Cytomegalovirus retinitis in advanced HIV-infected patients treated with protease inhibitors: incidence and outcome over 2 years.

Important note: Information in this article was accurate in 2000. The state of the art may have changed since the publication date.

Cytomegalovirus retinitis in advanced HIV-infected patients treated with protease inhibitors: incidence and outcome over 2 years.

J Acquir Immune Defic Syndr. 1999 Nov 1;22(3):228-34. Unique Identifier : AIDSLINE MED/20231111
Labetoulle M; Goujard C; Frau E; Rogier H; Niessen F; Furlan V; Lantz O; Lecointe D; Delfraissy JF; Offret H; Department of Ophthalmology, Hopital de Bicetre, Assistance; Publique-Hopitaux de Paris, Le Kremlin-Bicetre, France.

Abstract: We prospectively studied the incidence of cytomegalovirus (CMV) retinitis in 93 patients treated with highly active antiretroviral therapy (HAART) containing a protease inhibitor (PI), during a median follow-up period of 24 months. The median initial CD4+ count was 22 cells/microl (range, 1-311 cells/microl), and the median plasma HIV viral load was 5.1 log10 copies/ml (range, 2.4-6.4 log10 copies/ml). The fundus was examined monthly in patients with a history of CMV retinitis or an initial CD4+ count <50 cells/microl and every 3 months in the other patients. Of patients with previously controlled CMV retinitis, 1 of 7 relapsed. In addition, 6 of 59 patients with a CD4+ count <50 cells/microl and no history of CMV retinitis before starting PI therapy developed CMV retinitis. Of them, 3 had at least one relapse during follow-up. CD4+ counts were <40 cells/microl at the time of primary or recurrent CMV retinitis, except in two cases (147 cells/microl and 203 cells/microl). In conclusion, the incidence of CMV retinitis was 0.091 per patient-year among study subjects with advanced HIV infection who were receiving HAART (95% confidence interval [CI], 0.037-0.145). The time to progression of CMV retinitis (mean, 215 days; 95% CI, 113-317 days) was longer than reported before widespread use of PIs.

Keywords: CLINICAL TRIAL JOURNAL ARTICLE Adult AIDS-Related Opportunistic Infections/*DRUG THERAPY/EPIDEMIOLOGY/ IMMUNOLOGY Cytomegalovirus Retinitis/*DRUG THERAPY/EPIDEMIOLOGY/IMMUNOLOGY CD4 Lymphocyte Count Drug Therapy, Combination Foscarnet/ADMINISTRATION & DOSAGE/THERAPEUTIC USE Ganciclovir/ADMINISTRATION & DOSAGE/THERAPEUTIC USE Human HIV Protease Inhibitors/ADMINISTRATION & DOSAGE/*THERAPEUTIC USE Incidence Indinavir/THERAPEUTIC USE Nelfinavir/THERAPEUTIC USE Outcome Assessment (Health Care) Prospective Studies Reverse Transcriptase Inhibitors/ADMINISTRATION & DOSAGE/ THERAPEUTIC USE Ritonavir/THERAPEUTIC USE Saquinavir/THERAPEUTIC USE
000730
A0071423

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