Cytomegalovirus coinfection among people living with HIV in China before and on cART: A retrospective study

Abstract

Background Cytomegalovirus (CMV) was the common opportunistic pathogen among people living with HIV(PLWH), even in the combination antiretroviral therapy (ART) era. This study aimed to report the epidemiology and characteristics of CMV coinfection among Chinese PLWH. Methods Data were collected from two prospective longitudinal multicenter cohorts of PLWH initiating combination antiretroviral therapy (cART) from 2010 to 2015. This study extracted laboratory parameters, clinical symptoms, and serology of CMV baseline to 192 weeks of cART. Results 1552 patients were included in this analysis; the prevalence of CMV coinfection was 3.53% before cART. Logistics analysis showed that patients with lower CD4 T cell counts, RPR-seropositive, infected through homosexual contact, and from southern China had a higher risk of CMV/HIV coinfection at baseline. Patients with CMV coinfection at baseline had lower CD4/CD8 ratios at baseline (0.29 vs 0.22, p = 0.006), 96 weeks (0.63 vs 0.51, p = 0.015). After initiation of cART, the incidence of CMV recent infection was 10 cases/1000 PY. Cases coinfected with CMV during cART were mostly asymptomatic and had a comparable CD4, CD8 T cell counts, and CD4/CD8 ratio to non-coinfected patients. Conclusion This multicenter study reported a national prevalence and incidence of CMV recent infection among the Chinese PLWH before or on cART. CMV coinfection before cART initiation was associated with a slower recovery of CD4/CD8 ratio. However, CMV coinfection during successful treatment cART seems not to affect immunity parameters.