泰国南部 AIDS 相关巨细胞病毒视网膜炎患者视力丧失的发病率和危险因素。
Incidence Rates and Risk Factors for Vision Loss among AIDS-Related Cytomegalovirus Retinitis Patients in Southern Thailand.
机构信息
a Department of Ophthalmology, Faculty of Medicine , Prince of Songkla University , Hat Yai , Thailand.
出版信息
Ocul Immunol Inflamm. 2018;26(1):82-89. doi: 10.1080/09273948.2017.1283044. Epub 2017 Mar 21.
PURPOSE
To describe the incidence of and risk factors for visual acuity (VA) loss in patients with AIDS and cytomegalovirus (CMV) retinitis.
METHODS
A total of 132 patients were included. The main outcome measurements were the incidences of VA loss to ≤20/50 and ≤20/200.
RESULTS
The incidences of VA loss to ≤20/50 and ≤20/200 were 0.22/eye-year (EY) and 0.12/EY, respectively. Risk factors for the incidence of VA loss to ≤20/50 were low nadir CD4 T-cell count (adjusted hazard ratio [aHR], 3.1), large area of retinitis (aHR, 3.7), and no immune recovery (IR) (aHR, 13.9). Risk factors for the incidence of VA loss to ≤20/200 were not receiving highly active antiretroviral therapy (HAART) (aHR, 4.4) and large retinitis area (aHR, 2.1).
CONCLUSIONS
The incidence of VA loss in eyes affected by CMV retinitis was high. The use of HAART, particularly with subsequent immune recovery, substantially reduced the incidence of VA loss.
目的
描述 AIDS 合并巨细胞病毒（CMV）视网膜炎患者视力丧失的发生率和危险因素。
方法
共纳入 132 例患者。主要观察指标为视力丧失至≤20/50 和≤20/200 的发生率。
结果
视力丧失至≤20/50 和≤20/200 的发生率分别为 0.22/眼年（EY）和 0.12/EY。视力丧失至≤20/50 的发生率的危险因素包括：CD4 细胞计数最低值低（调整后的危险比[aHR]，3.1）、视网膜炎面积大（aHR，3.7）和无免疫恢复（IR）（aHR，13.9）。视力丧失至≤20/200 的发生率的危险因素包括：未接受高效抗逆转录病毒治疗（HAART）（aHR，4.4）和视网膜炎面积大（aHR，2.1）。
结论
CMV 视网膜炎影响的眼视力丧失发生率较高。HAART 的使用，特别是随后的免疫恢复，显著降低了视力丧失的发生率。
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