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Risk of cytomegalovirus (CMV) disease (CD) in persons with HIV (P) having less than 200 CD4.

Vaclav J, Fisher E, Hayashi H, Henry R, Farnum C, Husain N; International Conference on AIDS.

Int Conf AIDS. 1992 Jul 19-24; 8: B132 (abstract no. PoB 3271).

Henry Ford Hospital, Detroit, MI.

OBJECTIVES: Assess (1) rate of CD in P from time of 1st CD4 less than 200 (FC); (2) demographic (demo) differences (diff) in rates and P assessable (re potential prophylaxis (px) studies). METHODS: Retrospective chart review to 12/91 of all adult P with FC in our lab 1/87-12/90. Exclusions: (1) AIDS or FC prior to 1/87 (57P); (2) death in less than or equal to 2 months (mo) (59P); (3) lack of follow-up to less than or equal to 3 mo of death or of 12/91 (125P); (4) known negative CMV serology (10P); and (5) other (4P). CD included retinitis (ret); biopsy-proven GI, pulmonary (pulm) or mucocutaneous (MC); viremia (vir) or confirmed other CD. RESULTS: P assessable: 397. Major demo in %: 95M, 5F; 59 white (W), 39 black (B); risk factor: 76 male-male sex (M), 10 injection drug use (D), less than or equal to 5 each of other. Positive CMV serology in 77% (97% of those tested); 10% had other proof and 13% had no proof (but high probability) of CMV infection. Demo of those excluded from analysis for reasons 2 + 3 showed significantly more F, B and D. CD occurred in 119P with 143 diagnoses: 73 ret, 21GI, 13 pulm, 28 vir and 8 other (3 myelopathy, 3 MC, 1 liver, 1 pericarditis). Crude infection rates and Kaplan-Meier estimates: TABULAR DATA, SEE ABSTRACT VOLUME. Median initial #CD4: W 90, B 58, D 71, F 54, H/W 100, H/B 59. Multivariate analysis (Cox) adjusting for initial #CD4 showed significantly more CD in W vs B, H vs D and H/W vs H/B; there was trend to less in F vs M. In a subset with less than 100 CD4, monthly rates for ret or GI were .019 in H/W, .012 in H/B. Ascertainment bias will be discussed. CONCLUSION: Despite higher median initial #CD4, CD rate was higher in W vs B, H vs D and H/W vs H/B. More F, B and D were unassessable, raising concerns about their underrepresentation in px studies.

Publication Types:
  • Meeting Abstracts
Keywords:
  • Acquired Immunodeficiency Syndrome
  • Adult
  • Cytomegalovirus
  • Cytomegalovirus Infections
  • HIV Infections
  • HIV Seropositivity
  • Humans
  • Male
  • Retinitis
  • Risk Factors
  • Viremia
Other ID:
  • 92401004
UI: 102198717

From Meeting Abstracts




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