Cicatrization of cytomegalovirus retinitis following introduction of highly active anti-retroviral therapy: uveitis as a possible indicator of good ocular prognosis.
OBJECTIVE
To quantify the inflammatory reaction that can be seen in HIV-infected patients with cytomegalovirus (CMV) retinitis after the introduction of an HIV protease inhibitor and correlate it with ocular findings and systemic HIV parameters.


METHODS
Report of a patient with CMV retinitis systematically followed by slit-lamp examination, funduscopy, fundus photographs and laser flare photometry before and after introduction of an HIV protease inhibitor.


RESULTS
Manifest granulomatous panuveitis developed 2 months after the introduction of the protease inhibitor indinavir (CD4 rise from 2 to 64 CD4/mm3) and coincided with cicatrization of the CMV retinitis in the absence of efficient anti-CMV therapy.


CONCLUSIONS
Occurrence of uveitis in patients with CMV retinitis following the introduction of HIV protease inhibitors may be a factor indicating a good ocular prognosis, possibly pointing to the presence of the anti-CMV repertoire in the reconstituting CD4 cell population.
Herbort
C P
CP
Department of Ophthalmology, Hôpital Jules Gonin, University of Lausanne, Switzerland.
Chave
J P
JP
D000328:Adult; D018791:CD4 Lymphocyte Count; D002921:Cicatrix / Q000139:chemically induced*; D003586:Cytomegalovirus Infections / Q000150:complications / Q000188:drug therapy*; D017320:HIV Protease Inhibitors / Q000627:therapeutic use*; D006801:Humans; D019469:Indinavir / Q000627:therapeutic use*; D008297:Male; D011379:Prognosis; D012173:Retinitis / Q000150:complications / Q000473:pathology / Q000821:virology*; D016896:Treatment Outcome; D014605:Uveitis / Q000150:complications / Q000473:pathology / Q000503:physiopathology
D017320:HIV Protease Inhibitors; D019469:Indinavir