Cytomegalovirus Infection (CMV) in Patients with Acquired Immunodeficiency Syndrome

Czech version

Authors: A. Stepanov ¹; A. Feuermannová ¹; L. Hejsek ¹; N. Jirásková ¹; S. Plíšek ²; P. Rozsíval ¹
Authors‘ workplace: Oční klinika, Fakultní nemocnice Hradec Králové, přednosta prof. MUDr. Pavel Rozsíval, CSc., FEBO ¹; Infekční klinika, Fakultní nemocnice Hradec Králové, přednosta doc. MUDr. Stanislav Plíšek, Ph. D. ²
Published in: Čes. a slov. Oftal., 70, 2014, No. 4, p. 132-137
Category: Original Article

Overview

Cytomegalovirus infection (CMV) in patients with acquired immunodeficiency syndrome (Acquired Immune Deficiency Syndrome, AIDS) is the most common opportunistic infection. This infection is harmless for healthy individuals, but for weakened individuals cause disease. The most common form of CMV-infection in patients with AIDS is cytomegalovirus retinitis, which occurs in 15% to 40% of cases. We report the case of aman twenty-five year old, treated for CMV retinitis and retinal vasculitis vessels. Prescribed Valcyte 900mg tbl. twice daily for 21 days with agood therapeutic effect. In patients with AIDS and decreased visual acuity is need be primarily thinking about the possible presence of CMV-infection and in time to start treatment.

Key words:
Cytomegalovirus (CMV) retinitis, AIDS, valganciklovir

Sources

1. Anonymous: Foscarnet-ganciclovir cytomegalovirus retinitis trial: 5. Clinical features of cytomegalovirus retinitis at diagnosis. Studies of Ocular Complications of AIDS Research Group in collaboration with the AIDS Clinical Trials Group. Am J Ophthalmol, 1997; 124: 141–157.

2. Anonymous: Foscarnet-ganciclovir cytomegalovirus retinitis trial. 4. Visual outcomes. Studies of Ocular Complications of AIDS Research Group in collaboration with the AIDS Clinical Trials Group. Ophthalmology, 1994; 101: 1250–1261.

3. Anonymous: Valganciclovir. U.S. Department of Health and Human Services. AIDSinfo, 2004, 1–5. http://aidsinfo.nih.gov/drugs/ htmldrug_tech.asp?int_id_0271. Last accessed February 22, 2006.

4. Batisse, D., Eliaszewicz, M., Zazoun, L., et al.: Acute retinal necrosis in the course of AIDS: study of 26 cases., AIDS, 1996; 10: 55–60.

5. Benz, MS., Glaser, JS., Davis, JL.: Progressive outer retinal necrosis in immunocompetent patients treated initially for optic neuropathy with systemic corticosteroids. Am J Ophthalmol, 2003; 135: 551–553.

6. Bloom, JN., Palestine, AG.: The diagnosis of cytomegalovirus retinitis. Ann Intern Med, 1988, 109: 963-969.

7. Casado, JL., Arrizabalaga, J., Montes, M., et al.: Incidence and risk factors for developing cytomegalovirus retinitis in HIV-infected patients receiving protease inhibitor therapy. Spanish CMV-AIDS Study Group. AIDS, 1999; 13: 1497–1502.

8. Culbertson, WW.: Infections of the retina in AIDS. Int Ophthalmol Clin, 1989; 29: 108-118.

9. Drew, WL., Mintz, L., Miner, RC., et al.: Prevalence of cytomegalovirus infection in homosexual men. J Infect Dis, 1981; 143: 188–192.

10. Drew, WL.: Cytomegalovirus infection in patients with AIDS. J Infect Dis, 1988; 158: 449–456.

11. Dunn, JP., Martin DF.: Treatment of cytomegalovirus (CMV) retinitis in the era of highly active antiretroviral therapy., Elmwood Park, NJ: Medscape from WebMD, 2003. http://www.medscape.com/viewprogram/663. Last accessed February 22, 2006.

12. Egbert, PR., Pollard, RB., Gallagher, JG., et al.: Cytomegalovirus retinitis in immunosupressed hosts. II. Ocular manifestations. Ann Intern Med, 1980; 93: 664–670.

