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Cytomegalovirus retinitis: decreased risk of bilaterality with increased use of systemic treatment. Swiss HIV Cohort Study Group
Cytomegalovirus (CMV) retinitis may be treated systemically or intravitreally. We reviewed retrospectively patients with CMV retinitis, in order to determine whether systemic treatment was associated with less spread of CMV retinitis from one eye to the other. Of 222 cases, 92 patients had bilateral...
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| Published in: | Clinical infectious diseases 1997-04, Vol.24 (4), p.620-624 |
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| Main Authors: | , , , , , , , , |
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| container_end_page | 624 |
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| container_title | Clinical infectious diseases |
| container_volume | 24 |
| creator | Stalder, N Sudre, P Olmari, M Opravil, M Gabriel, V Sansonetti, A von Overbeck, J Herbort, C P Hirschel, B |
| description | Cytomegalovirus (CMV) retinitis may be treated systemically or intravitreally. We reviewed retrospectively patients with CMV retinitis, in order to determine whether systemic treatment was associated with less spread of CMV retinitis from one eye to the other. Of 222 cases, 92 patients had bilateral disease at onset of CMV retinitis, leaving 130 for analysis. Bilaterality occurred in 10 patients during 12,687 days of systemic treatment and in 34 during 14,791 days without systemic treatment (odds ratio [OR] = 2.92; confidence interval [CI], 1.44-5.90). Patients who had received systemic treatment for |
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Swiss HIV Cohort Study Group</title><source>JSTOR Archival Journals and Primary Sources Collection</source><source>Oxford Journals Online</source><creator>Stalder, N ; Sudre, P ; Olmari, M ; Opravil, M ; Gabriel, V ; Sansonetti, A ; von Overbeck, J ; Herbort, C P ; Hirschel, B</creator><creatorcontrib>Stalder, N ; Sudre, P ; Olmari, M ; Opravil, M ; Gabriel, V ; Sansonetti, A ; von Overbeck, J ; Herbort, C P ; Hirschel, B</creatorcontrib><description>Cytomegalovirus (CMV) retinitis may be treated systemically or intravitreally. We reviewed retrospectively patients with CMV retinitis, in order to determine whether systemic treatment was associated with less spread of CMV retinitis from one eye to the other. Of 222 cases, 92 patients had bilateral disease at onset of CMV retinitis, leaving 130 for analysis. Bilaterality occurred in 10 patients during 12,687 days of systemic treatment and in 34 during 14,791 days without systemic treatment (odds ratio [OR] = 2.92; confidence interval [CI], 1.44-5.90). Patients who had received systemic treatment for <50% of the follow-up period had a greater risk of bilaterality (OR = 3.7; CI, 2.79-4.54) than did the more intensively treated patients. CD4 cell levels also contributed to increased risk, but multivariate analysis showed that CD4 cell counts and treatment intensity were independent risk factors. CMV retinitis was more likely to become bilateral in patients who received less intravenous therapy. Local treatment can complete but does not replace systemically administered therapy.</description><identifier>ISSN: 1058-4838</identifier><identifier>PMID: 9145735</identifier><language>eng</language><publisher>United States</publisher><subject>Adult ; AIDS/HIV ; Antiviral Agents - administration & dosage ; CD4 Lymphocyte Count ; Cytomegalovirus Retinitis - drug therapy ; Cytomegalovirus Retinitis - immunology ; Cytomegalovirus Retinitis - prevention & control ; Cytomegalovirus Retinitis - transmission ; Drug Therapy, Combination ; Female ; Follow-Up Studies ; Foscarnet - administration & dosage ; Ganciclovir - administration & dosage ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; Treatment