The role of cytomegalovirus infection in the development of the nervous system lesions and retinitis in people living with HIV

Abstract

Purpose: identification of patients with manifest forms of CMVI among PLHIV with neurological manifestations and eye lesions.Materials and methods: 85 patients with CD4 less than 330 cells were examined who quantified CMV DNA in blood leukocytes. Patients depending on CD4 were divided into 2 groups: group 1 — patients with values of CD4<00 cells (n=42) and group 2 — patients with values of CD4 from 101 to 330 cells (n=43). According to indications, the patient underwent lumbar puncture followed by determination of CMV DNA in the cerebrospinal fluid.Results and discussion: There were 20 patients in the III clinical stage (23,5%) and 65 (76,5%) in the IV clinical stage. VL CMV among patients with CD4 less than 100 cells was positive in 52,4%, and with CD4 more than 101 cells in 18,6%. VL CMV of less than 1000 copies was detected in 23,8% in patients with CD4 less than 100 cells and in 16,3% in patients with CD4 101–330 cells. The diagnosis of CMV retinitis was made in 6 out of 21 patients (28,6%) with CMV DNA in the blood. CMV DNA in CSF was determined in 3 patients. Half of 42 patients (52,4%) with severe and final stages of cognitive and motor impairment showed a generalized form of CMVI. Physical, clinical and biochemical parameters are not highly informative for determining the generalization of CMVI.