[Cytomegalovirus retinitis in pediatric patients with AIDS receiving highly active antiretrovirus therapy].
BACKGROUND
To describe three cases of cytomegalovirus retinitis occurring in HIV-infected children taking protease inhibitors combined with transcriptase inhibitors (HAART).


METHODS
Three cases of HIV-infected children taking highly active antiretrovirus therapy (HAART) underwent an ocular examination at a university referral center-UNIFESP.


RESULTS
The average age was 6 years (10 months to 13 years old), and all of them were C3 (CDC-Atlanta-EUA 1994). Median CD4 cell count and plasma HIV RNA were 67 cells/mm3 (43-98 cells/mm3) and 190.000 copies/ml (53.600-460.000 copies/ml). The three patients presented HAART failure and all of them were treated with anti-CMV agents without success.


CONCLUSIONS
The unprecedented benefits resulting from highly active antiretroviral therapy (HAART) have been well described. However, treatment failure has become increasingly complex, because of the aggressive forms of opportunistic diseases like CMV retinitis, despite anti-CMV agents. Prompt diagnosis and treatment are essential to minimize the risk of long-term loss of vision for these infected children.
Dimantas
Maria Angélica
MA
Departamento de Oftalmologia, Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, SP. madimantas@oftalmo.com.br
Finamor
Luciana Peixoto
LP
Ewert
Vânia
V
Nakanami
Célia
C
Muccioli
Cristina
C
D017088:AIDS-Related Opportunistic Infections / Q000150:complications / Q000188:drug therapy*; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000188:drug therapy*; D000293:Adolescent; D023241:Antiretroviral Therapy, Highly Active; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use; D002648:Child; D017726:Cytomegalovirus Retinitis / Q000188:drug therapy* / Q000209:etiology; D024921:Drug Resistance, Multiple, Viral; D017809:Fatal Outcome; D015774:Ganciclovir / Q000009:adverse effects / Q000627:therapeutic use; D017320:HIV Protease Inhibitors / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D008297:Male; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use; D019562:Viral Load
D000998:Antiviral Agents; D017320:HIV Protease Inhibitors; D018894:Reverse Transcriptase Inhibitors; D015774:Ganciclovir