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Pathog Immun. 2019;4(1):66-78. doi: 10.20411/pai.v4i1.255. Epub 2019 Feb 14.

Increased CMV IgG Antibody Titer is Associated with Non-AIDS Events among Virologically Suppressed HIV-Positive Persons.

Author information

Division of Infectious Diseases; Rush University Medical Center; Chicago Illinois.
Department of Immunology/Microbiology; Rush University Medical Center; Chicago Illinois.
Center for Biostatistics in AIDS Research; Harvard TH Chan School of Public Health; Boston Massachusetts.



Among HIV-positive individuals, increased levels of inflammation and immune activation persist even in the setting of effective antiretroviral therapy (ART) and are associated with greater rates of non-AIDS events. The etiology of this persistent inflammation is incompletely understood.


Using a well-characterized cohort of 322 HIV-infected individuals on suppressive ART, we conducted a case-control study. Cytomegalovirus (CMV) immunoglobulin G (IgG) levels, plasma biomarkers, and T-cell phenotypes were measured/characterized from samples collected 1 year after ART initiation. Conditional logistic regression for matched case-control studies analyzed the associations of year 1 CMV-specific IgG level with the subsequent occurrence of any non-AIDS event. Correlations between continuous CMV IgG antibody levels and soluble and cellular markers were assessed.


We found that higher levels of CMV IgG were associated with increased risk of non-AIDS events (OR = 1.58 per IQR [95% CI: 1.12, 2.24], P = 0.01) and with elevated soluble and cellular markers of inflammation.


The magnitude of the host immune response to CMV may play a role in the persistent inflammation and resultant morbid events observed in the HIV-positive population.


HIV; cardiovascular events; cytomegalovirus (CMV); immunity; inflammation; malignancy

Conflict of interest statement

CONFLICTS OF INTEREST None of the authors have a commercial association that might pose a conflict of interest. Dr. Alan Landay is an associate editor for Pathogens and Immunity.

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