title: Prevalence and predictors of cytomegalovirus retinitis in HIV-infected patients with low CD4 lymphocyte counts in Vietnam.
abstract: We describe the results of a study to determine the prevalence and characteristics of cytomegalovirus (CMV) retinitis among HIV-infected patients in Vietnam. We conducted a cross-sectional prospective study of patients with CD4 lymphocyte count ≤100 cells/mm(3)recruited from public HIV clinics. The diagnosis was made by a trained ophthalmologist using slit lamp biomicroscopy and corroborated on fundus photography. A total of 201 patients were screened. The median age was 32 years, 77% were men, median CD4 count was 47 cells/mm(3), and 62% were on antiretroviral treatment. Prevalence of CMV retinitis was 7% (14/201, 95% CI 4-11%). CMV retinitis was not associated with age, gender, injection drug use, CD4 count, WHO clinical stage, or antiretroviral treatment status. Blurring of vision and reduced visual acuity <20/40 were associated with CMV retinitis, but only 29% of patients with the diagnosis reported blurry vision and only 64% had abnormal vision. On multivariate analysis, the sole predictor for CMV retinitis was decreased visual acuity (OR 22.8,p < 0.001). In Ho Chi Minh City, CMV retinitis was found in 7% of HIV-infected patients with low CD4. HIV-infected patients with a CD4 count <100/mm(3)or who develop blurring of vision in Vietnam should be screened for CMV retinitis.
authors: Harvard Medical School AIDS Initiative in Vietnam, Ho Chi Minh City, Vietnam Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA doctordonn@gmail.com.
authors: Donn J
authors: DJ
authors: Colby
authors: Retina Department, Ho Chi Minh City Eye Hospital, Ho Chi Minh City, Vietnam.
authors: Diem Qh
authors: DQ
authors: Vo
authors: National Healthcare Group Eye Institute, Department of Ophthalmology, Tan Tock Seng Hospital, Singapore.
authors: Stephen C
authors: SC
authors: Teoh
authors: Harvard Medical School AIDS Initiative in Vietnam, Ho Chi Minh City, Vietnam.
authors: Nguyen T
authors: NT
authors: Tam
authors: Harvard Medical School AIDS Initiative in Vietnam, Ho Chi Minh City, Vietnam.
authors: Nguyen T
authors: NT
authors: Liem
authors: Harvard Medical School AIDS Initiative in Vietnam, Ho Chi Minh City, Vietnam Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
authors: Doanh
authors: D
authors: Lu
authors: Harvard Medical School AIDS Initiative in Vietnam, Ho Chi Minh City, Vietnam.
authors: Thi T
authors: TT
authors: Nguyen
authors: Harvard Medical School AIDS Initiative in Vietnam, Ho Chi Minh City, Vietnam Division of Infectious Diseases, Brigham and Women's Hospital, Boston, MA, USA.
authors: Lisa
authors: L
authors: Cosimi
authors: Harvard Medical School AIDS Initiative in Vietnam, Ho Chi Minh City, Vietnam Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
authors: Todd
authors: T
authors: Pollack
authors: Harvard Medical School AIDS Initiative in Vietnam, Ho Chi Minh City, Vietnam Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
authors: Howard
authors: H
authors: Libman
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis* / Q000453:epidemiology; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D003587:Cytomegalovirus / Q000302:isolation & purification*; D017726:Cytomegalovirus Retinitis / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D015995:Prevalence; D011446:Prospective Studies; D015819:Substance Abuse, Intravenous / Q000150:complications* / Q000453:epidemiology; D014744:Vietnam / Q000453:epidemiology; D014786:Vision Disorders / Q000175:diagnosis / Q000453:epidemiology; D014792:Visual Acuity
chemical_list: D019380:Anti-HIV Agents
keywords: AIDS; CMV; HIV; Vietnam; cytomegalovirus; opportunistic infection; prevalence; retinitis