Pulmonary infection with cytomegalovirus (CMV) is a well recognised complication of AIDS. It is often possible to detect CMV-infected cells in bronchoalveolar lavage (BAL) specimens with monoclonal antibodies, but the clinical significance of their presence remains unclear. To investigate this, 24 AIDS patients were tested for CMV antigenaemia and viraemia, in addition to CMV detection in BAL. CMV was detected in the BAL of nine patients (38%), five with clinical and laboratory evidence of pulmonary infection and four without pulmonary involvement. Blood samples positive for CMV antigen were observed in two patients with CMV-positive BAL specimens and, in both cases, antigenaemia resolved without therapy. No case of viraemia was detected. Pneumocystis carinii was detected concomitantly with CMV in the BAL of four of the patients with pulmonary involvement and in one without signs of pulmonary infection. These data suggest that CMV-positive BAL results are of limited significance in the diagnosis of CMV pneumonia in AIDS patients, unless associated with high levels of antigenaemia or viraemia and compatible clinical symptoms.
EmanuelD.,
PeppardJ.,
StoverD.,
GoldJ.,
AmstrongD.,
HammerlingU. Rapid immunodiagnosis of cytomegalovirus pneumonia by bronchoalveolar lavage using human and murine monclonal antibodies. Ann Int Med1986; 104:476–481
VolinL.,
LeskinenR.,
TaskinenE. Bronchoalveolarlavage in the diagnosis of pulmonary complications in bone marrow transplant recipients. Transplant Proc1986; 18:130–131
RuutoP.,
RuutuT.,
VolinL.,
TukiainemP.,
UkkonenP.,
HouiT. Cytomegalovirus is frequently isolated in bronchoalveolar lavage fluid of bone marrow transplant recipients without pneumonia. Ann Int Med1990; 112:913–916
GlaserJ. H.,
SchuvalS.,
BursteinO.,
ByeM. R. Cytomegalovirus and Pneumocystic carinii pneumonia in children with acquired immunodeficiency syndrome. J Pediatr1992; 120:929–931
BrodieH. R.,
BroaddusC.,
Hopewell, PC., MossA.,
MillsJ. Is Cytomegalovirus (CMV) a cause of lung disease in patients with AIDS?. Am Rev Respir Dis1985; 131: Suppl A227
AngeliciE.,
Magno, MS., ForteS.,
Del MonacoF.,
SerraP.,
De RosaF. Rapid detection of Cytomegalovirus in bronchoalveolar lavage in AIDS patients: its possible clinical significance. Ther Infect Dis1991; 3:357–362
van der BijW.,
SchirmJ.,
TorensmanR.,
van SonuW. J.,
TegzessA. M. The TH. Comparison between viremia and antigenemia for detection of Cytomegalovirus in blood. J Clin Microbiol1988; 26:2531–2535
RevelloM. G.,
ZavattoniM.,
PercivalleE.,
GrossiP.,
GemaP. Correlation between immunofluorescent detection of human cytomegalovirus immediate early antigens in polymorphonuclear leukocytes and viremia. J Infect Dis1989; 160:159–160
RevelloM. G.,
PercivalleE.,
Di MatteoA.,
MoriniF. Gema G. Nuclear expression of the lower matrix protein of human cytomegalovirus in peripheral blood leucocytes of immune-compromised viremic patients. J Gen Virol1992; 73:437–442
NatoF.,
ContiniC.,
Zamora-ZamalaC. Production and characterization of monoclonal antibodies to human Pneumocystis carinii for the diagnosis of P. carinii pneumonia. Eur J Med1992; 1:132–138
DerouinF.,
MazeronM. C.,
GarinyJ. F. Comparative study of tissue culture and mouse inoculation methods for demonstration of Toxoplasma gondii. J Clin Microbiol1994; 25:1597–1600
ConnollyM. G.,
BaughmanR. P.,
DohnM. N.,
LinnemannC. C. Recovery of viruses other than cytomegalovirus from bronchoalveolar lavage fluid. Chest1994; 105:1775–1781
MillarA. B.,
PatouG.,
MillerR. Cytomegalovirus in the lungs of patients with AIDS. Respiratory pathogen or passenger?. Am Rev Respir Dis1990; 141:1474–1477
ContiniC.,
RomaniR.,
VulloV.,
DeliaS. Sorice F. Does laboratory recovery of Pneumocystis carinii always mean clinically significant disease?. AIDS1992; 162:1558–1559
GemaG.,
RevelloM. G.,
PercivalleE.,
ZavottoniM.,
PareaM. Battaglia M. Quantification of human cytomegalovirus viremia by using monoclonal antibodies to different viral proteins. J Clin Microbiol1990; 28:2681–2688
MazzulliT.,
RubinR.,
FerraroM. J. Cytomegalovirus antigenemia. Clinical correlations in transplant recipients and in persons with AIDS. J Clin Microbiol1993; 31:2824–2827
CollierA. C.,
MeyersJ. D.,
CoreyL.,
MurphyV. L.,
RobertsP. L.,
HandsfieldH. H. Cytomegalovirus infection in homosexual men. Relationship to sexual practices, antibody to human immune-deficiency vims, and cell-mediated immunity. Am J Med1987; 82:593–601