Tranient vitreou inflammatory reaction aociated with combination antiretroviral therapy in patient with AID and cytomegaloviru retiniti Original Reearch Article

Purpoe To report the obervation that a tranient vitreou inflammatory reaction may develop in the eye of patient with acquired immunodeficiency yndrome (AID), cytomegaloviru retiniti, and an increaed CD4+ T-lymphocyte count during treatment with antiretroviral therapy including a proteae inhibitor. Method We reviewed the medical record of eight patient with AID and cytomegaloviru retiniti who developed vitreou inflammatory reaction greater than thoe uually een with thi dieae. Reult Vitreou inflammatory reaction obcured the view of the poterior pole in all patient. No iri nodule, ynechiae, glaucoma, or cytoid macular edema were oberved. ix patient had unilateral cytomegaloviru retiniti, and, in each, the inflammation occurred only in the eye with cytomegaloviru retiniti. The vitreou inflammatory reaction were aociated with clinically inactive cytomegaloviru retiniti in ix patient, with dieae reactivation in one patient, and were preent at diagnoi of active dieae in one patient. Cyto-megaloviru retiniti ha not recurred in any of thee patient ince their epiode of vitreou inflammation. Vitreou inflammation developed in all eight patient after a ubtantial increae in CD4+ T-lymphocyte count caued by combination anti-retroviral therapy. Five patient had CD4+ T-lymphocyte count of greater than 100 cell per μl at the time the vitreou inflammatory reaction developed. No other caue of uveiti were found. Concluion Patient with AID and cyto-megaloviru retiniti may develop tranient intra-ocular inflammation aociated with combination antiretroviral therapy. We believe that thi inflammation reflect an improved immune repone againt cytomegaloviru.