Outcome</subject><ispartof>Clinical infectious diseases, 1997-04, Vol.24 (4), p.620-624</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9145735$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Stalder, N</creatorcontrib><creatorcontrib>Sudre, P</creatorcontrib><creatorcontrib>Olmari, M</creatorcontrib><creatorcontrib>Opravil, M</creatorcontrib><creatorcontrib>Gabriel, V</creatorcontrib><creatorcontrib>Sansonetti, A</creatorcontrib><creatorcontrib>von Overbeck, J</creatorcontrib><creatorcontrib>Herbort, C P</creatorcontrib><creatorcontrib>Hirschel, B</creatorcontrib><title>Cytomegalovirus retinitis: decreased risk of bilaterality with increased use of systemic treatment. Swiss HIV Cohort Study Group</title><title>Clinical infectious diseases</title><addtitle>Clin Infect Dis</addtitle><description>Cytomegalovirus (CMV) retinitis may be treated systemically or intravitreally. We reviewed retrospectively patients with CMV retinitis, in order to determine whether systemic treatment was associated with less spread of CMV retinitis from one eye to the other. Of 222 cases, 92 patients had bilateral disease at onset of CMV retinitis, leaving 130 for analysis. Bilaterality occurred in 10 patients during 12,687 days of systemic treatment and in 34 during 14,791 days without systemic treatment (odds ratio [OR] = 2.92; confidence interval [CI], 1.44-5.90). Patients who had received systemic treatment for <50% of the follow-up period had a greater risk of bilaterality (OR = 3.7; CI, 2.79-4.54) than did the more intensively treated patients. CD4 cell levels also contributed to increased risk, but multivariate analysis showed that CD4 cell counts and treatment intensity were independent risk factors. CMV retinitis was more likely to become bilateral in patients who received less intravenous therapy. Local treatment can complete but does not replace systemically administered therapy.</description><subject>Adult</subject><subject>AIDS/HIV</subject><subject>Antiviral Agents - administration & dosage</subject><subject>CD4 Lymphocyte Count</subject><subject>Cytomegalovirus Retinitis - drug therapy</subject><subject>Cytomegalovirus Retinitis - immunology</subject><subject>Cytomegalovirus Retinitis - prevention & control</subject><subject>Cytomegalovirus Retinitis - transmission</subject><subject>Drug Therapy, Combination</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Foscarnet - administration & dosage</subject><subject>Ganciclovir - administration & dosage</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Treatment Outcome</subject><issn>1058-4838</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1997</creationdate><recordtype>article</recordtype><recordid>eNo10DFPwzAUBGAPoFIKPwHJE1tQEsexzYYiaCtVYmjFGjnxCzUkcfBzqLLx02lFmU46fbrhLsg8ibmMMsnkFblG_IjjJJExn5GZSjIuGJ-Tn2IKroN33bpv60ekHoLtbbD4SA3UHjSCod7iJ3UNrWyrA3jd2jDRgw17avt_MyKcCE4YoLM1Dcc-dNCHB7o9WES6Wr_Rwu2dD3QbRjPRpXfjcEMuG90i3J5zQXYvz7tiFW1el-viaRMNnPEoj7UEJeu04XmVZ40xTR4nUqdaNBkonSohcs2OoZTQNTOZEIaxVIqKa-CKLcj93-zg3dcIGMrOYg1tq3twI5ZCKqmYOsG7MxyrDkw5eNtpP5Xnx9gvabNo-A</recordid><startdate>199704</startdate><enddate>199704</enddate><creator>Stalder, N</creator><creator>Sudre, P</creator><creator>Olmari, M</creator><creator>Opravil, M</creator><creator>Gabriel, V</creator><creator>Sansonetti, A</creator><creator>von Overbeck, J</creator><creator>Herbort, C P</creator><creator>Hirschel, B</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>199704</creationdate><title>Cytomegalovirus retinitis: decreased risk of bilaterality with increased use of systemic treatment. Swiss HIV Cohort Study Group</title><author>Stalder, N ; Sudre, P ; Olmari, M ; Opravil, M ; Gabriel, V ; Sansonetti, A ; von Overbeck, J ; Herbort, C P ; Hirschel, B</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p535-60a8e98c2f56b64fddf6018a2a7f4e9a29776a3297997ac3d477d33287b5ae593</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1997</creationdate><topic>Adult</topic><topic>AIDS/HIV</topic><topic>Antiviral