Cytomegalovirus (CMV) Retinitis Activity Is Accurately Reflected by the Presence and Level of CMV DNA in Aqueous Humor and Vitreous

• Published in: The Journal of infectious diseases Vol. 179; no. 5; pp. 1249 - 1253
• Main Authors: Smith, Irene L., Macdonald, J. Christopher, Freeman, William R., Shapiro, Amy M., Spector, Stephen A.
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 01-05-1999; University of Chicago Press; Oxford University Press
• Subjects: AIDS; AIDS-Related Opportunistic Infections - virology; AIDS/HIV; Aqueous humor; Aqueous Humor - virology; Biological and medical sciences; Biomarkers; Blood; Blood plasma; Concise Communications; Cytomegalovirus; Cytomegalovirus - genetics; Cytomegalovirus - isolation & purification; Cytomegalovirus Retinitis - blood; Cytomegalovirus Retinitis - pathology; Cytomegalovirus Retinitis - virology; DNA, Viral - analysis; Eyes; Human viral diseases; Humans; Infectious diseases; Medical sciences; Polymerase chain reaction; Polymerase Chain Reaction - methods; Retinitis; Specimens; Urine; Urine - virology; Viral diseases; Viral diseases with cutaneous or mucosal lesions and viral diseases of the eye; Viremia - virology; Vitreous Body - virology; Human; Immunopathology; Opportunistic infection; Retinopathy; Herpesviridae; Vitreous body; AIDS; Aqueous humor; Betaherpesvirinae; Immune deficiency; Human cytomegalovirus; Infection; Virus; Polymerase chain reaction; Eye disease; Viral disease; DNA; Retinitis; Diagnosis; Detection; Viral load; Quantitative analysis
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1086/314710

To evaluate the potential of ocular and systemic specimens to provide markers of active cytomegalovirus (CMV) retinitis, we examined the relationship between virologic and clinical aspects of CMV infections in AIDS patients with CMV retinitis. CMV polymerase chain reaction (PCR) analysis of 74 aqueous humor and vitreous specimens indicated that ocular specimens can provide accurate markers to differentiate active and inactive CMV retinitis (aqueous or vitreous PCR, P < .001). Moreover, these markers were superior to extraocular measures, including plasma PCR (P = .08) and blood and urine CMV cultures (P = .05). A direct correlation was identified between the quantity of CMV DNA in aqueous humor or vitreous specimens and the corresponding surface area of active CMV retinitis (r2 = .69 and .44, respectively). Thus, qualitative and quantitative PCR-based analyses of aqueous humor can provide valuable markers of CMV retinitis activity. Such assays could provide rapid and reliable tools to assist in management of patients with CMV retinitis in whom the view of the retina is obscured.