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HIV and cytomegalovirus

Cytomegalovirus, or CMV, is a relatively common herpes virus that can affect people with HIV and weakened immune systems.

CMV is called an opportunistic infection. The common illnesses CMV causes include chorioretinitis, an eye infection that can lead to blindness – colitis and pneumonia.

How you can get cytomegalovirus

Getting CMV from casual contact is not likely. But it is possible to become infected with cytomegalovirus by touching your eyes, nose, or mouth after contact with an infected person's:

You can also get cytomegalovirus in these ways:

  • Sexual contact
  • Blood transfusions
  • Organ transplants

An infant can become infected before birth or during breastfeeding. This usually happens if the pregnant woman becomes infected with CMV first during the pregnancy.

Signs and symptoms of cytomegalovirus

Most healthy people who are infected with CMV don't know it. CMV doesn’t usually cause any symptoms. However, you may have mild symptoms, such as fatigue, swollen glands, or fever. You can easily confuse these with other illnesses. For those with weakened immune systems left untreated the CMV can move around the body. Then it can cause a variety of symptoms such as these:

If you are HIV-positive, your risk for becoming sick with CMV and developing symptoms is greatest if your CD4 count falls below 100. CD4 cells are a type of immune system cell.

Diagnosing cytomegalovirus

Your doctor may diagnose cytomegalovirus by:

  • Doing a blood or urine test to check for the presence of the virus
  • Measuring antibodies against CMV (called serologic testing)
  • Doing an eye examination to look for inflammation in the retina
  • Removing tissue or fluid from the intestine, throat, or spine, for example, and examining it under a microscope (called a biopsy)
  • Conducting imaging tests such as CT scans to view a picture of the lungs

Treating cytomegalovirus

For CMV retinitis, you may receive intensive treatment for 2 weeks. This is called induction therapy. You receive the treatment intravenously, meaning a drug is given into a vein. You may need a permanent catheter in your chest for daily treatment.

After the infection is under control, you receive daily maintenance therapy by pill.

Your doctor may prescribe drugs like these to keep the CMV from replicating:

  • Ganciclovir
  • Foscarnet

These drugs cannot cure the disease. However, they may be used to treat CMV in other parts of your body. They can also slow the progression of the disease.


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