Reply to Manfredi

TO THE EDITOR—We read with interest the comments of Manfredi. The aim of our study was to determine the sero-prevalence of cytomegalovirus (CMV) antibodies among human immunodefi-ciency virus (HIV)–positive subjects in the ICONA cohort and to define the impact of CMV serostatus on the risk of AIDS and severe non-AIDS events/death. Although we agree that our analysis has several limitations, mentioned in the discussion section of the article [1], we believe that we have contributed useful new data to the debate about whether CMV infection might be associated with the risk of clinical progression in HIV-infected individuals. CMV is a herpes virus characterized by persistence in a latent state, resulting in lifelong infection [2]. Chronic CMV infection is diagnosed on the basis of detection of persistently positive CMV