1. Mortality of cytomegalovirus infection among people living with HIV: A retrospective study from a tertiary hospital in Indonesia.
- Author
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Yunihastuti E, Kurniati N, Yusuf M, Yasmon A, Sjatha F, Edwar L, Nusyirwan SA, Imran D, Kurniawan J, Lubis AM, Yulianti M, Pitoyo CW, Nugroho P, Rusdi L, Susilo A, Sinto R, Muktiarti D, Maharani K, Adhari AI, Nora RD, Achmad YN, Purap MM, Karjadi TH, and Widhani A
- Subjects
- Humans, Indonesia epidemiology, Male, Female, Retrospective Studies, Adult, Middle Aged, AIDS-Related Opportunistic Infections epidemiology, AIDS-Related Opportunistic Infections mortality, CD4 Lymphocyte Count, Risk Factors, Cytomegalovirus Retinitis epidemiology, Cytomegalovirus Retinitis complications, Cytomegalovirus Retinitis drug therapy, Cytomegalovirus Retinitis mortality, Cytomegalovirus Infections complications, Cytomegalovirus Infections epidemiology, Cytomegalovirus Infections mortality, HIV Infections drug therapy, HIV Infections complications, HIV Infections mortality, Tertiary Care Centers, Cytomegalovirus isolation & purification
- Abstract
Background: There are still many patients newly diagnosed with HIV at an advanced stage in Indonesia. We aimed to identify factors associated with 1-year mortality among cytomegalovirus (CMV)-infected people living with HIV (PLHIV)., Methods: This retrospective cohort study was carried out at a tertiary-care hospital in Jakarta, Indonesia (January 2017 to December 2022). We included PLHIV with CMV end-organ disease (EOD) and CMV syndrome. The presence of CMV infection was confirmed by fulfilling one of the following criteria: (1) positive PCR from plasma, urine, cerebrospinal fluid, or other body fluids, or associated tissue for CMV EOD; (2) positive immunoglobulin M (IgM); or (3) consistent symptoms and signs of CMV retinitis., Results: Out of 1737 PLHIV, 147 (8.5%, 95% CI: 7.2 to 9.9%) were diagnosed with CMV infection. Forty (27.2%, 95% CI: 20.6 to 35.1%) patients died within 1 year of being diagnosed. Only anti-retroviral therapy (ART) defaulting (aHR 3.31, 95% CI: 1.12 to 9.73) was found to be significantly associated with 1-year mortality in multivariate analysis., Conclusion: Defaulted ART status is significantly associated with reduced 1-year survival after CMV infection diagnosis. Patients with low CD4 counts, especially those with <50 cells/μL, should be assessed for CMV infection, monitored, and treated accordingly., Competing Interests: Declaration of conflicting interestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: All authors have completed the ICMJE uniform disclosure form at https://www.icmje.org/disclosure-of-interest/and-declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work; no other relationships or activities that could appear to have influenced the submitted work.
- Published
- 2024
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