Editor’s Choice: Restimulating Interest in Cytomegalovirus as a Cofactor for HIV Infection

June 14, 2015 at 8:45 pm

Journal of Infectious Diseases January 15, 2015 211 (2) P.169-171

EDITORIAL COMMENTARIES

Vincent C. Emery

Cytomegalovirus (CMV) is a complex virus that continues to contribute to morbidity in a range of patients.

These include solid organ and stem cell transplant recipients, in whom the virus is associated with both direct effects, such as CMV hepatitis [1] and gastrointestinal disease, and indirect effects, including acute rejection, reduced long-term graft function, accelerated posttransplantation vascular disease, and, in some cases, death [2].

In addition, CMV remains an important cause of congenital disease, leading to a range of sequelae, including microcephaly, mental retardation, and sensorineural hearing loss [3].

In human immunodeficiency virus (HIV)–infected individuals, CMV was once one of the most feared pathogens because it led to sight-threatening retinitis in patients whose CD4+ T-cell counts dropped below 50 cells/µL, and despite anti-CMV therapy, recurrences of infection were frequent and often due to drug-resistant strains of CMV [4, 5].

Fortunately, in HIV-infected populations with access to effective antiretroviral therapy (ART), the incidence of CMV retinitis is now very rare, and CMV disease in HIV patients has become a distant memory for many physicians.

Given the strong association of CMV with inflammation [6] and a skewing of the T-cell immune response [7], it is noteworthy that in the early days of the HIV epidemic, CMV was suggested as a cofactor for HIV disease progression. A seminal article in this area was published in 1989 by Webster et al [8].

This study investigated 108 HIV type 1 (HIV-1)–infected hemophiliac men whose date of HIV seroconversion was accurately known; the men were then stratified according to their CMV immunoglobulin G (IgG) status. Individuals with prior CMV infection, …

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http://jid.oxfordjournals.org/content/211/2/169.full.pdf+html

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Entry filed under: Biología Molecular, HIV/SIDA, HIV/SIDA Infeccion Aguda / Reciente, HIV/SIDA Infecciones Oportunistas, HIV/SIDA Laboratorio, Infecciones virales, Metodos diagnosticos.

GeSIDA/National AIDS Plan: Consensus document on antiretroviral therapy in adults infected by the human immunodeficiency virus (Updated January 2014). Does β-toxin Production Contribute to the Cytotoxicity of Hypervirulent Staphylococcus aureus?


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