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cmv/hiv
Jul 27, 2005

I have both cmv and hiv. Both are well controlled at this time. I saw somewhere that you had conducted a study regarding coinfection with cmv and hiv and increased risk of mortality. I am being followed by an excellant hiv doc at Duke. Do you have any specific recommendations for people with both?

Response from Dr. Wohl

The issue is when people have CMV actually in their blood rather than antibodies to the virus. Most people with HIV have antibodies to CMV, meaning they have been exposed to it, as do a sizable proportion of teh HIV negative population. However, most HIV+ folk do not have the virus in appreciable levels in their blood. CMV is in the same family of viruses as herpes virus and chicken pox. These viruses stay hidden in your body and only come out, usually, when the immune system is stressed.

Therefore, when the CD4 cells drop during AIDS, CMV can start to replicate and be found in the blood. CMV can then also lodge in organs like the retina of the eye and cause damage.

So, if you have CMV antibodies only, I would not worry as that has not been associated with any increased risk of mortality and this is very common. If you have evidence of a CMV viral load in the blood that is detectable, this has been linked by our group and others to doing less well. In such cases boosting the immune system with HAART is a priority. Those with CMV disease like retinitis particularly are in need for aggressive HIV therapy.

DW



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