Treating HIV-associated cytomegalovirus retinitis with oral valganciclovir and intra-ocular ganciclovir by primary HIV clinicians in southern Myanmar: a retrospective analysis of routinely collected data

Murray, Jillian; Hilbig, Adelene; Soe, Theint Thida; Sin, Win Le Shwe; Soe, Kyi Pyar; Ciglenečki, Iza

doi:10.1186/s12879-020-05579-2

Cited by 13 publications

(14 citation statements)

References 23 publications

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“…Our patients did not deteriorate, and thus maintained a stable vision after treatment. Our results were similar to a study by Murray et al ,[ 13 ] which showed that nearly 60% of eyes treated on oral valganciclovir maintained a stable vision. Lack of improvement in vision in our patients could be attributed to mainly zone 1 involvement in the affected eyes.…”

Section: Discussionsupporting

confidence: 92%

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Oral valganciclovir in human immunodeficiency virus-positive patients suffering from cytomegalovirus retinitis at a tertiary care hospital in North India

Markan

Gupta

Dogra

et al. 2022

Indian Journal of Ophthalmology

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Purpose: To study clinical efficacy of valganciclovir in cytomegalovirus retinitis (CMVR) in human immunodeficiency virus (HIV)-positive-positive patients in a tertiary care clinic in a developing nation. Methods: In a retrospective study, systemic and ocular records of HIV patients suffering from CMVR and treated with valganciclovir, were analyzed. Primary outcome measures were involvement of the other eye, incidence of retinal detachment, systemic involvement, and mortality encountered. Secondary outcome measures included change in BCVA. Results: Out of nine patients who were included, two patients developed CMVR in the other eye and only one patient (11.11%) developed retinal detachment during the course of the study. No patient developed any systemic manifestations or had mortality during the course of the study. The change in BCVA was not statistically significant. Conclusion: Use of oral valganciclovir showed good outcome and was found to be a better alternative compared to the use of intravitreal ganciclovir in the literature. Introduction of valganciclovir at an affordable price in developing nations can decrease disease burden.

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Section: Discussionsupporting

confidence: 92%

“…In developed countries, where oral valganciclovir is the mainstay of therapy, intraocular injections of ganciclovir are the mainstay of therapy in developing countries. Table 2 compares the results from various studies treating CMVR,[ 10 11 13 14 15 16 17 ] with present study.…”

Section: Discussionmentioning

confidence: 92%

Oral valganciclovir in human immunodeficiency virus-positive patients suffering from cytomegalovirus retinitis at a tertiary care hospital in North India

Markan

Gupta

Dogra

et al. 2022

Indian Journal of Ophthalmology

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“…34 Recently, the group from Myanmar was the first to report the use of oral valganciclovir by HIV clinicians for treating CMVR in a developing country, and concluded with the finding that oral valganciclovir was safe and effective. 35 To our knowledge, there has been no effort to train HIV clinicians to screen for CMVR in SA. Currently, there is also no consensus regarding screening by ophthalmologists, particularly in the ART era.…”

Section: Discussionmentioning

confidence: 99%

Cytomegalovirus retinitis and antiretroviral treatment: A fifteen year experience

Narain

Visser

Sibanda

2022

Southern African Journal of HIV Medicine

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Background: South Africa’s public antiretroviral treatment (ART) programme has undergone progressive changes since its introduction in 2004. The effect of this on the burden of the AIDS-defining opportunistic infection, cytomegalovirus retinitis (CMVR), in SA, has not been fully appreciated.Objectives: To determine the effect of ART availability in the public sector of SA on the trend in the number of cases of newly diagnosed CMVR over time.Methods: This is a retrospective study from 01 November 2002 to 31 August 2017 that took place at a tertiary hospital in the KwaZulu-Natal (KZN) province.Results: A total of 383 participants were included in the study, with 60.1% being female and 94% of black African origin. The mean age of patients was 34.08 years (SD ± 7.24). A linear trend model suggested an overall linear decrease in the number of new cases of CMVR per year (R2 of 0.67). The average number of new cases of CMVR per year prior to ART being available to all persons living with HIV (PLWH) with a CD4+ ≤ 350 cells/μL and after was 34 and 13, respectively, and the difference (61.76%) between these values was statistically significant, P = 0.001. The median CD4+ count at diagnosis of CMVR was 22 (interquartile range: 9–51.25) cells/μL. An overall 51% of patients in this study were on ART at diagnosis of CMVR. There was a higher proportion of patients on ART ≤ 6 months (63.3%), compared with those on ART 6 months (36.7%), and the difference was statistically significant, P 0.01.Conclusion: ART has resulted in a decrease in the burden of CMVR on ophthalmic services for many in KZN, particularly following the introduction of ART for all PLWH with a CD4 ≤ 350 cells/μL.

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“…Due to the cost barrier, only ganciclovir was in use in developing countries in the past. However, valganciclovir is now started to be introduced in low and middle-income countries as it is available at a reduced price within the WHO essential medicines list [ 36 , 37 ].…”

Section: Discussionmentioning

confidence: 99%

Human cytomegalovirus infection among treatment-naive HIV-1 infected patients in Ethiopia

et al. 2021

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Subclinical human cytomegalovirus (HCMV) replication is associated with immune dysfunction in immuno-suppressed antiretroviral therapy (ART) naive HIV infected individuals. No data is documented in Ethiopia so far concerning HCMV co-infection among HIV infected individuals. Hence, this study was aimed at generating data regarding the prevalence of active HCMV infection among treatment-naive HIV-infected individuals from Ethiopia. For this purpose, we enrolled 97 treatment-naive HIV infected study subjects in Addis Ababa from June to December 2018. ELISA and conventional PCR were performed consecutively to detect HCMV specific IgM antibody and HCMV DNA respectively. Of the 97 study subjects, 12 (12.4%) were positive for anti-CMV IgM antibodies but were not confirmed by PCR. With regard to the PCR positivity, 4/97 (4.1%) samples were positive for HCMV DNA. No statically significant associations were found between the dependent and independent variables. The presence of HCMV DNA in the current study highlights the need for a routine laboratory diagnosis for preventing HCMV disease among HIV-infected individuals early. Besides, the use of anti-CMV therapy for these CMV viremic individuals is also recommended as this can reduce the burden of CMV complications and consecutively prolonging the life of HIV infected individuals.

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Treating HIV-associated cytomegalovirus retinitis with oral valganciclovir and intra-ocular ganciclovir by primary HIV clinicians in southern Myanmar: a retrospective analysis of routinely collected data

Cited by 13 publications

References 23 publications

Oral valganciclovir in human immunodeficiency virus-positive patients suffering from cytomegalovirus retinitis at a tertiary care hospital in North India

Oral valganciclovir in human immunodeficiency virus-positive patients suffering from cytomegalovirus retinitis at a tertiary care hospital in North India

Cytomegalovirus retinitis and antiretroviral treatment: A fifteen year experience

Human cytomegalovirus infection among treatment-naive HIV-1 infected patients in Ethiopia

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