Non-cytomegalovirus ocular opportunistic infections in patients with acquired immunodeficiency syndrome.
OBJECTIVE
To report the incidence and clinical outcomes of non-cytomegalovirus (non-CMV) ocular opportunistic infections in patients with acquired immunodeficiency syndrome (AIDS) in the era of highly active antiretroviral therapy.


METHODS
Multicenter, prospective, observational study of patients with AIDS.


METHODS
Medical history, ophthalmologic examination, and laboratory tests were performed at enrollment and every 6 months subsequently. Once an ocular opportunistic infection was diagnosed, patients were seen every 3 months for outcomes.


RESULTS
At enrollment, 37 non-CMV ocular opportunistic infections were diagnosed: 16 patients, herpetic retinitis; 11 patients, toxoplasmic retinitis; and 10 patients, choroiditis. During the follow-up period, the estimated incidences (and 95% confidence intervals [CI]) of these were: herpetic retinitis, 0.007/100 person-years (PY) (95% CI 0.0004, 0.039); toxoplasmic retinitis, 0.007/100 PY (95% CI 0.004, 0.039); and choroiditis, 0.014/ 100 PY (95% CI 0.0025, 0.050). The mortality rates appeared higher among those patients with newly diagnosed or incident herpetic retinitis and choroiditis (rates = 21.7 deaths/100 PY [P = .02] and 12.8 deaths/100 PY [P = .04]), respectively, than those for patients with AIDS without an ocular opportunistic infection (4.1 deaths/100 PY); toxoplasmic retinitis did not appear to be associated with greater mortality (6.4/100 PY, P = .47). Eyes with newly diagnosed herpetic retinitis appeared to have a poor visual prognosis, with high rates of visual impairment (37.9/100 PY) and blindness (17.5/100 PY), whereas those outcomes in eyes with choroiditis appeared to be lower (2.3/100 PY and 0/100 PY, respectively).


CONCLUSIONS
Although uncommon, non-CMV ocular opportunistic infections may be associated with high rates of visual loss and/or mortality.
Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA.
Sapna
S
Gangaputra
Lea
L
Drye
Vijay
V
Vaidya
Jennifer E
JE
Thorne
Douglas A
DA
Jabs
Alice T
AT
Lyon
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000821:virology; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D000998:Antiviral Agents / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D002833:Choroiditis / Q000188:drug therapy / Q000453:epidemiology* / Q000821:virology; D017726:Cytomegalovirus Retinitis / Q000188:drug therapy / Q000453:epidemiology / Q000821:virology; D004359:Drug Therapy, Combination; D005260:Female; D006561:Herpes Simplex / Q000188:drug therapy / Q000453:epidemiology* / Q000821:virology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015270:Mycobacterium avium-intracellulare Infection / Q000188:drug therapy / Q000453:epidemiology* / Q000821:virology; D011446:Prospective Studies; D012173:Retinitis / Q000188:drug therapy / Q000453:epidemiology* / Q000821:virology; D015996:Survival Rate; D014126:Toxoplasmosis, Ocular / Q000188:drug therapy / Q000453:epidemiology* / Q000821:virology; D014481:United States / Q000453:epidemiology; D014792:Visual Acuity / Q000502:physiology; D014794:Visual Fields / Q000502:physiology
D000998:Antiviral Agents