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CMV AB titre
Jan 21, 2000
Patient has CD4 of 47. CMV IGG is 1428, while IGM is 0.132.
Opthalmalogist consult - no CMV retinitis seen. I realize that the patient has been exposed to CMV and that with an IGM of O.132 does not have an acute infection right now. Does the CMV IGG titre (over 10) confer immunity? Does this patient need every 3 months to be reevaluated by the opthalmalogist. Does he need periodic testing for CMV AB.
He is on HAART, but is noncompliant. Suprisingly, he is asymptomatic. Thank You
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Response from Dr. Feinberg
The actual value of the CMV IgG antibody titer is of no value in following AIDS patients, just the fact that it is positive. There is some debate about how often patients who are IgG+ with CD4 <50 should be screened for asymtpomatic retinitis; some experts believe that every 4-6 months are the appropriate intervals. I also suggest educating your patient about typical symptoms such as floaters, loss of visual acuity and blind spots, so that an immediate referral to an eye doctor can be made.
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