Cytomegalovirus viremia as a risk factor for mortality in HIV-associated cryptococcal and tuberculous meningitis.


Journal

International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
ISSN: 1878-3511
Titre abrégé: Int J Infect Dis
Pays: Canada
ID NLM: 9610933

Informations de publication

Date de publication:
Sep 2022
Historique:
received: 07 03 2022
revised: 22 06 2022
accepted: 11 07 2022
pubmed: 18 7 2022
medline: 9 9 2022
entrez: 17 7 2022
Statut: ppublish

Résumé

CMV viremia is associated with increased mortality in persons with HIV. We previously demonstrated that CMV viremia was a risk factor for 10-week mortality in antiretroviral therapy (ART)-naïve persons with cryptococcal meningitis. We investigated whether similar observations existed over a broader cohort of patients with HIV-associated meningitis at 18 weeks. We prospectively enrolled Ugandans with cryptococcal or TB meningitis into clinical trials in 2015-2019. We quantified CMV DNA concentrations from stored baseline plasma or serum samples from 340 participants. We compared 18-week survival between those with and without CMV viremia. We included 308 persons with cryptococcal meningitis and 32 with TB meningitis, of whom 121 (36%) had detectable CMV DNA. Baseline CD4 CMV viremia at baseline was associated with a higher risk of death at 18 weeks among persons with HIV-associated cryptococcal or TB meningitis, and the risk increased as the CMV viral load increased. Further investigation is warranted to determine whether CMV is a modifiable risk contributing to deaths in HIV-associated meningitis or is a biomarker of immune dysfunction.

Identifiants

pubmed: 35843498
pii: S1201-9712(22)00430-1
doi: 10.1016/j.ijid.2022.07.035
pmc: PMC9653033
mid: NIHMS1834308
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

785-792

Subventions

Organisme : NIAID NIH HHS
ID : U01 AI089244
Pays : United States
Organisme : NINDS NIH HHS
ID : R01 NS086312
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR002494
Pays : United States
Organisme : FIC NIH HHS
ID : K01 TW010268
Pays : United States
Organisme : NCATS NIH HHS
ID : KL2 TR002492
Pays : United States
Organisme : NICHD NIH HHS
ID : R01 HD079918
Pays : United States
Organisme : NIAID NIH HHS
ID : T32 AI055433
Pays : United States
Organisme : FIC NIH HHS
ID : D43 TW009345
Pays : United States

Informations de copyright

Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.

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Auteurs

Caleb P Skipper (CP)

University of Minnesota Medical School, Minneapolis, USA; Infectious Diseases Institute, Makerere University, Kampala, Uganda. Electronic address: skipp015@umn.edu.

Katherine Huppler Hullsiek (KH)

University of Minnesota Division of Biostatistics, Minneapolis, USA.

Fiona V Cresswell (FV)

Infectious Diseases Institute, Makerere University, Kampala, Uganda; Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK; Global Health and Infection, Brighton and Sussex Medical School, Brighton, UK.

Kiiza K Tadeo (KK)

Infectious Diseases Institute, Makerere University, Kampala, Uganda.

Michael Okirwoth (M)

Infectious Diseases Institute, Makerere University, Kampala, Uganda.

Mark Blackstad (M)

University of Minnesota Medical School, Minneapolis, USA.

Nelmary Hernandez-Alvarado (N)

University of Minnesota Medical School, Minneapolis, USA.

Claudia Fernández-Alarcón (C)

University of Minnesota Medical School, Minneapolis, USA.

Stewart Walukaga (S)

University of Minnesota Medical School, Minneapolis, USA.

Emily Martyn (E)

Infectious Diseases Institute, Makerere University, Kampala, Uganda; Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.

Jayne Ellis (J)

Infectious Diseases Institute, Makerere University, Kampala, Uganda; Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.

Kenneth Ssebambulidde (K)

Infectious Diseases Institute, Makerere University, Kampala, Uganda.

Lillian Tugume (L)

Infectious Diseases Institute, Makerere University, Kampala, Uganda.

Edwin Nuwagira (E)

Infectious Diseases Institute, Makerere University, Kampala, Uganda; Department of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.

Joshua Rhein (J)

University of Minnesota Medical School, Minneapolis, USA.

David B Meya (DB)

University of Minnesota Medical School, Minneapolis, USA; Infectious Diseases Institute, Makerere University, Kampala, Uganda.

David R Boulware (DR)

University of Minnesota Medical School, Minneapolis, USA.

Mark R Schleiss (MR)

University of Minnesota Medical School, Minneapolis, USA.

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