Clinical Features of Cytomegalovirus Retinitis in HIV Infected Patients.

Yang Tang,Jianjun Sun,Corklin R Steinhart,Renfang Zhang,Yinzhong Shen,Zhenyan Wang,Li Liu,Wei Song,Tangkai Qi,Taiwen He,Jun Chen

doi:10.3389/fcimb.2020.00136

Yang Tang, Jianjun Sun + Show 9 more

Open Access

https://doi.org/10.3389/fcimb.2020.00136

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Abstract

Objectives: The purpose of this study was to investigate the clinical features and related laboratory indicators of cytomegalovirus retinitis in HIV infected patients in order to find a suitable laboratory reference guide to aid in the early diagnosis of CMVR, which should improve the prognosis of the severe retinitis.Methods: PLHIVs who were admitted to our hospital from January 2010 to December 2016 were included. The diagnosis of AIDS follows the AIDS Treatment Guidelines. Levels of CMV IgG and IgM were measured by ELISA in order to detect the CMV infection status of the patient. CMV-DNA levels were assessed by a quantitative PCR method, and CD4+ T lymphocytes were detected by flow cytometry. Logistical regression was used to analyze the risk factors for CMV retinitis in HIV-infected patients.Results: There were 93 patients with HIV that were also diagnosed with CMV retinitis. After ART, the intraocular pressure, visual acuity, cotton plaque incidence, and CD4+ T lymphocyte count were significantly improved, and the yellow-white retinal lesions gradually disappeared. In patients with HIV infections, the CD4+ T lymphocyte count, and peripheral blood quantitative CMV-DNA levels were found to be independent risk factors for CMV retinitis (P < 0.05). Patients with HIV infection who had CMV-DNA levels >6,390 copies/mL were associated with more severe ophthalmolgic conditions related to CMV retinitis.Conclusion: Patients with HIV infections with quantitative CMV-DNA levels >6,390 copies/mL have a higher probability of having a diagnosis of CMV retinitis and a worse prognosis than those whose CMV-DNA level is <6,390 copies/mL.

Highlights

Cytomegalovirus (CMV) infection is a common late stage AIDS complication and may involve a number of organs (Jacobson and Mills, 1988); of these, CMV retinitis is the most common and may lead to blindness if not diagnosed and treated as early as possible
When the CMV-DNA value was
For patients with HIV infection with CMV-DNA ≥ 2,000 copies/mL, there was an increased risk of CMV retinitis (AOR 2.8, 95% confidence interval (95% confidence interval (CI)) 1.7–4.7)

Summary

Introduction

Cytomegalovirus (CMV) infection is a common late stage AIDS complication and may involve a number of organs (Jacobson and Mills, 1988); of these, CMV retinitis is the most common and may lead to blindness if not diagnosed and treated as early as possible. CMV eye complications in patients with HIV infection often make care of these persons difficult; if they can be diagnosed and treated for CMVR earlier, better outcomes should occur. Developing countries such as Ghana often have different types of CMV retinitis manifestations compared to those reported in developed countries (Holbrook et al, 2003). If not detected and treated in time, posterior complications often lead to severe visual impairment or blindness (Ayena et al, 2010)

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