Cytomegaloviru retiniti in HIV-infected patient with and without highly active antiretroviral therapy

PURPOE: To ae the impact of highly active antiretroviral therapy on the epidemiology of cytomegaloviru retiniti in patient infected with the human immunodeficiency viru (HIV). METHOD: In a tudy performed in a ingle center for infectiou dieae, we compared the data collected in 1995 (without highly active antiretroviral therapy) with 1997 data (with highly active antiretroviral therapy). REULT: In a comparion of 1997 with 1995 data, the mean CD4+ cell count of patient with cytomegaloviru (CMV) retiniti wa higher (169 ± 150 CD4/μl v 15 ± 47 CD4/μl) (P = .05), and the relape of CMV retiniti were le frequent (17% v 36%) (P = .02). Newly diagnoed CMV retiniti decreaed from 6.1% (59 of 952 patient) in 1995 to 1.2% (nine of 726 patient) in 1997 (P < .0001). In 1997, patient with newly diagnoed or relaping CMV retiniti had a lower mean CD4+ (37 ± 42) cell count than patient with no relaping CMV retiniti (197 ± 160) (P = .01). CONCLUION: The incidence and recurrence of CMV retiniti decreaed from 1995 to 1997, probably a a reult of retored immunity while the patient were undergoing highly active antiretroviral therapy; however, the increaing frequency of HIV reitance to highly active antiretroviral therapy jutifie cloe ocular follow-up.