Abstract
BackgroundCytomegalovirus infection dramatically decreased with the introduction of antiretroviral therapy. Whether incidence, clinical characteristics and prognosis of cytomegalovirus in HIV infected patients, has changed over time is. scarcely known.MethodsRetrospective single-center study. Patients included in this study were all HIV infected patients that went to our center for any disease, and were diagnosed with cytomegalovirus, during the period 2004–2015. epidemiological, clinical and laboratory patients variables were collected in a clinical database. Clinical characteristics, incidence of cytomegalovirus and predictors of mortality during the study were assessed. Results were considered statistically significant when p < 0.05. All statistical analyses were calculated by SPSS version 20.0 (Chicago, IL,USA).ResultsFifty-six cases of cytomegalovirus infection, in HIV infected patients were identified during the study period (incidence rate-1.7 cases per 1000 persons/year). The most frequent presentation was systemic illness in 43% of cases. Of note,no patients presented with ophthalmic manifestations. The 30-days mortality was 18%. Predictors of mortality were, in the univariate analysis, admission to the intensive care unit OR 32.4 (3.65–287.06) p = 0.0001, and mechanic ventilation 84 OR (8.27–853.12) p = 0.0001, and ART OR 4.1 (0.97–17.31) p = 0.044. These variables were assessed by multivariate analysis, and only mechanical ventilation was statistically significant (p < 0.05)ConclusionIncidence of cytomegalovirus infection was higher than described in the antiretroviral therapy era. Clinical presentation has changed. Mechanic ventilation predicted mortality.
Highlights
Cytomegalovirus infection dramatically decreased with the introduction of antiretroviral therapy
Different studies suggest that Cytomegalovirus (CMV) is a cofactor for rapid HIV-1 disease progression [3], and CMV has been associated with inflammation and immune activation in HIV-infected patients [4], but
We aimed to review how Cytomegalovirus infection (CMVI) may have changed in HIV-infected patients in recent years, that CMV DNA testing is available for clinical routine
Summary
Cytomegalovirus infection dramatically decreased with the introduction of antiretroviral therapy. Clinical characteristics and prognosis of cytomegalovirus in HIV infected patients, has changed over time is. Cytomegalovirus infection (CMVI), is an AIDS-defining condition that is much less frequent than in the past due to the widespread availability of combination antiretroviral therapy (ART) [1]. We aimed to review how CMVI may have changed in HIV-infected patients in recent years, that CMV DNA testing is available for clinical routine. The objectives of this study were to determine the incidence of CMVI in an institution caring for a large cohort of HIV-infected adults, to describe the clinical characteristics of CMVI, and to identify factors associated with a worse prognosis, defined by 30-day mortality and the need for intensive care unit (ICU) admission
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