Cytomegalovirus Retinitis After Initiation of Highly Active Antiretroviral Therapy in Hiv-Infected Patients

Lin, Ding‐Zheng; Warren, John F; Lazzeroni, Laura C.; Wolitz, Richard A.; Mansour, Sam E.

doi:10.1097/00006982-200206000-00003

Cited by 29 publications

(15 citation statements)

References 35 publications

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“…At that time patients had low CD4+ T-cell counts and elevated HIV viral loads (4,12) , although patients receiving HAART showed a broader range of CD4+ count, including values of more than 50 cells/µl (4) . As in other studies, most of these patients have longstanding AIDS, had received HAART and are intolerant or non responsive to this therapy (4)(5)(6) . Visual symptoms were frequent at the time of diagnosis and blurring was the most common presenting symptom, as previously described (22) .…”

Section: Discussionsupporting

confidence: 54%

“…The incidence of systemic complications and opportunistic infections, including cytomegalovirus (CMV) retinitis declined dramatically compared to the rates from the pre-HAART era (1)(2)(3)(4)(5)(6)(7) . Cytomegalovirus retinitis is still one of the most common ocular manifestations and the major cause of blindness in patients with AIDS and, despite all the advances in AIDS treatment, it continues to be diagnosed (4)(5)(6)(7)(8) .…”

Section: Introductionmentioning

confidence: 99%

“…The estimated lifetime probability of a patient with AIDS developing CMV retinitis in the pre-HAART era was about 30% (9) but its incidence has declined 55 to 85% after the introduction of HAART (2)(3)(4)(5)(6) . In Brazil this drop in the incidence may be explained by the fact that HAART therapy is distributed with no cost by the National AIDS Programme from the National Ministry of Health (10) .…”

Section: Introductionmentioning

confidence: 99%

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Clinical features and outcomes of AIDS-related cytomegalovirus retinitis in the era of highly active antiretroviral therapy

Arantes¹,

Garcia²,

Saraceno³

et al. 2010

Arq. Bras. Oftalmol.

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Clinical features and outcomes of AIDS-related cytomegalovirus retinitis in the era of highly active antiretroviral therapy Keywords: Cytomegalovirus; Retinitis; Acquired immunodeficiency syndrome; Antiretroviral therapy, highly active; AIDS-related opportunistic infections; Uveitis, posterior; Eye infections/etiology; HIV infections Purpose: To describe the features and outcomes of patients with AIDS-related cytomegalovirus retinitis after highly active antiretroviral therapy availability. Methods: Retrospective chart review of 30 consecutive patients (44 eyes) with AIDS and newly diagnosed, active AIDS-related cytomegalovirus retinitis, examined from January 2005 to December 2007. Results: The mean age was 34.8 years, 18 patients (60.0%) were male and median duration of AIDS was 90 months. Nineteen patients (63.3%) had evidence of highly active antiretroviral therapy failure and median CD4+ lymphocyte count was 12.5 cells/µl. Visual acuity at presentation was 20/40 or better in 27 eyes (61.4%). Retinitis involved Zone 1 in 13 eyes (39.5%). Despite specific anti-AIDSrelated cytomegalovirus therapy, 16 eyes (36.4%) presented relapse of retinitis and 10 eyes (22.7%) lost at least three lines of vision. When compared to highly active antiretroviral therapy responsive patients, eyes of highly active antiretroviral therapy failure patients were more likely to develop relapse of retinitis (p=0.03) and loss of at least three lines of vision (p=0.03). Conclusion: The patients in this series are essentially young men with longstanding AIDS, non-responsive to highly active antiretroviral therapy and with a similar immunological profile as noted before highly active antiretroviral therapy era. These findings have implications for the management of the disease and confirm the magnitude of rational periodic screening after diagnosis of AIDS. ABSTRACT INTRODUCTION

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Section: Discussionsupporting

confidence: 54%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical features and outcomes of AIDS-related cytomegalovirus retinitis in the era of highly active antiretroviral therapy

Arantes¹,

Garcia²,

Saraceno³

et al. 2010

Arq. Bras. Oftalmol.

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“…Most of the studies have shown reduced incidence and prevalence of ocular manifestations in patients on HAART in different places (Palella et al, 1998;Jacobson et al, 1997;Song et al, 2000;Lin et al, 2002;Torriani et al, 2000). Nepal is now going through a transition phase, and with the introduction of voluntary counseling and testing center (VCTC) and the provision of HAART free of cost to HIV-infected patients, the spectrum of ophthalmological manifestations may have varied.…”

Section: Introductionmentioning

confidence: 99%

Eye changes among HIV positive patients on antiretroviral therapy in Nepal

2016

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Background: HIV/AIDS has various ocular manifestations. Objective: To find out eye findings among HIV positive patients in the era of antiretroviral therapy. Method This Hospital based cross sectional descriptive study was carried at B. P. Koirala Lions Centre for Ophthalmic Studies. Patient profile, WHO clinical stage, CD4+ cell count, duration of HIV, antiretroviral therapy, and systemic diseases were recorded. All the cases underwent ocular examination as per the study protocol and the findings were noted in a proforma developed for the study. The results were analysed with SPSS 14.0. Results: Of 100 HIV positive cases (including 55 antiretroviral therapy patients) 62% patients were male and 38% were female. The mean age of presentation was 27.72 years. Heterosexual transmission (62%) was the commonest mode of transmission of HIV. Thirty seven percent patients were illiterate. Systemic disease was present in 20% cases. Ocular complaint was present in 53% patients. Ocular disease was present in 40% HIV positive patients. Almost 55% of these cases were on antiretroviral therapy. Moderate to lower CD4 count patient had frequent eye disease. Patients in WHO Stage III and IV also had frequent eye problems. Anterior segment and external ocular disorder was present in 25% patients. The commonest manifestation was conjunctivitis in10% of total cases. Posterior segment manifestation was present in 11%, neuro-ophthalmic lesion in 4% and orbital lesion in 1% patient. Conclusion: Anterior segment manifestation is still common ocular manifestations in HIV positive patients in Nepal. Patients in WHO Stage III and IV are more vulnerable for eye changes. Young aged male and migrant workers are at risk of acquiring HIV in developing country like Nepal. Eye findings even in patientson antiretroviral therapy are similar. However, large sample size and long follow up study is required to have final disclosure.

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“…[1][2][3][4] However, the introduction of highly active antiretroviral therapy (HAART) has led to a considerable decline in opportunistic infections and a reduction in HIV-related deaths. 5,6 All of the available reports concerning ocular involvement in HIV-infected patients in the HAART era relate to adults; [7][8][9][10] no childhood data are available. The aim of this study was to determine the effect of HAART on the natural history of ocular manifestations in HIV-infected children.…”

Section: Introductionmentioning

confidence: 99%

Effect of highly active antiretroviral therapy (HAART) on the natural history of ocular manifestations in HIV-infected children

Esposito

Porta

Bojanin

et al. 2006

Eye

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Cytomegalovirus Retinitis After Initiation of Highly Active Antiretroviral Therapy in Hiv-Infected Patients

Cited by 29 publications

References 35 publications

Clinical features and outcomes of AIDS-related cytomegalovirus retinitis in the era of highly active antiretroviral therapy

Clinical features and outcomes of AIDS-related cytomegalovirus retinitis in the era of highly active antiretroviral therapy

Eye changes among HIV positive patients on antiretroviral therapy in Nepal

Effect of highly active antiretroviral therapy (HAART) on the natural history of ocular manifestations in HIV-infected children

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