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Journal of Virology, August 1999, p. 7027-7030, Vol. 73, No. 8
0022-538X/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.

Cytomegalovirus (CMV) DNA Load Is an Independent Predictor of CMV Disease and Survival in Advanced AIDS

Stephen A. Spector,1,2,3,* Karen Hsia,1 Michael Crager,4 Marshall Pilcher,1 Sheila Cabral,1 and Mary Jean Stempien4

Department of Pediatrics,1 Center for Molecular Genetics,2 and Center for AIDS Research,3 University of California, San Diego, La Jolla, and Roche Global Development, Palo Alto,4 California

Received 30 October 1998/Accepted 20 April 1999

The impact of cytomegalovirus (CMV) on human immunodeficiency virus type 1 (HIV-1) disease progression has been controversial. In this study, we sought to determine if CMV viral load is independent of HIV-1 viral load in predicting CMV disease and survival. Our findings indicate that in patients with advanced AIDS, CMV DNA load is an independent marker of CMV disease and survival and is more predictive than HIV-1 RNA load. Moreover, patients who respond to preemptive therapy with oral ganciclovir, with resulting undetectable levels of CMV DNA, in their plasma, have a significantly lower risk of developing CMV disease and higher rates of survival, despite stable or increasing HIV-1 RNA loads. These data provide support for CMV as an independent risk factor for mortality in persons with advanced AIDS and further suggest that effective preemptive therapy for CMV can improve patient survival rates.

* Corresponding author. Mailing address: University of California, San Diego, Clinical Sciences Building, 9500 Gilman Dr., La Jolla, CA 92093-0672. Phone: (858) 534-7170. Fax: (858) 534-7411. E-mail: saspector{at}ucsd.edu.

Journal of Virology, August 1999, p. 7027-7030, Vol. 73, No. 8
0022-538X/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.


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Copyright © 1999 by the American Society for Microbiology. All rights reserved.