瑞典艾滋病毒感染者中的巨细胞病毒感染:卡罗林斯卡大学医院 2010-2020 年病例概况、治疗策略和患者疗效。

IF 2.8 3区 医学 Q2 INFECTIOUS DISEASES
HIV Medicine Pub Date : 2024-02-13 DOI:10.1111/hiv.13618
Xinling Xu, Emmi Andersson, Afsar Rahbar, Cecilia Söderberg-Nauclér, Piotr Nowak
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引用次数: 0

摘要

目标:在能够尽早接受抗逆转录病毒治疗(ART)的国家,艾滋病病毒感染者(PLWH)中由巨细胞病毒(CMV)引起的机会性感染正变得越来越罕见。由于潜在的并发症非常严重,因此保持对这一重要诊断的警惕至关重要。方法:在此,我们汇编了 2010-2020 年间在卡罗林斯卡大学医院传染病诊所接受治疗的艾滋病病毒感染者中 CMV 感染的临床表现、管理和预后:根据 CMV-DNA 的检测结果,我们发现了 51 例活动性 CMV 感染病例,主要在 CD4 T 细胞计数为零的患者中确诊:视网膜炎仍是 PLWH 中无症状 CMV 感染的最常见表现。识别 CMV 感染非常重要,尤其是在治疗 "晚期患者 "时。必须确保抗病毒治疗的持续时间和适当的随访,以避免并发症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Cytomegalovirus infection among people living with HIV in Sweden: Case profiles, treatment strategies and patient outcomes at Karolinska University Hospital 2010–2020

Cytomegalovirus infection among people living with HIV in Sweden: Case profiles, treatment strategies and patient outcomes at Karolinska University Hospital 2010–2020

Objectives

In countries with access to early antiretroviral treatment (ART), opportunistic infections caused by cytomegalovirus (CMV) in people living with HIV (PLWH) are becoming increasingly rare. As potential complications are severe, it is critical to remain aware of this important diagnosis. However, clinical characteristics and prognosis of CMV infection in PLWH in the era of modern ART have not been well described.

Methods

Here, we compiled the clinical presentation, management and outcome of CMV infection in PLWH treated at the infectious diseases clinic of Karolinska University Hospital during 2010–2020.

Results

We identified 51 cases of active CMV infection, based on detection of CMV-DNA, mainly diagnosed in patients with CD4 T-cell count <200 cells/μL (86%). Median time from HIV diagnosis to detection of CMV infection was 16 days. In 20 cases (39%), CMV infection was symptomatic with retinitis identified as a manifestation in 70% of cases. Symptomatic CMV infection was treated for 73 (20–313) days upon diagnosis, mostly using valganciclovir. One-year mortality was 22% and was associated with longer time to ART initiation from HIV diagnosis and with comorbidities, but not with CMV-DNA levels or CD4 count. Immune reconstitution was not significantly compromised in patients with symptomatic CMV, although CD4/8 ratio tended to be lower in patients with systemic CMV infection.

Conclusions

Retinitis remains the most common manifestation of symptomatic CMV infection in PLWH. Recognizing CMV infection is important, especially in the management of ‘late presenters’. Adequate duration of antiviral therapy and appropriate follow-up must be ensured to avoid complications.

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来源期刊
HIV Medicine
HIV Medicine 医学-传染病学
CiteScore
5.10
自引率
10.00%
发文量
167
审稿时长
6-12 weeks
期刊介绍: HIV Medicine aims to provide an alternative outlet for publication of international research papers in the field of HIV Medicine, embracing clinical, pharmocological, epidemiological, ethical, preclinical and in vitro studies. In addition, the journal will commission reviews and other feature articles. It will focus on evidence-based medicine as the mainstay of successful management of HIV and AIDS. The journal is specifically aimed at researchers and clinicians with responsibility for treating HIV seropositive patients.
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