ABSTRACT
PURPOSE: To calculate the incidence of, and to identify the risk factors for developing contralateral eye involvement among patients with AIDS and unilateral cytomegalovirus retinitis (CMV retinitis), who were treated, in the era of highly-active antiretroviral therapy (HAART), with repetitive intravitreal ganciclovir injections. MATERIALS AND METHODS: The clinical records of 119 patients were included. The main outcome measurement was the occurrence of contralateral eye involvement. RESULTS: Over a mean follow-up period of 1.6 years, the overall incidence rate of contralateral involvement was 0.17/person-year. The cumulative incidence of contralateral involvement at 6 months and 1 year was 23.8% and 28.4%, respectively. Receiving HAART at the visit before the event was associated with a decreased risk of developing contralateral retinitis (hazard ratio [HR] = 0.26, P = 0.002). CONCLUSIONS: The use of HAART, associated with subsequent immune recovery, significantly reduced the incidence of contralateral eye involvement by approximately 75% among patients in our setting.
Subject(s)
AIDS-Related Opportunistic Infections/epidemiology , Antiretroviral Therapy, Highly Active , Antiviral Agents/therapeutic use , Cytomegalovirus Retinitis/epidemiology , Eye Infections, Viral/epidemiology , Ganciclovir/therapeutic use , AIDS-Related Opportunistic Infections/drug therapy , Adult , CD4 Lymphocyte Count , CD4-Positive T-Lymphocytes/immunology , Cohort Studies , Cytomegalovirus Retinitis/drug therapy , Eye Infections, Viral/drug therapy , Female , Follow-Up Studies , Humans , Incidence , Intravitreal Injections , Male , Retrospective Studies , Risk Factors , Visual AcuityABSTRACT
PURPOSE: To calculate the incidence of, and to identify the risk factors for developing contralateral eye involvement among patients with AIDS and unilateral cytomegalovirus retinitis (CMV retinitis), who were treated, in the era of highly-active antiretroviral therapy (HAART), with repetitive intravitreal ganciclovir injections. MATERIALS AND METHODS: The clinical records of 119 patients were included. The main outcome measurement was the occurrence of contralateral eye involvement. RESULTS: Over a mean follow-up period of 1.6 years, the overall incidence rate of contralateral involvement was 0.17/person-year. The cumulative incidence of contralateral involvement at 6 months and 1 year was 23.8% and 28.4%, respectively. Receiving HAART at the visit before the event was associated with a decreased risk of developing contralateral retinitis (hazard ratio [HR] = 0.26, P = 0.002). CONCLUSIONS: The use of HAART, associated with subsequent immune recovery, significantly reduced the incidence of contralateral eye involvement by approximately 75% among patients in our setting.
