Cytomegalovirus

"C.M.V."

Now that protease inhibitors are combating HIV to the point that PWAs are living longer, one doctor at a recent conference noted that managing HIV Disease has become managing CMV more than anything else. CMV is very common in those with low t-cell counts -- less than 100.

This is part of a series on Opportunistic Infections ("OIs"). Please note that --

This Page Is Just A Starting Point: ÆGIS is a great place for you to find overview information about HIV and opportunistic infections, but it is not a substitute for getting medical advice from a doctor who specializes in treating HIV.
Finding The Latest Information: Advances in treating opportunistic infections can happen at any time, so the material on this page may be outdated. Some links in the see also section at the bottom of this page are actually special database links. They may contain information published after this page was written.

Classification

herpes-type virus (cytomegalovirus)

Description

Relax, there is a good chance you are already infected with cytomegalovirus. About half of all (not just HIV+) adults in developed countries are infected. Almost all gay/bisexual men with HIV are infected, and 75% of other HIV+ have it.
CMV attacks the eyes (retina), colon, and throat. Less commonly, it can infect almost any other internal organ.
CMV Retinitis (eyes)
- Symptoms include vision blurring, blind spots.
- CMV can cause blindness.
CMV Encephalitis (brain)
- CMV in the brain isn't common.
- Symptoms include headache, fever.
CMV Esophagitis (throat)
- Symptoms include difficulty swallowing, chest pains, hiccups.
CMV Colitis (large intestines)
- Symptoms include diarrhea, cramps, rectal spasms, weight loss.
CMV Gastritis (stomach)
- Symptoms include fever, dirrhea, abdominal pain.
CMV Radiculopathy (spinal cord)
- Symptoms include leg pain, leg tingling.
The US Centers For Disease Control considers this an AIDS-defining condition --
- Cytomegalovirus disease (other than liver, spleen, or nodes)
- Cytomegalovirus retinitis (with loss of vision)

Danger Zone

CD4+ counts lower than 100 cells/mm (see notes below)

NOTES:

Protease inhibitors: There is a study indicating taking a protease inhibitor may make you more likely to get CMV Retinitis, even at higher t-cell levels. [details]

CD4 count: If you are undergoing treatment that has increased your CD4+ levels, see the important note on Naive T-Cells. There is some evidence that you should use the lowest CD4+ level you ever had when considering your risk for some opportunistic infections.

Prevention

Cidofovir ( si-DOF-o-veer), ganciclovir, foscarnet, Fomivirsen

Treatment