Natl Conf Hum Retroviruses Relat Infect (1st). 1993 Dec 12-16;:146.
Autoimmune thrombocytopenia, neutropenia and anemia occur in a large
number of patients infected with human immunodeficiency virus (HIV).
Serologic evidence for CMV and histological changes at autopsy
consistent with CMV occur in nearly all patients with HIV infection.
Fourteen patients with pancytopenia and AIDS presented with CMV
esophagitis, gastritis, colitis, myeloradiculitis and retinitis. These
infections were documented as localized either by biopsy and DNA
hybridization studies, presence of CMV by PCR or ophthalmologic
examination. In one instance, blood cultures grew CMV. All had IgG CMV
antibody titers greater than 1:1000 and none had IgM antibody indicating
probable reactivation of infection. Thrombocytopenia (less than 100,000
platelets per cmm) with IgG or IgM direct platelet bound antibodies were
present in all but one patient. Hypergammaglobulinemia was absent and
all patients had less than 200 CD4+ cells/cmm and more than 400 CD8+
/cmm T-helper and T-suppressor cells. Treatment with either ganciclovir
or foscarnet resulted in clinical improvement and a near resolution of
the thrombocytopenia. We believe that this group of patients represents
a favorable subset of HIV+ persons with recurrent CMV infection.
Acquired Immunodeficiency Syndrome/*COMPLICATIONS Adult
Chromatography, High Pressure Liquid Cytomegalovirus Infections/*DRUG
THERAPY/ETIOLOGY CD4 Lymphocyte Count
Foscarnet/PHARMACOKINETICS/*THERAPEUTIC USE Gastrointestinal
Diseases/*DRUG THERAPY/ETIOLOGY Human ABSTRACT