Barberá J R, Capdevila J A, García-Quintana A M, Calicó I, Allende H, Ruiz I, Ocaña I, Pahissa A
Unidad de Enfermedades Infecciosas, Hospital General Vall d'Hebron, Barcelona.
Enferm Infecc Microbiol Clin. 1996 Aug-Sep;14(7):411-5.
In this paper we study the digestive manifestations of cytomegalovirus (CMV) in AIDS patients. Also, we evaluate the antiviral treatment and the necessity of maintenance therapy.
Retrospective review of medical charts of all patients with AIDS and digestive CMV disease diagnosed and followed-up since 1983 to december 1993.
Of 720 AIDS patients, 96 presented a CMV disease. Among them, 30 patients (31%) complained digestive manifestations. These were 26 males and 4 females, mean age: 37.4 y-old. Risk factors for HIV were: 13 homosex and 12 intravenous drug abusers. Average of time between AIDS diagnosis and digestive CMV disease: 13.4 months. Fourteen patients had esophagitis, 9 proctocolitis, 3 hepatitis, 3 pancreatitis, 2 gastric ulcerations, one small bowel disease and other an oral ulceration. Two patients had a concomitant CMV chorioretinitis. CD4 lymphocytes were below 0.05 x 10(9)/l in 29 patients. Twenty-four patients received antiviral treatment during the acute disease period, with a clinical curation rate of 60%. Seven patients received maintenance therapy and remained free of CMV disease until death. Eleven patients didn't received maintenance treatment. Of them, one patient presented a digestive relapse and two developed a CMV chorioretinitis. Mortality in the first month from diagnosis was 23% and the median of survival time for patients who cured and initial episode of digestive CMV disease was 208 days, wether or not the patient received maintenance therapy or not.
One third of ours patients with AIDS and CMV infection have a digestive disease. This CMV digestive disease appears in patients with a severe immunosuppression. Acute phase mortality was 23%. The median survival was 7 months, independently or receiving maintenance treatment or not.
在本文中，我们研究了艾滋病患者巨细胞病毒（CMV）的消化系统表现。此外，我们评估了抗病毒治疗及维持治疗的必要性。
回顾性分析1983年至1993年12月期间所有诊断并随访的艾滋病合并消化系统CMV疾病患者的病历。
在720例艾滋病患者中，96例出现CMV疾病。其中，30例（31%）有消化系统表现。这些患者中男性26例，女性4例，平均年龄：37.4岁。HIV感染的危险因素为：13例同性恋者和12例静脉吸毒者。艾滋病诊断至消化系统CMV疾病的平均时间为：13.4个月。14例患者有食管炎，9例有直肠结肠炎，3例有肝炎，3例有胰腺炎，2例有胃溃疡，1例有小肠疾病，另1例有口腔溃疡。2例患者同时合并CMV脉络膜视网膜炎。29例患者的CD4淋巴细胞低于0.05×10⁹/L。24例患者在急性期接受了抗病毒治疗，临床治愈率为60%。7例患者接受了维持治疗，直至死亡均未再出现CMV疾病。11例患者未接受维持治疗。其中，1例患者出现消化系统复发，2例发生CMV脉络膜视网膜炎。诊断后第一个月的死亡率为23%，治愈且首次发作消化系统CMV疾病的患者的生存时间中位数为208天，无论患者是否接受维持治疗。
我们的艾滋病合并CMV感染患者中有三分之一患有消化系统疾病。这种CMV消化系统疾病出现在免疫严重抑制的患者中。急性期死亡率为23%。中位生存期为7个月，无论是否接受维持治疗。
