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

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.

• Authors: M Labetoulle, C Goujard, E Frau, H Rogier, F Niessen, V Furlan, O Lantz, D Lecointe, J F Delfraissy, H Offret
• Journal: Journal of acquired immune deficiency syndromes (1999) (J Acquir Immune Defic Syndr) Vol. 22 Issue 3 Pg. 228-34 (Nov 01 1999) ISSN: 1525-4135 [Print] United States
• PMID: 10770342 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• HIV Protease Inhibitors
• Reverse Transcriptase Inhibitors
• Foscarnet
• Indinavir
• Nelfinavir
• Saquinavir
• Ritonavir
• Ganciclovir

Topics

• AIDS-Related Opportunistic Infections (drug therapy, epidemiology, immunology)
• Adult
• CD4 Lymphocyte Count
• Cytomegalovirus Retinitis (drug therapy, epidemiology, immunology)
• Drug Therapy, Combination
• Foscarnet (administration & dosage, therapeutic use)
• Ganciclovir (administration & dosage, therapeutic use)
• HIV Protease Inhibitors (administration & dosage, therapeutic use)
• Humans
• 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)