Cytomegalovirus: 40 years and still the major viral cofactor in HIV infection.
Cytomegalovirus: 40 years and still the major viral cofactor in HIV infection.
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巨细胞病毒：40年，仍然是HIV感染中的主要病毒辅助因子。
DOI：
10.1097/qad.0000000000003284
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发表时间：
2022-07-15
期刊：
影响因子：
--
通讯作者：
中科院分区：
文献类型：
--
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1979年，亨利贝尔福（Henry Balfour）将巨细胞病毒（CMV）称为“桥下的巨魔”，因为它在新生儿和免疫抑制者中具有显著的、多变的临床表现[1]。两年后，CMV感染是第一批艾滋病病例中最突出的机会性感染之一[2]。在有效的抗逆转录病毒治疗（ART）出现之前，疱疹病毒仍然是一种主要的机会致病菌[3]。在当前的ART时代，由CMV引起的终末器官疾病不再是显著的威胁[3，4]。尽管美国和西方世界约40-45%的成年人持续感染，因此CMV血清阳性[5，6]，但绝大多数HIV感染高风险的成年人在HIV感染前终身潜伏感染CMV [7]。在这期艾滋病杂志中，Levi et al. [8]目前的证据表明，巨细胞病毒仍然是桥下的巨魔与艾滋病毒（PWH）的人。他们定量了来自四个大型临床试验的储存血清中的CMV DNA，以表明超过3000名PWH中CMV病毒血症的存在与晚期HIV感染有关。重要的是，只有ART开始后持续的CMV病毒血症与较高的发病率和死亡率风险相关。这证实并扩展了先前的研究，显示接受ART的PWH中CMV疾病显著减少和改善[9，10]。重要的是，结果强调，即使在HIV抑制性ART期间，CMV仍然是严重的非AIDS定义的健康并发症的风险因素[11，12]。
In 1979, Henry Balfour termed cytomegalovirus (CMV) the ‘‘troll under the bridge’’for its significant, protean clinical manifestations in neonates and immunosuppressed persons [1]. Two years later, CMV infection was one of the most prominent opportunistic infections noted in the first cases of AIDS [2]. The herpesvirus remained a major opportunistic pathogen until the advent of effective antiretroviral therapy (ART)[3]. In the current era of ART, end-organ disease caused by CMV is no longer a significant threat [3, 4].Although approximately 40–45% of adults in the United States and Western world are persistently infected and hence seropositive for CMV [5, 6], the vast majority of adults at a high risk for HIV infection are latently infected for life with CMV prior to HIV infection [7]. In this issue of AIDS, Levi et al.[8] present evidence that CMV is still the troll under the bridge for people with HIV (PWH). They quantitated CMV DNA in stored sera from four large clinical trials to show that the presence of CMV viremia in over 3000 PWH is associated with advanced HIV infection. Importantly, only persistent CMV viremia after ART initiation is related to a higher risk of morbidity and mortality. This confirms and extends previous studies showing a significant decrease and amelioration of CMV diseases in PWH on ART [9, 10]. Importantly, the results emphasize that CMV is still a risk factor for serious, non-AIDS defining health complications even during HIV-suppressive ART [11, 12].
影响因子：
7.3
作者：
Holder KA;Lajoie J;Grant MD
通讯作者：
Grant MD