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CMV - IgG / IgM Results

May 22, 2004

I was diagnosed with HIV/Full blown AIDS about a year ago at a routine checkup. My cd4 was about 90 and VL 700,000. At that time I also had many OI's such as oral thrush and esophageal thrush, as well as wasting syndrome, moloscum, Anemia, low cortisol <3.0 at times and several infections never defined of colon, stomach, and mouth. As well I usually have bronchitis and sinusitus.

Today i'm on a HAART regimen with reoccurant thrush and infectionsl and a reluctant cd4 still in the 100's and VL less than 2000 at the moment. I am I'm on and off meds for allergic reactions a lot and on Regiman #9 now. When i am off meds for any period of time my VL rises on average about 100,000/ml a week, which has made my viral count a roller coaster month to month from the 400,000+ area to as low as 500 and back up and down and now down to 2000 and i'm still on HAART.

My question is for the past year I have had symptoms of what could be a range of different types of CMV Infections. Symptoms include - fevers, rashes, headaches, continuous Low WBC's, Low RBC, muscle aches, and fatigue, distorted thinking at times, and confusion, blood in the stools, nausea, and diarrhea, and dizziness to name some. I have results from tests done, but I am not quite sure what they mean or what tests i should do next to see if I infact do have an active infection. My results this week were:

CMV IgG = Result "high" is Greater than 400 ref 0.0 - 4.0 and CMV IgM = Result "negative" is 0.24 ref. 0.0 - 0.69.

I also found a random test from a year ago that tested my CMV IgG had a result of 84units which is now over 400. If you could please reply with some information on these results, what they mean, and how to go about getting the situation diagnosed, and any other tests that would be helpful, I would appreciate it. Thanks Kev.

Response from Dr. Holodniy

All these test tell you is that you have antibodies against cytomegalovirus (CMV). This means you have been exposed, and presumably chronically infected, like the majority of all people. Most of us get infected as children, and then never develop disease again (infection becomes latent), unless we get severely immunosuppressed because of AIDS, cancer, or transplanted organs. In order to detect actively infection, a blood or urine culture is usually done. or a culutre is done from a particular site that appears consistent with CMV infection like the lungs, GI tract, liver, or brain. Alternatively a CMV PCR can be done and the amount of CMV in blood measured, which tends to correlate with active disease (higher the level, more likely there is active disease). Given your current CD4 count, some of the symptoms you describe could be the result of reactivated CMV infection.

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