CYTOMEGALOVIRUS INFECTIONS IN AIDS

Important note: Information in this article was accurate in 1988. The state of the art may have changed since the publication date.

CYTOMEGALOVIRUS INFECTIONS IN AIDS

AIDS, Acquired Immune Deficiency Syndrome, and other Manifestations of HIV Infection. Wormser GP et al, eds. Park Ridge, NJ, Noyes Publications, p. 478-517, 1987.. Unique Identifier : AIDSLINE ICDB/88647007
Yarrish RL; Dept. of Medicine, New York Medical Coll., Valhalla, NY

Abstract: Infection with human cytomegalovirus (CMV) is extremely common in all populations, but transmission of infection seems to be particularly intense among sexually active homosexual men. In immunocompetent individuals, CMV may cause a form of mononucleosis, but is often asymptomatic. In patients (pts) with impaired cell-mediated immunity, however, CMV frequently causes severe and even life-threatening disease. There also are some data that suggest that CMV infection itself may have an immunosuppressive effect. Characteristics of CMV, its epidemiology, manifestations of infection, CMV as a cause of immunosuppression, CMV infection in pts with acquired immune deficiency syndrome (AIDS), impact of CMV on AIDS mortality, CMV and Kaposi's sarcoma, diagnosis of CMV infection, and antiviral chemotherapy for CMV are discussed. CMV infection is the most common opportunistic infection and one of the most frequent causes of death in pts with AIDS. Manifestations include interstitial pneumonitis, necrotizing adrenalitis, gastrointestinal ulceration, encephalomyelitis, retinitis, and less serious disease at numerous other sites. Diagnosis of significant CMV infection in AIDS pts rests on demonstration of the characteristic cytomegalic cells in tissues, but virus culture is sometimes helpful, especially when used with new rapid detection techniques. The new antiviral agent DHPG (9-(1,3-dihydroxy-2-propoxymethyl)guanine), a purine analog, has produced good results in the treatment of CMV retinitis and gastrointestinal disease in AIDS pts, but effective therapy for CMV pneumonitis has yet to be developed. (186 Refs)

Keywords: Acquired Immunodeficiency Syndrome/*IMMUNOLOGY/THERAPY Acyclovir/*ANALOGS & DERIVATIVES/THERAPEUTIC USE Antibody Formation Antiviral Agents/THERAPEUTIC USE Cytomegalovirus/IMMUNOLOGY Cytomegalovirus Infections/*IMMUNOLOGY/THERAPY Human HIV/*IMMUNOLOGY Opportunistic Infections/*IMMUNOLOGY/THERAPY Pneumonia, Viral/IMMUNOLOGY Risk Factors MONOGRAPH REVIEW REVIEW, TUTORIAL

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