Purchase this article with an account.
R.W. Sedeek, J.H. Membreno, N.A. Afshari, R.A. Adelman; Risk Factors of AIDS–Related Cytomegalovirus Retinitis in the Highly Active Anti–Retroviral Therapy Era . Invest. Ophthalmol. Vis. Sci. 2006;47(13):3065.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To report the clinical risk factors for Cytomegalovirus retinitis (CMVR) among HIV+ patients after the widespread use of the highly active antiretroviral therapy (HAART).
A retrospective case control study of 104 HIV+ patients on HAART. Nine patients had CMVR. Clinical and laboratory data were compared between patients with and without CMVR.
The CD4 cell count of CMVR patients ranged from 5–200 cells/µl. CMVR patients differed significantly (p ≤0.05) from control group in all the following: mean CD4 cell count (51.3 vs. 335.4 cells/µl), mean CD4/CD8 cell ratio (0.078 vs. 0.312), mean HIV–VL (277k vs. 85k copies/ml), history of HIV vasculopathy (OR=4.35), history of opportunistic infections (Mycobacterium avium–intracellulare (OR=10.50), Varicella zoster ophthalmicus (OR=8.67), Pneumocystis carinii pneumonia (OR=6.09)), co–morbidities (Hepatitis B (OR=11.73), Hepatitis C (OR=4.72)), and history of change in the HAART regimen (>2 nucleoside analogue reverse transcriptase inhibitors (OR=4.21), >2 protease inhibitors (OR=4.09)).
With the widespread use of HAART, prevalence of CMVR is decreased. However, it is occurring in HIV+ patients with higher CD4 cell count. Risk factors include: low CD4 cell count, low CD4/CD8 cell ratio, high HIV–VL, history of HIV vasculopathy, of multiple opportunistic infections, of viral hepatitis, and of multiple HAART regimen failure.
This PDF is available to Subscribers Only