Abstract
PURPOSE: To describe the characteristics of patients with AIDS and cytomegalovirus retinitis in the era of highly active antiretroviral therapy (HAART). METHODS: Prospective cohort study. Baseline (enrollment) data were compared between patients with newly diagnosed cytomegalovirus retinitis (incident cases) and those with previously diagnosed cytomegalovirus retinitis (prevalent cases). RESULTS: As of December 31, 2000, 45 incident and 200 prevalent cases had been enrolled. Among prevalent cases, the median time from cytomegalovirus retinitis diagnosis was 2.9 years. Incident cases were more likely than prevalent cases to be women (35.4% vs 15.3%, P = .001), African American (45.4% vs 20.4%, P = .002), and uninsured (29.6% vs 7.6%, P < .001). Incident cases were less likely than prevalent cases to be on HAART (51.2% vs 77.6%, P = .001) and to have had an immunologic response to HAART (increase in CD4 + T-cell count to > 100 cells/μl) (12.2% vs 57.5%, P < .001). The median CD4 + T-cell count at enrollment among incident cases was 17 cells/μl and among prevalent cases was 159 cells/μl (P < .001). Immune recovery uveitis had been diagnosed in 15.5% of the prevalent cases. Sixty-three percent of prevalent cases were not on anticytomegalovirus therapy. CONCLUSIONS: There is a population of patients with previously diagnosed and longstanding cytomegalovirus retinitis who have experienced immune recovery as a consequence of HAART and are no longer receiving anticytomegalovirus therapy. There are demographic differences between incident and prevalent cases that may reflect the evolution of the AIDS epidemic and differences in utilization of health care services.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 48-61 |
| Number of pages | 14 |
| Journal | American journal of ophthalmology |
| Volume | 133 |
| Issue number | 1 |
| DOIs | |
| State | Published - 2002 |
Funding
This work was supported by cooperative agreements from the National Eye Institute to The Johns Hopkins University School of Medicine (U10 EY08052), The Johns Hopkins University School of Hygiene and Public Health (U10 EY08057), and the University of Wisconsin, Madison (U10 EY08067). Additional support was provided by the National Center for Research Resources through the General Clinical Research Center grants 5MO1 RR00188 (Baylor College of Medicine), MO1 RR00052 (Johns Hopkins University School of Medicine), 5MO1 RR05096 (Louisiana State University), 5MO1 RR00865 (University of California, Los Angeles), 5MO1 RR05280 (University of Miami), 5M01 RR00046 (University of North Carolina), 5MO1 RR00043 (University of Southern California), and 5MO1 RR00047 (Weill Medical College of Cornell University).
ASJC Scopus subject areas
- Ophthalmology
