Epidemiology and Predictors of Mortality in AIDS Patients with Cytomegalovirus Retinitis
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Yes
Purpose
CMVR is an AIDS defining disease and the commonest ocular infection in AIDS patients that can portend early mortality. This study explores the epidemiology and potential predictors of mortality in AIDS patients with CMVR, emphasizing on clinical features of CMVR and CD4+ T cell counts.
Methods
This is a retrospective study of AIDS patients with CMVR presenting to a tertiary eye centre in Singapore from January 2004 to December 2015. Patients’ demographic data were recorded and correlation of clinical findings such as size, zone and laterality of CMVR lesions, CD4+ T cell counts and duration of treatment with HAART and Ganciclovir to mortality were analysed with statistical software.
Results
A total of 144 patients were included, mostly middle age (mean 46.5 years), males (93.1%) and of Chinese ethnicity (78.5%). Mean time to mortality from CMVR diagnosis was 103.5 and 70.6 months with unilateral and bilateral disease respectively and reached statistical significance (hazard ratio: 1.82, 95% CI: 1.02 to 3.24, p = 0.043). Mean time to mortality from CMVR diagnosis was 10.9, 16.4 and 116.1 months with final CD4+ T cells count <20 cells/mm3, 20-50 cells/mm3 and >50 cells/mm3 respectively and this was statistically significant (p<0.001). Other features like initial CD4+ T cell count clinical features of CMVR lesions at baseline were not significantly associated with mortality.
Conclusion
This study describes the epidemiology and clinical features of AIDS patients with CMVR in Singapore. Bilateral disease and lack of immune recovery despite HAART with final CD4+ T cell count <50 cells/mm3 predicted early mortality for these patients.
Conflict of interest
No
Author 1
Last name
THNG
Initials of first name(s)
ZX
City
Singapore
Country
Singapore
Author 2
Last name
TEOH
Initials of first name(s)
SCB
City
Singapore
Country
Singapore
Author 3
Last name
AGRAWAL
Initials of first name(s)
R
City
Singapore
Country
Singapore
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