q000627:therapeutic use; D011379:Prognosis; D011446:Prospective Studies; D015996:Survival Rate; D014556:Urine / Q000821:virology*; D014766:Viremia / Q000821:virology*
D000998:Antiviral Agents; D063065:Organophosphonates; D009943:Organophosphorus Compounds; D017245:Foscarnet; D003596:Cytosine; D000077404:Cidofovir; D015774:Ganciclovir