PLoS ONE (Jan 2014)

Cytomegalovirus viral load kinetics in patients with HIV/AIDS admitted to a medical intensive care unit: a case for pre-emptive therapy.

  • Simnikiwe H Mayaphi,
  • Marieke Brauer,
  • Daniel M Morobadi,
  • Ahmad H Mazanderani,
  • Rendani T Mafuyeka,
  • Steve A S Olorunju,
  • Gregory R Tintinger,
  • Anton Stoltz

DOI
https://doi.org/10.1371/journal.pone.0093702
Journal volume & issue
Vol. 9, no. 4
p. e93702

Abstract

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BACKGROUND: Cytomegalovirus (CMV) infection is associated with severe diseases in immunosuppressed patients; however, there is a lack of data for pre-emptive therapy in patients with HIV/AIDS. METHOD: This was a retrospective study, which enrolled patients diagnosed with HIV/AIDS (CD41,000 copies/ml at baseline testing had significantly higher mortality compared to those who had 5,100 copies/ml and did not receive ganciclovir had 100% mortality compared to 58% mortality in those who received ganciclovir at VLs of >5,100 copies/ml, 50% mortality in those who were not treated and had low VLs of <5,100 copies/ml, and 44% mortality in those who had ganciclovir treatment at VLs of <5,100 copies/ml (p = 0.084, 0.046, 0.037, respectively). CONCLUSION: This study showed a significantly increased mortality in patients with HIV/AIDS who had high CMV VLs, and suggests that a threshold value of 1,000 copies/ml may be appropriate for pre-emptive treatment in this group.