title: Cytomegalovirus retinitis in patients with AIDS before and after introduction of HAART in China.
abstract: OBJECTIVE
  To determine the prevalence of cytomegalovirus retinitis (CMVR) and other fundus lesions in subjects with acquired immunodeficiency syndrome (AIDS) before and after the introduction of highly active antiretroviral therapy (HAART) in China.
  
  
  METHODS
  The retrospective study included subjects with AIDS who consecutively attended a third referral center in Beijing before and after HAART was introduced. Comprehensive systemic and ophthalmic examinations, including CD4+ T-cell count, ophthalmoscopy, and fundus photography, were carried out.
  
  
  RESULTS
  A total of 173 HIV-infected, HAART-naive individuals and 267 people undergoing HAART were included in the study. The HAART-naive group as compared with the HAART group was significantly older (39.5 ± 11.5 years versus 36.7 ± 11.2 years; p = 0.02) and included significantly more men (p = 0.045). Prevalence of CMVR, microvascular retinopathy, and optic neuropathy in the HAART group (9.0 ± 1.8%, 7.9 ± 1.7%, and 4.9 ± 1.3%, respectively) were significantly (all p≤0.001) lower than in the HAART-naive group (20.2 ± 3.1%, 31.2 ± 3.5%, and 13.9 ± 2.6%, respectively). Microvascular retinopathy was significantly associated with HAART-naive status (p<0.001; odds ratio [OR] 0.20; 95% confidence interval [CI] 0.12, 0.36) and higher age (p = 0.002; OR 1.04; 95% CI 1.10, 1.06). Cytomegalovirus retinitis was significantly associated with CD4+ cell count <50 cells/μL (p = 0.001; OR 5.50; 95% CI 1.95, 15.5), HAART-naive status (p = 0.02; OR 0.23; 95% CI 0.07, 0.79), and lower best-corrected visual acuity (p<0.001; OR 5.44; 95% CI 2.11, 14.0).
  
  
  CONCLUSIONS
  As in Western countries, prevalence of CMVR and microvascular retinopathy in Chinese subjects with AIDS were significantly associated with a low CD4+ cell count and a HAART-naive status as the 2 major risk factors.
authors.affiliation: 2 Department of Ophthalmology, Beijing Di Tan Hospital, Capital Medical University, Beijing - China.
authors.forename: Hui Yu
authors.initials: HY
authors.lastname: Sun
authors.forename: Xiao Yan
authors.initials: XY
authors.lastname: Peng
authors.forename: Dan
authors.initials: D
authors.lastname: Li
authors.forename: Fei Fei
authors.initials: FF
authors.lastname: Mao
authors.forename: Qi Sheng
authors.initials: QS
authors.lastname: You
authors.forename: Jost B
authors.initials: JB
authors.lastname: Jonas
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy / Q000453:epidemiology*; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D018414:CD8-Positive T-Lymphocytes; D002681:China / Q000453:epidemiology; D017726:Cytomegalovirus Retinitis / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors