Effect of potent antiretroviral therapy on recurrent cytomegaloviru retiniti treated with the ganciclovir implant Original Reearch Article

PURPOE: To determine the effect of highly active antiretroviral therapy on cytomegaloviru (CMV) retiniti treated with ganciclovir implant. METHOD: A retropective cohort tudy wa performed of 15 patient with recurrent CMV retiniti treated with the ganciclovir implant and highly active antiretroviral therapy (cae) and 38 patient with recurrent retiniti treated with ganciclovir implant before availability of improved antiretroviral therapy (control). Progreion wa defined a occurrence of new leion in the treated eye or advancement of the retiniti border by more than 750 μm. REULT: Cae and control were tatitically imilar in age, ethnicity, and duration of acquired immunodeficiency yndrome (AID). Control had received intravenou ganciclovir for 9.5 ± 9.5 month v 3.5 ± 4.6 month in cae (P = .003). The mean (± E) time to progreion of retiniti after implantation of the device wa 26.7 ± 2.4 month (95% confidence interval, 22.1 to 31.3) in the cae receiving highly active antiretroviral therapy v 6.2 ± 0.9 month (95% confidence interval, 4.5 to 7.9) in the control (P = .001). Multivariate analyi, adjuted for preoperative variable, confirmed a ignificantly prolonged time to progreion in patient receiving highly active antiretroviral therapy (P = .0003). The odd ratio for progreion in the cae v control wa 0.034 (95% confidence interval, 0.003 to 0.350). Cae had higher CD4+ T-lymphocyte count (P = .004) and longer urvival (P < .001) than control. CONCLUION: Highly active antiretroviral therapy i aociated with improved outcome in patient with AID and recurrent CMV retiniti treated with the ganciclovir implant.