Cytomegalovirus (CMV)

October 2007     View PDF     En español

How do I prevent CMV disease?

There is a difference between CMV infection and CMV disease. While most people living with HIV also have CMV, not all will develop CMV disease. People with very low CD4+ cell counts are most at risk for CMV disease, but there are medicines that can help suppress CMV and prevent its disease.

The most effective way to prevent CMV disease is by getting the best care you can for your HIV—keeping your immune system intact, which in turn keeps CMV in check. Using effective anti-HIV therapy to maintain your immune health can help keep CD4+ cell counts above 200. A healthy immune system is your best defense against CMV becoming a problem. If your immune system shows signs of being damaged, taking CMV preventive therapy is an important decision to make.

While CMV can cause disease in many places in the body, one of the more common places it occurs in people with HIV is in the eye, as CMV retinitis. Seeing an HIV experienced eye doctor, called an ophthalmologist, is an important part of a comprehensive strategy to prevent CMV retinitis. He or she can recommend treatment before permanent damage occurs to your eyesight. For those at risk, regular visits usually occur every 3–6 months.

Finally, for those with very low CD4+ cell counts, taking preventive medicine for CMV might be part of a comprehensive strategy against CMV disease. The drug, ganciclovir (sold as Cytovene), is used to prevent CMV disease in people with CD4+ cell counts below 50 or with other signs of weakened immune systems. It can also be considered for children. Ganciclovir as preventive therapy may be not be desirable for everyone because of its side effects, lack of proven benefit, cost and risk for developing resistance to it. Talk with your doctor about the pros and cons of using ganciclovir to prevent CMV disease and decide if it’s right for you.