Bouchet E, Rabian C, Memain N, Ngo N, Viard JP, Rouzioux C; International Conference on AIDS.

Int Conf AIDS. 1996 Jul 7-12; 11: 285 (abstract no. Th.B.4197).

Clinical Immunology Department, Hopital Necker, Paris, France. Fax: (1) 44 49 54 20.

Objective: To determine cytomegalovirus antigenemia (CMV Ag) predictive value for CMV disease in a cohort of HIV-positive patients. Methods: One hundred and fourty six HIV-positive patients were included in this retrospective study as soon as they had at least one CMV Ag determination during their follow-up since 1/1993. CMV Ag was detected by direct immunofluorescence on blood leukocytes and expressed as number of CMV positive cells among 105 leukocytes. CMV Ag sensitivity and specificity for CMV disease were calculated within this cohort. Statistical differences between patients groups were studied using Mann and Whitney test. Results: Eight hundred and forty CMV Ag results were available for the 146 patients (mean: 5 CMV Ag determinations per patient). CMV disease occured in thirty eight patients (26%): 10 patients were already symptomatic at the day of inclusion, 28 patients developed CMV disease during their follow-up (including 46% retinitis). CMV Ag sensitivity for CMV disease diagnosis was 82%. One hundred and eight patients never developed any CMV disease during their follow-up. Among these asymptomatic patients 28 (19%) had positive CMV Ag. CMV Ag specificity for CMV disease diagnosis was 74%. 96% of symptomatic patients had CD4 count below 100/mm3. There was no significant statistical difference in CD4 count between symptomatic and asymptomatic patients with positive CMV Ag (p is greater than 0,01). 89% of asymptomatic patients had CMV Ag level below 25/105 leucocytes. CMV Ag median level was 17/105 cells for symptomatic patients and 4/105 cells for asymptomatic patients. CMV Ag level was statistically different between symptomatic and asymptomatic patients (p is less than 0,01). Conclusions: Determination of CMV Ag has good sensitivity (82%) but less satisfying specificity (74%) to predict CMV disease. CMV Ag level above 25/105 cells could be a significant threshold to select high risk patients for CMV disease. These high risk patients should benefit close medical attention and could be offered an anti-CMV preemptive therapy.

Publication Types:

• Meeting Abstracts

Keywords:

• CD4 Lymphocyte Count
• Cytomegalovirus
• Cytomegalovirus Infections
• Cytomegalovirus Retinitis
• HIV Seropositivity
• Humans
• Leukocytes
• Retrospective Studies
• Sensitivity and Specificity
• epidemiology

Other ID:

• 96924590

UI: 102220489

From Meeting Abstracts