Rasmussen L, Zipeto D, Wolitz R A, Dowling A, Efron B, Merigan T C
Center for AIDS Research at Stanford, Department of Medicine, Stanford University, California 94305, USA.
J Infect Dis. 1997 Nov;176(5):1146-55. doi: 10.1086/514106.
Cytomegalovirus (CMV) retinitis in patients infected with human immunodeficiency virus (HIV) is a significant clinical problem. Seventy-five patients with CD4 T cell counts <100/mm3 were monitored prospectively every 2 months for CMV DNA burden. The target for DNA amplification was a 162-bp fragment from the CMV immediate early gene. CMV DNA burden, at levels of > or =320 in white blood cells or > or =32 in plasma (P = .001), particularly when sustained (P = .005 and .008, respectively), distinguished patients who developed retinitis from those who remained free of disease. Progression to retinitis was not consistently accompanied by increases in CMV burden, indicating that quantitation of CMV burden beyond threshold levels is not necessary to predict risk for development of retinitis. Virus isolation from WBC, but not urine, was also significantly associated with risk for retinitis (P = .001).
感染人类免疫缺陷病毒（HIV）的患者发生巨细胞病毒（CMV）视网膜炎是一个重大的临床问题。对75例CD4 T细胞计数<100/mm3的患者每2个月进行一次前瞻性监测，检测其CMV DNA载量。DNA扩增的靶标是CMV即刻早期基因的一个162 bp片段。白细胞中CMV DNA载量≥320或血浆中≥32（P = .001），特别是持续存在时（分别为P = .005和.008），可区分发生视网膜炎的患者和未发病的患者。视网膜炎的进展并不总是伴随着CMV载量的增加，这表明在预测视网膜炎发生风险时，超过阈值水平的CMV载量定量并非必要。从白细胞而非尿液中分离出病毒也与视网膜炎风险显著相关（P = .001）。
