Prevalence, risk factors, and impact on outcome of cytomegalovirus replication in serum of Cambodian HIV-infected patients (2004-2007)

Hdl Handle:
http://hdl.handle.net/10144/115226
Title:
Prevalence, risk factors, and impact on outcome of cytomegalovirus replication in serum of Cambodian HIV-infected patients (2004-2007)
Authors:
Micol, Romain; Buchy, Philippe; Guerrier, Gilles; Duong, Veasna; Ferradini, Laurent; Dousset, Jean-Philippe; Guerin, Philippe J; Balkan, Suna; Galimand, Julie; Chanroeun, Hak; Lortholary, Olivier; Rouzioux, Christine; Fontanet, Arnaud; Leruez-Ville, Marianne
Journal:
Journal of Acquired Immune Deficiency Syndromes (1999)
Abstract:
BACKGROUND: In developing countries, the study of cytomegalovirus (CMV) coinfection in HIV-infected patients remains neglected. Quantitative CMV polymerase chain reaction (PCR) is the gold standard diagnostic tool for analyzing serum CMV replication and for predicting CMV disease. We estimated the prevalence of replicating CMV in sera of newly diagnosed HIV-infected Cambodian patients and examined its impact on mortality. METHODS: This cohort study was based on 2 highly active antiretroviral therapy treatment programs in Cambodia between 2004 and 2007. Quantitative CMV PCR was performed on baseline serum samples of 377 HIV-infected patients. RESULTS: The prevalence of serum CMV DNA was 55.2% (150 of 272) in patients with CD4 count <100/mm. In multivariate analysis, hemoglobin <9 g/dL, CD4 count <100/mm, and Karnofsky index <50 were independently associated with positive serum CMV DNA at baseline. During a 3-year follow-up period, CMV viral load >or=3.1 log10 copies per milliliter was significantly associated with death independently of CD4 count, other opportunistic infections, and highly active antiretroviral therapy. CONCLUSIONS: As in industrialized countries, serum CMV replication is highly prevalent among HIV-infected Cambodian patients and is associated with increased mortality. This underscores the importance of diagnostic CMV infection by PCR in sera of HIV-infected patients with CD4 count <100/mm and treating this opportunistic infection to reduce its associated mortality.
Affiliation:
Unité d'Epidémiologie des Maladies Emergentes, Institut Pasteur, Paris, France; Laboratoire de Virologie, Universite Rene Descartes, Hopital Necker-Enfants Malades, Paris, France; Unite de virologie, Institut Pasteur du Cambodge, Phnom Penh, Cambodia; Medecins Sans Frontieres, Hopital Prea Bath Norodom Sihanouk, Phnom Penh, Cambodia; Medecins Du Monde, Hopital Kosamak, Phnom Penh, Cambodia; Epicentre, Paris, France; Medecins Sans Frontieres, Paris, France; Service des Maladies Infectieuses et Tropicales, Hopital Calmette, Phnom Penh, Cambodia; Universite Rene Descartes, Service des Maladies Infectieuses et Tropicales, Centre d’Infectiologie Necker–Pasteur, Hopital Necker–Enfants Malades, Paris, France
Issue Date:
1-Aug-2009
URI:
http://hdl.handle.net/10144/115226
DOI:
10.1097/QAI.0b013e3181a254c2
PubMed ID:
19421071
Additional Links:
http://journals.lww.com/jaids/pages/articleviewer.aspx?year=2009&issue=08010&article=00017&type=abstract
Submitted date:
2010-10-15
Type:
Article
Language:
en
ISSN:
1525-4135
Appears in Collections:
HIV/AIDS

