Cytomegalovirus seropositivity and human immunodeficiency virus type 1 RNAlevels in individuals with hemophilia

The effect of cytomegalovirus (CMV) seropositivity on the course of human i mmunodeficiency virus (HIV) type 1 RNA levels and HIV disease progression w as assessed in a cohort of 109 hemophilic men infected with HIV-1 for a med ian of 12.7 years. There was no evidence of higher HIV RNA levels in the fi rst year after HIV seroconversion (P = .88) or faster rates of increase ove r infection (P = .20) in the 59 CMV-seropositive individuals than in the CM V-seronegative individuals. In univariate analyses, CMV seropositivity was associated with significantly faster progression to AIDS and death (relativ e hazards of 1.58 and 2.22, respectively). These effects were unchanged aft er adjusting for the RNA level, but they were reduced after adjusting for t he CD4 cell count, age at seroconversion, and calendar year of follow-up, T hus, the effect of CMV seropositivity on clinical progression remains signi ficant in this cohort but does not appear to be mediated through an increas e in HIV RNA levels.