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Am J Ophthalmol. 2012 Jun;153(6):1016-24.e5. doi: 10.1016/j.ajo.2011.11.014. Epub 2012 Feb 4.

Incidence of cytomegalovirus retinitis in the era of highly active antiretroviral therapy.

Collaborators (473)

Lewis RA, Bourg JM, Krason Z, Morales JF, Orengo-Nania S, Spencer SS, Stephenson KR, Weikert MP, Allen RC, Fainstein V, Frady P, Gross R, Samo TC, Schmidt A, Shawver L, Shigley J, Slight B, Sotuyo R, Travers S, Yeh S, Gibbs D, Jordan D, Myles B, Rutter J, Capone A Jr, Furukuwa D, Gibbs A, Hubbard B, Baker S, Martin DF, Schwent B, Srivastava SK, Goldman M, Brown J, Ciulla T, Craft J, Danis R, Fry P, Gao H, Richardson JD, Steffens T, Wheat LJ, Zwickl B, Dunn JP, Brown DM, Cain D, Emmert D, Herring M, Leder HA, Livingston AG, Nolan KD, Semba RD, Thorne JE, Barditch-Crovo P, Bélair ML, Bolton SG, Brodine JB, Brune LM, Galor A, Jabs DA, Jacobowitz A, Kapoor M, Kedhar SR, Kempen JH, Kim SJ, Morton Y, Oliver AL, Peters GB 3rd, Soto P, Stevenson R, Tarver-Carr M, Wittenberg S, Wang MY, Bergsma D, Clark R, Cooper R, Fuller B, Jarrott C, O'Sullivan SP, Romero C, Barron B, Bye R, Conway M, Dillon L, Elison J, Lombard A, Otillio L, Peyman G, Reinoso M, Rescigno R, Bhagat N, Paez-Boham R, Paez-Quinde M, Heinemann MH, Cho M, Coleman S, Daniel S, Janis R, Khanifar A, Kozbial A, Rivera DI, Sepkowitz K, Boyd K, Chan RV, Chiu C, Cole C, Doering C, Elison J, Lee S, Lu F, Murphy J, Pachydaki S, Peroni C, Rahhal FM, Reddy A, Warden S, Friedberg DN, Addessi A, Dieterich D, Lorenzo-Latkany M, Pei M, McMeeking A, Lyon AT, Ackatz L, Gill M, Kaminski L, Mirza R, Murphy R, Palella F, Ramirez C, Rozenbajgier Z, Ryan D, Simjanoski E, Habib A, Koecher J, Mathura J, Muñana A, Shankle J, Weinberg DV, Yuhr J, MacCumber MW, Gaynes B, Giannoulis C, Hulvey P, Kessler H, Khan HS, Kopp A, Merrill P, Morini F, Smith N, Tenorio A, Voskuil-Marre D, Woo K, Kuppermann BD, Alexandiescu B, Forthal DN, Grijalva J, Jehan F, Lopez K, Magallon R, Moinfar N, Trump B, Vega M, Williams R, Holland GN, Almanzor RD, Carlson ME, Gonzales S, Johiro AK, Kalyani PS, LeBeck DL, Lipka KM, Ransome SS, Castellanos JT, Chafey SA, Charonis AC, Craddock JA, Kapamajian MA, Kappel PJ, Moe AA, Piñón G, Sanderson A, Shah KH, Stalling R, Thayer D, Vaudaux JD, Kozak I, Cochran D, Freeman WR, Holmes L, Nguyen V, Yesensky K, Chaidhawanqual S, Cheng L, Clark T, Cleveland M, Gannon RL, Garcia C, Goldberg D, Hedaya J, Karavellas M, Kemper T, Kosobucki B, Loughran M, Magana L, Mask A, Morrison V, Oster S, Reagan N, Song MK, Torriani F, Wong D, Young T, Duncan J, Ballesteros F Jr, Bhisitkul R, Brown D, Clay D, Deiner M, Eubank D, Jacobson M, Lew M, Margolis T, Mian A, Aberg J, Hoffman J, Irvine A, Larson J, Jody L, Narahara M, Trinidad M, Meredith TA, Barnhart S, Cantrell D, Garg S, Houghton O, Kaur H, Landers MB, Moyer S, Wohl D, Betran S, DeBoer K, Eifrig D, Foley J, Hartnett E, Jeffries A, Kylstra J, Longmire B, Myers S, N'Dure F, Oh KT, Pantell J, Pedersen S, Rich C, Sotelo CA, van der Horst C, Wadhvania S, Nichols CW, Bardsley M, Devine CC, Kostman J, Maguire A, Nyberg W, Helker C, MacGregor R, McGibney K, Mickelberg K, Smith L, Lim JI, Bhatti R, Canzano J, Chang TS, Charonis A, Chong L, Equi R, Fawzi A, Flaxel C, Garcia J, Klesert T, Francoise K, Levin L, Nichols T, Pelzek C, Podilla M, Richine L, Romo D, Sadda S, Scartozzi R, See R, Shiramizu K, Thomas M, Walonker AF, Walsh A, Wu Z, Pavan PR, Albritton K, Leto J, Brian M, Mayor L, Oehler R, Patel N, Saxon W, Sherouse S, Burrows A, Carlton S, Goldstein B, Gompf S, Hernandez B, Iyer M, Kelty P, Kramer A, Millard S, Nadler J, Paulter SE, Tordilla-Wadia J, Walker N, Davis G, Blem R, Bourg JM, Horna J, Kelso C, Krason Z, Li HK, Nguyen LC, Nolen R, Onarato M, Paar D, Rivas S, Seitz V, Spillar H, Uwaydat S, Jabs DA, Hilal Y, Nieves M, Pascual K, Slutsky-Sanon J, Southall JC, Stevens M, Meinert CL, Ahuja A, Amend-Libercci DA, Collins KL, Collison BJ, Colvin R, Dodge J, Donithan M, Ewing C, Frick K, Holbrook JT, Isaacson MR, Jackson RM, Livingston H, McCaffrey L, Puhan M, Reyes G, Smith J, Smith M, Sugar E, Thorne JE, Tonascia JA, Van Natta ML, Wagoner A, Benham C, Foster G, Harle J, Kaplan Gilpin AM, Kempen JH, Martin BK, Min N, Murrow L, Oziemkowska MJ, Ng WP, Scott PE, Smothers E, West E, Woo C, Wu A, Zong A, Danis R, Chandler C, Gangaputra S, Guilfoil G, Hubbard L, Joyce J, Pauli T, Robinson N, Thayer D, Pak JW, Zhang G, Altaweel M, Armstrong J, Davis MD, Glaeser S, Hughes K, Hurlburt D, Kastorff L, Neider M, Traut T, Vanderhoof-Young M, Wabers H, Natalie K, Jabs DA, Danis R, Kurinij N, Meinert CL, Thorne JE, Davis MD, Holbrook JT, Jabs DA, Dunn JP, Holland GN, Isaccson MR, Jacobson M, Kurinij N, Lewis R, Nolan KD, Meinert CL, Nyberg W, Palella F, Thorne JE, Addessi A, Brune L, Clark R, Clark T, Davis J, Davis MD, Freeman WR, Friedberg D, Gilman J, Holbrook JT, Horna J, Hubbard L, Jacobson M, Martin DF, Meredith TA, Muñana A, Murphy R, Pavan PR, Spencer S, Steffens T, Thayer D, van der Horst C, Wallach F, Phair JP, Conway BP, Danis R, Davis BR, Jabs DA, Kurinij N, Meinert CL, Musch D, Nussenblatt RB, Thorne JE, Whitley R, Wolf L, Brown BW Jr, Davis MD, Grizzle J, Hillis A, Holbrook JT, Smith H, Tonascia JA, Spencer S, Almanzor RD, Gibbs D, Isaacson M, Lew M, Lewis RA, Ballesteros F, Grijalva J, Lopez K, Neisser LG, Paez-Boham R.

