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[Digestive cytomegalovirus disease in AIDS patients]
J R Barberá1, J A Capdevila, A M García-Quintana
1Unidad de Enfermedades Infecciosas, Hospital General Vall d'Hebron, Barcelona.
Enfermedades Infecciosas Y Microbiologia Clinica
|August 1, 1996
Summary
Cytomegalovirus (CMV) digestive disease affects one-third of patients with acquired immunodeficiency syndrome (AIDS), appearing in those with severe immunosuppression. Acute mortality was 23%, with a median survival of 7 months, regardless of maintenance therapy.
Area of Science:
- Infectious Diseases
- Gastroenterology
- Immunology
Context:
- Cytomegalovirus (CMV) is an opportunistic infection common in patients with acquired immunodeficiency syndrome (AIDS).
- Digestive manifestations of CMV can significantly impact patient morbidity and mortality.
- Understanding the clinical course and treatment efficacy is crucial for managing these patients.
Purpose:
- To investigate the prevalence and characteristics of digestive cytomegalovirus (CMV) disease in patients with acquired immunodeficiency syndrome (AIDS).
- To evaluate the effectiveness of antiviral treatment during the acute phase of digestive CMV disease.
- To assess the necessity and impact of maintenance antiviral therapy on patient outcomes.
Summary:
- A retrospective review of 720 AIDS patients identified 96 with CMV disease, 30 of whom (31%) presented with digestive manifestations.
- Common sites included esophagitis and proctocolitis, occurring in severely immunocompromised patients (CD4 < 0.05 x 10(9)/l).
- Antiviral treatment yielded a 60% clinical cure rate; maintenance therapy did not significantly alter the median survival of 7 months, despite preventing relapses or new CMV events.
Impact:
- This study highlights that CMV digestive disease is a significant complication in AIDS patients with severe immunosuppression.
- Acute mortality is substantial (23%), emphasizing the need for prompt diagnosis and treatment.
- The findings suggest that while acute treatment is beneficial, maintenance therapy's role in survival requires further investigation, as survival appears independent of its use.