Kilimanjaro Centre for Community Ophthalmology, Good Samaritan Foundation, Moshi, Tanzania.
Br J Ophthalmol. 2011 Apr;95(4):460-2. doi: 10.1136/bjo.2010.186965. Epub 2010 Nov 24.
To determine the prevalence of cytomegalovirus virus (CMV) retinopathy among a consecutive group of Tanzanians with AIDS with CD4 count <100 cells/μl.
Patients with HIV infection with CD4 count <100 cells/μl presenting consecutively to infectious disease services at two hospitals were examined by indirect ophthalmoscopy with fully dilated pupils. Additional clinical information was collected by interview and from patient files.
One-hundred and fifty patients with CD4 count <100 cells/μl were examined, of whom 74 had CD4 count <50 cells/μl; 129 patients (86%) were classified as WHO stage 3 or 4. Only two patients (1.3%; 95% CI 0 to 2.3%) had CMV retinitis.
This study demonstrates that AIDS patients in Tanzania do survive into the stage of severe immunosuppression, and that even among this group CMV retinitis is very uncommon. This supports previous studies reporting low prevalence of CMV where CD4 counts were not available. Differences in immune response in AIDS patients in different settings may depend on environmental exposure to specific viruses early in life.
确定连续一组坦桑尼亚艾滋病患者中 CD4 计数<100 细胞/μl 的巨细胞病毒（CMV）视网膜炎的患病率。
对在两家医院传染病科就诊的 HIV 感染患者，使用充分散瞳的间接检眼镜进行检查。通过访谈和患者档案收集其他临床信息。
检查了 150 名 CD4 计数<100 细胞/μl 的患者，其中 74 名患者的 CD4 计数<50 细胞/μl；129 名患者（86%）被归类为世界卫生组织（WHO）3 或 4 期。只有两名患者（1.3%；95%CI 0 到 2.3%）患有 CMV 视网膜炎。
本研究表明，坦桑尼亚的艾滋病患者确实能存活到严重免疫抑制阶段，即使在这一群体中，CMV 视网膜炎也非常罕见。这支持了先前报告 CD4 计数不可用时 CMV 患病率较低的研究。不同环境中艾滋病患者的免疫反应差异可能取决于早期特定病毒的环境暴露。
