Incidence of Cytomegaloviru (CMV) Retiniti in econd Eye of Patient With the Acquired Immune Deficiency yndrome and Unilateral CMV Retiniti

Purpoe To evaluate the rik and rik factor for developing cytomegaloviru (CMV) retiniti in previouly uninvolved econd eye among patient with unilateral CMV retiniti. Deign Cohort tudy. Method etting: ingle-center academic AID ophthalmology practice. patient population: Three hundred eventy-ix conecutive patient with AID and unilateral CMV retiniti were followed from the time of CMV retiniti diagnoi for the development of econd-eye retiniti. experimental procedure: Demographic and clinical characteritic were noted at baeline. Ue of highly active antiretroviral therapy (HAART) and immune recovery in repone to HAART were noted propectively. main outcome meaure: Development of CMV retiniti in a previouly uninvolved eye. Reult Ninety-one percent of ubject received ytemic anti-CMV treatment. econd-eye retiniti occurred in 26.1%/peron-year (19.6% within the firt 6 month), le than half the rate previouly reported in untreated group. Initial CD4+ T cell count >12 cell/μl, ue of HAART, and initial poterior pole involvement were aociated with 64%, 46%, and 41% reduction in incidence vi-à-vi comparion group. Benefit from HAART wa limited to that ubet who developed immune recovery of a degree expected to retore innate control of CMV (a rie in the CD4+ T cell count by >50 cell/μl to a level >100 cell/μl). Concluion The rik of econd-eye retiniti i ubtantial in patient with unilateral CMV retiniti but appear to be reduced by anti-CMV therapy and by HAART-induced immune recovery. Patient are at highet rik when CD4+ T cell count are very low and in the month immediately after CMV retiniti diagnoi