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Published on: October 6, 2015
CMV as a cofactor enhancing progression of AIDS
1Centre for Virology, The Royal Free and University College Medical School, Hampstead Campus, Rowland Hill Street, London NW3 2PF, UK. p.griffiths@medsch.ucl.ac.uk
Summary
Cytomegalovirus (CMV) remains an important cofactor in HIV progression, even with modern treatments. Studies show CMV viral load, not just HIV, significantly impacts mortality in AIDS patients.
Area of Science:
- Virology
- Immunology
- Infectious Diseases
Background:
- Cytomegalovirus (CMV) has been implicated as a cofactor in HIV pathogenicity since the late 1980s.
- In vitro mechanisms and in vivo criteria for CMV's cofactor activity have been previously proposed.
Purpose of the Study:
- To review recent literature for new insights into CMV's role as an HIV cofactor.
- To update the understanding of CMV's in vitro and in vivo effects since 1998.
Main Methods:
- A literature survey was conducted.
- Information was gathered to support an overview lecture.
Main Results:
- No novel in vitro mechanisms of CMV cofactor activity were identified.
- Clinical cohort studies suggest active CMV infection can act as a cofactor.
- One study indicated CMV viral load was a stronger predictor of mortality than HIV viral load in AIDS patients.
- Despite highly active antiretroviral therapy (HAART) controlling CMV end-organ disease, CMV viraemia remains associated with death in AIDS patients.
Conclusions:
- CMV continues to be a significant factor in the era of HAART.
- CMV's role as an important cofactor in HIV disease has been historically underestimated.
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