title: Cytomegalovirus retinitis in HIV-infected patients with and without highly active antiretroviral therapy.
abstract: OBJECTIVE
  To assess the impact of highly active antiretroviral therapy on the epidemiology of cytomegalovirus retinitis in patients infected with the human immunodeficiency virus (HIV).
  
  
  METHODS
  In a study performed in a single center for infectious diseases, we compared the data collected in 1995 (without highly active antiretroviral therapy) with 1997 data (with highly active antiretroviral therapy).
  
  
  RESULTS
  In a comparison of 1997 with 1995 data, the mean CD4+ cell count of patients with cytomegalovirus (CMV) retinitis was higher (169 +/- 150 CD4/microl vs 15 +/- 47 CD4/microl) (P = .05), and the relapses of CMV retinitis were less frequent (17% vs 36%) (P = .02). Newly diagnosed CMV retinitis decreased from 6.1% (59 of 952 patients) in 1995 to 1.2% (nine of 726 patients) in 1997 (P < .0001). In 1997, patients with newly diagnosed or relapsing CMV retinitis had a lower mean CD4+ (37 +/- 42) cell count than patients with no relapsing CMV retinitis (197 +/- 160) (P = .01).
  
  
  CONCLUSIONS
  The incidence and recurrences of CMV retinitis decreased from 1995 to 1997, probably as a result of restored immunity while the patients were undergoing highly active antiretroviral therapy; however, the increasing frequency of HIV resistance to highly active antiretroviral therapy justifies close ocular follow-up.
authors.affiliation: Service d'Ophthalmologie, Hôpital Bichat, Claude-Bernard, Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Doan
authors.forename: I
authors.initials: I
authors.lastname: Cochereau
authors.forename: N
authors.initials: N
authors.lastname: Guvenisik
authors.forename: M C
authors.initials: MC
authors.lastname: Diraison
authors.forename: H
authors.initials: H
authors.lastname: Mousalatti
authors.forename: H X
authors.initials: HX
authors.lastname: Thanh
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000276:immunology; D000998:Antiviral Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D017726:Cytomegalovirus Retinitis / Q000188:drug therapy / Q000453:epidemiology* / Q000276:immunology; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006678:HIV; D006801:Humans; D015994:Incidence; D015995:Prevalence; D012008:Recurrence; D012189:Retrospective Studies; D015996:Survival Rate; D019562:Viral Load
chemical_list: D000998:Antiviral Agents