Non-cytomegalovirus ocular opportunistic infections in patients with acquired immunodeficiency syndrome.
Publication/Presentation Date
2-1-2013
Abstract
PURPOSE: To report the incidence and clinical outcomes of non-cytomegalovirus (non-CMV) ocular opportunistic infections in patients with acquired immunodeficiency syndrome (AIDS) in the era of highly active antiretroviral therapy.
DESIGN: Multicenter, prospective, observational study of patients with AIDS.
METHODS: Medical history, ophthalmologic examination, and laboratory tests were performed at enrollment and every 6 months subsequently. Once an ocular opportunistic infection was diagnosed, patients were seen every 3 months for outcomes.
RESULTS: At enrollment, 37 non-CMV ocular opportunistic infections were diagnosed: 16 patients, herpetic retinitis; 11 patients, toxoplasmic retinitis; and 10 patients, choroiditis. During the follow-up period, the estimated incidences (and 95% confidence intervals [CI]) of these were: herpetic retinitis, 0.007/100 person-years (PY) (95% CI 0.0004, 0.039); toxoplasmic retinitis, 0.007/100 PY (95% CI 0.004, 0.039); and choroiditis, 0.014/ 100 PY (95% CI 0.0025, 0.050). The mortality rates appeared higher among those patients with newly diagnosed or incident herpetic retinitis and choroiditis (rates = 21.7 deaths/100 PY [P = .02] and 12.8 deaths/100 PY [P = .04]), respectively, than those for patients with AIDS without an ocular opportunistic infection (4.1 deaths/100 PY); toxoplasmic retinitis did not appear to be associated with greater mortality (6.4/100 PY, P = .47). Eyes with newly diagnosed herpetic retinitis appeared to have a poor visual prognosis, with high rates of visual impairment (37.9/100 PY) and blindness (17.5/100 PY), whereas those outcomes in eyes with choroiditis appeared to be lower (2.3/100 PY and 0/100 PY, respectively).
CONCLUSIONS: Although uncommon, non-CMV ocular opportunistic infections may be associated with high rates of visual loss and/or mortality.
Volume
155
Issue
2
First Page
206
Last Page
212
ISSN
1879-1891
Published In/Presented At
Gangaputra, S., Drye, L., Vaidya, V., Thorne, J. E., Jabs, D. A., Lyon, A. T., & Studies of the Ocular Complications of AIDS (SOCA) Research Group (2013). Non-cytomegalovirus ocular opportunistic infections in patients with acquired immunodeficiency syndrome. American journal of ophthalmology, 155(2), 206–212.e5. https://doi.org/10.1016/j.ajo.2012.07.019
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
23068916
Department(s)
Administration and Leadership
Document Type
Article