Course of cytomegalovirus retinitis in the era of highly active antiretroviral therapy: 2. Second eye involvement and retinal detachment. Ophthalmology 2004 Dec;111(12):2232-9
Date
12/08/2004Pubmed ID
15582079DOI
10.1016/j.ophtha.2004.05.028Scopus ID
2-s2.0-9644275423 (requires institutional sign-in at Scopus site) 75 CitationsAbstract
PURPOSE: To describe the course of cytomegalovirus (CMV) retinitis in patients with AIDS in the era of highly active antiretroviral therapy (HAART).
DESIGN: Multicenter, prospective, observational study.
PARTICIPANTS: Two hundred seventy-one patients with AIDS and CMV retinitis.
METHODS: Follow-up every 3 months with medical history, ophthalmologic examination, laboratory testing, and fundus photographs.
MAIN OUTCOME MEASURE: Second (contralateral) eye involvement among patients with unilateral disease and retinal detachment (RD).
RESULTS: The overall rate of second eye involvement among patients with unilateral CMV retinitis was 0.07 per person-year (PY); among those with CD4+ T-cell counts of <50/microl it was 0.34/PY, compared with 0.02/PY among those with CD4+ T-cell counts of > or =200/microl (P<0.0001). Risk factors for contralateral eye involvement included low CD4+ T-cell count and detectable CMV load. The overall rate of RD was 0.06/PY; among those with CD4+ T-cell counts of <50/microl it was 0.30/PY, compared with 0.02/PY among those with CD4+ T-cell counts of > or =200/microl (P<0.0001). Risk factors for RD included a low CD4+ T-cell count and larger area of CMV retinitis.
CONCLUSIONS: Compared with the rates reported in the pre-HAART era of second eye involvement (approximately 0.40/PY) and RD (approximately 0.50/PY), the rates of these events were reduced among patients in the HAART era. However, among patients with CD4+ T-cell counts of <50/microl, the rates were more similar to those from the pre-HAART era.
Author List
Jabs DA, Van Natta ML, Thorne JE, Weinberg DV, Meredith TA, Kuppermann BD, Sepkowitz K, Li HK, Studies of Ocular Complications of AIDS Research GroupAuthor
David V. Weinberg MD Professor in the Ophthalmology and Visual Sciences department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AIDS-Related Opportunistic InfectionsAdult
Anti-HIV Agents
Antiretroviral Therapy, Highly Active
CD4 Lymphocyte Count
CD4-Positive T-Lymphocytes
Cytomegalovirus Retinitis
Female
Humans
Male
Prospective Studies
Retinal Detachment
Risk Factors
