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Cytomegalovirus seroconversion as a cofactor for progression to AIDS.
M Robain1, F Boufassa, J B Hubert
1Department of Epidemiology, INSERM U292, H pital du Kremlin-Bicêtre, France. u292@kb.inserm.fr
AIDS (London, England)
|February 24, 2001
Summary
Cytomegalovirus (CMV) seroconversion significantly increases the risk of developing AIDS in individuals with HIV-1. This study confirms that recent CMV infection impacts HIV-1 disease progression, highlighting the need for further research.
Area of Science:
- Immunology
- Virology
- Infectious Diseases
Background:
- Cytomegalovirus (CMV) infection is common in individuals with HIV-1.
- The impact of CMV seroconversion on HIV-1 disease progression requires further investigation.
Purpose of the Study:
- To determine the effect of CMV seroconversion on the progression of HIV-1 disease.
- To assess the association between CMV seroconversion and clinical outcomes in HIV-1 infected individuals.
Main Methods:
- Follow-up of 290 CMV-seronegative individuals in French HIV cohorts (SEROCO/HEMOCO).
- Regular serological testing for CMV infection every 6 months.
- Cox proportional hazards models were used to analyze time-dependent CMV seroconversion, adjusting for age, baseline CD4+ cell count, and HIV exposure group.
Main Results:
- 61 CMV seroconversions were observed with an incidence rate of 4.4 per 100 person-years.
- CMV seroconversion did not increase the risk of progression to a CD4+ cell count below 200 x 10(6) cells/l.
- A two-fold increased risk of progression to AIDS was observed in CMV seroconverters (RR = 2.09, P = 0.01).
Conclusions:
- Recent CMV infection, indicated by seroconversion, is associated with an increased risk of progression to AIDS in HIV-1 positive individuals.
- This study, the largest to date analyzing 61 CMV seroconversions, confirms the detrimental impact of CMV on HIV-1 disease progression.