Effect of Immune-Modulatory Interventions on Asymptomatic Cytomegalovirus Shedding during Suppressive Antiretroviral Therapy.

Long-term consequences of HIV are likely the result of persistent inflammation and immune dysfunction of which CMV is a known contributor. We leveraged two ACTG clinical trials exploring effects of immune modulators (ruxolitinib and sirolimus) on inflammation in people with HIV on ART to determine if these interventions affected CMV shedding at various mucosal sites. Analyzing 635 mucosal samples collected, we found no significant difference in CMV levels across study arms or time points. Men had more CMV shedding than women. We did confirm an association between higher CMV DNA and immune markers associated with HIV persistence and HIV-associated mortality.