Shah Jinesh M, Leo Seo W, Lee Tian L, Tan Xiu L, Pan James C, Wong Elizabeth P, Yong Vernon K, Lim Tock H, Teoh Stephen C
a Yong Loo Lin School of Medicine, National University of Singapore , Singapore .
b Dr Leo Adult & Paediatric Eye Specialist , Singapore .
Ocul Immunol Inflamm. 2015;23(5):362-70. doi: 10.3109/09273948.2014.902472. Epub 2014 Apr 11.
Identification of optimal enrollment criteria for a CMVR screening program suitable for a resource-limited environment.
A prospective audit was performed on newly diagnosed HIV patients referred for CMVR screening with any of the following four criteria: (1) visual symptoms, (2) low CD4(+) counts (<50 cells/µL), (3) AIDS-defining illnesses (ADI), and/or (4) opportunistic infections (OI). Odds ratios for each of the demographic factors and enrollment criteria were calculated. Sensitivities, specificities, and workload reduction for the various combinations were determined.
A total of 348 screening visits for 176 HIV patients were performed. While individually only ADI was statistically significant for increased CMVR risk, the combination of CD4(+) counts <50 cells/μL with either ADI or visual symptoms or all 3 criteria were also statistically significant. Two enrollment criteria, ADI and ADI with CD4(+) <50 cells/μL, demonstrated good sensitivities, specificities, and workload reduction.
We propose ADI and possibly CD4(+) counts <50 cells/μL as enrollment criteria for CMVR screening.
确定适用于资源有限环境的巨细胞病毒性视网膜炎（CMVR）筛查项目的最佳纳入标准。
对新诊断的HIV患者进行前瞻性审计，这些患者根据以下四个标准中的任何一个被转诊进行CMVR筛查：（1）视觉症状，（2）低CD4（+）细胞计数（<50个细胞/微升），（3）艾滋病定义疾病（ADI），和/或（4）机会性感染（OI）。计算每个人口统计学因素和纳入标准的优势比。确定各种组合的敏感性、特异性和工作量减少情况。
对176名HIV患者进行了总共348次筛查就诊。虽然单独来看只有ADI对CMVR风险增加具有统计学意义，但CD4（+）细胞计数<50个细胞/微升与ADI或视觉症状或所有三个标准的组合也具有统计学意义。两个纳入标准，即ADI以及ADI合并CD4（+）<50个细胞/微升，显示出良好的敏感性、特异性和工作量减少。
我们建议将ADI以及可能的CD4（+）细胞计数<50个细胞/微升作为CMVR筛查的纳入标准。
