Resumen

NARAIN, Serisha Jay; VISSER, Linda  y  SIBANDA, Wilbert. Cytomegalovirus retinitis and antiretroviral treatment: A fifteen year experience. South. Afr. j. HIV med. (Online) [online]. 2022, vol.23, n.1, pp.1-8. ISSN 2078-6751.  http://dx.doi.org/10.4102/sajhivmed.v23i1.1322.

BACKGROUND: South Africa's public antiretroviral treatment (ART) programme has undergone progressive changes since its introduction in 2004. The effect of this on the burden of the AIDS-defining opportunistic infection, cytomegalovirus retinitis (CMVR), in SA, has not been fully appreciated. OBJECTIVES: To determine the effect of ART availability in the public sector of SA on the trend in the number of cases of newly diagnosed CMVR over time. METHODS: This is a retrospective study from 01 November 2002 to 31 August 2017 that took place at a tertiary hospital in the KwaZulu-Natal (KZN) province. RESULTS: A total of 383 participants were included in the study, with 60.1% being female and 94% of black African origin. The mean age of patients was 34.08 years (SD ± 7.24). A linear trend model suggested an overall linear decrease in the number of new cases of CMVR per year (R² of 0.67). The average number of new cases of CMVR per year prior to ART being available to all persons living with HIV (PLWH) with a CD4+ ≤ 350 cells/μL and after was 34 and 13, respectively, and the difference (61.76%) between these values was statistically significant, P = 0.001. The median CD4+ count at diagnosis of CMVR was 22 (interquartile range: 9-51.25) cells/μL. An overall 51% of patients in this study were on ART at diagnosis of CMVR. There was a higher proportion of patients on ART ≤ 6 months (63.3%), compared with those on ART > 6 months (36.7%), and the difference was statistically significant, P < 0.01. CONCLUSION: ART has resulted in a decrease in the burden of CMVR on ophthalmic services for many in KZN, particularly following the introduction of ART for all PLWH with a CD4 ≤ 350 cells/μL.

Palabras clave : cytomegalovirus retinitis; opportunistic infection; ocular; acquired immunodeficiency disease; human immunodeficiency virus; antiretroviral therapy.

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