The prognosis of CMV retinitis among patients with AIDS in Serbia

Autor: Branko Brmbolic, Djordje Jevtovic, Olgica Djurković-Djaković, Jovan Ranin, Dubravka Salemovic, Mirjana Dujic
Rok vydání: 2007
Předmět:
Adult
Male
medicine.medical_specialty
Adolescent
Retinitis
Blindness
survival
Antiviral Agents
03 medical and health sciences
Young Adult
0302 clinical medicine
Acquired immunodeficiency syndrome (AIDS)
Betaherpesvirinae
Predictive Value of Tests
Internal medicine
Antiretroviral Therapy
Highly Active
medicine
Humans
030212 general & internal medicine
Sida
Ganciclovir
Immunodeficiency
Aged
Retrospective Studies
Pharmacology
Acquired Immunodeficiency Syndrome
biology
business.industry
virus diseases
Retrospective cohort study
General Medicine
Retinite
Middle Aged
biology.organism_classification
medicine.disease
Prognosis
Survival Analysis
3. Good health
Surgery
CD4 Lymphocyte Count
AIDS
Cytomegalovirus Retinitis
CMV retinitis
030221 ophthalmology & optometry
Female
Viral disease
business
Serbia
Zdroj: Biomedicine & Pharmacotherapy
ISSN: 0753-3322
Popis: Background Cytomegalovirus (CMV) end-organ diseases, including CMV retinitis, are major opportunistic events in terminal AIDS patients. Methods A retrospective study of 30 AIDS patients with CMV retinitis treated between 1997 and 2007 in Serbia was conducted to examine the prognosis and factors associated with survival. Results Eighteen (60%) patients survived the mean follow-up period of 46.4 ± 36 months. Patients' sex, mode of HIV transmission or previous AIDS diagnosis did not affect survival. Bilateral CMV retinitis predicted dissemination of CMV disease and poor prognosis (OR 7.8, 95% CI 1.3–47.0, P = 0.012), but was not associated with blindness (P = 0.33). Among patients treated with HAART and CMV therapy the probability of surviving 10 years was 70%, while in those on CMV therapy alone, the median survival was 10 months (log rank P = 0.00). However, HAART itself was not sufficient to prevent blindness and the major predictor of blindness was a baseline CD4 cell count of less than 50/μL (OR 6.8, 95% CI 1.1–41.8, P = 0.03). After CMV disease, most patients suffered other opportunistic events regardless of HAART introduction. Conclusion Even in the HAART era patients with advanced immunodeficiency and CMV retinitis may not escape from the high risk mortality group, while survivors commonly lose sight.
Databáze: OpenAIRE
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