Immune recovery uveitis in patients with AIDS and cytomegalovirus retinitis after highly active antiretroviral therapy - 05/09/11

Doi : 10.1016/S0002-9394(00)00356-1

Quan Dong Nguyen, MD, MS ^a, John H Kempen, MD, MPH ^a, Stephen G Bolton ^a : CRNP, James P Dunn, MD ^a, Douglas A Jabs, MD, MS ^a,^b,⁎
^a Department of Ophthalmology, The Johns Hopkins University School of Medicine, Baltimore, Maryland USA (Drs Nguyen, Kempen, Dunn, and Jabs and Mr Bolton)
^b Department of Medicine (Dr Jabs), The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

^*Reprints requests to Douglas A. Jabs, MD, MS, 550 N Broadway, Suite 700, Baltimore, MD 21205; fax: (410) 955-0629

Abstract

PURPOSE: To estimate the incidence and describe the characteristics of immune recovery uveitis in patients with acquired immunodeficiency syndrome (AIDS) and cytomegalovirus retinitis treated with highly active antiretroviral therapy.

METHODS: The records of all patients with AIDS and cytomegalovirus retinitis from 1995 to 1998 seen at the AIDS Ophthalmology Service of the Johns Hopkins Medical Institutions were reviewed. Eighty-two patients with cytomegalovirus retinitis treated with highly active antiretroviral therapy were identified. Thirty-three patients (40.2%) were classified as responders to highly active antiretroviral therapy, defined as an increase in CD4+ T-cell count by 50 cells/μL or more to a level of 100 cells/μL or more.

RESULTS: Immune recovery uveitis occurred in six patients. Among the 33 patients with an immunologic response to highly active antiretroviral therapy, the incidence rate of immune recovery uveitis was 0.109/person-year. Ocular complications associated with immune recovery uveitis included cystoid macular edema (four patients), epiretinal membranes (two patients), and optic disk neovascularization (one patient).

CONCLUSIONS: Immune recovery uveitis was uncommon in our population but may have vision-impairing complications.

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This study was supported in part by grants EY10268 (Dr Jabs) and EY00386 (Dr Kempen) from the National Eye Institute, National Institutes of Health, Bethesda, Maryland. Dr Nguyen is a recipient of the Heed Ophthalmic Foundation Fellowship, the American Ophthalmological Society–Herman Knapp Fellowship, and the National Institutes of Health–National Research Service Award.

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Vol 129 - N° 5

P. 634-639 - mai 2000 Retour au numéro

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Immune recovery uveitis in patients with AIDS and cytomegalovirus retinitis after highly active antiretroviral therapy - 05/09/11

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