13. Elkins, BS., Holland, GN., Opremcak, EM., et al.: Ocular toxoplasmosis misdiagnosed as cytomegalovirus retinopathy in immunocompromised patients. Ophthalmology, 1994, 101: 499-507.

14. Engstrom, RE, Jr., Holland, GN., Hardy, WD., et al.: Hemorheologic abnormalities in patients with human immunodeficiency virus infection and ophthalmic microvasculopathy. Am J Ophthalmol, 1990; 109: 153–161.

15. Engstrom, RE, Jr., Holland, GN., Margolis, TP., et al.: The progressive outer retinal necrosis syndrome. A variant of necrotizing herpetic retinopathy in patients with AIDS. Ophthalmology, 1994; 101: 1488–1502.

16. Foster, RE., Petersen, MR., Neuss, MN., et al.: Progressive outer retinal necrosis syndrome in a lymphoma patient with good visual outcome., Am J Ophthalmol, 2001; 132: 117–120.

17. Furrer, H., Barloggio, A., Egger, M., et al.: The Swiss HIV Cohort Study. Retinal microangiopathy in human immunodeficiency virus infection is related to higher human immunodeficiency virus-1 load in plasma., Ophthalmology, 2003; 110: 432–436.

18. Gagliuso, DJ., Teich, SA., Friedman, AH., et al.: Ocular toxoplasmosis in AIDS patients. Trans Am Ophthalmol Soc, 1990; 88: 63–86.

19. Gallant, JE., Moore, RD., Richman, DD., et al.: Incidence and natural history of cytomegalovirus disease in patients with advanced human immunodeficiency virus disease treated with zidovudine. The Zidovudine Epidemiology Study Group. J Infect Dis, 1992; 166: 1223–1227.

20. Henderly, DE., Freeman, WR., Causey, DM., et al.: Cytomegalovirus retinitis and response to therapy with ganciclovir. Ophthalmology, 1987; 94: 425–434.

21. Hennis, HL., Scott, AA., Apple, DJ.: Cytomegalovirus retinitis. Surv Ophthalmol, 1989; 34: 193–203.

22. Ho, M.: Epidemiology of cytomegalovirus infections. Rev Infect Dis, 1990; 12(7): 701–710.

23. Hodge, WG., Boivin, JF., Shapiro, SH., et al.: Clinical risk factors for cytomegalovirus retinitis in patients with AIDS. Ophthalmology, 2004; 111: 1326–1333.

24. Holland, G., Tufail, A., Jordan, MC.: Cytomegalovirus diseases. In Pepose, JS., Holland, GN., Wilhelmus, KR., et al.: Ocular Infection & Immunity, New York, Mosby, 1996, s. 1088–1129.

25. Holland, GN., Buhles, WC Jr, Mastre, B., et al.: A controlled retrospective study of ganciclovir treatment for cytomegalovirus retinopathy. Use of a standardized system for the assessment of disease outcome. The UCLA CMV Retinopathy Study Group., Arch Ophthalmol, 1989; 107: 1759–1766.

26. Holland, GN., Engstrom, RE, Jr., Glasgow, BJ., et al.: Ocular toxoplasmosis in patients with acquired immunodeficiency syndrome. Am J Ophthalmol, 1988; 106: 653–667.

27. Holland, GN., Shuler, JD.: Progression rates of cytomegalovirus retinopathy in ganciclovir-treated and untreated patients. Arch Ophthalmol, 1992; 110: 1435–1442.

28. Holland, GN.: Standard diagnostic criteria for the acute retinal necrosis syndrome. Executive Committee of the American Uveitis Society. Am J Ophthalmol, 1994; 117: 663–666.

29. Jabs, DA., Bartlett, JG.: AIDS and ophthalmology: a period of transition. Am J Ophthalmol, 1997, 124: 227-233.

30. Jabs, DA., Van, Natta, ML., Thorne, JE., et al.: Course of cytomegalovirus retinitis in the era of highly active antiretroviral therapy: 1. Retinitis progression. Ophthalmology, 2004; 111: 2224–2231.

