[Twenty-three cases of cytomegalovirus infection in acquired immunodeficiency syndrome].

OBJECTIVE: To investigate the clinical features, therapeutic approaches, outcomes and alterations of peripheral lymphocytes subsets in cytomegalovirus (CMV) infections in patients with AIDS. METHODS: Ninety-six cases of AIDS were treated in Peking Union Medical College Hospital and 23 of them had CMV infection. We analyzed the clinical features, peripheral lymphocytes subsets, outcomes, CMV pp65 antigen and/or specific anti-CMV IgM. RESULTS: In the 23 CMV patients, nonspecific symptoms including fever, cough, chest distress and diarrhea occurred in 18, 11, 9 and 8 patients, respectively. Thirteen patients had retinitis identified by ophthalmofundoscopy, 7 of them had blurred vision or floating as primary symptoms. Pneumocystis pneumonia, tuberculosis infection and other infection appeared in 18 patients. Fifteen (65.2%) of the patients had positive serum tests. The positive rates for CMV pp65 and specific anti-CMV-IgM were 43.5% and 30.4%, respectively. CD(4)(+)T cell count in CMV patients was remarkably decreased than that in non-CMV patients [14(4, 39) cells/microl vs (48(12, 128) cells/microl, P = 0.005] and the proportion of CD(8)(+)CD(38)(+)T cells in CMV patients was higher than that in non-CMV patients, whereas the difference of CD(8)(+)T cell was not statistically different between the 2 groups. CONCLUSIONS: CMV infection often occurs in advanced AIDS patients. In HIV/AIDS patients with CD(4)(+)T cell count

[The correlation of HIV-1 viral load to expression of CD8+ T lymphocyte activators CD38 and HLA-DR].

OBJECTIVE: To investigate the correlation of CD38 and HLA-DR abnormal activating expression on CD8+ T with plasma viral load (VL) and evaluate the possibility of the economical CD38 and HLA-DR test to substitute VL assay in HIV/AIDS patients. METHODS: A multi-point correlation study of the percentage of CD38 and HLA-DR on CD8+ T by flow cytometry with plasma VL by bDNA was performed in 103 HIV/AIDS patients during a 12-month highly active anti-retroviral therapy (HAART). The cutoff values of CD38 and HLA-DR were evaluated with ROC area, sensitivity and specificity for predictive VL < 50 copies/ml, < 500 copies/ml, > 1000 copies/ml and > 10,000 copies/ml respectively. RESULTS: The level of CD38 and HLA-DR on CD8+ T in 103 patients decreased gradually with the reduction of VL during a 12-month HAART. The correlation of CD38 and HLA-DR with VL in the year of HAART was 0.424, 0.376, 0.335, 0.326, 0.297, 0.285 and 0.377, 0.318, 0.333, 0.312, 0.361, 0.358 with significant P value. Moreover, the overall correlation of CD38 and HLA-DR with VL were 0.483 (P < 0.001) and 0.477 (P < 0.001). Depending on optimal ROC, sensitivity and specificity for the substitute method, the cutoffs percentage of CD38 were < 68.5% and < 72.5% for predictive VL < 50 copies/ml and < 500 copies/ml as well as > 39.5% and > 46.5% of HLA-DR cutoff to predict VL > 1000 copies/ml and > 10,000 copies/ml. CONCLUSION: The detection of CD38 and HLA-DR percentage expression on CD8+ T can be available for prediction about HIV VL assay as a substitute method to survey the disease progression and HAART outcome in some resource-limited areas of China.