Chest ACCP Member Benefits
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Guest Access | Sign In via User Name/Password
This Article
Right arrow Full Text (PDF) Free
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Article Archive
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Uberti-Foppa, C.
Right arrow Articles by Lazzarin, A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Uberti-Foppa, C.
Right arrow Articles by Lazzarin, A.
(Chest. 1998;113:919-923.)
© 1998 American College of Chest Physicians

Cytomegalovirus Pneumonia in AIDS Patients

Value of Cytomegalovirus Culture From BAL Fluid and Correlation With Lung Disease

Caterina Uberti-Foppa MD1; Flavia Lillo MD2; Maria R. Terreni MD3; Armando Puglisi MD4; Monica Guffanti MD1; Nicola Gianotti MD1; and Adriano Lazzarin MD

1 From the Department of Infectious Diseases, IRCCS San Raffaele Hospital and University of Milan, Italy
2 From the Laboratory of Virology, IRCCS San Raffaele Hospital and University of Milan, Italy
3 From the Department of Pathology, IRCCS San Raffaele Hospital and University of Milan, Italy
4 From the Chest Unit, IRCCS San Raffaele Hospital and University of Milan, Italy

Objectives: To verify the value of cytomegalovirus (CMV) cultures of BAL fluid vs postmortem lung histopathology in detecting CMV pneumonia, and to correlate the BAL viral dose with the number of CMV inclusion bodies (CMV-IB) in the lung tissue of AIDS patients.

Design: Retrospective analysis of 434 BALs and 40 autopsies involving 307 AIDS patients; clinical follow-up lasted 10 months.

Patients and methods: The 40 patients who died within 20 days of undergoing BAL were divided on the basis of histopathologic findings into subjects with and without CMV-IB in the lung tissue. The relationship between the BAL viral dose and CMV lung infection was evaluated by counting the early antigen (CMV-EA) positive cells/200 µL of BAL and the number of CMV-IB/mm2 of lung tissue.

Results: The predictive value of BAL virus isolation for the diagnosis of CMV pneumonia was 61% for positive and 100% for negative results. The patients with the largest number of CMV-IB had CMV-EA counts from 2 to 840; in those with a moderate and small number, the CMV-EA counts were, respectively, from 11 to 700 and 2 to 300. Among the patients surviving up to 10 months after the BAL index sample, the frequency of recurrent extrapulmonary CMV abnormalities was 27% in those with positive and 7% in those with negative cultures.

Conclusions: BAL CMV cultures from AIDS patients have a very high negative and relatively low positive predictive value for CMV pneumonia. The presence and replication of CMV in the lung may lead to systemic dissemination as suggested by the higher probability of CMV extrapulmonary diseases. Viral titers do not seem to be related to the degree of lung damage.

Key Words: AIDS • bronchoalveolar lavage • CMV culture • lung

Submitted on April 29, 1997
Accepted on October 7, 1997




This article has been cited by other articles:


Home page
 Am. J. Respir. Crit. Care Med.Home page
J. M. BECK, M. J. ROSEN, and H. H. PEAVY
Pulmonary Complications of HIV Infection . Report of the Fourth NHLBI Workshop
Am. J. Respir. Crit. Care Med., December 1, 2001; 164(11): 2120 - 2126.
[Full Text] [PDF]

Home page
 ChestHome page
M. Tamm, P. Traenkle, B. Grilli, M. Soler, C. T. Bolliger, P. Dalquen, and G. Cathomas
Pulmonary Cytomegalovirus Infection in Immunocompromised Patients
Chest, March 1, 2001; 119(3): 838 - 843.
[Abstract] [Full Text] [PDF]

Home page
 J. Virol.Home page
A. Singh, G. Besson, A. Mobasher, and R. G. Collman
Patterns of Chemokine Receptor Fusion Cofactor Utilization by Human Immunodeficiency Virus Type 1 Variants from the Lungs and Blood
J. Virol., August 1, 1999; 73(8): 6680 - 6690.
[Abstract] [Full Text]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 1998 by the American College of Chest Physicians.