Decrease of cytomegalovirus replication in human immunodeficiency virus infected-patients after treatment with highly active antiretroviral therapy

Cytomegalovirus (CMV) viremia, as measured by a hybrid capture assay, was used to measure the effectiveness of "immune reconstitution" in human immunodeficiency virus (HIV)-infected subjects treated with highly active antiretroviral therapy (HAART), Of the 28 enrolled patients (mean age, 38 years), 86% were male and 68% were antiretrovirally naive. Of the 23 patients who returned for follow-up, baseline median characteristics were 4.1 log(10) CMV DNA copies/10(6) white blood cells (WBCs), 5.1 log(10) HIV RNA copies/mL, and 35 CD4 cells/mm(3). After initiation of HAART, median log(10) CMV DNA copies/10(6) WBCs at means of 33, 87, and 385 days were 4.0, 3.3, and 2.5, respectively, Median log(10) HIV RNA levels declined from 5.1 to 1.7 at 385 days with a commensurate rise in median CD4 T cells to 166/mm(3). Immune reconstitution secondary to HAART results in a significant and progressive decline in CMV viremia in the absence of specific anti-CMV therapy.