[Twenty-three cases of cytomegalovirus infection in acquired immunodeficiency syndrome].

OBJECTIVE

To investigate the clinical features, therapeutic approaches, outcomes and alterations of peripheral lymphocytes subsets in cytomegalovirus (CMV) infections in patients with AIDS.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.