RISK FOR RETINITIS IN PATIENTS WITH AIDS CAN BE ASSESSED BY QUANTITATION OF THRESHOLD LEVELS OF CYTOMEGALOVIRUS DNA BURDEN IN BLOOD

Cytomegalovirus (CMV) retinitis in patients infected with human immuno deficiency virus (HIV) is a significant clinical problem, Seventy-five patients with CD4 T cell counts <100/mm(3) were monitored prospective ly every 2 months for CMV DNA burden, The target for DNA amplification was a 162-bp fragment from the CMV immediate early gene. CMV DNA burd en, at levels of greater than or equal to 320 in white blood cells or greater than or equal to 32 in plasma (P = .001), particularly when su stained (P = .005 and .008, respectively), distinguished patients who developed retinitis from those who remained free of disease, Progressi on to retinitis was not consistently accompanied by increases in CMV b urden, indicating that quantitation of CMV burden beyond threshold lev els is not necessary to predict risk for development of retinitis, Vir us isolation from WBC, but not urine, was also significantly associate d with risk for retinitis (P = .001).