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Pancytopenia and localized cytomegalovirus (CMV) disease in patients with AIDS.


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


Information in this article was accurate in December 30, 1995. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.