Tao Mei-Mei, Ye Jun-Jie, Kuang Ji-Qiu
Department of Infectious Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
Zhonghua Nei Ke Za Zhi. 2008 Oct;47(10):802-4.
To investigate the clinical features, therapeutic approaches, outcomes and alterations of peripheral lymphocytes subsets in cytomegalovirus (CMV) infections in patients with AIDS.
Ninety-six cases of AIDS were treated in Peking Union Medical College Hospital and 23 of them had CMV infection. We analyzed the clinical features, peripheral lymphocytes subsets, outcomes, CMV pp65 antigen and/or specific anti-CMV IgM.
In the 23 CMV patients, nonspecific symptoms including fever, cough, chest distress and diarrhea occurred in 18, 11, 9 and 8 patients, respectively. Thirteen patients had retinitis identified by ophthalmofundoscopy, 7 of them had blurred vision or floating as primary symptoms. Pneumocystis pneumonia, tuberculosis infection and other infection appeared in 18 patients. Fifteen (65.2%) of the patients had positive serum tests. The positive rates for CMV pp65 and specific anti-CMV-IgM were 43.5% and 30.4%, respectively. CD(4)(+)T cell count in CMV patients was remarkably decreased than that in non-CMV patients [14(4, 39) cells/microl vs (48(12, 128) cells/microl, P = 0.005] and the proportion of CD(8)(+)CD(38)(+)T cells in CMV patients was higher than that in non-CMV patients, whereas the difference of CD(8)(+)T cell was not statistically different between the 2 groups.
CMV infection often occurs in advanced AIDS patients. In HIV/AIDS patients with CD(4)(+)T cell count </= 100 cells/microl, routine check for CMV pp65 antigen, specific anti-CMV IgM and ophthalmofundoscopy are recommended. Whenever encountering a young patient presenting with fever, blurred vision or floating, CMV complicating AIDS should be considered.
探讨艾滋病患者巨细胞病毒（CMV）感染的临床特征、治疗方法、转归及外周血淋巴细胞亚群的变化。
北京协和医院收治的96例艾滋病患者中，23例合并CMV感染。分析其临床特征、外周血淋巴细胞亚群、转归、CMV pp65抗原和/或特异性抗CMV IgM。
23例CMV感染患者中，分别有18例、11例、9例和8例出现发热、咳嗽、胸闷和腹泻等非特异性症状。13例患者经眼底镜检查确诊为视网膜炎，其中7例以视力模糊或眼前漂浮物为主要症状。18例患者合并肺孢子菌肺炎、结核感染及其他感染。15例（65.2%）患者血清学检查阳性。CMV pp65和特异性抗CMV-IgM的阳性率分别为43.5%和30.4%。CMV感染患者的CD4(+)T细胞计数显著低于非CMV感染患者[14(4, 39)个/微升 vs (48(12, 128)个/微升，P = 0.005]，CMV感染患者CD8(+)CD38(+)T细胞比例高于非CMV感染患者，而两组CD8(+)T细胞差异无统计学意义。
CMV感染多见于晚期艾滋病患者。对于CD4(+)T细胞计数≤100个/微升的HIV/AIDS患者，建议常规检测CMV pp65抗原、特异性抗CMV IgM及进行眼底镜检查。遇到年轻患者出现发热、视力模糊或眼前漂浮物时，应考虑CMV合并艾滋病的可能。
