Mortality Risk for Patients with Cytomegalovirus Retinitis and Acquired Immune Deficiency Syndrome

John H. Kempen, Douglas Jabs, Laura Wilson, James P. Dunn, Sheila K West, James A Tonascia

Research output: Contribution to journalArticle

Abstract

We prospectively followed up 589 patients to evaluate the relationship of anti-cytomegalovirus (CMV) treatment and immune reconstitution in response to highly active antiretroviral therapy (HAART) on the mortality risk of patients with CMV retinitis and acquired immune deficiency syndrome. The use of HAART was associated with an 81% lower mortality rate (95% confidence interval [CI], 74%-86%); it was 96% lower (95% CI, 92%-98%) for those who developed immune recovery and 49% lower (95% CI, 30-63%) for those who did not. Using time-updated multivariate analysis, current systemic anti-CMV treatment was independently associated with a 28% lower mortality rate (95% CI, 8%-43%). On the basis of these results, for patients who continue to have profound immunodeficiency despite HAART, the continued use of HAART and systemic anti-CMV therapy is predicted to reduce the risk of mortality by 65%, over and above the benefits of Pneumocystis carinii and Mycobacterium avium prophylaxis.

Original languageEnglish (US)
Pages (from-to)1365-1373
Number of pages9
JournalClinical Infectious Diseases
Volume37
Issue number10
DOIs
StatePublished - Nov 15 2003

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Cytomegalovirus Retinitis
Highly Active Antiretroviral Therapy
Acquired Immunodeficiency Syndrome
Cytomegalovirus
Confidence Intervals
Mortality
Pneumocystis carinii
Mycobacterium avium
Therapeutics
Multivariate Analysis

ASJC Scopus subject areas

  • Immunology

Cite this

Mortality Risk for Patients with Cytomegalovirus Retinitis and Acquired Immune Deficiency Syndrome. / Kempen, John H.; Jabs, Douglas; Wilson, Laura; Dunn, James P.; West, Sheila K; Tonascia, James A.

In: Clinical Infectious Diseases, Vol. 37, No. 10, 15.11.2003, p. 1365-1373.

Research output: Contribution to journalArticle

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