Author information

1
Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21204, USA. esugar@jhsph.edu

Abstract

PURPOSE:

To estimate the incidence of cytomegalovirus (CMV) retinitis in the era of highly active antiretroviral therapy (HAART) and to characterize the factors associated with increased risk of CMV retinitis.

DESIGN:

Prospective cohort study.

METHODS:

A total of 1600 participants with acquired immunodeficiency syndrome (AIDS) but without CMV retinitis at enrollment who completed at least 1 follow-up visit in the Longitudinal Study of the Ocular Complications of AIDS (LSOCA) were seen every 6 months to obtain disease and treatment history, ophthalmic examination, and laboratory testing. Incidence of CMV retinitis and risk factors for incident CMV retinitis were assessed.

RESULTS:

The incidence rate of CMV retinitis in individuals with AIDS was 0.36/100 person-years (PY) based upon 29 incident cases during 8134 PY of follow-up. The rate was higher for those with a CD4+ T cell count at the immediately prior visit below 50 cells/μL (3.89/100 PY, P < .01), whereas only 1 individual with a CD4+ T cell count of 50 to 99 cells/μL and 2 individuals with a CD4+ T cell count >100 cells/μL developed CMV retinitis. Having a CD4+ T cell count below 50 cells/μL at the clinical visit prior to CMV retinitis evaluation was the single most important risk factor (HR: 136, 95% CI: 30 to 605, P < .0001) for developing retinitis.

CONCLUSIONS:

Patients with AIDS, especially those with severely compromised immune systems, remain at risk for developing CMV retinitis in the HAART era, although the incidence rate is reduced from that observed in the pre-HAART era.

PMID:
22310076
PMCID:
PMC3358595
DOI:
10.1016/j.ajo.2011.11.014
[Indexed for MEDLINE]
Free PMC Article
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