Banker Alay S, Patel Atul
Banker's Retina Clinic and Laser Centre, 5 Subhash Society, Behind Ishvar Bhuvan, Ahmedabad 380 009, India.
Indian J Ophthalmol. 2002 Mar;50(1):29-33.
To study the various changes in the course of cytomegalovirus (CMV) retinitis following combination antiretroviral treatment.
Combination antiretroviral treatment was given to 12 patients with active CMV retinitis following which all anti-CMV medications were discontinued once the CD4 cell counts were > 100/mm3 for 3 months.
The median CD4 cell count increased from 36.5/mm3 (range, 3-74/mm3) at baseline to 175.5/mm3 (range, 97-410/mm3) at 3 months. No patient had reactivation of CMV retinitis or developed extraocular CMV infection during median follow-up of 16.7 months. In one patient with peripheral active CMV retinitis, the retinitis resolved completely and remained so throughout the follow-up period without specific anti-CMV treatment. Five (41.7%) patients had immune recovery vitritis.
Patients receiving combination antiretroviral treatment following treatment for CMV retinitis have better control of CMV retinitis but immune recovery vitritis is a common sequelae. Reactivation of CMV retinitis is common in patients who discontinue combination antiretroviral treatment.
研究联合抗逆转录病毒治疗后巨细胞病毒（CMV）视网膜炎病程中的各种变化。
对12例活动性CMV视网膜炎患者给予联合抗逆转录病毒治疗，一旦CD4细胞计数连续3个月>100/mm³，即停用所有抗CMV药物。
CD4细胞计数中位数从基线时的36.5/mm³（范围3 - 74/mm³）增至3个月时的175.5/mm³（范围97 - 410/mm³）。在16.7个月的中位随访期内，无患者出现CMV视网膜炎复发或发生眼外CMV感染。1例患有周边活动性CMV视网膜炎的患者，视网膜炎完全消退，且在整个随访期内未接受特异性抗CMV治疗，病情一直保持稳定。5例（41.7%）患者发生免疫恢复性葡萄膜炎。
CMV视网膜炎治疗后接受联合抗逆转录病毒治疗的患者对CMV视网膜炎有更好的控制，但免疫恢复性葡萄膜炎是常见的后遗症。停用联合抗逆转录病毒治疗的患者中，CMV视网膜炎复发很常见。
