Background: Cytomegalovirus (CMV) is a common herpesvirus that has spread throughout the human population. It can easily cause organ damage in individuals who are immunocompromised. While many studies have examined the virology and immunology of simple CMV infection, few articles have described the unique immunological features of patients with HIV-CMV coinfection.
Methods: CMV infection was detected in 808 HIV/AIDS inpatients in our center from January 2017 to October 2019, and the relevant data from these patients were retrospectively analyzed. HIV-RNA, CD4+ T lymphocyte count, CMV-DNA, and related antibodies were measured in all patients. The positive rates of CMV-DNA in blood, urine, and cerebrospinal fluid (CSF) were compared. The positive rates between anti-CMV-immunoglobulin M (IgM) antibody and CMV-DNA in blood were compared. The correlation between immune status and CMV positive rate was analyzed based on the CD4+ T lymphocyte count.
Results: The overall positive rate of CMV infection in HIV/AIDS patients was 29.05%. The positive rate of CMV-DNA in urine, blood, and CSF samples was 25.27%, 26.01%, and 5.70%, respectively, and showed no significant difference between urine and blood. However, plasma CMV-IgM antibody level was significantly different between the urine and blood. The absolute CD4+ T lymphocyte count and the HIVRNA level were significantly different between the CMV-infected group and the non-CMV infected group.
Conclusions: Low CD4+ T lymphocyte count and high HIV-1 viral load are risk factors for CMV infection in HIV/AIDS patients. Detection of urine or plasma CMV-DNA by using real-time fluorescence quantitative polymerase chain reaction (PCR) is highly valuable in screening CMV infection in HIV/AIDS patients, while detection of blood CMV IgG and CMV IgM levels has limited clinical value.
Keywords: AIDS; CD4+ T lymphocytes; Cytomegalovirus (CMV); HIV-RNA quantification.