Cytomegalovirus retinitis, human immunodeficiency virus antibody positivity and normal T helper cell numbers.
We describe a 46-year-old man in whom retinitis was diagnosed as his initial HIV and AIDS defining illness. A diagnosis of CMV infection was made based on the clinical appearance of the fundus and confirmed by DNA polymerase chain reaction (PCR) on his vitreous biopsy. His CD4+ T lymphocyte count at the time was 580 x 10(6)/l (16%) with a CD4:CD8 ration of 0.28. He had a splenectomy following trauma more than 20 years earlier. He responded very well to intravenous and oral ganciclovir and remains recurrence-free almost 2 years later. This case and others highlight two issues: (i) CMV retinitis in HIV positive is not confined to those with very low CD4+ T lymphocyte counts; (ii) previous splenectomy may have an impact on CD4+ cell numbers and function.
Thomson
R M
RM
University Department of Medicine and Infectious Diseases, Mater Hospital, South Brisbane, Australia.
Conrad
D
D
Antoszewska
H
H
Croxson
M C
MC
McCormack
J G
JG
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology*; D018791:CD4 Lymphocyte Count; D016516:CD4-CD8 Ratio; D017726:Cytomegalovirus Retinitis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology*; D015658:HIV Infections / Q000150:complications / Q000175:diagnosis / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013156:Splenectomy; D006377:T-Lymphocytes, Helper-Inducer