AEGiS-11IAC: Systemic CMV infection and malignant tumors in HIV-infected patients.

11th International AIDS Conference

Vancouver, British Columbia — July 7-12, 1996

Systemic CMV infection and malignant tumors in HIV-infected patients.

Int Conf AIDS 1996 Jul 7-12; 11:446 (abstract no. Pub.B.1052)
Kravtchenko AV, Shakhgildian V, Parkhomenko Y, Shipulina O, Gruzdev B, Yurin O; Russia AIDS Federal Centre, Moscow, Russia. Fax: 7-095-365-46-80.

OBJECTIVE: To describe two cases of systemic CMV infection and malignant tumors in HIV-infected patients (pts.).

METHODS: The presence of active CMV infection was proved by detection of high concentration of DNA CMV (PCR) in the blood and pathomorphologically.Case 1: A 24-year-old man was hospitalized with HIV-1 infection and pulmonary tuberculosis (MBT+) in Jan. 1993 (CD4 - 80 cells/mm3). He was successfully treated with AZT and anti-tuberculosis drugs for 12 months. Disseminated Kaposi's sarcoma (KS) of skin and active CMV infection were diagnosed in Jan. 1994 (CD4- 10 cells/mm3). He complained of fever, shortness of breath, cough, cachexia and esophagitis. In March 1994 he died. The pathomorphological examination showed: 1) systemic CMV infection with involvement of brain, heart, lungs, esophagus, intestine, kidneys and adrenals; 2) disseminated KS with involvement of skin, tongue and small intestine; 3) bronchoalveolar cell cancer of right main bronchus with lobular spread and lung cavity.Case 2: A 40-year-old man, HIV-1 positive since 1990, was hospitalized with candidiasis esophogitis (CD4 -30 cells/mm3) in June 1992. He was treated with AZT, diflucan and i.v.immunoglobulin with improvement. A chest X-ray showed the tumour of both lungs in Jan. 1994 (CD4 -10 cells/mm3). He had fever, encephalomyelitis, cachexia and intestinal bleeding. Active CMV infection was diagnosed. In March 1994 he died. The pathomorphological examination showed: 1) systemic CMV infection with involvement of brain, heart, lungs, liver, intestine, kidneys and adrenals; 2) central cancer of both lungs (microcells cancer) with metastases in lymph nodes, liver, heart, small intestine and adrenals. The lung's cancer and its metastases were infiltrated of cytomegalocells in both cases.

CONCLUSIONS: Recently, the findings of herpes-like DNA sequences in all types of KS have been reported in several studies. The presence of cytomegalocells in the lung's cancer is an argument for a pathogenic role of CMV in carcinogenesis in HIV-infected pts.

Keywords: AEGIS, Cytomegalovirus, Cytomegalovirus Infections, Antineoplastic Combined Chemotherapy Protocols, HIV Infections, Neoplasms, Sarcoma, Kaposi, Sepsis, Polymerase Chain Reaction, Herpesviridae Infections, Viremia, Lung Neoplasms, MEC protocol 1, Human, Male, ICA11

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PubB1052