Therapeutic Effect of Combination Antiretroviral Therapy on Cytomegalovirus Retinitis

Publisher Website
Google Scholar
Abstract
To the Editor. —Cytomegalovirus (CMV) retinitis is the most common intraocular infection in patients with acquired immunodeficiency syndrome (AIDS) and tends to occur after CD4+cell counts decrease to less than 0.10X 109/L.1Although anti-CMV therapy with ganciclovir, foscarnet sodium, or cidofovir initially leads to inactivation of the retinitis in the majority of patients, the disease later progresses in most patients despite continued therapy due to inadequate control of the replicating virus. Without therapy, the median time to detection of progression of CMV retinitis is approximately 2 to 3 weeks2,3; resolution of active retinitis without anti-CMV therapy rarely if ever occurs in immunosuppressed patients. Two recent studies have shown that treatment with highly active combination antiretroviral therapy, consisting of nucleoside analogs and protease inhibitors, has led to decreased human immunodeficiency virus (HIV) loads and increased CD4+cell counts.4,5We present 4 patients with AIDS and