Cytomegalovirus retinitis in HIV-infected patients with and without highly active antiretroviral therapy.
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.
Doan
S
S
Service d'Ophthalmologie, Hôpital Bichat, Claude-Bernard, Paris, France.
Cochereau
I
I
Guvenisik
N
N
Diraison
M C
MC
Mousalatti
H
H
Thanh
H X
HX
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
D000998:Antiviral Agents