Effect of combination antiretroviral therapy on cytomegalovirus retinitis.
OBJECTIVE
To study the various changes in the course of cytomegalovirus (CMV) retinitis following combination antiretroviral treatment.


METHODS
Combination antiretroviral treatment was given to 12 patients with active CMV retinitis following which all anti-CMV medications were discontinued once the CD4 cell counts were > 100/mm3 for 3 months.


RESULTS
The median CD4 cell count increased from 36.5/mm3 (range, 3-74/mm3) at baseline to 175.5/mm3 (range, 97-410/mm3) at 3 months. No patient had reactivation of CMV retinitis or developed extraocular CMV infection during median follow-up of 16.7 months. In one patient with peripheral active CMV retinitis, the retinitis resolved completely and remained so throughout the follow-up period without specific anti-CMV treatment. Five (41.7%) patients had immune recovery vitritis.


CONCLUSIONS
Patients receiving combination antiretroviral treatment following treatment for CMV retinitis have better control of CMV retinitis but immune recovery vitritis is a common sequelae. Reactivation of CMV retinitis is common in patients who discontinue combination antiretroviral treatment.
Banker
Alay S
AS
Banker's Retina Clinic and Laser Centre, 5 Subhash Society, Behind Ishvar Bhuvan, Ahmedabad 380 009, India. banker@egujarat.net
Patel
Atul
A
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy* / Q000276:immunology; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D017726:Cytomegalovirus Retinitis / Q000188:drug therapy* / Q000276:immunology; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity
D000998:Antiviral Agents