May 2004
Volume 45, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2004
Course of cytomegalovirus retinitis in the era of highly active antiretroviral therapy.
D.A. Jabs; M.L. Van Natta; J.E. Thorne; D.V. Weinberg; T.A. Meredith; B.D. Kuppermann; K. Sepkowitz; H.K. Li; Studies of Ocular Complications of AIDS Res. Group
Author Affiliations & Notes
  • D.A. Jabs
    The Johns Hopkins University School of Medicine, Baltimore, MD
    The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
  • M.L. Van Natta
    The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
  • J.E. Thorne
    The Johns Hopkins University School of Medicine, Baltimore, MD
    The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
  • D.V. Weinberg
    The Feinberg School of Medicine, Northwestern University, Chicago, IL
  • T.A. Meredith
    University of North Carolina School of Medicine, Chapel Hill, NC
  • B.D. Kuppermann
    University of California, Irvine, Irvine, CA
  • K. Sepkowitz
    Weill Medical College, Cornell University, New York, NY
  • H.K. Li
    The University of Texas Medical Branch, Galveston, TX
  • Studies of Ocular Complications of AIDS Res. Group
    The Johns Hopkins University School of Medicine, Baltimore, MD
  • Footnotes
    Commercial Relationships  D.A. Jabs, None; M.L. Van Natta, None; J.E. Thorne, None; D.V. Weinberg, None; T.A. Meredith, None; B.D. Kuppermann, None; K. Sepkowitz, None; H.K. Li, None.
  • Footnotes
    Support  NIH Grant U10 EY08052, U10 EY08057, U10 EY08067
Investigative Ophthalmology & Visual Science May 2004, Vol.45, 1129. doi:
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      D.A. Jabs, M.L. Van Natta, J.E. Thorne, D.V. Weinberg, T.A. Meredith, B.D. Kuppermann, K. Sepkowitz, H.K. Li, Studies of Ocular Complications of AIDS Res. Group; Course of cytomegalovirus retinitis in the era of highly active antiretroviral therapy. . Invest. Ophthalmol. Vis. Sci. 2004;45(13):1129.

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Abstract

Abstract: : Purpose: To describe the course of cytomegalovirus (CMV) retinitis in patients with AIDS in the era of highly active antiretroviral therapy (HAART). Methods: 271 patients with AIDS and CMV retinitis were followed in a multicenter, prospective, observational study every 3 months with history, eye examination, laboratory testing, and fundus photographs. Photographs were read for progression by graders at a centralized reading center. Outcome measures included retinitis progression, contralateral eye involvement among patients with unilateral disease, and retinal detachment. Results: The rate of retinitis progression was 0.10/person–year (PY). The rate of retinitis progression decreased with increasing CD4+ T cell count; among those with CD4+ T cell counts <50 cells/µL it was 0.58/PY vs 0.02/PY among those with CD4+ T cell counts >200 cells/µL (P<0.0001). In the multivariate analysis, significant risk factors for retinitis progression included low CD4+ T cell count, positive CMV viral load, longer time from AIDS diagnosis, and low Karnofsky score. The rate of contralateral eye involvement among patients with unilateral CMV retinitis was 0.07/PY, and among those with CD4+ T cell counts <50 cells/µL it was 0.34/PY. Risk factors for contralateral eye involvement included low CD4+ T cell count and detectable CMV viral load. The rate of retinal detachment was 0.06/PY, and among those with CD4+ T cell counts <50 cells/µL it was 0.30/PY. Risk factors for a retinal detachment included low CD4+ T cell count and larger area of CMV retinitis. Conclusions: Compared to the rates reported in the pre–HAART era for retinitis progression (3.0/PY), contralateral eye involvement (0.20/PY), and retinal detachment (0.50/PY), the rates of these events were reduced among patients in the HAART era, even among those with low CD4+ T cell counts. However, these events also occurred among patients with immune recovery and high CD4+ T cell counts. Continued ophthalmologic follow–up of patients, including those with immune recovery, is recommended in order to detect early retinitis progression.

Keywords: cytomegalovirus • retinitis • AIDS/HIV 
© 2004, The Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Permission to republish any abstract or part of an abstract in any form must be obtained in writing from the ARVO Office prior to publication.
Copyright © 2025 Association for Research in Vision and Ophthalmology.
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