Correlates of change in cytomegalovirus viremia in patients with advanced human immunodeficiency virus infection who require transfusion.

Pubmed ID: 11343218

Journal: The Journal of infectious diseases

Publication Date: June 1, 2001

MeSH Terms: Humans, Male, Adult, CD4 Lymphocyte Count, Female, HIV Infections, RNA, Viral, DNA, Viral, Polymerase Chain Reaction, Viremia, Cytomegalovirus, Cytomegalovirus Infections, Double-Blind Method, Erythrocyte Transfusion, Anti-HIV Agents, Blood Transfusion, Autologous, Karnofsky Performance Status

Grants: HB-57115, HB-57116, HB-57117, HB-57118, HB-57119, HB-57120, HB-57121, HB-57122, HB-57123, HB-57124, HB-57125, HB-57126, HB-57127

Authors: Kalish LA, Murphy EL, Drew WL, Para MF, Collier AC

Cite As: Para MF, Kalish LA, Collier AC, Murphy EL, Drew WL, Viral Activation Transfusion Study Group. Correlates of change in cytomegalovirus viremia in patients with advanced human immunodeficiency virus infection who require transfusion. J Infect Dis 2001 Jun 1;183(11):1673-7. Epub 2001 Apr 27.

Studies:

Abstract

The Viral Activation Transfusion Study compared leukocyte-reduced to unfiltered red blood cell transfusions in human immunodeficiency virus (HIV)- and cytomegalovirus (CMV)-coinfected patients. Relationships between serially measured plasma CMV load and clinical and laboratory outcomes over a median of 12 months were examined in 511 subjects. At baseline, subjects had a median of 15 CD4(+) cells/mm(3), 25% had CMV disease, and 21.5% were viremic. No relationship was found between changes in CMV viremia and changes in HIV RNA. Increased CMV viremia was associated with a concomitant fall in Karnofsky score. Highly active antiretroviral therapy (HAART) led to a decrease in CMV viremia after a 90-day delay. After adjustment for HIV load and CD4(+) cell count, CMV viremia remained associated with an increased risk of CMV disease (relative hazard, 5.78). In late-stage HIV-infected patients, CMV viremia was associated with lower functional status and increased risk of CMV disease. HAART suppressed CMV viremia only after a delay of several months.