Cytomegalovirus (CMV) polymerase chain reaction profiles in individuals with advanced human immunodeficiency virus infection: relationship to CMV disease.
Cytomegalovirus (CMV) disease is a common complication of patients with advanced human immunodeficiency virus infection. The aim of the present study, based on a case-cohort design, was to determine the predictive value of follow-up and baseline qualitative plasma CMV polymerase chain reaction (PCR) values for CMV end-organ disease in 378 patients (158 who progressed to CMV end-organ disease and 220 who did not develop CMV disease). These patients are part of the full AIDS Clinical Trials Group 204 multinational study (1227 patients), a randomized, controlled trial that compared the effects of valacyclovir with those of acyclovir for CMV disease prevention. Baseline PCR positivity was a significant risk factor for CMV disease progression (relative risk [RR], 1.81; 95% confidence interval [CI], 1.09-3.00). In multivariate analyses, time-updated PCR positivity was strongly associated with progression to CMV end-organ disease (RR, 4.42; 95% CI, 2.87-6.81). Change in cumulative PCR status was informative for the risk of subsequent CMV disease.
Nokta
Mostafa A
MA
Department of Internal Medicine, Division of Infectious Disease, University of Texas Medical Branch, Galveston, TX 77555-0835, USA. mnokta@utmb.edu
Holland
Fiona
F
De Gruttola
Victor
V
Emery
Vincent C
VC
Jacobson
Mark A
MA
Griffiths
Paul
P
Pollard
Richard B
RB
Feinberg
Judith E
JE
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis* / Q000821:virology; D000212:Acyclovir / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000328:Adult; D016022:Case-Control Studies; D003587:Cytomegalovirus / Q000235:genetics*; D003586:Cytomegalovirus Infections / Q000175:diagnosis* / Q000209:etiology / Q000821:virology; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy / Q000821:virology*; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D016133:Polymerase Chain Reaction; D011237:Predictive Value of Tests; D012307:Risk Factors; D000077483:Valacyclovir; D014633:Valine / Q000031:analogs & derivatives* / Q000627:therapeutic use
D014633:Valine; D000077483:Valacyclovir; D000212:Acyclovir