title: Quantitation of cytomegalovirus (CMV) DNA by real-time PCR for occurrence of CMV disease in HIV-infected patients receiving highly active antiretroviral therapy.
abstract: In HIV-infected patients treated with highly active antiretroviral therapy (HAART) included in the Predivir cohort, we have evaluated the usefulness of CMV DNA quantitation by a TaqMan PCR assay from peripheral blood leukocytes (PBLs) to predict CMV disease occurrence. In parallel with the immune restoration after treatment by HAART, the percentage of positive samples decreased progressively from 7.3% at Day 0 to 3.5% at Month 12. Among the CMV markers, the smallest concordance with PBL CMV TaqMan PCR, as evaluated by kappa, was observed with pp65 antigenemia, whereas concordance with all other CMV markers was high. Among the 16 patients with CMV DNA copies at least once >100/150,000 cells, CMV disease occurred in six during follow-up, whereas among the 159 patients with CMV DNA copies always <10/150,000 cells, CMV disease occurred in three and among the seven patients with CMV DNA copies >10 and <100 occurred in only one. In univariate Cox models, all the CMV markers including PBL CMV TaqMan PCR >10/150,000 cells (RR: 27.6, IC95: 7.1-107.2), the CD4 cell count <75 cells/mm(3) and the HIV viral load >100,000 copies/ml were predictive for CMV disease. In a stepwise multivariate analysis, which should be interpreted with caution due to the small number of events (n = 10), three covariates were associated independently with CMV disease: pp65 antigenemia >100 nuclei/200,000, PBL CMV TaqMan PCR >10 copies/150,000 cells and HIV viral load remaining or increasing >100,000 copies/ml.
authors.affiliation: Department of Virology, Pitié-Salpêtrière Hospital, Paris, France.
authors.forename: Karine
authors.initials: K
authors.lastname: Gourlain
authors.forename: Dominique
authors.initials: D
authors.lastname: Salmon
authors.forename: Elyanne
authors.initials: E
authors.lastname: Gault
authors.forename: Catherine
authors.initials: C
authors.lastname: Leport
authors.forename: Christine
authors.initials: C
authors.lastname: Katlama
authors.forename: Sophie
authors.initials: S
authors.lastname: Matheron
authors.forename: Dominique
authors.initials: D
authors.lastname: Costagliola
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Mazeron
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Fillet
mesh_terms: D000328:Adult; D000368:Aged; D023241:Antiretroviral Therapy, Highly Active; D015331:Cohort Studies; D003587:Cytomegalovirus / Q000235:genetics / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000150:complications / Q000821:virology*; D004279:DNA, Viral / Q000097:blood*; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000379:methods*; D011446:Prospective Studies; D019914:Taq Polymerase / Q000378:metabolism
chemical_list: D004279:DNA, Viral; D019914:Taq Polymerase