Abstract
A retrospective review of diagnosis of cytomegalovirus retinitis (CMVR) before and after introduction of routine immediate eye examination among AIDS patients in Myanmar with an absolute CD4 T-cell count <100 cells/μL demonstrated an increased detection of CMVR from 1.1% (14/1233) to 10.7% (65/608), an improvement of ~10-fold. Diagnosis of CMVR was achieved a mean of 2 days after clinic enrollment.
Highlights
Win Le Shwe Sin Ei,1 Kyi Pyar Soe,2 Adelene Hilbig,3 Jillian Murray,3 and David Heiden4 1MSFCH, Yangon, Myanmar Mission, Myanmar; 2MSFCH, Dawei, Myanmar Mission, Myanmar; 3Medecins Sans Frontieres, Geneva, Switzerland; 4Pacific Eye Associates, California Pacific Medical Center Department of Ophthalmology, San Francisco, California; Seva Foundation, Berkeley, California
A retrospective review of diagnosis of cytomegalovirus retinitis (CMVR) before and after introduction of routine immediate eye examination among AIDS patients in Myanmar with an absolute CD4 T-cell count
We identified patients with a comorbid diagnosis of CMVR from 2004 until April 2017 using Medicins Sans Frontiers (MSF) FUCHIA software (Epicentre, Paris, France) and conducted chart reviews to extend inclusion of CMVR patients through December 2017
Summary
Cytomegalovirus retinitis (CMVR) is a common late-stage AIDSrelated opportunistic infection that occurred in up to one-third of patients before the combined antiretroviral therapy (cART) era. CMVR accounts for >90% of AIDS-related blindness, and due to inadequate management, a growing cadre of HIV patients are being made well by cART but left irreversibly blind from CMVR. This is highlighted by a report from Thailand, where CMVR followed only curable cataract as a cause of blindness [3], despite only occurring in HIV-positive individuals, who comprise but 1.4% of that general population. Because early diagnosis of CMVR and provision of systemic anti-CMV therapy may provide an opportunity to reduce AIDS mortality and blindness, a premium must be placed on establishing the diagnosis at the earliest possible moment
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