Qualitative and quantitative PCR measures of cytomegalovirus in patients with advanced HIV infection who require transfusions

The Viral Activation Transfusion Study (VATS) was a randomized trial that c ompared leukocyte-reduced transfusions with unfiltered red blood cell trans fusions in HIV and cytomegalovirus (CMV) antibody-positive patients with an emia who were undergoing their first blood transfusion. The relations of th e baseline qualitative and quantitative polymerase chain reaction (PCR) mea sures of plasma CMV viremia, HIV RNA, CD4(+) cell counts, and quality of li fe in these study subjects were examined. The 511 study subjects had a medi an CD4(+) cell count equal to 15 cells/mm(3), and 110 (21.5%) had CMV virem ia by qualitative assay. In multivariate models, frequency of positive qual itative CMV increased with decreasing CD4(+) cell counts (p = .04 trend), h igher HIV RNA (p < .001), and a history of CMV disease (p < .001). Quantita tive CMV PCR were performed on the 110 qualitative assay-positive study sub jects. Median CMV viral load was 1780 copies/ml. In multivariate regression models, lower CD4(+) cell count (p = .03), and a history of CMV disease (p < .001) correlated with the level of CMV load. HIV RNA load and CMV load w ere not correlated. A lower Karnofsky score was associated with both the pr esence and quantity of CMV DNA.