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Global issues
Active cytomegalovirus retinitis after the start of antiretroviral therapy
  1. David Heiden1,2,
  2. NiNi Tun3,
  3. Frank N Smithuis4,
  4. Jeremy David Keenan5,
  5. Catherine E Oldenburg5,
  6. Gary N Holland6,7,
  7. W Lawrence Drew8
  1. 1 Department of Ophthalmology, California Pacific Medical Center, Pacific Eye Associates, San Francisco, USA
  2. 2 Center for Innovation in Eye Care, Seva Foundation, Berkeley, USA
  3. 3 Medical Action Myanmar, Yangon, Myanmar
  4. 4 Myanmar Oxford Clinical Research Unit and Medical Action Myanmar, Yangon, Myanmar
  5. 5 Francis I. Proctor Foundation, University of California, San Francisco, San Francisco, USA
  6. 6 Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, USA
  7. 7 Ocular Inflammatory Disease Center, Jules Stein Eye Institute, Los Angeles, USA
  8. 8 Departments of Laboratory Medicine, UCSF and Mount Zion Medical Center, San Francisco, USA
  1. Correspondence to Dr David Heiden, California Pacific Medical Center Department of Ophthalmology, Pacific Eye Associates, San Francisco, USA; davidheiden{at}gmail.com

Abstract

Patients with AIDS-related cytomegalovirus (CMV) retinitis receiving combined antiretroviral therapy (cART), but not specific anti-CMV therapy, consistently showed active retinitis for several months. Delayed diagnosis and treatment of CMV retinitis may have severe consequences. Patients first entering care with advanced HIV infection and vulnerability to reactivation of latent CMV infection should be screened immediately for CMV retinitis by dilated indirect ophthalmoscopy and treated with specific anti-CMV therapy without delay, in addition to cART.

  • cytomegalovirus
  • CMV retinitis
  • treatment CMV retinitis
  • diagnosis CMV retinitis
  • AIDS-related opportunistic infections
  • eye examination in AIDS

https://doi.org/10.1136/bjophthalmol-2018-312406

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    Footnotes

    • Contributors DH: conceived the project, designed the work, acquired the data, and collaborated in the analysis and interpretation of the data, and drafting the paper. NNT: collaborated in the design of the work and acquiring the data. FNS: collaborated in the design of the work and acquiring the data. JDK: collaborated in the analysis and interpretation of the data and drafting and revising of the paper. CEO: collaborated in the analysis and interpretation of the data and drafting and revising of the paper. GNH: collaborated in the analysis and interpretation of the data and drafting and revising of the paper. WLD: collaborated in the analysis and interpretation of the data and drafting and revising of the paper. All authors approved the final version.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Not required.

    • Ethics approval This study did not require ethical approval because it used retrospective de-identified data.

    • Provenance and peer review Not commissioned; externally peer reviewed.