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CMV and liver involvement
Oct 30, 2001

My Mom was in between protease inhibitor regimens, when her cd4 count dropped to about 100. She was sent to the hospital with dehydration, and what she thought was sinus infection. It turns out she has acute CMV. Her Prothrombin time is elevated, she has developed severe ascites, and this apparently the effect the CMV has had on her liver. My question is, how advanced is this case of CMV, is there hope to arrest it's course. Do these patient's usually recover? Also, they have told us that she does not currently have PCP, could that change in this acute period? They have her on ganciclovir, and Coletra (sp?) and clindamycin and Tequin. Thanks for your input.

Response from Dr. Feinberg

Hepatitis is a rare manifestation of CMV disease in people with AIDS, but it does occur. There is no way to describe one case of CMV as more or less "advanced" than another. She is on ganciclovir, which is a first-line medicine for CMV, and she should improve with this treatment. She may need to take ganciclovir or valganciclovir pills for the rest of her life if her CD4 cells don't improve with HIV medicines. Lopinavir/ritonavir (Kaletra) is a very potent protease inhibitor, but she must be on some additional HIV medications as well, as this medicine should not be used by itself. Clindamycin and gatifloxacin (Tequin) are antibiotics that may be used in her case to treat a suspected bacterial infection. n extrmely

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