title: Failure of a prospective trial to detect cytomegalovirus retinitis after initiation of highly active antiretroviral therapy.
abstract: Thirty-one patients with AIDS with CD4+ T-cell counts of less than 75/mm3 were enrolled in a prospective study to determine the incidence of cytomegalovirus (CMV) retinitis and changes in CD4+ T-cell counts and viral loads following initiation of highly active anti-retroviral therapy (HAART). Patients were assessed using an Amsler grid, a visual field test, a questionnaire, and direct and indirect funduscopy. Only one patient developed an opportunistic infection, and the majority of patients had a threefold decrease in their viral loads and an increase in CD4+ T-cell counts within 2 months of initiating HAART. These findings support the belief that recent therapies modify the natural history of HIV infection and that new clinical approaches will be needed to address the changing profile of HIV/AIDS patients. None of our patients developed CMV retinitis. The findings add to those of other researchers, and suggest that if CMV retinitis does develop after HAART, it is an unusual finding that may be due to preexisting, subclinical retinitis rather than failure of HAART to reconstitute full immune cell recovery.
authors.affiliation: Department of Nursing, VA Medical Center, Gainesville, Florida, USA. Upholcr.ufcon@shands.ufl.edu
authors.forename: C R
authors.initials: CR
authors.lastname: Uphold
authors.forename: M F
authors.initials: MF
authors.lastname: Smith
authors.forename: B S
authors.initials: BS
authors.lastname: Bender
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology*; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000188:drug therapy*; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D015496:CD4-Positive T-Lymphocytes / Q000378:metabolism*; D017726:Cytomegalovirus Retinitis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011795:Surveys and Questionnaires
chemical_list: D019380:Anti-HIV Agents