Choosing Wisely:

Don’t routinely test for CMV immunoglobulin G in HIV-infected patients who have a high likelihood of being infected with CMV.

Rationale and Comments: CMV immunoglobulin G testing is recommended only in patients who are at lower risk for CMV to detect latent CMV infection. CMV immunoglobulin G testing is not necessary in patients at higher risk for CMV, including men who have sex with men and injection drug users, because they can be assumed to be CMV positive. Testing for CMV antibody in low-risk populations is recommended to foster patient counseling in avoidance of CMV infection through practicing safe sex and to avoid transfusion except with CMV-negative blood products. Patients at lower risk for CMV infection, e.g., patients who are heterosexual and have not injected drugs, should be tested for latent CMV infection with an anti–CMV immunoglobulin G upon initiation of care.
Sponsoring Organizations:
  • HIV Medicine Association
  • Sources:
  • IDSA guideline
  • Disciplines:
  • Infectious disease
  • References: • Aberg JA, Gallant JE, Ghanem KG, Emmanuel P, Zingman BS, Horberg MA; Infectious Diseases Society of America. Primary care guidelines for the management of persons infected with HIV: 2013 update by the HIV Medicine Association of the Infectious Diseases Society of America. Clin Infect Dis. 2014 Jan;58(1):1-10.
    • Panel on Opportunistic Infections in HIV-Infected Adults and Adolescents. Guidelines for prevention and treatment of opportunistic infections in HIV-infected adults and adolescents: recommendations from the Centers for Disease Control and Prevention, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America; 2015 Apr. 414 p. Available at http://aidsinfo.nih.gov/contentfiles/lvguidelines/adult_oi.pdf.

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