[The use of hyperimmune anti-cytomegalovirus immunoglobulins in HIV infection]. / Impiego delle immunoglobuline iperimmuni anti-cytomegalovirus in corso di infezione da HIV.

ABSTRACT

Cytomegalovirus (CMV) is one of the most frequent opportunistic agents that affects HIV positive subjects. The prophylaxis and treatment of cytomegalovirus infection in HIV positive subjects represent difficult and controversial problems. In this study we evaluated efficacy of anti-CMV immunoglobulins (derived from plasma with a high titer of CMV anti-bodies) in primary and in secondary prophylaxis for CMV disease in adults with severe immunodeficiency caused by HIV infection. For primary prophylaxis, in 22 patients with CD4 < 200/mmc enrolled to receive a monthly infusion of intravenous immunoglobulins (IVIG) at 200 mg/kg we observed prophylactic effect for the prevention of CMV and bacterial infections. Concerning secondary prophylaxis, 7 patients with CMV manifestation treated after remission with anti-CMV IVIG at 200 mg/kg every two weeks, had a low frequency of relapse and a good clinical outcome. Because their tolerability, anti-CMV immunoglobulins are an interesting option particularly for the prevention of CMV and bacterial infection in HIV-positive adults in advanced stages of disease.