Cytomegalovirus DNA level on biopsy specimens during treatment of cytomegalovirus gastrointestinal disease

Abstract

BACKGROUND & AIMS: There is no clear and point for the response to treatment of gastrointestinal human cytomegalovirus (HCMV) disease. HCMV-DNA quantitation on gastrointestinal biopsy specimens has proven its value for the diagnosis of gastrointestinal HCMV disease in patients with acquired immunodeficiency syndrome (AIDS). The aim was to study HCMV-DNA levels on gastrointestinal biopsy specimens during the treatment of gastrointestinal HCMV disease. METHODS: HCMV-DATA quantitation was performed using two different polymerase chain reaction assays on 90 biopsy specimens obtained before anti-HCMV therapy, during the induction phase, or during maintenance therapy for gastrointestinal HCMV disease in 21 patients with AIDS. RESULTS: HCMV- DNA was detected on all the biopsy specimens ranging from 9 to > or = 80,000 Eq/0.1 microgram DNA. Pretherapeutic mean level was 69,000 +/- 27,000 Eq/0.1 microgram DNA. Induction therapy was followed by a mean decrease of 1.7 +/- 1.3 log10 Eq/0.1 microgram DNA. HCMV-DNA levels decreased during induction therapy to < 1000 Eq/0.1 microgram DNA in 60% of patients but remained > 80,000 Eq/0.1 microgram DNA in 20% of patients. Relapse occurred in all the patients in a mean time of 100 days. HCMV-DNA level at the end of the induction phase seems to influence the time to relapse. CONCLUSIONS: Quantitation of HCMV-DNA on gastrointestinal biopsy specimens seems to be useful for monitoring gastrointestinal HCMV disease in patients with AIDS. (Gastroenterology 1996 Aug;111(2):439-44)