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Ophthalmology. 2010 Jan;117(1):128-132.e2. doi: 10.1016/j.ophtha.2009.06.016. Epub 2009 Oct 8.

Mortality associated with resistant cytomegalovirus among patients with cytomegalovirus retinitis and AIDS.

Author information

1
Department of Ophthalmology, The Johns Hopkins University School of Medicine.douglas.jabs@mssm.edu

Abstract

OBJECTIVE:

To evaluate the effect of drug-resistant cytomegalovirus (CMV) on survival among patients with CMV retinitis.

DESIGN:

Prospective cohort study during 1993 to 2003.

PARTICIPANTS:

We included 266 patients with AIDS and newly diagnosed CMV retinitis treated with either ganciclovir or foscarnet.

METHODS:

Data on ganciclovir and foscarnet resistance were obtained from blood and urine specimens collected at regular, predetermined intervals. The effect of resistant CMV on mortality was evaluated with a time-dependent Cox proportional hazard model.

MAIN OUTCOME MEASURES:

Mortality.

RESULTS:

The median survival of the entire cohort was 12.6 months. Analysis of risk factors for mortality demonstrated that resistant CMV was associated with an increased mortality (hazard ratio, 1.65; 95% confidence interval, 1.05-2.56; P = 0.032). Among the other parameters tested, only time since AIDS diagnosis was associated significantly with mortality, with a hazard ratio of 1.10 per year since AIDS diagnosis (P = 0.001).

CONCLUSIONS:

Resistant CMV is associated with increased mortality among patients with AIDS being treated for CMV retinitis.

FINANCIAL DISCLOSURE(S):

Proprietary or commercial disclosure may be found after the references.

PMID:
19818505
PMCID:
PMC2815221
DOI:
10.1016/j.ophtha.2009.06.016
[Indexed for MEDLINE]
Free PMC Article

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