New data from the ICONA Foundation study in Italy suggest that coinfection with cytomegalovirus was associated with an increased risk for severe non-AIDS event and non-AIDS death.
“Based on our findings, [cytomegalovirus]-seropositive status should be considered as a negative prognostic factor and a closer monitoring for cardio-cerebral vascular diseases as well as management of other modifiable risk factors could be considered in CMV/HIV coinfected individuals,” the researchers wrote in The Journal of Infectious Diseases. “The inclusion of this parameter in available prognostic scores should be evaluated.”
The study included 6,111 patients enrolled in the ICONA study who had at least one cytomegalovirus (CMV) immunoglobulin G test and did not have active CMV disease. The ICONA study is a prospective, observational study of people with HIV set up in 1997. The researchers evaluated time to AIDS events, AIDS death and time to severe non-AIDS events and non-AIDS deaths. Non-AIDS events included non-AIDS-defining cancers, cardio-cerebral vascular events, non-vascular neurological diseases and end-stage renal disease.
Among the 6,111 patients, 5,119 (83.3%) were CMV-IgG positive at baseline. During a median follow-up of 5.6 years, 338 patients experienced severe non-AIDS events or non-AIDS death. The 10-year estimated proportion reaching non-AIDS events or deaths was 6.2% for CMV-negative and 8.9% for CMV-positive patients. After controlling for potential confounders, CMV seropositivity remained an independent risk factor (adjusted HR=1.53; 95% CI, 1.08-2.16). Other risk factors included older age (adjusted HR=1.65; 95% CI, 1.47-1.85) and AIDS at baseline (adjusted HR=1.49; 95% CI, 1.09-2.03).
There were no associations between CMV seropositivity and non-AIDS malignancies or non-vascular neurological diseases, but CMV seropositivity was an independent risk factor for cardio-cerebral vascular events (adjusted HR=2.27; 95% CI, 0.97-5.32).
“Cardio-cerebral vascular events seem to be strictly linked to CMV seropositivity, confirming the potential atherogenetic role of CMV also in HIV-infected subjects,” the researchers wrote.
Disclosure: The researchers report no relevant financial disclosures.