Decrease of Cytomegalovirus Replication in Human Immunodeficiency Virus Infected–Patients after Treatment with Highly Active Antiretroviral Therapy

Abstract

Cytomegalovirus (CMV) viremia, as measured by a hybrid capture assay, was used to measure the effectiveness of “immune reconstitution” in human immunodeficiency virus (HIV)—infected subjects treated with highly active antiretroviral therapy (HAART). Of the 28 enrolled patients (mean age, 38 years), 86% were male and 68% were antiretrovirally naive. Of the 23 patients who returned for follow-up, baseline median characteristics were 4.1 log₁₀ CMV DNA copies/10⁶ white blood cells (WBCs), 5.1 log₁₀ HIV RNA copies/mL, and 35 CD4 cells/mm³. After initiation of HAART, median log₁₀ CMV DNA copies/10⁶ WBCs at means of 33, 87, and 385 days were 4.0, 3.3, and 2.5, respectively. Median log₁₀ HIV RNA levels declined from 5.1 to 1.7 at 385 days with a commensurate rise in median CD4 T cells to 166/mm³. Immune reconstitution secondary to HAART results in a significant and progressive decline in CMV viremia in the absence of specific anti-CMV therapy.