Cytomegalovirus, or CMV, is a virus. It is a herpes virus, a family of viruses that also includes the herpes zoster virus (responsible for chicken pox and shingles) and herpes simplex I (responsible for cold sores).
Approximately half of all people in industrialized nations, which includes the United States, are infected with this virus. Almost all gay/bisexual men are infected with CMV and more than 75% of all HIV-infected people carry the virus. However, with potent antiretroviral (ARV) therapy, only a small percentage of these people—mainly patients with severely compromised immune systems—will actually develop CMV disease and experience symptoms of this infection.
Being infected with CMV is no reason to panic. CMV is only a threat when the immune system becomes damaged. If your CD4 cell count falls below 50, you're at a much greater risk of developing CMV disease, particularly CMV retinitis (discussed below). ARV treatment can help protect and repair the immune system. Additionally, preventive therapy (prophylaxis) is available to HIV-infected patients who are at risk of developing CMV disease.
What is CMV disease?
In HIV-infected people, CMV can cause disease in one or several parts of the body. These include:
The Types of CMV Disease
CMV Retinitis: CMV can cause damage to the back of the eye, or the retina. This can lead to blurred vision, blind spots or moving spots, and blindness. This is the most common type of CMV disease in people with HIV. While usually not life-threatening, problems seeing and blindness is usually permanent, even if treatment has been successful.
CMV Encephalitis: CMV can also cause damage to the brain. If CMV reaches the brain and the immune system is unable to control it, death can occur within weeks to months. CMV-related brain damage, when less severe, can cause dementia, with confusion, fever and memory problems. The symptoms are very similar to HIV-associated dementia.
CMV Radiculopathy: CMV disease of the nerves. This can cause pain or tingling in the limbs, particularly the legs and feet. It can also lead to loss of urinary or bowel movement control.
CMV Colitis: CMV disease of the colon is often associated with symptoms of abdominal pain, weight loss, diarrhea, and cramping. Most forms of CMV almost always occur in patients with less than 50 T-cells. CMV colitis has been reported in patients with higher T-cell counts, even those who are receiving anti-HIV therapy. It is the second most common form of CMV disease (after CMV retinitis).
CMV Gastritis: CMV of the upper gut, including the stomach, can lead to symptoms like those seen in patients with CMV colitis.
CMV Esophagitis: CMV disease of the throat. Can lead to pain while swallowing, chest pain, and hiccups.
CMV Pneumonitis: CMV disease of the lungs. Can lead to difficulty breathing and cough.
Last Revised: June 09, 2009
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