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Multicenter Study
. 2012 Jun;153(6):1016-24.e5.
doi: 10.1016/j.ajo.2011.11.014. Epub 2012 Feb 4.

Incidence of cytomegalovirus retinitis in the era of highly active antiretroviral therapy

Elizabeth A Sugar  1 , Douglas A Jabs, Alka Ahuja, Jennifer E Thorne, Ronald P Danis, Curtis L Meinert; Studies of the Ocular Complications of AIDS Research Group
Collaborators, Affiliations
Multicenter Study

Incidence of cytomegalovirus retinitis in the era of highly active antiretroviral therapy

Elizabeth A Sugar et al. Am J Ophthalmol. 2012 Jun.

Abstract

Purpose: To estimate the incidence of cytomegalovirus (CMV) retinitis in the era of highly active antiretroviral therapy (HAART) and to characterize the factors associated with increased risk of CMV retinitis.

Design: Prospective cohort study.

Methods: A total of 1600 participants with acquired immunodeficiency syndrome (AIDS) but without CMV retinitis at enrollment who completed at least 1 follow-up visit in the Longitudinal Study of the Ocular Complications of AIDS (LSOCA) were seen every 6 months to obtain disease and treatment history, ophthalmic examination, and laboratory testing. Incidence of CMV retinitis and risk factors for incident CMV retinitis were assessed.

Results: The incidence rate of CMV retinitis in individuals with AIDS was 0.36/100 person-years (PY) based upon 29 incident cases during 8134 PY of follow-up. The rate was higher for those with a CD4+ T cell count at the immediately prior visit below 50 cells/μL (3.89/100 PY, P < .01), whereas only 1 individual with a CD4+ T cell count of 50 to 99 cells/μL and 2 individuals with a CD4+ T cell count >100 cells/μL developed CMV retinitis. Having a CD4+ T cell count below 50 cells/μL at the clinical visit prior to CMV retinitis evaluation was the single most important risk factor (HR: 136, 95% CI: 30 to 605, P < .0001) for developing retinitis.

Conclusions: Patients with AIDS, especially those with severely compromised immune systems, remain at risk for developing CMV retinitis in the HAART era, although the incidence rate is reduced from that observed in the pre-HAART era.

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Figures

Figure 1
Figure 1
Incident cytomegalovirus (CMV) retinitis among eyes free from CMV retinitis at enrollment. Follow-up is measured from the reported date of AIDS diagnosis. The dotted lines represent the upper and lower bounds of the 95% confidence interval.
See this image and copyright information in PMC

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