Highly active antiretroviral therapy-associated regression of cytomegalovirus retinitis: Long-term results in a small case series

J. B. Reed, J. W. Briggs, J. C. McDonald, W. R. Freeman, Lawrence S Morse

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

Purpose: To report the stability of acquired immunodeficiency syndrome (AIDS)-associated cytomegalovirus (CMV) retinitis lesions that have undergone regression in the absence of specific anti-CMV medications owing to highly active antiretroviral therapy (HAART)-generated immune recovery. Methods: The initial examination revealed HAART-associated regression of CMV retinitis lesions in eight subjects at two institutions. Patients were monitored for recurrences of CMV activity. CD4+ T-lymphocyte counts and human immunodeficiency virus (HIV) loads were measured. Results: All patients had positive initial responses to HAART with an average HIV load decrease of 2.26 log units (range 0.3-5.57). Mean CD4+ T-lymphocyte count at baseline was 45.6 (range 4-107) and increased by an average of 132.5 (range 7-266) within the first 2 to 4 months of HAART. Patients were observed for an average of 15.5 months (range 11-20 months). Six subjects had a vigorous and sustained response to therapy, achieving an average HIV load of 9,400 copies/mL (3.32 log10 decrease) and CD4+ T-lymphocyte count of 158.2 cells/μL. These patients had no CMV retinitis progression. By contrast, two others who attained an average log10 decrease of only 0.48 had modest and short-lived increases in the CD4+ T-lymphocyte count. These patients experienced reactivation of CMV retinitis after 5 and 7 months, respectively. Conclusions: Regressed CMV retinitis may remain healed for long periods. However, failure of HAART to induce substantial decreases in HIV load may predict poor or unsustainable rises in the CD4+ T-lymphocyte count and presage recurrence of CMV retinitis. Vigilance in ophthalmic examinations is especially mandatory in these subjects.

Original languageEnglish (US)
Pages (from-to)339-343
Number of pages5
JournalRetina
Volume21
Issue number4
StatePublished - 2001
Externally publishedYes

Keywords

  • Acquired immunodeficiency virus
  • Cytomegalovirus retinitis
  • Highly active antiretroviral therapy
  • Immune recovery

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems

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