Do we need separate screening strategies for cytomegalovirus retinitis in different underlying immunosuppressed states? A retrospective study from Western India

Doshi, Bindiya; Khatib, Niha Z; Phatak, Sumita; Modi, Rohit Ramesh; Tiwari, Sarvesh; Subramanyam, Anand

doi:10.4103/ijo.ijo_1398_20

Cited by 3 publications

(2 citation statements)

References 17 publications

(11 reference statements)

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“…In this study, PJ combined CMV infection occurred in HIV-infected people, and the detection rate was 12.5%. CMV retinitis is the most common AIDS-related ocular abnormalities, HIV infected patients presented with granular appearance of the fundus lesions with often unilateral involvement [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

Cytopathological analysis of bronchoalveolar lavage fluid in patients with and without HIV infection

et al. 2022

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Background Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) infection can lead to a broad spectrum of lung diseases, including infectious diseases and tumors. Recently, with the wide application of bronchoscopes and cytopathology of bronchoalveolar lavage fluid (BALF), the diagnostic efficiency of lung diseases has improved. The present study focuses on analyzing the cytopathologic characteristics of BALF in the diagnosis of HIV/AIDS-related lung disease and comparing the lung disease spectrum between HIV and HIV-uninfected patients. Methods BALF specimens were collected from 2211 patients. Using ThinPrep liquid-based technology, the cytologic smears were prepared by staining with Hematoxylin and Eosin (HE), Gomori's methenamine silver (GMS), and Periodic Acid Schiff (PAS), acid-fast and immunocytochemical (ICC) staining. Real-time PCR was used to detect cytomegalovirus (CMV) and Mycobacterium tuberculosis (M. tuberculosis) in the remaining BALF. PCR-reverse dot hybridization was used for mycobacterial species identification. Results From the 2211 BALF specimens, 1768 (79.96%) were specimens from HIV-infected patients, and 443 (20.04%) were speciments from HIV-uninfected patients. The HIV-infected patients with a median age of 38.5 ± 11.3 years were markedly younger than the HIV-uninfected patients (52.9 ± 14.9 years) (p < 0.01). We found that 1635 (92.5%) HIV-infected patients were males, showing a prominently higher proportion than those without HIV infection (71.1%) (p < 0.01). Meanwhile, 1045 specific lesions were found in 1768 HIV-infected patients (59.1%), including 1034 cases of infectious diseases and 11 neoplastic lesions, also exhibiting a distinctly higher proportion compared to the HIV-uninfected patients (12.2%) (p < 0.001). For the HIV-infected group, a distinctly higher proportion of single infection lesions (724/1768, 41%) was noted than the HIV-uninfected group (14/443, 3.2%) (p < 0.001). Among single infection lesions, the most common was Cytomegalovirus(CMV) infection (20.9%) for the HIV-infected group, followed by Pneumocystis jiroveci(PJ) (13.0%), Fungal (3.5%), and Mycobacterial infections (3.4%), of which M. tuberculosis infection accounted for 3.1%. Double infections (300/1768, 17.0%) and Triple infections (10/1768, 0.6%) were found only among the patients with HIV. The malignancies among HIV-infected patients included adenocarcinomas (0.22%), small cell carcinomas (0.2%), squamous cell carcinomas (0.1%), and diffuse large B-cell lymphoma (0.1%). HIV-infected patients exhibited a significantly lower incidence of neoplastic lesions (0.6% vs. 9.0%) than the HIV-uninfected patients (p < 0.001). Conclusions There was a significant difference in the spectrum of lung diseases between HIV-infected and non-infected patients diagnosed by BALF cytopathology.

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Section: Discussionmentioning

confidence: 99%

Cytopathological analysis of bronchoalveolar lavage fluid in patients with and without HIV infection

et al. 2022

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“…Although HCMV infection can occur in healthy individuals, it is uncommon to observe symptomatic infection in individuals without immune suppression [3,20]. HCMV retinitis is a clinical syndrome characterized by full-thickness necrotizing retinitis, which can result in profound vision loss, retinal detachment, and permanent vision loss [21].…”

Section: Pathogenesis Of Hcmv Ocular Diseasesmentioning

confidence: 99%

Ocular Infection of HCMV: Immunology, Pathogenesis, and Interventions

Yan¹,

Chen²

2023

Viral Outbreaks - Global Impact and Newer Horizons

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Human cytomegalovirus (HCMV) retinitis accounts for 70% of herpesvirus-infected ocular diseases. Recent advances in knowledge of innate immune responses to viral infections have elucidated a complex network of the interplay between the invading virus, the target cells, and the host immune responses. Ocular cytomegalovirus latency exacerbates the development of choroidal neovascularization. Viruses have various strategies to evade or delay the cytokine response, and buy time to replicate in the host. Some signaling proteins impact the virologic, immunologic, and pathological processes of herpesvirus infection with particular emphasis on retinitis caused by HCMV. The accumulated data suggest that signaling proteins can differentially affect the severity of viral diseases in a highly cell-type-specific manner, reflecting the diversity and complexity of herpesvirus infection and the ocular compartment. By summarizing the immunological characteristics and pathogenesis of HCMV ocular infection, it will provide important information on the development of antiviral therapy, immunotherapy, and antidrug resistance.

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Mishra

2021

Indian Journal of Ophthalmology

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Do we need separate screening strategies for cytomegalovirus retinitis in different underlying immunosuppressed states? A retrospective study from Western India

Cited by 3 publications

References 17 publications

Cytopathological analysis of bronchoalveolar lavage fluid in patients with and without HIV infection

Cytopathological analysis of bronchoalveolar lavage fluid in patients with and without HIV infection

Ocular Infection of HCMV: Immunology, Pathogenesis, and Interventions

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