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Response to anti-CMV treatment in persons with AIDS and correlation to CMV DNA Levels.
Moe AA; Miller MJ; Tufail; Bruckner DA; Wagar EA; Hardy WD; UCLA Medical
November 30, 1996
3rd Conf Retro and Opportun Infect. 1996 Jan 28-Feb 1;:156. Unique

OBJECTIVE: To investigate if a measure of systemic CMV viral burden correlates to clinical signs of CMV in AIDS. METHODS: Blood was collected every 1-2 weeks in 8 persons with CMV retinitis (R) who began treatment with cidofovir (C), dose range 3-5mg/kg, and in one person with CMV colitis who was treated with ganciclovir(G) and then foscarnet(F) for a mean of 4.2 samples/subject. Nine control subjects with CD4 less than 50, and CMV antibody were enrolled and blood was drawn every 3-4 weeks (mean 2.4 samples). Eye exams were done by masked ophthalmologists. For Diagene Hybrid Capture (D) white cells were lysed and DNA hybridized with a CMV RNA probe linked to chemiluminesce; results are correlated with a standard. Values are read as pg/ml of CMV DNA. Lower limit of detection is 3-5 antigen positive cells/10 (5) cells with a specificity equal to shell vial assay. RESULTS: Three subjects had progression or persistent activity despite treatment with C; D at end were 789.4 (from 0.7 prior to treatment); 289.4 (from 4.3) and 1530(from 439.8). One of these patients died with lymphoma, new CNS CMV, and CMV colitis; a second developed CMV colitis. Two subjects begun on C with active R became quiet; D at end were 0 (from 6.8) and 3.2 (from 2.6). Two subjects begun on C were inactive and remained inactive; their D remained 0. One subject on C had two readings of increased activity and one reading of decreased activity. D rose from 0.2 to 2457.0. The subject with CMV colitis had a D of 110 prior to therapy with G; after induction diarrhea decreased and D was 1.6. Subject stopped G and diarrhea recurred 48 hours later; D was 70.8. He was switched to F; diarrhea decreased and D became 0. Median D for the controls was 1.5(range 0-81). One control developed R; his mean D was 9.7. CONCLUSION: Diagene Hybrid Capture System has potential for evaluating response to therapy in AIDS and CMV disease.

Acquired Immunodeficiency Syndrome/*COMPLICATIONS Antibodies, Viral/ANALYSIS Antiviral Agents/*THERAPEUTIC USE CD4 Lymphocyte Count Chemiluminescence Cytomegalovirus/GENETICS/*ISOLATION & PURIF Cytomegalovirus Infections/COMPLICATIONS/*DRUG THERAPY DNA, Viral/BLOOD Foscarnet/THERAPEUTIC USE Ganciclovir/THERAPEUTIC USE Human ABSTRACT