CASE REPORT: CYTOMEGALOVIRUS INFECTION IN AN IMMUNOCOMPETENT PATIENT
DOI:
https://doi.org/10.56238/levv16n53-034Keywords:
HIV, Cytomegalovirus, Opportunistic Infections, ImmunocompetenceAbstract
Introduction: The Human Immunodeficiency Virus (HIV) causes progressive immunosuppression through the depletion of CD4 T lymphocytes, predisposing patients to opportunistic infections such as cytomegalovirus (CMV) disease. However, cases of CMV reactivation in immunocompetent individuals have been reported. Method: Case report. Results: This report describes a 34-year-old male patient, HIV-positive since 2021, on regular antiretroviral therapy (Tenofovir + Lamivudine + Dolutegravir), with undetectable viral load and CD4 count of 1,123 cells/mm³. The patient presented with hyaline anal discharge that later became bloody. Rectosigmoidoscopy revealed multiple ulcerations and erosions in the distal rectum and anal margin. Biopsy showed findings suggestive of viral infection, confirmed by immunohistochemistry positive for CMV. Initially treated for herpes simplex infection without clinical improvement, the patient achieved partial response with Valganciclovir and complete remission after treatment for coinfection with Chlamydia trachomatis, Mycoplasma hominis, and Ureaplasma urealyticum. Conclusion: This case highlights the possibility of CMV reactivation even in patients with adequate immune response and regular antiretroviral therapy, suggesting that local factors or coinfections may act as triggers. CMV infection should be considered in the differential diagnosis of persistent anorectal lesions in people living with HIV, even when immunocompetent. Early histopathological confirmation is essential for proper diagnosis and treatment.
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