Revista del Instituto de Medicina Tropical
versão impressa ISSN 1996-3696
ALARCON, Raquel et al. Cytomegalovirus infection in AIDS patients. Rev. Inst. Med. Trop. [online]. 2009, vol.4, n.2, pp. 07-13. ISSN 1996-3696.
Background: Cytomegalovirus (CMV) is the most common agent of viral infections in AIDS patients. Retinitis, gastrointestinal disease, the involvement of the CNS and lung are sites of reactivation and is associated with low levels of CD4. Diagnosis (Dx.) and treatment (tto) appropriate may change the prognosis of the condition that compromises the overall life of patients. Objective: To describe clinical characteristics, treatment and outcome of patients with CMV and AIDS admitted to the Institute of Tropical Medicine. Design: retroprospective, descriptive, observational, cross-sectional. Methods: A total of 16 patient records (Ptes) with Dx. AIDS and CMV, were identified between January 2007 and August 2009. We analyzed age, sex, CD4 count, affected organs, clinical manifestations, methods Dxs, treatment and outcome. Results: 16 patients were studied, 13 (81.25%) male. Mean age 34 years. The CD4 count was conducted in 15 (93.75%), of which 12 (80%) with <50 cells and 3 (20%) between 50 and 100. The Dx. CMV pp65 Ag was confirmed in 12 (75%) patients, 3 (18.75%) for biopsy: 1 transbronchial (pp65 Ag negative), 1 colonic and 1 esophageal, 1 PCR in CSF (with pp65 Ag positive), 1 by autopsy (with generalized infection). 8 (50%) patients with pneumonitis, (all with dyspnea, productive cough and fever), 6 (37.5%) gastrointestinal: 5 intestinal (diarrhea and fever), and 1 esophageal (with prolonged fever and dysphagia). 3 (18.75%) ocular form: 2 retinitis (with concomitant pulmonary and gastrointestinal panuveitis with pneumonitis and 1), 1 cerebellitis encephalitis, 1 pancytopenia with severe neutropenia. Ganciclovir treatment was performed in 13 (81.25%) patients, 12 (92.30%) with good outcome, 4 deaths (25%), all with pneumonitis and 3 patients received no treatment specified by the rapid fatal outcome. Conclusion. The condition was the most common respiratory half of the cases, followed by digestive, being the eye less than 20%. The presence of CMV antigenemia was demonstrated by in most cases. The outcome was favorable in most of the treated.
Palavras-chave : CD4; clinical manifestations; pneumonitis.