OBJECTIVES: The objectives of the study were to assess the utility of dried blood spots (DBS) for the detection of cytomegalovirus (CMV) antibody and viremia in a resource-poor setting, to study the prevalence of CMV antibody and viremia in HIV-infected patients with access to antiretroviral therapy (ART) in Tanzania, and to relate CMV viremia to outcome. METHODS: DBS were prepared from 168 ART-naïve patients at baseline. Demographic, clinical, and laboratory data were obtained from patient records. CMV antibody was analyzed by chemiluminescent microparticle immunoassay and viremia by quantitative PCR. RESULTS: All patients were CMV-seropositive. At baseline 38 (22.6%) had detectable CMV viremia and 14 (8.3%) had a CMV viral load ≥ 200 copies/ml. In 135 patients available for follow-up, CMV ≥ 200 copies/ml was an independent risk factor for death with a hazard ratio of 5.0 (95% confidence interval 2.1-11.9) after adjusting for confounders. Symptoms compatible with CMV disease were common with viremia ≥ 200 copies/ml and CD4+ T cell counts <100 cells/mm(3), but confirmatory diagnostic procedures were unavailable. CONCLUSIONS: DBS are suitable for the detection of CMV antibody and viremia in HIV patients in resource-poor areas. CMV viremia was frequent and associated with an increased risk of death. Improved diagnosis and treatment of CMV may improve the prognosis for HIV-infected patients in developing countries and should be addressed in future studies.
OBJECTIVES: The objectives of the study were to assess the utility of dried blood spots (DBS) for the detection of cytomegalovirus (CMV) antibody and viremia in a resource-poor setting, to study the prevalence of CMV antibody and viremia in HIV-infectedpatients with access to antiretroviral therapy (ART) in Tanzania, and to relate CMV viremia to outcome. METHODS: DBS were prepared from 168 ART-naïve patients at baseline. Demographic, clinical, and laboratory data were obtained from patient records. CMV antibody was analyzed by chemiluminescent microparticle immunoassay and viremia by quantitative PCR. RESULTS: All patients were CMV-seropositive. At baseline 38 (22.6%) had detectable CMV viremia and 14 (8.3%) had a CMV viral load ≥ 200 copies/ml. In 135 patients available for follow-up, CMV ≥ 200 copies/ml was an independent risk factor for death with a hazard ratio of 5.0 (95% confidence interval 2.1-11.9) after adjusting for confounders. Symptoms compatible with CMV disease were common with viremia ≥ 200 copies/ml and CD4+ T cell counts <100 cells/mm(3), but confirmatory diagnostic procedures were unavailable. CONCLUSIONS: DBS are suitable for the detection of CMV antibody and viremia in HIVpatients in resource-poor areas. CMV viremia was frequent and associated with an increased risk of death. Improved diagnosis and treatment of CMV may improve the prognosis for HIV-infectedpatients in developing countries and should be addressed in future studies.
Authors: Caleb Skipper; Mark R Schleiss; Ananta S Bangdiwala; Nelmary Hernandez-Alvarado; Kabanda Taseera; Henry W Nabeta; Abdu K Musubire; Sarah M Lofgren; Darin L Wiesner; Joshua Rhein; Radha Rajasingham; Charlotte Schutz; Graeme Meintjes; Conrad Muzoora; David B Meya; David R Boulware Journal: Clin Infect Dis Date: 2020-07-27 Impact factor: 9.079
Authors: Christopher C Moore; Shevin T Jacob; Patrick Banura; Jixian Zhang; Suzanne Stroup; David R Boulware; W Michael Scheld; Eric R Houpt; Jie Liu Journal: Clin Infect Dis Date: 2019-01-07 Impact factor: 9.079
Authors: Fahimah Amini; Erick Auma; Yingfen Hsia; Sam Bilton; Tom Hall; Laxmee Ramkhelawon; Paul T Heath; Kirsty Le Doare Journal: PLoS One Date: 2021-03-15 Impact factor: 3.240
Authors: Damien Portevin; Félicien Moukambi; Maxmillian Mpina; Asli Bauer; Frederick Haraka; Mkunde Chachage; Philipp Metzger; Elmar Saathoff; Petra Clowes; Nyanda E Ntinginya; Andrea Rachow; Michael Hoelscher; Klaus Reither; Claudia A Daubenberger; Christof Geldmacher Journal: PLoS One Date: 2015-05-14 Impact factor: 3.240