Cytomegalovirus

Lisa A. Spacek, M.D., Ph.D.
Cytomegalovirus is a topic covered in the Johns Hopkins HIV Guide.

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MICROBIOLOGY

  • Member of Betaherpesviridae, double-stranded DNA virus with envelope; viral DNA polymerase is target for antivirals. Histology reveals large basophilic intranuclear ’owl’s eye’ and intracytoplasmic inclusion bodies.
  • Transmission via saliva, blood, semen, cervical secretions, breast milk, urine, or feces.
  • Latency established after infection. 60-100% seroprevalence. As high as 90-100% seroprevalence in people living with HIV. High-frequency of CMV-specific CD4+ and CD8+ memory T cells circulating in blood.[13]
    • Reactivation of latent infection increases with advancing immune suppression and is responsible for most HIV-related disease.
  • Persistent immune activation and chronic inflammation due to HIV may be modified by CMV infection.[12]
  • Recent studies detail contribution of CMV to immune activation[15] and non-AIDS-defining events, such as malignancy, cardiovascular and cerebrovascular events, nonvascular neurologic diseases, and ESRD.[14]

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MICROBIOLOGY

  • Member of Betaherpesviridae, double-stranded DNA virus with envelope; viral DNA polymerase is target for antivirals. Histology reveals large basophilic intranuclear ’owl’s eye’ and intracytoplasmic inclusion bodies.
  • Transmission via saliva, blood, semen, cervical secretions, breast milk, urine, or feces.
  • Latency established after infection. 60-100% seroprevalence. As high as 90-100% seroprevalence in people living with HIV. High-frequency of CMV-specific CD4+ and CD8+ memory T cells circulating in blood.[13]
    • Reactivation of latent infection increases with advancing immune suppression and is responsible for most HIV-related disease.
  • Persistent immune activation and chronic inflammation due to HIV may be modified by CMV infection.[12]
  • Recent studies detail contribution of CMV to immune activation[15] and non-AIDS-defining events, such as malignancy, cardiovascular and cerebrovascular events, nonvascular neurologic diseases, and ESRD.[14]

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Last updated: March 5, 2022