PMID- 34557308
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220426
IS  - 2055-6640 (Print)
IS  - 2055-6659 (Electronic)
IS  - 2055-6640 (Linking)
VI  - 7
IP  - 3
DP  - 2021 Sep
TI  - High prevalence of gastrointestinal manifestations among Cytomegalovirus 
      end-organ disease in the combination antiretroviral era.
PG  - 100052
LID - 10.1016/j.jve.2021.100052 [doi]
LID - 100052
AB  - BACKGROUND: Cytomegalovirus (CMV) end-organ disease (EOD) continues to pose a 
      significant risk to patients with advanced HIV disease despite decreased 
      incidence with combination anti-retroviral therapy (ART) and lower mortality with 
      effective anti-CMV therapy. Subclinical CMV shedding may also contribute to 
      ongoing inflammation and non-infectious comorbidities. METHODS: We examined the 
      occurrence of CMV EOD and CMV shedding in a cohort of patients participating in a 
      prospective observational study of severely immunosuppressed (CD4 </=100 cells/mul), 
      ART-naive, HIV-1 infected adult participants. RESULTS: We studied 206 
      participants, of whom 193 (93.7%) were CMV IgG positive. Twenty-five participants 
      (12.1%) developed confirmed CMV EOD. At baseline, 47 (22.8%) had CMV viremia 
      detectable by PCR in the absence of clinical disease (CMV viremia). The remaining 
      134 (65%) had neither CMV EOD nor CMV viremia detected at baseline. Five 
      participants with CMV EOD (2.4% of total cohort, 20% of CMV EOD) met AIDS 
      Clinical Trials Group criteria for CMV immune reconstitution inflammatory 
      syndrome (IRIS). Only one-third of CMV EOD patients had retinitis, while 
      two-thirds presented with histologically confirmed gastrointestinal illness. CMV 
      viremia was associated with higher percentages of activated CD8(+) T cells even 
      after HIV suppression. CONCLUSION: The manifestations of CMV EOD in advanced HIV 
      disease before and after initiation of ART may be more diverse than previously 
      described, with high incidence of gastrointestinal illness. Recognition and 
      treatment of unusual clinical presentations of CMV infection remains important in 
      reducing morbidity and mortality from HIV co-infections.
CI  - (c) 2021 Published by Elsevier Ltd.
FAU - Caplan, Margaret R
AU  - Caplan MR
AD  - Clinical Research Directorate, Frederick National Laboratory for Cancer Research, 
      Bethesda, MD, 20817, USA.
FAU - Wilson, Eleanor M P
AU  - Wilson EMP
AD  - Laboratory of Immunoregulation, National Institute of Allergy and Infectious 
      Diseases, National Institutes of Health, Bethesda, MD, 20892, USA.
FAU - Schechter, Melissa
AU  - Schechter M
AD  - Clinical Research Directorate, Frederick National Laboratory for Cancer Research, 
      Bethesda, MD, 20817, USA.
AD  - Laboratory of Immunoregulation, National Institute of Allergy and Infectious 
      Diseases, National Institutes of Health, Bethesda, MD, 20892, USA.
FAU - Cai, Catherine W
AU  - Cai CW
AD  - Laboratory of Immunoregulation, National Institute of Allergy and Infectious 
      Diseases, National Institutes of Health, Bethesda, MD, 20892, USA.
FAU - Venner, Allison
AU  - Venner A
AD  - Laboratory of Immunoregulation, National Institute of Allergy and Infectious 
      Diseases, National Institutes of Health, Bethesda, MD, 20892, USA.
FAU - Bishop, Rachel
AU  - Bishop R
AD  - National Eye Institute, National Institutes of Health, Bethesda, MD, 20892, USA.
FAU - Adelsberger, Joseph
AU  - Adelsberger J
AD  - Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer 
      Research, Frederick, MD, 21701, USA.
FAU - Higgins, Jeanette
AU  - Higgins J
AD  - Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer 
      Research, Frederick, MD, 21701, USA.
FAU - Roby, Gregg
AU  - Roby G
AD  - Laboratory of Immunoregulation, National Institute of Allergy and Infectious 
      Diseases, National Institutes of Health, Bethesda, MD, 20892, USA.
FAU - Wang, Jing
AU  - Wang J
AD  - Clinical Monitoring Research Program Directorate, Frederick National Laboratory 
      for Cancer Research, Frederick, MD, 21701, USA.
FAU - Sheikh, Virginia
AU  - Sheikh V
AD  - Laboratory of Immunoregulation, National Institute of Allergy and Infectious 
      Diseases, National Institutes of Health, Bethesda, MD, 20892, USA.
FAU - Sereti, Irini
AU  - Sereti I
AD  - Laboratory of Immunoregulation, National Institute of Allergy and Infectious 
      Diseases, National Institutes of Health, Bethesda, MD, 20892, USA.
LA  - eng
PT  - Journal Article
DEP - 20210909
PL  - England
TA  - J Virus Erad
JT  - Journal of virus eradication
JID - 101654142
PMC - PMC8446803
OTO - NOTNLM
OT  - AIDS
OT  - CMV
OT  - Cytomegalovirus
OT  - HIV
OT  - Immune reconstitution inflammatory syndrome
COIS- The authors declare that they have no known competing financial interests or 
      personal relationships that could have appeared to influence the work reported in 
      this paper.
EDAT- 2021/09/25 06:00
MHDA- 2021/09/25 06:01
PMCR- 2021/09/09
CRDT- 2021/09/24 07:08
PHST- 2021/07/25 00:00 [received]
PHST- 2021/09/07 00:00 [revised]
PHST- 2021/09/07 00:00 [accepted]
PHST- 2021/09/24 07:08 [entrez]
PHST- 2021/09/25 06:00 [pubmed]
PHST- 2021/09/25 06:01 [medline]
PHST- 2021/09/09 00:00 [pmc-release]
AID - S2055-6640(21)00025-X [pii]
AID - 100052 [pii]
AID - 10.1016/j.jve.2021.100052 [doi]
PST - epublish
SO  - J Virus Erad. 2021 Sep 9;7(3):100052. doi: 10.1016/j.jve.2021.100052. eCollection 
      2021 Sep.