Incidence and natural history of cytomegalovirus disease in patients with advanced human immunodeficiency virus disease treated with zidovudine

Joel E. Gallant, Richard D. Moore, Douglas D. Richman, Jeanne Keruly, Richard E. Chaisson, John Bartlett, Sharon McAvinue, Yvonne Bryson, Helene Cohen, Margaret Fischl, Terry Bolin, Harold Kessler, Yvonne Burrough, Donna Mildvan, Alice Fox, Douglas Richman, Ben Freeman, Gary Simon, Kathy Ward Grabowy, David ChernoffPatricia Duff, Sumner Thompson, Kara Barrett, Robert Awe, Ruby Chapman, Shirley Leonard, Paul Turner, Marge Hawkins, Henry Murray, Jill Bowers, Clifford Lane, Hugh Tilson, Elizabeth Andrews, Lynn Smiley

Research output: Contribution to journalArticlepeer-review

503 Scopus citations

Abstract

Data were analyzed from a multicenter observational cohort study of 1002 persons with AIDS or AIDS-related complex (ARC) and total CD4 cell count <0.25 × 109/L treated with zidovudine between April 1987 and April 1988. Cytomegalovirus (CMV) disease developed in 109 patients (10.9%), with a 2-year actuarial risk of 15%. Manifestations included retinitis (93 patients), esophagitis (10), colitis (8), gastritis (1), hepatitis (1), and encephalitis (1). The probability of CMV disease at 2 years for patients with initial counts <0.1 × 109/L was 21.4%, compared with 10.3% for patients with initial counts ⩾0.1 × 109/L (P <.001). By proportional hazards analysis, baseline CD4 cell count <0.1 × 109/L, enrollment diagnosis of AIDS, and homosexuality were significantly associated with subsequently developing CMV disease. Median survival after diagnosis of CMV disease was 173 days, and CMV was an independent predictor of death. CMV contributes to AIDS-related morbidity and mortality. As new anti-CMV drugs become available, prophylaxis should be targeted at individuals with CD4 cell counts <0.1 × 109/L.

Original languageEnglish (US)
Pages (from-to)1223-1227
Number of pages5
JournalJournal of Infectious Diseases
Volume166
Issue number6
DOIs
StatePublished - Dec 1992

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

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