Optimal management of cytomegalovirus retinitis in patients with aids. Treatment of congenital cytomegalovirus retinitis with. Cytomegalovirus cmv is a ubiquitous dna herpes virus that causes significant morbidity and mortality in immunocompromised individuals. Clinical outcomes of cmv retinitis in patients with aids are. It usually occurs in the late stages of the disease about 18 months after the declaration of the clinical onset in patients with a lower limit of cd4 levels of 50. Cmv retinitis is a potentially blinding manifestation of cmv infection that was commonly seen in advanced acquired immunodeficiency syndrome aids in the era before modern combination antiretroviral therapy era, but is also recognized in patients with immune. It is estimated that before the beginning of the art era, this retinopathy was present in 30% of patients with vih, although this figure decreased by approximately 80% after the start of art. Cytomegalovirus retinitis and the acquired immunodeficiency.
Cytomegalovirus retinitis is a treatable cause of blindness in people with human immunodeficiency virus hiv typically with cd4 counts cytomegalovirus cmv retinitis is the most common intraocular infection in patients with acquired immune deficiency syndrome aids, and a leading cause of aidsrelated morbidity. A tissue biopsy can detect the viral infection and presence of cmv virus particles, but this is rarely. Cytomegalovirus cmv is the most common infectious congenital syndrome worldwide, occurring in 0. To report an unusual case of cmv retinitis in primary immune deficiency disease pidd.
Therapy of cmv retinitis by using intravitreal ganciclovir and oral valganciclovir has. Cytomegalovirus cmv retinitis is the most common ocular opportunistic infection in patients with acquired immunodeficiency syndrome aids. Intravitreal injections were unable to be given in a regular and timely manner under general anaesthesia due to her underlying systemic disease. Cytomegalovirus retinitis cmv retinitis is a serious viral eye infection of the retina. Cmv infection can be diagnosed with blood or urine tests that look for substances specific to the infection. Cytomegalovirus retinitis in hivaids patients ncbi. Pdf cytomegalovirus retinitis in hivaids patients researchgate. Cytomegalovirus retinitis is the most frequent ocular infection due to opportunistic germs and is the main cause of visual loss in patients with aids 9. This study was to investigate the prevalence and clinical management of the cytomegalovirus retinitis associated with aids in a large municipality of china. Chaisson, in mandell, douglas, and bennetts principles and practice of infectious diseases eighth edition, 2015. Cytomegalovirus retinitis is a common aidsassociated illness, leading to blindness in up to 30% of patients.
Cytomegalovirus retinitis in patients with acquired immune. Cmv retinitis is diagnosed through an ophthalmologic exam. The diagnosis of cmv retinitis is a clinical one and it is important for physicians to be familiar with the clinical. Cytomegalovirus retinitis an overview sciencedirect topics.
Prevention and treatment of cmv retinitis related blindness in. In contrast, retinitis is quite uncommon in solidorgan transplant sot and hematopoietic stemcell transplant hsct recipients. Characteristics of cytomegalovirus retinitis in patients with acquired. Failure to diagnose cmv retinitis, and failure to treat affected patients with systemic anticmv medication, has an unfavorable impact on aidsrelated morbidity and mortality, because cmv is a systemic disease, and the extraocular forms of cmv, including colitis, esophagitis, encephalitis, radiculitis, pneumonitis, bone marrow suppression, and. Cytomegalovirus retinitis in primary immune deficiency disease. It is most often found in people with weakened immune systems. With the availability of potent antiretroviral therapy for hiv, the incidence of cmv retinitis has decreased significantly 2,3. The retina is the lightsensing nerve layer that lines the back of the eye. Untreated cmv retinitis in aids patients is a progressive and potentially blinding disorder.
Cytomegalovirus retinitis in patients with good syndrome. Therefore, this disease usually presents in patients who have already been diagnosed with acquired immunodeficiency syndrome aids. Although cmv disease occurs most often in patients with depressed cellmediated immunity, there is evidence that humoral immunity plays a protective role against the virus. Cytomegalovirus cmv retinitis is the most common intraocular infection in patients with acquired immune deficiency syndrome aids, and a leading cause of aidsrelated morbidity. Cytomegalovirus retinitis is the most common ocular opportunistic infection, representing 90% of the infectious retinitis, 2030% of the patients with aids develop cmv retinitis. Dilation of the pupils and ophthalmoscopy will show signs of cmv retinitis. The authors describe cmv retinitis in resourcepoor settings and suggest possibilities for management. The rate of progression of untreated cmv retinitis is variable. Rates of favorable clinical response among evaluatable patients were 91 84% of 108 for cmv retinitis, 35 83% of 42 for gastrointestinal cmv infection, and 26 72% of 36 for cmv pneumonia. Cytomegalovirus retinitis is the most common ocular opportunistic.
264 524 288 145 1171 53 356 464 1362 127 211 216 590 848 1361 327 169 1008 1237 872 736 1226 61 134 1439 271 67 1439 6 1274 989 1221 467 665 1232 778 1089 1322 1169 1482 4 606 1076 1444 1225