DETECTION OF CYTOMEGALOVIRUS DNA IN SERUM CORRELATES WITH CLINICAL CYTOMEGALOVIRUS RETINITIS IN AIDS

The high sensitivity of nested polymerase chain reaction (PCR) offers the possibility of rapid detection of cytomegalovirus (CMV) DNA in ser um. Five consecutive serum samples were examined from 52 human immunod eficiency virus (HIV)-seropositive patients (19 of whom had clinically presumed diagnosis of CMV chorioretinitis). Presence of CMV DNA in se rum was shown to precede development of clinical disease. Eleven patie nts who developed chorioretinitis were positive for CMV DNA in serum s amples obtained 3 months before clinical disease, and 3 retinitis pati ents who initially were negative for CMV DNA became positive with the onset of clinical retinitis. In contrast, 29 of 33 HIV-seropositive su bjects without clinical CMV chorioretinitis and matched with respect t o age and CD4 T cell numbers were negative for CMV DNA in all 5 serum samples. Thus, the presence of CMV DNA in serum analyzed by PCR is a g ood predictive marker of CMV retinitis in HIV-seropositive subjects. A positive PCR result supports the clinical diagnosis and may be useful for monitoring response to antiviral treatment.