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Ophthalmology. 2007 Apr;114(4):780-6. Epub 2007 Jan 25.

Longitudinal study of the ocular complications of AIDS: 1. Ocular diagnoses at enrollment.

Author information

1
Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. djabs@jhmi.edu

Abstract

OBJECTIVE:

To report the prevalence of ocular complications of AIDS in the era of highly active antiretroviral therapy (HAART).

DESIGN:

Cohort study.

PARTICIPANTS:

Patients with AIDS, 13 years or older.

METHODS:

History, eye examination, and laboratory testing at enrollment.

MAIN OUTCOME MEASURE:

Frequency of ocular complications at enrollment.

RESULTS:

As of March 31, 2003, 1632 participants with AIDS were enrolled. The cohort had a history of severe immune deficiency, as evidenced by a median nadir CD4+ T-cell count of 30 cells per microliter. At enrollment, the median CD4+ T-cell count was 164 cells per microliter. CD4+ T-cell counts were <50 in 24.1% but > or =100 in 63.6% and > or =200 in 43.0%. Cytomegalovirus (CMV) retinitis was present in 22.1%, whereas other ocular opportunistic infections each were present in < or =0.6%. The incidence of CMV retinitis estimated from retrospective data was 5.60/100 person-years. Of the 360 patients with CMV retinitis, 22.5% were newly diagnosed at enrollment, and the remainder had more long-standing CMV retinitis (median, 2.8 years).

CONCLUSIONS:

Although there is the possibility of oversampling patients with AIDS and ocular complications (as compared with a random sample), which would lead to increased estimates of prevalent and incident ocular morbidities, these data still suggest a substantial decline in the incidence of CMV retinitis from the pre-HAART era. Nevertheless, new cases of CMV retinitis continue to occur, and there is a population of patients with long-standing retinitis who will require management.

PMID:
17258320
DOI:
10.1016/j.ophtha.2006.11.008
[Indexed for MEDLINE]

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