AEGiS-11IAC: Cytomegalovirus (CMV) glycoprotein B (GB) groups associated with retinitis in AIDS.

11th International AIDS Conference

Vancouver, British Columbia — July 7-12, 1996

Cytomegalovirus (CMV) glycoprotein B (GB) groups associated with retinitis in AIDS.

Int Conf AIDS 1996 Jul 7-12; 11:218 (abstract no. Th.A.391)
Shepp DH, Match ME, Ashraf AB, Lipson SM, Millan C, Pergolizzi R; Div. of Infectious Disease, North Shore Univerity Hospital, Manhasset, NY. Fax: (516) 562-2626.

OBJECTIVE: To assess the effect of variation in the gB gene of CMV on disease expression in patients with AIDS.

METHODS: CMV isolates from the blood of 44 patients with AIDS were studied. Polymerase chain reaction (PCR) was used to amplify a 550-556 nucleotide segment of the gB gene. Strains were assigned to 1 of 4 gB groups by the DNA sequence and/or restriction endonuclease digest pattern of the PCR product. Clinical records of each patient were reviewed to determine if CMV disease had occurred.

RESULTS: Forty-two patients (95%) had been followed clinically until the development of CMV retinitis or death. Fourteen of 18 (78%, 95% CI 59 - 97%) patients with gB group 2 isolates and 6 of 26 (23%, 95% CI 7 - 39%) with isolates belonging to other gB groups developed CMV retinitis (P = 0.002). The median CD4 lymphocyte count at the start of follow-up, the median duration of follow-up and the proportion of homosexuals were nearly identical in patients with gB group 2 and non-group 2 isolates (37 vs. 37/mm3; 21 vs. 20 months; 28 vs. 27%, respectively) and could not account for the observed differences. Six patients with CMV retinitis also had biopsy proven CMV disease at another site at some time during their illness. Five had enteritis and 1 had pneumonia. Five of the 6 had gB group 2 isolates and one had a gB group 1 isolate. There were no cases of CMV disease diagnosed in patients who never developed retinitis.

CONCLUSIONS: Viremia with gB group 2 CMV strains is more frequently associated with CMV retinitis and disease than viremia due to other CMV gB groups. The association of CMV gB gene with disease suggests this gene, or one linked to it, is a virulence factor for CMV. This finding may have implications for optimal use of chemoprophylaxis and the conduct of clinical trials of CMV prevention.

Keywords: AEGIS, Cytomegalovirus, Retinitis, Acquired Immunodeficiency Syndrome, Cytomegalovirus Retinitis, Cytomegalovirus Infections, Antineoplastic Combined Chemotherapy Protocols, Viremia, CD4 Lymphocyte Count, Polymerase Chain Reaction, MEC protocol 1, Human, ICA11

960707
ThA391