Cytomegalovirus retinitis after initiation of highly active antiretroviral therapy

Jacobson, Mark A.; Zegans, Michael E.; Pavan, Peter R.; O’Donnell, James J.; Sattler, Fred R.; Rao, Narsing A.; Owens, Susan; Pollard, Richard B.

doi:10.1016/s0140-6736(96)11431-8

Cited by 351 publications

(151 citation statements)

References 9 publications

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“…In immunocompromised AIDS patients, the high morbidity of CMV infection is mainly associated with retinitis [1, 2, 3, 4, 5, 6]. Because of the fast disease progression and as the available antiviral agents are effective in the early stages of the disease, a method for accurate and confirming diagnosis is required [13].…”

Section: Discussionmentioning

confidence: 99%

“…The rate of occurence is approximately 20–40%, especially in patients whose CD4+ lymphocytes were fewer than 50 cells/µl [2, 3, 4, 5, 6]. If CMV retinitis were left untreated, it could result in progressive retina damage and loss of vision [1, 2, 3, 4, 5, 6]. Several published methods based on polymerase chain reaction (PCR), a method that can rapidly and specifically amplify signals, could quickly identify ocular CMV infection [7, 8, 9, 10, 11].…”

Section: Introductionmentioning

confidence: 99%

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Using Conjunctival Swab with Polymerase Chain Reaction to Aid Diagnosis of Cytomegalovirus Retinitis in AIDS Patients

Liu¹,

Hsu²,

Wong³

et al. 2000

Ophthalmologica

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Conjunctival swabs were used in combination with polymerase chain reactions (PCR) or virus culture to aid to confirm the diagnosis of cytomegalovirus (CMV) retinitis in AIDS patients. Based on ophthalmoscopic findings, 13 AIDS patients were diagnosed as having CMV retinitis and treated with systemic ganciclovir from January 1997 to December 1998. Nine of 13 AIDS patients with CMV retinitis were found to be positive for CMV DNA by using a conjunctival swab with PCR (CS-PCR). CMV was also isolated from the conjunctival swab culture in 2 AIDS patients with CMV retinitis. Following 1 month of systemic ganciclovir treatment, except for 1 patient who had disease progression and remained positive for CMV DNA by using CS-PCR, 12 patients were negative for CMV with a concordant lesion regression. Results of this study also indicate that this CS-PCR method is valuable for confirming the diagnosis of CMV retinitis and monitoring the ganciclovir effect on the treatment of CMV retinitis in AIDS patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Using Conjunctival Swab with Polymerase Chain Reaction to Aid Diagnosis of Cytomegalovirus Retinitis in AIDS Patients

Liu¹,

Hsu²,

Wong³

et al. 2000

Ophthalmologica

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“…Ocular manifestations have been reported in 70-80% of individuals infected with HIV,andcan involve any ocular structures anterior to posterior (Holland, 1992;Biswas et al, 2000). Since, the introduction of highly active antiretroviral therapy (HAART) in late 1996, there is marked case reduction in acquired immune deficiency syndrome (AIDS) -related morbidity and mortality (Jabs, 1997(Jabs, , 2002Jacobson, 1997Jacobson, , 2000Palella et al, 1998). …”

Section: Introductionmentioning

confidence: 99%

“…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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“…AIDS patients with advanced HIV infection, particularly when their CD4 cell counts fall below 50 cell/µl, are at risk of developing ophthalmic opportunistic infection, including HIV-related retinopathy, cytomegalovirus (CMV) retinitis, toxoplasmic retinitis and cryptococcal chorioretinitis [1, 2, 3, 4, 5]. Although the ocular manifestations of AIDS have been attributed to CMV infection or toxoplasmosis, the role of HIV replication in the ocular disorders associated with AIDS has not been clearly defined.…”

Section: Introductionmentioning

confidence: 99%

The HIV RNA Levels of Plasma and Ocular Fluids in AIDS Patients with Ophthalmic Infections

et al. 2004

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The aim of the present study was to evaluate the impact of highly active antiretroviral therapy (HAART) on HIV viral load of plasma and intraocular fluids in AIDS patients with ophthalmic opportunistic infections. We further compared the treatment effect of HAART on these patients. From June 1997 to July 2003, we examined and followed up the ophthalmic conditions of 49 patients receiving HAART with ophthalmic diseases during this period. The method of reverse-transcriptase polymerase chain reaction was used to detect and monitor HIV load in plasma and/or aqueous humor of AIDS patients. Before HAART, the HIV levels in the plasma and aqueous humor in 8 AIDS patients with ophthalmic opportunistic infections were significantly higher than those in 6 patients with HIV-related retinopathy (p < 0.05). Compared to the eye findings and clinical improvement, HIV loads of aqueous humor in 10 of 14 AIDS patients (6 with HIV-related retinopathy, 5 with cytomegalovirus retinitis, 2 with toxoplasmic retinitis and 1 with cryptococcal chorioretinitis) declined to undetectable levels (<400 copies/ml) after 4–8 months of HAART. HIV virus levels in the plasma of AIDS patients were significantly decreased, and the CD4 counts of these patients were significantly increased (Wilcoxon test) after initiation of HAART.

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Cytomegalovirus retinitis after initiation of highly active antiretroviral therapy

Cited by 351 publications

References 9 publications

Using Conjunctival Swab with Polymerase Chain Reaction to Aid Diagnosis of Cytomegalovirus Retinitis in AIDS Patients

Using Conjunctival Swab with Polymerase Chain Reaction to Aid Diagnosis of Cytomegalovirus Retinitis in AIDS Patients

Eye changes among HIV positive patients on antiretroviral therapy in Nepal

The HIV RNA Levels of Plasma and Ocular Fluids in AIDS Patients with Ophthalmic Infections

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