Cytomegalovirus retinitis in hospitalized people living with HIV in the late antiretroviral therapy era in São Paulo, Brazil

• Published in: International journal of STD & AIDS 2023-01, Vol.34 (1), p.48-53
• Main Authors: Bogoni, Giuliane, Lucas Júnior, Rodovaldo M, Reis Schneider, Gustavo Arthur, Castanheira de Souza, Nidyanara F, Carvalho, Maria Kassab, Marcusso, Rosa Maria, Vidal, José Ernesto
• Format: Article
• Language: English
• Subjects: Adult; AIDS-Related Opportunistic Infections - diagnosis; AIDS-Related Opportunistic Infections - drug therapy; AIDS-Related Opportunistic Infections - epidemiology; Antiretroviral Therapy, Highly Active; Brazil - epidemiology; CD4 Lymphocyte Count; CD4-Positive T-Lymphocytes; Cytomegalovirus Retinitis - diagnosis; Cytomegalovirus Retinitis - drug therapy; Cytomegalovirus Retinitis - epidemiology; Female; HIV Infections - complications; HIV Infections - drug therapy; HIV Infections - epidemiology; Humans; Male; Retrospective Studies
• ISSN: 0956-4624; 1758-1052
• DOI: 10.1177/09564624221135294

Background There is scarce information on AIDS-related cytomegalovirus (CMV) retinitis in middle-income countries. The objectives of this study were to identify the prevalence of active CMV retinitis in severely immunosuppressed people living with HIV (PLWHIV) and to describe its main features. Methods This retrospective cohort study was carried out at a tertiary center in São Paulo, Brazil. We included hospitalized adults PLWHIV with CD4 count ≤100 cells/μL, ≥ one quantitation of CMV DNA in plasma, and indirect ophthalmoscopy evaluation. Results Thirty-eight (21.6%) of 176 participants had at least an ophthalmoscopy diagnosis and only 3 (1.7%) individuals presented active CMV retinitis. All these participants were male, and retinitis was asymptomatic in 2 cases. Two participants had extraocular end-organ CMV disease and detectable CMV DNA in plasma. Conclusions These results show a low prevalence of active CMV retinitis in the evaluated population. However, 2 of 3 participants had asymptomatic active CMV retinitis and a fifth of participants had at least one ophthalmoscopy diagnosis, suggesting the need for routine ophthalmologic evaluation in hospitalized severely immunosuppressed PLWHIV. The profile of participants with active CMV retinitis was similar to that described in the pre-ART era and quantitation of CMV DNA in plasma was variable.