Kozner Pavel, Rozsypal Hanus, Machala Ladislav, Filous Ales, Brozek Bretislav
Eye Department, The Faculty Hospital Na Bulovce, Prague, Czech Republic.
Klin Mikrobiol Infekc Lek. 2009 Oct;15(5):180-2.
CMV retinitis is the most serious ocular complication of AIDS. Introduction of the combination antiretroviral therapy markedly reduced the occurrence of CMV retinitis, on the other hand it brought a new ocular complication - CMV uveitis. CMV uveitis is an immunopathological inflammatory reaction associated with the immune reconstitution inflammatory syndrome, which is a side effect of successfully initiated cART. These two forms of CMV ocular complications differ in pathogenesis, symptomatology and therapy. The CMV retinitis is treated with anti-CMV virostatics whereas the therapy of CMV uveitis is based on attenuation of the inflammatory reaction by administration of corticosteroids. The optimal prevention of both complications is an early initiation of cART before the CD4+ T lymphocytes drop below 200/microl.
巨细胞病毒性视网膜炎是艾滋病最严重的眼部并发症。联合抗逆转录病毒疗法的引入显著降低了巨细胞病毒性视网膜炎的发生率，另一方面，它带来了一种新的眼部并发症——巨细胞病毒性葡萄膜炎。巨细胞病毒性葡萄膜炎是一种与免疫重建炎症综合征相关的免疫病理炎症反应，这是成功启动cART的一种副作用。这两种形式的巨细胞病毒眼部并发症在发病机制、症状学和治疗方面有所不同。巨细胞病毒性视网膜炎用抗巨细胞病毒抑制病毒药物治疗，而巨细胞病毒性葡萄膜炎的治疗基于通过给予皮质类固醇减轻炎症反应。对这两种并发症的最佳预防是在CD4 + T淋巴细胞降至低于200/微升之前尽早启动cART。
