Cytomegalovirus infection in AIDS patients. An illustrative case series

ABSTRACT Background: Cytomegalovirus (CMV) is an opportunistic infection (OI) in immunosuppressed patients. However, there are no clear cut-off values available for quantitative plasmatic CMV measures (viral load [VL]) to discriminate those with CMV illness from those infected suffering a transient...

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Autores principales:	Mondaca,Roberto, Fica,Alberto, Delama,Ignacio, Olivares,Felipe, Navarrete,Maritza
Lenguaje:	English
Publicado:	Sociedad Médica de Santiago 2020
Materias:	Acquired Immunodeficiency Syndrome Cytomegalovirus Patient Outcome Assessment ROC Curve Drug-Related Side Effects and Adverse Reactions
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872020000600778
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spelling	oai:scielo:S0034-988720200006007782020-09-29Cytomegalovirus infection in AIDS patients. An illustrative case seriesMondaca,RobertoFica,AlbertoDelama,IgnacioOlivares,FelipeNavarrete,Maritza Acquired Immunodeficiency Syndrome Cytomegalovirus Patient Outcome Assessment ROC Curve Drug-Related Side Effects and Adverse Reactions ABSTRACT Background: Cytomegalovirus (CMV) is an opportunistic infection (OI) in immunosuppressed patients. However, there are no clear cut-off values available for quantitative plasmatic CMV measures (viral load [VL]) to discriminate those with CMV illness from those infected suffering a transient viral reactivation. Aim: To estimate a CMV VL cut-off point that discriminates infected patients and those with CMV related diseases, and to clinically characterize AIDS patients with this OI. Patients and Methods: Retrospective analysis of AIDS patients admitted by any reason between years 2017 and 2019 and who had a positive plasma CMV VL at any titer. Cases were categorized with illness or infected using accepted criteria and the cut-off value was obtained by receiver operating characteristic curve (ROC) analysis. Results: Twelve patients were identified as having a CMV-associated illness and seven with CMV infection. A CMV VL of 3,800 copies/mL had a sensitivity of 91.6% and 100% specificity to discriminate both states. Of the 12 patients with CMV illness, all were in AIDS stage and only five were receiving HIV therapy. Predominant clinical presentations were gastrointestinal (50%), followed by liver involvement (25%) and CMV disease (25%). All patients were treated with ganciclovir or valganciclovir. Ten patients had a favorable response (83.3%), one patient only had a laboratory improvement (8.3%) and one died during treatment (8.3%). Drug toxicity was recorded in nine patients but in only three cases, a dose adjustment was necessary. Conclusions: The predominant clinical manifestation in our series was gastrointestinal. A CMV VL cutoff level of CMV VL of 3,800 copies / mL is useful to discriminate infected patients from those with CMV related disease.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.148 n.6 20202020-06-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872020000600778en10.4067/S0034-98872020000600778
institution	Scielo Chile
collection	Scielo Chile
language	English
topic	Acquired Immunodeficiency Syndrome Cytomegalovirus Patient Outcome Assessment ROC Curve Drug-Related Side Effects and Adverse Reactions
spellingShingle	Acquired Immunodeficiency Syndrome Cytomegalovirus Patient Outcome Assessment ROC Curve Drug-Related Side Effects and Adverse Reactions Mondaca,Roberto Fica,Alberto Delama,Ignacio Olivares,Felipe Navarrete,Maritza Cytomegalovirus infection in AIDS patients. An illustrative case series
description	ABSTRACT Background: Cytomegalovirus (CMV) is an opportunistic infection (OI) in immunosuppressed patients. However, there are no clear cut-off values available for quantitative plasmatic CMV measures (viral load [VL]) to discriminate those with CMV illness from those infected suffering a transient viral reactivation. Aim: To estimate a CMV VL cut-off point that discriminates infected patients and those with CMV related diseases, and to clinically characterize AIDS patients with this OI. Patients and Methods: Retrospective analysis of AIDS patients admitted by any reason between years 2017 and 2019 and who had a positive plasma CMV VL at any titer. Cases were categorized with illness or infected using accepted criteria and the cut-off value was obtained by receiver operating characteristic curve (ROC) analysis. Results: Twelve patients were identified as having a CMV-associated illness and seven with CMV infection. A CMV VL of 3,800 copies/mL had a sensitivity of 91.6% and 100% specificity to discriminate both states. Of the 12 patients with CMV illness, all were in AIDS stage and only five were receiving HIV therapy. Predominant clinical presentations were gastrointestinal (50%), followed by liver involvement (25%) and CMV disease (25%). All patients were treated with ganciclovir or valganciclovir. Ten patients had a favorable response (83.3%), one patient only had a laboratory improvement (8.3%) and one died during treatment (8.3%). Drug toxicity was recorded in nine patients but in only three cases, a dose adjustment was necessary. Conclusions: The predominant clinical manifestation in our series was gastrointestinal. A CMV VL cutoff level of CMV VL of 3,800 copies / mL is useful to discriminate infected patients from those with CMV related disease.
author	Mondaca,Roberto Fica,Alberto Delama,Ignacio Olivares,Felipe Navarrete,Maritza
author_facet	Mondaca,Roberto Fica,Alberto Delama,Ignacio Olivares,Felipe Navarrete,Maritza
author_sort	Mondaca,Roberto
title	Cytomegalovirus infection in AIDS patients. An illustrative case series
title_short	Cytomegalovirus infection in AIDS patients. An illustrative case series
title_full	Cytomegalovirus infection in AIDS patients. An illustrative case series
title_fullStr	Cytomegalovirus infection in AIDS patients. An illustrative case series
title_full_unstemmed	Cytomegalovirus infection in AIDS patients. An illustrative case series
title_sort	cytomegalovirus infection in aids patients. an illustrative case series
publisher	Sociedad Médica de Santiago
publishDate	2020
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872020000600778
work_keys_str_mv	AT mondacaroberto cytomegalovirusinfectioninaidspatientsanillustrativecaseseries AT ficaalberto cytomegalovirusinfectioninaidspatientsanillustrativecaseseries AT delamaignacio cytomegalovirusinfectioninaidspatientsanillustrativecaseseries AT olivaresfelipe cytomegalovirusinfectioninaidspatientsanillustrativecaseseries AT navarretemaritza cytomegalovirusinfectioninaidspatientsanillustrativecaseseries
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Cytomegalovirus infection in AIDS patients. An illustrative case series

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