31. Jabs, DA., Van, Natta, ML., Thorne, JE., et al.: Course of cytomegalovirus retinitis in the era of highly active antiretroviral therapy: 2. Second eye involvement and retinal detachment. Ophthalmology, 2004; 111: 2232–2239.

32. Jackson, JB., Erice, A., Englund, JA., et al.: Prevalence of cytomegalovirus antibody in hemophiliacs and homosexuals infected with human immunodeficiency virus type 1., Transfusion, 1988; 28: 187–189.

33. Jacobson, MA., Mills, J.: Serious cytomegalovirus disease in the acquired immunodeficiency syndrome (AIDS). Clinical findings, diagnosis, and treatment., Ann Intern Med, 1988; 108: 585–594.

34. Jung, D., Dorr, A.: Single-dose pharmacokinetics of valganciclovir in HIV-and CMV-seropositive subjects. J Clin Pharmacol, 1999; 39: 800–804.

35. Kempen, JH., Jabs, DA., Wilson, LA., et al.: Risk of vision loss in patients with cytomegalovirus retinitis and the acquired immunodeficiency syndrome. Arch Ophthalmol, 2003; 121: 466–476.

36. Kožner, P., Rozsypal, H., Machala, L., et al: Dva typy cytomegalovirového postižení oka u pacientů s HIV infekcí., Klin mikrobiol inf lék, 2009, 15(5): 180-182.

37. Kožner, P., Machala, L., Rozsypal, H., et al: HIV retinopatie. Klin mikrobiol inf lék, 2009, 15(5): 183-184.

38. Kuppermann, BD., Petty, JG., Richman, DD., et al.: Correlation between CD4+ counts and prevalence of cytomegalovirus retinitis and human immunodeficiency virus-related noninfectious retinal vasculopathy in patients with acquired immunodeficiency syndrome. Am J Ophthalmol, 1993; 115: 575–582.

39. Lalezari, J., Lindley, J., Walmsley, S., et al.: A safety study of oral valganciclovir maintenance treatment of cytomegalovirus retinitis. The Roche Valganciclovir Study Group. JAIDS J Acquir Immune Defic Syndr, 2002; 30: 392–400.

40. Lee, CH., Bright, DC., Ferrucci, S.: Treatment of cytomegalovirus retinitis with oral valganciclovir in an acquired immunodeficiency syndrome patient unresponsive to combination antiretroviral therapy. Optometry, 2006; 77: 167–176.

41. Mintz, L., Drew, WL., Miner, RC., et al.: Cytomegalovirus infections in homosexual men. An epidemiological study. Ann Intern Med, 1983; 99: 326–329.

42. Palestine, AG., Rodrigues, MM., Macher, AM., et al.: Ophthalmic involvement in acquired immunodeficiency syndrome. Ophthalmology, 1984; 91: 1092–1099.

43. Pertel, P., Hirschtick, R., Phair, J., et al.: Risk of developing cytomegalovirus retinitis in persons infected with the human immunodeficiency virus. J Acquir Immune Defic Syndr, 1992; 5(11): 1069–1074.

44. Pescovitz, MD., Rabkin, J., Merion, RM., et al.: Valganciclovir results in improved oral absorption of ganciclovir in liver transplant recipients. Antimicrob Agents Chemother, 2000; 44: 2811-2815.

45. Sterling, TR., Chaisson, RE.: General clinical manifestation of human immunodeficiency virus infection (including the acute retroviral syndrome and oral, cutaneous, renal, ocular, and cardiac diseases). In: Mandell, GL., Bennett, JE., Dolin, R.: Mandell, Douglas and Bennett’s principles and practice of infectious diseases., 6th ed., Philadelphia, Elsevier Churchill Livingstone, 2005, s. 1546–1566.

Labels

Ophthalmology

Contrast Sensitivity and Optic Coherence Tomography Examinations in Adolescent Patients with Diabetes Type I Preretinopathy (A Pilot Study)

Rare Case of Pathological Biomineralization of Eye Tissue

Clinical Findings in Family with Aniridia due the PAX6 Mutation

Supracor, Laser Correction of Presbyopia: One-year Follow-up Outcomes

Lymphangioma of the Orbitopalpebral Area

Article was published in

Czech and Slovak Ophthalmology

2014 Issue 4