Full metadata record

DC FieldValue Language
dc.contributor.authorMicol, Romainen
dc.contributor.authorBuchy, Philippeen
dc.contributor.authorGuerrier, Gillesen
dc.contributor.authorDuong, Veasnaen
dc.contributor.authorFerradini, Laurenten
dc.contributor.authorDousset, Jean-Philippeen
dc.contributor.authorGuerin, Philippe Jen
dc.contributor.authorBalkan, Sunaen
dc.contributor.authorGalimand, Julieen
dc.contributor.authorChanroeun, Haken
dc.contributor.authorLortholary, Olivieren
dc.contributor.authorRouzioux, Christineen
dc.contributor.authorFontanet, Arnauden
dc.contributor.authorLeruez-Ville, Marianneen
dc.date.accessioned2010-11-10T09:16:15Z-
dc.date.available2010-11-10T09:16:15Z-
dc.date.issued2009-08-01-
dc.date.submitted2010-10-15-
dc.identifier.citationJ. Acquir. Immune Defic. Syndr.2009;51(4):486-91en
dc.identifier.issn1525-4135-
dc.identifier.pmid19421071-
dc.identifier.doi10.1097/QAI.0b013e3181a254c2-
dc.identifier.urihttp://hdl.handle.net/10144/115226-
dc.description.abstractBACKGROUND: In developing countries, the study of cytomegalovirus (CMV) coinfection in HIV-infected patients remains neglected. Quantitative CMV polymerase chain reaction (PCR) is the gold standard diagnostic tool for analyzing serum CMV replication and for predicting CMV disease. We estimated the prevalence of replicating CMV in sera of newly diagnosed HIV-infected Cambodian patients and examined its impact on mortality. METHODS: This cohort study was based on 2 highly active antiretroviral therapy treatment programs in Cambodia between 2004 and 2007. Quantitative CMV PCR was performed on baseline serum samples of 377 HIV-infected patients. RESULTS: The prevalence of serum CMV DNA was 55.2% (150 of 272) in patients with CD4 count <100/mm. In multivariate analysis, hemoglobin <9 g/dL, CD4 count <100/mm, and Karnofsky index <50 were independently associated with positive serum CMV DNA at baseline. During a 3-year follow-up period, CMV viral load >or=3.1 log10 copies per milliliter was significantly associated with death independently of CD4 count, other opportunistic infections, and highly active antiretroviral therapy. CONCLUSIONS: As in industrialized countries, serum CMV replication is highly prevalent among HIV-infected Cambodian patients and is associated with increased mortality. This underscores the importance of diagnostic CMV infection by PCR in sera of HIV-infected patients with CD4 count <100/mm and treating this opportunistic infection to reduce its associated mortality.en
dc.language.isoenen
dc.relation.urlhttp://journals.lww.com/jaids/pages/articleviewer.aspx?year=2009&issue=08010&article=00017&type=abstracten
dc.rightsArchived with thanks to Wolters-Kluwer and the Journal of Acquired Immune Deficiency Syndromes (1999)en
dc.subject.meshAdulten
dc.subject.meshAntiretroviral Therapy, Highly Activeen
dc.subject.meshCD4 Lymphocyte Counten
dc.subject.meshCambodiaen
dc.subject.meshCytomegalovirusen
dc.subject.meshDNA, Viralen
dc.subject.meshFemaleen
dc.subject.meshHIV Infectionsen
dc.subject.meshHumansen
dc.subject.meshMaleen
dc.subject.meshPrevalenceen
dc.subject.meshRisk Factorsen
dc.subject.meshVirus Replicationen
dc.titlePrevalence, risk factors, and impact on outcome of cytomegalovirus replication in serum of Cambodian HIV-infected patients (2004-2007)en
dc.typeArticleen
dc.contributor.departmentUnité d'Epidémiologie des Maladies Emergentes, Institut Pasteur, Paris, France; Laboratoire de Virologie, Universite Rene Descartes, Hopital Necker-Enfants Malades, Paris, France; Unite de virologie, Institut Pasteur du Cambodge, Phnom Penh, Cambodia; Medecins Sans Frontieres, Hopital Prea Bath Norodom Sihanouk, Phnom Penh, Cambodia; Medecins Du Monde, Hopital Kosamak, Phnom Penh, Cambodia; Epicentre, Paris, France; Medecins Sans Frontieres, Paris, France; Service des Maladies Infectieuses et Tropicales, Hopital Calmette, Phnom Penh, Cambodia; Universite Rene Descartes, Service des Maladies Infectieuses et Tropicales, Centre d’Infectiologie Necker–Pasteur, Hopital Necker–Enfants Malades, Paris, Franceen
dc.identifier.journalJournal of Acquired Immune Deficiency Syndromes (1999)en

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