dc.contributor.author |
Mayaphi, Simnikiwe Horatious
|
|
dc.contributor.author |
Brauer, Marieke
|
|
dc.contributor.author |
Morobadi, Daniel M.
|
|
dc.contributor.author |
Mazanderani, Ahmad Haeri
|
|
dc.contributor.author |
Mafuyeka, Rendani T.
|
|
dc.contributor.author |
Olorunju, Steve A.S.
|
|
dc.contributor.author |
Tintinger, Gregory Ronald
|
|
dc.contributor.author |
Stoltz, Anton Carel
|
|
dc.date.accessioned |
2014-09-01T10:34:13Z |
|
dc.date.available |
2014-09-01T10:34:13Z |
|
dc.date.issued |
2014-04-03 |
|
dc.description.abstract |
BACKGROUND : Cytomegalovirus (CMV) infection is associated with severe diseases in immunosuppressed patients; however,
there is a lack of data for pre-emptive therapy in patients with HIV/AIDS.
METHOD : This was a retrospective study, which enrolled patients diagnosed with HIV/AIDS (CD4,200 cells/ml), who had
detectable CMV viral load (VL) during their stay in an adult medical intensive care unit between 2009–2012.
RESULTS : After screening 82 patients’ records, 41 patients met the enrolment criteria. Their median age was 37 (interquartile
range [IQR]: 31–46), and median CD4 count was 29 cells/ml (IQR: 5–55). Sixteen patients (39%) had serial measurements of
CMV VL before treatment with ganciclovir. Patients whose baseline CMV VL values were between 1,000–3,000 copies/ml
had significantly higher values (median of 14,650 copies/ml) on follow-up testing done 4–12 days later. Those with
undetectable VLs at baseline testing had detectable VLs (median of 1,590 copies/ml) mostly within 20 days of follow-up
testing. Patients who had VLs .1,000 copies/ml at baseline testing had significantly higher mortality compared to those
who had ,1,000 copies/ml {hazard ratio of 3.46, p = 0.003 [95% confidence interval (CI): 1.55–7.71]}. Analysis of the highest
CMV VL per patient showed that patients who had VLs of .5,100 copies/ml and did not receive ganciclovir had 100%
mortality compared to 58% mortality in those who received ganciclovir at VLs of .5,100 copies/ml, 50% mortality in those
who were not treated and had low VLs of ,5,100 copies/ml, and 44% mortality in those who had ganciclovir treatment at
VLs of ,5,100 copies/ml (p = 0.084, 0.046, 0.037, respectively).
CONCLUSION : This study showed a significantly increased mortality in patients with HIV/AIDS who had high CMV VLs, and
suggests that a threshold value of 1,000 copies/ml may be appropriate for pre-emptive treatment in this group. |
en_US |
dc.description.librarian |
am2014 |
en_US |
dc.description.uri |
http://www.plosone.org |
en_US |
dc.identifier.citation |
Mayaphi SH, Brauer M, Morobadi DM, Mazanderani AH, Mafuyeka RT, et al. (2014) Cytomegalovirus Viral Load Kinetics in Patients with HIV/AIDS Admitted to a Medical Intensive Care Unit: A Case for Pre-Emptive Therapy. PLoS ONE 9(4): e93702. DOI:10.1371/journal.pone.0093702. |
en_US |
dc.identifier.issn |
1932-6203 |
|
dc.identifier.other |
10.1371/journal.pone.0093702 |
|
dc.identifier.uri |
http://hdl.handle.net/2263/41864 |
|
dc.language.iso |
en |
en_US |
dc.publisher |
Public Library of Science |
en_US |
dc.rights |
© 2014 Mayaphi et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
en_US |
dc.subject |
Therapy |
en_US |
dc.subject |
HIV/AIDS |
en_US |
dc.subject |
Human immunodeficiency virus (HIV) |
en_US |
dc.subject |
Acquired immune deficiency syndrome (AIDS) |
en_US |
dc.subject |
Cytomegalovirus (CMV) |
en_US |
dc.subject |
CMV viral load (VL) |
en_US |
dc.subject |
Immunosuppressed patients |
en_US |
dc.title |
Cytomegalovirus viral load kinetics in patients with HIV/AIDS admitted to a medical intensive care unit : a case for pre-emptive therapy |
en_US |
dc.type |
Article |
en_US |