USE OF A QUANTITATIVE CYTOMEGALOVIRUS (CMV) ANTIGENEMIA TEST IN EVALUATING HIV+ PATIENTS WITH AND WITHOUT CMV DISEASE

Cytomegalovirus (CMV) infection remains a life-threatening infection i n patients with HIV disease. A rapid, quantitative diagnostic techniqu e is needed to aid in the diagnosis of CMV disease. This study was und ertaken to evaluate the CMV antigenemia test in patients with HIV dise ase who are at risk for CMV disease. The study included 22 patients wh o underwent ophthalmologic exams or selected diagnostic techniques in whom CMV cultures and CMV antigenemia tests were performed. All of 11 patients with CMV disease had positive CMV antigenemia assays [range, 48-1,000 positive cells/2 x 10(5) peripheral blood leukocytes (PBL)], and 10 were also CMV viremic. There was no clinical evidence of CMV di sease in 11 patients, including seven in whom the CMV antigenemia assa y was negative and who remained without evidence of CMV disease after a median follow-up of 159 days, Four patients had low antigenemia leve ls. Of these four, two subsequently developed CMV retinitis. In conclu sion, a positive CMV antigenemia result with greater than or equal to 48 positive cells/2 x 10(5) PBL correlated with concurrent CMV disease . The CMV antigenemia test appears to be a valuable tool for the rapid diagnosis of CMV disease in HIV-infected individuals.