Cytomegalovirus (CMV) Viremia and the CD4+ Lymphocyte Count as Predictors of CMV Disease in Patients Infected with Human Immunodeficiency Virus

Open Access

1 May 1997

journal article
clinical trial
Published by Oxford University Press (OUP) in Clinical Infectious Diseases

Vol. 24 (5) , 836-840
https://doi.org/10.1093/clinids/24.5.836

Abstract

We screened 192 patients infected with human immunodeficiency virus (HIV) to examine the relation between CD4⁺ lymphocyte counts and cytomegalovirus (CMV) viremia and the occurrence of CMV disease and subsequent duration of survival. When we stratified the viremic patients by CD4⁺ lymphocyte counts, the proportions were as follows: 150/mm³, 1 (1.5%) of 62. After a mean follow-up period of 8.5 months, 21 (11%) of 192 patients developed CMV disease. The probability of developing CMV disease at 6 months was 13% when the CD4⁺ lymphocyte count was 100/mm³; this probability was 46% for viremic patients and 1% for nonviremic patients. In a multivariate analysis, CMV viremia was independently prognostic of CMV disease (relative risk, 22.03; 95% confidence interval, 6.49–78.97; P < .001), whereas a CD4⁺ lymphocyte count of 3 was not (P = .26). These results support the value of CMV viremia for predicting which HIV-infected patients are at risk of developing CMV disease and should therefore receive primary prophylaxis.

Keywords

LYMPHOCYTE COUNT MEASUREMENT

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