Incidence Rate and Risk Factors for Contralateral Eye Involvement among Patients with AIDS and Cytomegalovirus Retinitis Treated with Local Therapy.
OBJECTIVE
To calculate the incidence of, and to identify the risk factors for developing contralateral eye involvement among patients with AIDS and unilateral cytomegalovirus retinitis (CMV retinitis), who were treated, in the era of highly-active antiretroviral therapy (HAART), with repetitive intravitreal ganciclovir injections.


METHODS
The clinical records of 119 patients were included. The main outcome measurement was the occurrence of contralateral eye involvement.


RESULTS
Over a mean follow-up period of 1.6 years, the overall incidence rate of contralateral involvement was 0.17/person-year. The cumulative incidence of contralateral involvement at 6 months and 1 year was 23.8% and 28.4%, respectively. Receiving HAART at the visit before the event was associated with a decreased risk of developing contralateral retinitis (hazard ratio [HR] = 0.26, P = 0.002).


CONCLUSIONS
The use of HAART, associated with subsequent immune recovery, significantly reduced the incidence of contralateral eye involvement by approximately 75% among patients in our setting.
a Department of Ophthalmology, Faculty of Medicine , Prince of Songkla University , Hat Yai , Thailand and.
Wantanee
W
Sittivarakul
a Department of Ophthalmology, Faculty of Medicine , Prince of Songkla University , Hat Yai , Thailand and.
Thanyapat
T
Benjhawaleemas
a Department of Ophthalmology, Faculty of Medicine , Prince of Songkla University , Hat Yai , Thailand and.
Nipat
N
Aui-Aree
a Department of Ophthalmology, Faculty of Medicine , Prince of Songkla University , Hat Yai , Thailand and.
Pichai
P
Jirarattanasopa
b Epidemiology Unit, Faculty of Medicine , Prince of Songkla University , Hat Yai , Thailand.
Tippawan
T
Liabsuetrakul
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy / Q000453:epidemiology*; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D000998:Antiviral Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D015331:Cohort Studies; D017726:Cytomegalovirus Retinitis / Q000188:drug therapy / Q000453:epidemiology*; D015828:Eye Infections, Viral / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D015774:Ganciclovir / Q000627:therapeutic use*; D006801:Humans; D015994:Incidence; D058449:Intravitreal Injections; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D014792:Visual Acuity
D000998:Antiviral Agents; D015774:Ganciclovir
AIDS; Ganciclovir; contralateral retinitis; cytomegalovirus retinitis; local therapy