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Scientific article
English

Cytomegalovirus retinitis: decreased risk of bilaterality with increased use of systemic treatment. Swiss HIV Cohort Study Group

Published inClinical infectious diseases, vol. 24, no. 4, p. 620-624
Publication date1997
Abstract

Cytomegalovirus (CMV) retinitis may be treated systemically or intravitreally. We reviewed retrospectively patients with CMV retinitis, in order to determine whether systemic treatment was associated with less spread of CMV retinitis from one eye to the other. Of 222 cases, 92 patients had bilateral disease at onset of CMV retinitis, leaving 130 for analysis. Bilaterality occurred in 10 patients during 12,687 days of systemic treatment and in 34 during 14,791 days without systemic treatment (odds ratio [OR] = 2.92; confidence interval [CI], 1.44-5.90). Patients who had received systemic treatment for <50% of the follow-up period had a greater risk of bilaterality (OR = 3.7; CI, 2.79-4.54) than did the more intensively treated patients. CD4 cell levels also contributed to increased risk, but multivariate analysis showed that CD4 cell counts and treatment intensity were independent risk factors. CMV retinitis was more likely to become bilateral in patients who received less intravenous therapy. Local treatment can complete but does not replace systemically administered therapy.

Keywords
  • Adult
  • Antiviral Agents/ administration & dosage
  • CD4 Lymphocyte Count
  • Cytomegalovirus Retinitis/ drug therapy/immunology/ prevention &
  • Control/transmission
  • Drug Therapy, Combination
  • Female
  • Follow-Up Studies
  • Foscarnet/ administration & dosage
  • Ganciclovir/ administration & dosage
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome
Citation (ISO format)
STALDER, N. et al. Cytomegalovirus retinitis: decreased risk of bilaterality with increased use of systemic treatment. Swiss HIV Cohort Study Group. In: Clinical infectious diseases, 1997, vol. 24, n° 4, p. 620–624.
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ISSN of the journal1058-4838
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