Agents - administration & dosage</topic><topic>CD4 Lymphocyte Count</topic><topic>Cytomegalovirus Retinitis - drug therapy</topic><topic>Cytomegalovirus Retinitis - immunology</topic><topic>Cytomegalovirus Retinitis - prevention & control</topic><topic>Cytomegalovirus Retinitis - transmission</topic><topic>Drug Therapy, Combination</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Foscarnet - administration & dosage</topic><topic>Ganciclovir - administration & dosage</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Stalder, N</creatorcontrib><creatorcontrib>Sudre, P</creatorcontrib><creatorcontrib>Olmari, M</creatorcontrib><creatorcontrib>Opravil, M</creatorcontrib><creatorcontrib>Gabriel, V</creatorcontrib><creatorcontrib>Sansonetti, A</creatorcontrib><creatorcontrib>von Overbeck, J</creatorcontrib><creatorcontrib>Herbort, C P</creatorcontrib><creatorcontrib>Hirschel, B</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical infectious diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Stalder, N</au><au>Sudre, P</au><au>Olmari, M</au><au>Opravil, M</au><au>Gabriel, V</au><au>Sansonetti, A</au><au>von Overbeck, J</au><au>Herbort, C P</au><au>Hirschel, B</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cytomegalovirus retinitis: decreased risk of bilaterality with increased use of systemic treatment. Swiss HIV Cohort Study Group</atitle><jtitle>Clinical infectious diseases</jtitle><addtitle>Clin Infect Dis</addtitle><date>1997-04</date><risdate>1997</risdate><volume>24</volume><issue>4</issue><spage>620</spage><epage>624</epage><pages>620-624</pages><issn>1058-4838</issn><abstract>Cytomegalovirus (CMV) retinitis may be treated systemically or intravitreally. We reviewed retrospectively patients with CMV retinitis, in order to determine whether systemic treatment was associated with less spread of CMV retinitis from one eye to the other. Of 222 cases, 92 patients had bilateral disease at onset of CMV retinitis, leaving 130 for analysis. Bilaterality occurred in 10 patients during 12,687 days of systemic treatment and in 34 during 14,791 days without systemic treatment (odds ratio [OR] = 2.92; confidence interval [CI], 1.44-5.90). Patients who had received systemic treatment for <50% of the follow-up period had a greater risk of bilaterality (OR = 3.7; CI, 2.79-4.54) than did the more intensively treated patients. CD4 cell levels also contributed to increased risk, but multivariate analysis showed that CD4 cell counts and treatment intensity were independent risk factors. CMV retinitis was more likely to become bilateral in patients who received less intravenous therapy. Local treatment can complete but does not replace systemically administered therapy.</abstract><cop>United States</cop><pmid>9145735</pmid><tpages>5</tpages></addata></record> |
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| identifier | ISSN: 1058-4838 |
| ispartof | Clinical infectious diseases, 1997-04, Vol.24 (4), p.620-624 |
| issn | 1058-4838 |
| language | eng |
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| source | JSTOR Archival Journals and Primary Sources Collection; Oxford Journals Online |
| subjects | Adult AIDS/HIV Antiviral Agents - administration & dosage CD4 Lymphocyte Count Cytomegalovirus Retinitis - drug therapy Cytomegalovirus Retinitis - immunology Cytomegalovirus Retinitis - prevention & control Cytomegalovirus Retinitis - transmission Drug Therapy, Combination Female Follow-Up Studies Foscarnet - administration & dosage Ganciclovir - administration & dosage Humans Male Middle Aged Retrospective Studies Risk Factors Treatment Outcome |
| title | Cytomegalovirus retinitis: decreased risk of bilaterality with increased use of systemic treatment. Swiss HIV Cohort Study Group |
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