CMV retinitis and the controversies associated with highly active antiretroviral therapy and the immune recovery hypothesis

J. Brian Reed, Lawrence S Morse

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

The aggressive multidrug regimen of highly active antiretroviral therapy (HAART) has offered some degree of promise of immune reconstitution in AIDS patients, a phenomenon that theoretically would impact positively on the incidence and severity of opportunistic infections. Some studies already have noted complete regression of cytomegalovirus (CMV) retinitis without specific use of anti-CMV agents in patients undergoing HAART. However, the role of HAART in CMV retinitis remains controversial among investigators. This review of the salient details regarding the controversies associated with CMV retinitis and the immune recovery hypothesis is meant to shed light on current and future therapeutic issues concerns. Early data seem to predict a decline in CMV retinitis. However, some investigators have noted that increased CD4 T-lymphocyte counts may not protect against CMV retinitis; therefore, the diagnosis cannot be excluded based on count alone. There is also the question of whether CMV retinitis progression in any way represents failure of HAART in those patients receiving this type of combination therapy. HAART is seen as an encouraging development in the treatment of AIDS and opportunistic infection, but its more specific therapeutic effect on CMV retinitis requires further research with controlled prospective clinical trials.

Original languageEnglish (US)
Pages (from-to)181-185
Number of pages5
JournalAIDS Patient Care and STDs
Volume12
Issue number3
StatePublished - 1998

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Cytomegalovirus Retinitis
Highly Active Antiretroviral Therapy
Opportunistic Infections
Acquired Immunodeficiency Syndrome
Research Personnel
Controlled Clinical Trials
Proxy
Therapeutic Uses
CD4 Lymphocyte Count
Cytomegalovirus
Therapeutics
T-Lymphocytes
Incidence
Research

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Leadership and Management
  • Nursing(all)

Cite this

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abstract = "The aggressive multidrug regimen of highly active antiretroviral therapy (HAART) has offered some degree of promise of immune reconstitution in AIDS patients, a phenomenon that theoretically would impact positively on the incidence and severity of opportunistic infections. Some studies already have noted complete regression of cytomegalovirus (CMV) retinitis without specific use of anti-CMV agents in patients undergoing HAART. However, the role of HAART in CMV retinitis remains controversial among investigators. This review of the salient details regarding the controversies associated with CMV retinitis and the immune recovery hypothesis is meant to shed light on current and future therapeutic issues concerns. Early data seem to predict a decline in CMV retinitis. However, some investigators have noted that increased CD4 T-lymphocyte counts may not protect against CMV retinitis; therefore, the diagnosis cannot be excluded based on count alone. There is also the question of whether CMV retinitis progression in any way represents failure of HAART in those patients receiving this type of combination therapy. HAART is seen as an encouraging development in the treatment of AIDS and opportunistic infection, but its more specific therapeutic effect on CMV retinitis requires further research with controlled prospective clinical trials.",
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