CMV infection can predict HIV disease progression

HIV-positive people who have persistent cytomegalovirus in their blood are more likely to experience rapid HIV disease progression to an AIDS diagnosis and death than those who have intermittent CMV infection or are clear of the virus, Reuters Health reports. The link between CMV infection and HIV disease progression was present even in study subjects on highly active antiretroviral therapy, according to the study by researchers at the Royal Free and University College Medical School in London. "In the era of HAART, there has been a dramatic decline" in the rates of CMV-related disease, according to lead study author Paul D. Griffiths. "But our results indicate that CMV infection is still present and it is still associated with progression of HIV disease." The findings are based on a study of 374 HIV-positive adults seen after January 1, 1997, and followed up for about 37 months. Nearly 95% of the patients received HAART at some point in the study. About 69% of patients tested negative for CMV throughout the study period, 4% of the study subjects were persistently CMV-positive, and 27% were intermittently positive. Study subjects with persistent CMV in the blood had double the risk of progressing to AIDS and quadruple the risk of death compared to other study subjects. The researchers are unsure whether persistent CMV infection is a predictor of HIV disease progression or if it is the cause of the rapid onset of AIDS and higher risk of death. They called for additional research to determine whether the use of drugs to treat CMV infection will slow the rate of HIV disease progression to help determine CMV's role in the development of AIDS. They also say their findings indicate that doctors should regularly screen their HIV patients for CMV infection to help determine whether more aggressive anti-HIV therapy may be needed. The full study, titled "Importance of Cytomegalovirus Viraemia in Risk of Disease Progression and Death in HIV-Infected Patients Receiving Highly Active Antiretroviral Therapy," appears in The Lancet.