title: Possible association between cytomegalovirus infection and gastrointestinal bleeding in hemophiliac patients.
abstract: Cytomegalovirus (CMV) infection is of major concern in immunocompromised and immunosuppressed patients. Prior to the introduction of HIV-1 antibody screening and efficient virucidal processes to inactivate viruses, individuals with a factor VIII or factor IX deficiency had a high risk of contracting HIV-1 infection through the infusion of contaminated blood products. In addition, blood products were also frequently associated with alterations in immune function. This study investigated the frequency of active CMV infection and its clinical relevance in Brazilian hemophiliacs. One hundred hemophiliacs were screened for the presence of CMV-DNA in their blood using nested PCR. Twenty-five out of 100 patients (25%) were positive for CMV-DNA and 24 of these 100 patients (24%) were HIV-1 positive; 6 of these 24 (25%) were positive for CMV-DNA. A similar frequency was observed among HIV-1-negative patients. In 60 hemophiliacs, the clinical relevance of the CMV infection was assessed. Twenty-one patients were positive for CMV-DNA. Of these, 10 had gastrointestinal bleeding compared to only 9 of 39 patients who were CMV-DNA negative (p = 0.05; chi(2) test). These data indicate a high prevalence of active CMV infection in Brazilian hemophiliac patients, irrespective of whether the patients were or were not infected by HIV-1. There was a possible association between the presence of CMV and the occurrence of gastrointestinal bleeding.
authors.affiliation: Departamento de Clínica Médica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, Brazil.
authors.forename: E
authors.initials: E
authors.lastname: Nogueira
authors.forename: V R
authors.initials: VR
authors.lastname: Arruda
authors.forename: J M
authors.initials: JM
authors.lastname: Bizzacchi
authors.forename: F F
authors.initials: FF
authors.lastname: Costa
authors.forename: M C
authors.initials: MC
authors.lastname: Ozelo
authors.forename: C L
authors.initials: CL
authors.lastname: Rossi
authors.forename: S C
authors.initials: SC
authors.lastname: Costa
mesh_terms: D001938:Brazil; D015897:Comorbidity; D003587:Cytomegalovirus / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000150:complications* / Q000453:epidemiology / Q000635:transmission; D004279:DNA, Viral / Q000097:blood; D004340:Drug Contamination; D005164:Factor IX / Q000009:adverse effects; D005169:Factor VIII / Q000009:adverse effects; D006471:Gastrointestinal Hemorrhage / Q000453:epidemiology / Q000209:etiology* / Q000821:virology; D018023:HIV Seronegativity; D015528:HIV Seroprevalence; D006467:Hemophilia A / Q000150:complications* / Q000453:epidemiology; D002836:Hemophilia B / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D016867:Immunocompromised Host; D016133:Polymerase Chain Reaction; D015995:Prevalence; D065227:Transfusion Reaction; D014766:Viremia / Q000150:complications / Q000453:epidemiology
chemical_list: D004279:DNA, Viral; D005169:Factor VIII; D005164:Factor IX