       Document 0609
 DOCN  M9610609
 TI    Evidence of active cytomegalovirus infection in clinically stable
       HIV-infected individuals with CD4+ lymphocyte counts below
       100/microliters of blood: features and relation to risk of subsequent
       CMV retinitis.
 DT    9601
 AU    MacGregor RR; Pakola SJ; Graziani AL; Montzka DP; Hodinka RL; Nichols
       CW; Friedman HM; Department of Medicine, University of Pennsylvania
       School of; Medicine 19104, USA.
 SO    J Acquir Immune Defic Syndr Hum Retrovirol. 1995 Nov 1;10(3):324-30.
       Unique Identifier : AIDSLINE MED/96027800
 AB    To determine the frequency and significance of cytomegalovirus (CMV)
       viremia and viruria in HIV-positive subjects with low CD4+ lymphocyte
       counts but with no clinical indications for culture, we studied 100
       consecutive clinically stable subjects with CD4+ cells < or =
       100/microliters of blood who agreed to culture of blood and urine. Serum
       was tested for CMV antibody, p24 antigen, neopterin, and liver enzyme
       concentrations, and patients were offered funduscopic examination.
       Subjects' records were reviewed an average of 9.1 months after
       enrollment for evidence of subsequent CMV retinitis. Three of the
       original cohort proved ineligible because of CD4+ count >
       100/microliters; CMV antibody was present in 96% of the remainder.
       Isolation of CMV from blood was uncommon (2 of 93 seropositive subjects)
       whereas viruria occurred in 51.6%; likelihood of having a positive urine
       culture was significantly related to the subject's absolute CD4+
       lymphocyte count: 60% for those with CD4+ < or = 50/microliters, vs.
       26.1% for those with CD4+ 51-100/microliters. Neither serum p24 antigen
       nor neopterin was predictive of CMV in urine or blood. No subjects
       submitting to ophthalmologic exam had unsuspected CMV retinitis.
       Subsequent development of retinitis correlated with CMV viruria on
       entry: 13.5% if urine-positive, 1.9% if negative (p = 0.029; Fisher
       exact test).
 DE    Adult  Antibodies, Viral/ANALYSIS  Biopterin/ANALOGS & DERIVATIVES/BLOOD
       Cohort Studies  Cytomegalovirus/IMMUNOLOGY/ISOLATION & PURIF
       Cytomegalovirus Infections/DIAGNOSIS/*ETIOLOGY  Cytomegalovirus
       Retinitis/DIAGNOSIS/*ETIOLOGY  CD4 Lymphocyte Count  Enzymes/ANALYSIS
       Female  Follow-Up Studies  Human  HIV Core Protein p24/BLOOD  HIV
       Infections/*COMPLICATIONS/IMMUNOLOGY/URINE  Liver/ENZYMOLOGY  Male
       Middle Age  Risk Factors  Support, Non-U.S. Gov't  Support, U.S. Gov't,
       P.H.S.  Urine/VIROLOGY  Viremia/DIAGNOSIS/*ETIOLOGY  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

