Recurrences of cytomegalovirus retinitis in a human immunodeficiency virus-infected patient, despite potent antiretroviral therapy and apparent immune reconstitution.
We describe a 42-year-old man with human immunodeficiency virus infection who developed multiple recurrences of cytomegalovirus (CMV) retinitis despite receiving highly active antiretroviral therapy and having apparent immune reconstitution as evidenced by CD4(+) T lymphocyte counts of > 200 cells/mm(3). Laboratory investigation during one recurrence of retinitis confirmed that there was active CMV replication in the plasma and vitreous fluid. In addition, lymphoproliferative responses to CMV antigens were absent despite evidence of reactivity to Candida antigen and pokeweed mitogen. The clinical significance of this case and of other recently reported cases is discussed.
Division of Infectious Diseases, Department of Medicine, University of Colorado Health Sciences Center, Denver, CO 80262, USA. steven.johnson@uchsc.edu
S C
SC
Johnson
C A
CA
Benson
D W
DW
Johnson
A
A
Weinberg
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy / Q000276:immunology / Q000821:virology; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D003587:Cytomegalovirus / Q000235:genetics / Q000502:physiology; D017726:Cytomegalovirus Retinitis / Q000276:immunology / Q000517:prevention & control / Q000821:virology; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy* / Q000276:immunology*; D006801:Humans; D008213:Lymphocyte Activation; D008297:Male; D012367:RNA, Viral / Q000097:blood; D012008:Recurrence
D012367:RNA, Viral