Karavellas M P, Plummer D J, Macdonald J C, Torriani F J, Shufelt C L, Azen S P, Freeman W R
Department of Ophthalmology, Shiley Eye Center, University of California, San Diego, La Jolla, CA 92093-0946, USA.
J Infect Dis. 1999 Mar;179(3):697-700. doi: 10.1086/314639.
This study was conducted to determine the likelihood of the development of a new ocular inflammatory syndrome (immune recovery vitritis, IRV), which causes vision loss in AIDS patients with cytomegalovirus (CMV) retinitis, who respond to highly active antiretroviral therapy (HAART). We followed 30 HAART-responders with CD4 cell counts of >/=60 cells/mm3. Patients were diagnosed with IRV if they developed symptomatic vitritis of >/=1+ severity associated with inactive CMV retinitis. Symptomatic IRV developed in 19 (63%) of 30 patients and in 26 (59%) of 44 eyes over a median follow-up from HAART response of 13.5 months. The annual incidence of IRV was 83/100 person-years. Excluding patients with previous cidofovir therapy did not significantly alter the time course of IRV (P=.79). These data suggest that IRV develops in a significant number of HAART-responders with CMV retinitis and is unrelated to previous cidofovir therapy.
本研究旨在确定一种新的眼部炎症综合征（免疫恢复性葡萄膜炎，IRV）发生的可能性，该综合征会导致巨细胞病毒（CMV）视网膜炎的艾滋病患者在接受高效抗逆转录病毒治疗（HAART）后出现视力丧失。我们对30名CD4细胞计数≥60个细胞/mm³的HAART反应者进行了随访。如果患者出现与非活动性CMV视网膜炎相关的≥1+严重程度的症状性葡萄膜炎，则诊断为IRV。在HAART反应后的中位随访期为13.5个月时，30名患者中有19名（63%）出现了症状性IRV，44只眼中有26只（59%）出现了症状性IRV。IRV的年发病率为83/100人年。排除先前接受西多福韦治疗的患者并没有显著改变IRV的病程（P = 0.79）。这些数据表明，大量患有CMV视网膜炎的HAART反应者会发生IRV，且与先前的西多福韦治疗无关。
