Risk for retinitis in patients with AIDS can be assessed by quantitation of threshold levels of cytomegalovirus DNA burden in blood

Cytomegalovirus (CMV) retinitis in patients infected with human immunodeficiency virus (HIV) is a significant clinical problem, Seventy-five patients with CD4 T cell counts <100/mm(3) were monitored prospectively every 2 months for CMV DNA burden, The target for DNA amplification was a 162-bp fragment from the CMV immediate early gene. CMV DNA burden, at levels of greater than or equal to 320 in white blood cells or greater than or equal to 32 in plasma (P = .001), particularly when sustained (P = .005 and .008, respectively), distinguished patients who developed retinitis from those who remained free of disease, Progression to retinitis was not consistently accompanied by increases in CMV burden, indicating that quantitation of CMV burden beyond threshold levels is not necessary to predict risk for development of retinitis, Virus isolation from WBC, but not urine, was also significantly associated with risk for retinitis (P = .001).