Correlation Between CD4+ Counts and Prevalence of Cytomegalovirus Retinitis and Human Immunodeficiency Virus-Related Noninfectious Retinal Vasculopathy in Patients with Acquired Immune Deficiency Syndrome

Kuppermann, B. D.; Petty, John G.; Richman, Douglas D.; Mathews, W. Christopher; Fullerton, S; Rickman, Leland S.; Freeman, W. R.

doi:10.1097/00006982-199313030-00015

Cited by 4 publications

(3 citation statements)

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“…With the advent of HAART, there has been a 75% reduction in the number of new cases of CMV retinitis. [4] The principles of treatment of CMV retinitis are to improve the patient's immune function and to use specific anti-CMV agents to inhibit viral replication. Many studies have investigated the effect of HAART on CMV retinitis.…”

Section: Researchmentioning

confidence: 99%

“…The decision when to stop anti-CMV therapy depends upon many factors, including rising CD4 counts, decreasing systemic HIV viral load, duration of HAART and inactivity of CMV RESEARCH lesions. [4] The US Public Health Service provided guidelines in 1999 [10] suggesting the discontinuation of anti-CMV therapy after patients with quiescent retinitis achieve sustained immune recovery, defined as CD4 counts of ≥100 cells/µL for at least two consecutive visits at least 6 months apart.…”

Section: Researchmentioning

confidence: 99%

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Cytomegalovirus retinitis in Cape Town, South Africa: Clinical management and outcomes

Lapere

Rice

2017

S Afr Med J

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Background. Cytomegalovirus (CMV) retinitis is a vision-threatening opportunistic infection that occurs mainly in immunocompromised individuals. Limited data on treatment protocols and management outcomes are available in South Africa (SA). Objectives. To review the clinical presentation, management and outcomes of patients who were diagnosed and treated for CMV retinitis at Groote Schuur Hospital, Cape Town, SA, over a 10-year period, and to compare treatment protocols of 13 public hospitals in SA that treat patients for CMV retinitis. Methods. A retrospective case review was performed of all patients treated for CMV retinitis at Groote Schuur Hospital between 2003 and 2013. In addition, a questionnaire was sent to 13 public hospitals in SA that treat patients with CMV retinitis. Results. A total of 141 eyes in 91 patients were polymerase chain reaction-positive for CMV. Of these patients, 98.6% were HIV-positive and 72.5% were on highly active antiretroviral therapy (HAART) at the time of presentation. Patients who were on HAART at presentation had better mean final visual acuity (VA) than those who were not on HAART (p<0.001). There was a significant association between the number of retinal quadrants involved and final visual outcome (p=0.009). Macular (central vision) involvement had a significant adverse effect on visual outcome compared with cases in which the macula was uninvolved (p=0.005). Conclusions. Independent risk factors that predict final visual outcome include presenting VA, number of retinal quadrants involved, macular involvement and being on HAART at presentation. The diagnosis and management of CMV retinitis differ among treatment centres in SA.

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Section: Researchmentioning

confidence: 99%

Section: Researchmentioning

confidence: 99%

Cytomegalovirus retinitis in Cape Town, South Africa: Clinical management and outcomes

Lapere

Rice

2017

S Afr Med J

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“…The CMVretinitis occurs primarily after a decrease of CD4π T-lymphocyte cell counts below 50 cells/ml (Kuppermann et al 1993).…”

mentioning

confidence: 99%

Control of cytomegalovirus retinitis after combination antiretroviral therapy

Ruhswurm¹,

Ries²,

Krepler³

et al. 1999

Acta Ophthalmologica Scandinavica

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ABSTRACT.Purpose: To report on AIDS patients having combination antiretroviral therapy whose cytomegalovirus (CMV) retinitis remained inactive after discontinuation of anti-CMV maintenance therapy. Methods: We describe the course of CMV-retinitis in 3 patients with AIDS after initiation of combination antiretroviral therapy. Results: After cessation of anti-CMV therapy no relapse of CMV-retinitis has been observed for up to 18 months. Two of the patients developed new CMVretinitis in the first months after initiation of combination therapy, nevertheless after further improvement of immunological parameters retinitis remained stable without anti-CMV therapy. Conclusion: The sustained immunological effects of combination therapy are possibly sufficient enough to provide protection against CMV-retinitis.

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