RESUMO
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.
Assuntos
Infecções Oportunistas Relacionadas com a AIDS/epidemiologia , Terapia Antirretroviral de Alta Atividade , Antivirais/uso terapêutico , Retinite por Citomegalovirus/epidemiologia , Infecções Oculares Virais/epidemiologia , Ganciclovir/uso terapêutico , Infecções Oportunistas Relacionadas com a AIDS/tratamento farmacológico , Adulto , Contagem de Linfócito CD4 , Linfócitos T CD4-Positivos/imunologia , Estudos de Coortes , Retinite por Citomegalovirus/tratamento farmacológico , Infecções Oculares Virais/tratamento farmacológico , Feminino , Seguimentos , Humanos , Incidência , Injeções Intravítreas , Masculino , Estudos Retrospectivos , Fatores de Risco , Acuidade VisualRESUMO
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.
