CYTOMEGALOVIRUS-INFECTION IN CHILDREN WITH HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION

Objectives. To determine retrospectively the prevalence of positive cy tomegalovirus (CMV) cultures in pediatric patients with human immunode ficiency virus infection, Methods, We reviewed the records of 273 chil dren with human immunodeficiency virus infection referred to the Pedia tric Branch of the National Cancer Institute for whom CMV cultures wer e performed between January, 1991, and October, 1994, Results, Of this group 189 patients (69%) had negative CMV cultures and 84 (31%) had p ositive cultures. The prevalence of CMV-related disease was 9% for the entire group, including 4 (2.1%) patients with negative CMV cultures, Among the 84 patients with positive CMV cultures, 21 (25%) had eviden ce of CMV disease. Patients with positive CMV cultures had a statistic ally significant decrease in survival in the presence of severe immuno compromise defined as an age-corrected CD4 count of <21%. Nine of 35 ( 26%) autopsies performed demonstrated evidence of CMV disease, includi ng 7 patients with disseminated CMV disease, Conclusions. Although CMV disease appears to be less frequent in children than adults, CMV infe ction still contributes significantly to morbidity and mortality in th is population, especially when combined with severe immunosuppression.