CENTRAL VENOUS CATHETER INFECTIONS IN AIDS PATIENTS RECEIVING DAILY HOME THERAPY FOR CYTOMEGALOVIRUS DISEASE

We studied the infection rate of long-term intravenous access used for daily home treatment of cytomegalovirus (CMV) disease in 61 AIDS pati ents who had 75 central venous catheters implanted for antiviral maint enance therapy between February 1989 and December 1994. In 39 patients (64%) the risk factor for AIDS was intravenous drug abuse. Sixty-thre e catheters were Hickman type and 12 were totally implanted ports. The cumulative follow-up time was 19 000 catheter-days (52 patient-years) , with median duration of placement of 249 days. The infection rate wa s 0.22 infections per 100 catheter days. The probability of remaining free of catheter-related sepsis was 58% at 6 months. In 25 cases (61%) antimicrobial therapy without catheter removal was successful. Three patients died because of a catheter-related infection (mortality rate 7.3%). Infection-free survival time was not related to the risk factor for AIDS (p=0.44) or type of device (p=0.41). The total infection rat e in these patients receiving daily home maintenance therapy for CMV d isease through a long-term catheter was similar to that in other AIDS patients receiving weekly treatment in hospital facilities.