Human Cytomegalovirus Infection Among Patients Living With AIDS in a Tertiary Level Hospital in India

Abstract

Objective: Detecting the prevalence of human cytomegalovirus (CMV) coinfection in HIV-infected individuals attending a tertiary care hospital in Delhi by using 3 laboratory tests namely pp65 antigenemia assay, CMV DNA polymerase chain reaction (PCR), and immunoglobulin M (IgM) enzyme-linked immunosorbent assay (ELISA) for anti-CMV antibody. Design: HIV seropositive patients with CD4 count 100 cells/mm 3 were included as cases and HIV-negative healthy individuals as controls. Blood samples were collected from all participants and 3 tests were performed. Methods: pp65 antigenemia assay and IgM ELISA were performed by commercially available kits; PCR was performed by an in-house nested PCR method. Results: In all, 7.1%, 5.7%, and 2.9% were positive for pp65 antigenemia, CMV DNA, and IgM antibody against CMV, respectively. On the basis of pp65 and/or PCR positivity, it can be said that active CMV coinfection was present in 8.57% of the cases. Conclusion: In the postantiretroviral therapy (ART) era, CMV coinfection in HIV-infected patients has significantly declined.

Ongoing burden of disease and mortality from HIV/CMV coinfection in Africa in the antiretroviral therapy era

“… Worldwide CMV seroprevalence rates in adults . We have represented studies of adults aged 16–50 years published between 2005 and 2015 from Australia, Belgium, Brazil, Canada, Cambodia, Chile, China, Finland, France, Gambia, Germany, Ghana, India, Israel, Italy, Japan, Kenya, Mexico, Nigeria, Panama, South Africa, Spain, Sweden, Taiwan, Tanzania, Turkey, UK, USA, Zambia, and Zimbabwe (Chakraborty et al, 2003 ; Schlesinger et al, 2005 ; Miles et al, 2007 , 2008 ; van der Sande et al, 2007 ; Zhang et al, 2007 ; Dar et al, 2008 ; Alao et al, 2009 ; Compston et al, 2009 ; Micol et al, 2009 ; Pass et al, 2009 ; Cannon et al, 2010 ; Chakravarti et al, 2010 ; Fielding et al, 2011 ; Brantsæter et al, 2012 ; Hsiao et al, 2013 ; Manicklal et al, 2013 , 2014 ; Gumbo et al, 2014 ; Lanzieri et al, 2014 ; Mwaanza et al, 2014 ; Schaftenaar et al, 2014 ; Lichtner et al, 2015 ; Tembo et al, 2015 ; Viljoen et al, 2015 ). …”

“…In Western settings, active CMV disease in HIV-infected patients has significantly declined in the ART era (Chakravarti et al, 2010 ), perhaps providing false reassurance that CMV is not a relevant co-pathogen. However, in resource poor settings, including many parts of sub-Saharan Africa, there are few data to inform our understanding of clinical interplay between CMV and HIV.…”