PMID- 27984023
OWN - NLM
STAT- MEDLINE
DCOM- 20170602
LR  - 20181113
IS  - 1879-1891 (Electronic)
IS  - 0002-9394 (Print)
IS  - 0002-9394 (Linking)
VI  - 174
DP  - 2017 Feb
TI  - Cytomegalovirus Retinitis in Patients With Acquired Immunodeficiency Syndrome 
      After Initiating Antiretroviral Therapy.
PG  - 23-32
LID - S0002-9394(16)30523-2 [pii]
LID - 10.1016/j.ajo.2016.10.011 [doi]
AB  - PURPOSE: To evaluate the rates of new-onset cytomegalovirus (CMV) retinitis and 
      worsening existing CMV retinitis in patients with AIDS after initiating 
      combination antiretroviral therapy (cART) and the role of an immune recovery 
      inflammatory syndrome (IRIS). DESIGN: Cohort study. METHODS: Immune recovery was 
      defined as an increase in CD4(+) T cells to >/=100 cells/muL; rates of new-onset CMV 
      retinitis and of worsening of CMV retinitis (either increasing border activity or 
      retinitis progression) were compared between those with and without immune 
      recovery. RESULTS: Among patients without CMV retinitis, 1 of 75 patients with 
      immune recovery developed CMV retinitis in the first 6 months after initiating 
      cART vs 1 of 31 without immune recovery (P = .14). Among patients with CMV 
      retinitis, the rates of retinitis progression and increasing retinitis border 
      activity among patients during the first 6 months after initiating cART in those 
      with immune recovery were 0.11 per person-year (PY; 95% confidence interval [CI] 
      0-0.62) and 0.11 per PY (95% CI 0-0.62), respectively, vs 0.67 per PY (95% CI 
      0.22-1.56) and 0.40 per PY (95% CI 0.08-1.17), respectively, for those without 
      immune recovery (P = .11 and .47). CONCLUSIONS: Among persons with AIDS who 
      experience immune recovery, there was neither an increased rate of new-onset CMV 
      retinitis nor worsening of existing CMV retinitis in the first 6 months after 
      initiating cART vs those without immune recovery. These data are consistent with 
      the known 3- to 6-month lag in recovery of specific immunity to CMV after 
      initiating cART and suggest that "immune recovery retinitis," a proposed immune 
      recovery inflammatory syndrome phenomenon, is rare.
CI  - Copyright (c) 2016 Elsevier Inc. All rights reserved.
FAU - Jabs, Douglas A
AU  - Jabs DA
AD  - Departments of Ophthalmology and Medicine, The Icahn School of Medicine at Mount 
      Sinai, New York, New York; Center for Clinical Trials, Department of 
      Epidemiology, The Johns Hopkins University Bloomberg School of Public Health, 
      Baltimore, Maryland. Electronic address: douglas.jabs@mssm.edu.
FAU - Van Natta, Mark L
AU  - Van Natta ML
AD  - Center for Clinical Trials, Department of Epidemiology, The Johns Hopkins 
      University Bloomberg School of Public Health, Baltimore, Maryland.
FAU - Holland, Gary N
AU  - Holland GN
AD  - UCLA Stein Eye Institute, Department of Ophthalmology, David Geffen School of 
      Medicine, University of California, Los Angeles, Los Angeles, California.
FAU - Danis, Ronald
AU  - Danis R
AD  - Department of Ophthalmology, The University of Wisconsin School of Medicine and 
      Public Health, Madison, Wisconsin.
CN  - Studies of the Ocular Complications of AIDS Research Group
LA  - eng
GR  - U10 EY008052/EY/NEI NIH HHS/United States
GR  - U10 EY008057/EY/NEI NIH HHS/United States
GR  - U10 EY008067/EY/NEI NIH HHS/United States
PT  - Journal Article
PT  - Multicenter Study
PT  - Observational Study
DEP - 20161027
PL  - United States
TA  - Am J Ophthalmol
JT  - American journal of ophthalmology
JID - 0370500
RN  - 0 (Antiviral Agents)
SB  - IM
MH  - AIDS-Related Opportunistic Infections/*drug therapy/immunology
MH  - Adult
MH  - *Antiretroviral Therapy, Highly Active
MH  - Antiviral Agents/therapeutic use
MH  - CD4 Lymphocyte Count
MH  - Cytomegalovirus Retinitis/*drug therapy/immunology
MH  - Disease Progression
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Immunity, Cellular
MH  - Male
MH  - Prospective Studies
MH  - Time Factors
MH  - Visual Acuity
PMC - PMC5253245
MID - NIHMS825730
EDAT- 2016/12/17 06:00
MHDA- 2017/06/03 06:00
PMCR- 2018/02/01
CRDT- 2016/12/17 06:00
PHST- 2016/07/21 00:00 [received]
PHST- 2016/10/12 00:00 [revised]
PHST- 2016/10/14 00:00 [accepted]
PHST- 2016/12/17 06:00 [pubmed]
PHST- 2017/06/03 06:00 [medline]
PHST- 2016/12/17 06:00 [entrez]
PHST- 2018/02/01 00:00 [pmc-release]
AID - S0002-9394(16)30523-2 [pii]
AID - 10.1016/j.ajo.2016.10.011 [doi]
PST - ppublish
SO  - Am J Ophthalmol. 2017 Feb;174:23-32. doi: 10.1016/j.ajo.2016.10.011. Epub 2016 
      Oct 27.