@article{a25cca57b4ae4681889354583378f7a8,
title = "Incidence of cytomegalovirus retinitis in the era of highly active antiretroviral therapy",
abstract = "Purpose: To estimate the incidence of cytomegalovirus (CMV) retinitis in the era of highly active antiretroviral therapy (HAART) and to characterize the factors associated with increased risk of CMV retinitis. Design: Prospective cohort study. Methods: A total of 1600 participants with acquired immunodeficiency syndrome (AIDS) but without CMV retinitis at enrollment who completed at least 1 follow-up visit in the Longitudinal Study of the Ocular Complications of AIDS (LSOCA) were seen every 6 months to obtain disease and treatment history, ophthalmic examination, and laboratory testing. Incidence of CMV retinitis and risk factors for incident CMV retinitis were assessed. Results: The incidence rate of CMV retinitis in individuals with AIDS was 0.36/100 person-years (PY) based upon 29 incident cases during 8134 PY of follow-up. The rate was higher for those with a CD4+ T cell count at the immediately prior visit below 50 cells/μL (3.89/100 PY, P <.01), whereas only 1 individual with a CD4+ T cell count of 50 to 99 cells/μL and 2 individuals with a CD4+ T cell count >100 cells/μL developed CMV retinitis. Having a CD4+ T cell count below 50 cells/μL at the clinical visit prior to CMV retinitis evaluation was the single most important risk factor (HR: 136, 95% CI: 30 to 605, P <.0001) for developing retinitis. Conclusions: Patients with AIDS, especially those with severely compromised immune systems, remain at risk for developing CMV retinitis in the HAART era, although the incidence rate is reduced from that observed in the pre-HAART era.",
author = "Sugar, {Elizabeth A.} and Jabs, {Douglas A.} and Alka Ahuja and Thorne, {Jennifer E.} and Danis, {Ronald P.} and Meinert, {Curtis L.}",
note = "Funding Information: All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Publication of this article was supported by cooperative agreements from the National Eye Institute, the National Institutes of Health, Bethesda, Maryland, to the Johns Hopkins University Bloomberg School of Public Health , Baltimore, Maryland ( U10 EY08057 ); to the Mount Sinai School of Medicine , New York, New York ( U10 EY08052 ); and to the University of Wisconsin , Madison, Madison, Wisconsin ( U10 EY08067 ). Dr Thorne is the recipient of a Research to Prevent Blindness (RPB) Sybil B. Harrington Special Scholars Award. Dr Jabs serves as a member of the board for Applied Genetic Technologies and as a consultant for the following: Abbott Laboratories, Alcon Laboratories, Allergan Pharmaceutical Corporation, Corcept Therapeutics, GenenTech, Genzyme Corporation, GlaxoSmithKline, Novartis Pharmaceuticals Corporation, and Roche Pharmaceuticals. Dr Thorne serves on a scientific advisory board for Allergan, Inc. and has been a consultant for Heron Evidence Development Ltd. All other authors have no financial disclosures to report. Involved in design and conduct of study (E.A.S., D.A.J., A.A., J.E.T., R.P.D., C.L.M.); collection and management of the data (E.A.S., A.A., SOCA Research Group); provision of patients and resources (D.A.J., R.P.D., C.L.M., SOCA Research Group); analysis and interpretation of the data (E.A.S., D.A.J., A.A., J.E.T., R.P.D., C.L.M.); preparation of manuscript (E.A.S., D.A.J., A.A., J.E.T.); and review and approval of the manuscript (E.A.S., D.A.J., A.A., J.E.T., R.P.D., C.L.M., SOCA Research Group). The study protocol and questionnaires were reviewed and approved by the institutional review boards at each of the participating SOCA clinical centers and at the three resource centers (Chairman's office, coordinating center, Reading Center), and the study was conducted in compliance with HIPAA regulations and in accordance with the principles of the Declaration of Helsinki. All participants gave written informed consent. ",
year = "2012",
month = jun,
doi = "10.1016/j.ajo.2011.11.014",
language = "English (US)",
volume = "153",
pages = "1016--1024.e5",
journal = "American journal of ophthalmology",
issn = "0002-9394",
publisher = "Elsevier USA",
number = "6",
}