Cytomegalovirus (CMV) infection in HIV positive patients with advanced disease and low CD4 counts (<100 cells/jal) is common and is a well-documented cause of retinitis, colitis, adrenalitis and radiculopathy. In patients with renal allografts and bone marrow transplants, CMV may cause pneumonitis on an immunopathogenic basis and this is frequently fatal.
CMV was originally thought to be an important cause of pneumonitis in patients with AIDS but it is now known that CMV pulmonary infection occurs only rarely in the absence of other pathogens and its presence does not adversely affect outcome and survival. Treatment with specific anti-CMV treatment such as foscarnet (phosphonoformate) does not seem to improve outcome (as would be expected if CMV was causing the pneumonitis).
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