Virology & Mycology
Open Access
ISSN: 2161-0517
+44 1223 790975
ISSN: 2161-0517
+44 1223 790975
Sven Grutzmeier
Karolinska Institute, Sweden
Scientific Tracks Abstracts: Virol Mycol
Background: Before the era of combination therapy (c-ART) more than 90% of the patients with HIV-infection died of one or more opportunistic infections (OI). We and others noted early on that cytomegalovirus (CMV) was an important pathogen in these patients. We investigated: all OIs and opportunistic cancers (OCs) in patients who died with CD4+ counts below 100x106/mL; the prevalence of CMV encephalitis (CMV-E) and Korsakoff syndrome; CMV retinitis (CMV-R) in relation to CMV-E; CMV adrenalitis (CMV-A) and its relation to CMV-R and CMV-E; the correlation between CMV disease and other OIs and OC and; the interaction between CMV, Epstein Barr virus (EBV) and other human herpes viruses in a case of anaplastic large cell lymphoma (ALCL).
Material & Methods: We followed all patients died at Venh�?¤lsan from 1989-1996, with intensive blood testing, X-rays, CT scans, Synacthen tests, neurological examinations, and ophthalmologic examinations to.
Results: Of all 219 patients died with CD4+ < 100x106/mL, 87% showed signs of reactivated CMV-infection. CMV-R was found in 84, CMV-E in 65, CMV-A in 41 and CMV in the gastrointestinal tract in 21. Mycobacterial infection was found in 87 and toxoplasmosis in 29. Kaposi��?s sarcoma was the most common tumor (68 cases) followed by 22 patients with malignant lymphoma and 20 with CNS-lymphoma. CMV-reactivation was seen in most. A case of primary CMV-infection leading to a malignant lymphoma by interaction with two other herpes viruses (EBV and HHV-8) was also seen.
Conclusion: CMV-infection was the main OI in AIDS-patients during the pre-c-ART era and the main cause of death by itself or together with other OIs. Reactivation of CMV was found in 87%. The most important CMV manifestations were CMV-R, CMV-E and CMV-A that seemed to occur at the same time. This is still today important in patients with CD4+ <100x106/mL without access to modern HIV-treatment. These findings reveal the intimate interaction between HIV and CMV which should be considered in all co-infected patients also today.
Recent Publications
1. Gr�?¼tzmeier S, Porwit A, Schmitt C, Sandstr�?¶m E, �?�?kerlund B and Ernberg I (2016) Fulminant anaplastic large cell lymphoma (ALCL) concomitant with primary cytomegalovirus (CMV) infection, and human herpes virus 8 (HHV-8) infection together with Epstein-Barr-virus (EBV) reactivation in a patient with asymptomatic HIV-infection. Infectious Agent Cancer DOI: 10.1186/s13027-016-0094-5.
2. Pirskanen Matell R, Gr�?¼tzmeier S, Nennesmo I, Sandstr�?¶m E and Ehrnst A (2009) Impairment of short-term memory and Korsakoff syndrome are common in AIDS patients with cytomegalovirus encephalitis. European Journal of Neurology 16(1):48-53.