Non-cytomegalovirus Ocular Opportunistic Infections in Patients With Acquired Immunodeficiency Syndrome
Non-cytomegalovirus Ocular Opportunistic Infections in Patients With Acquired Immunodeficiency Syndrome
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DOI：
10.1016/j.ajo.2012.07.019
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发表时间：
2013-02-01
影响因子：
4.2
通讯作者：
Lyon, Alice T.
中科院分区：
文献类型：
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作者：
Gangaputra, Sapna;Drye, Lea;Lyon, Alice T.
目得：报道在高效抗逆转录病毒治疗时代获得性免疫缺陷综合征（AIDS）患者非巨细胞病毒（non-CMV）眼部机会性感染的发病率和临床结局。设计：对AIDS患者进行多中心、前瞻性、观察性研究。方法：病史、眼科检查和实验室检查在入组时和随后每6个月进行一次。一旦眼部机会性感染被诊断，患者每3个月进行一次outcome.RESULTS：在登记，37非CMV眼部机会性感染被诊断：16例，疱疹性视网膜炎，11例，弓形体视网膜炎，和10例，脉络膜炎。在随访期间，估计发生率（和95%置信区间[CI]）：疱疹性视网膜炎，0.007/100人-年（PY）（95% CI 0.0004，0.039）;弓形体视网膜炎，0.007/100 PY（95% CI 0.004，0.039）;脉络膜炎，0.014/ 100 PY（95% CI 0.0025，0.050）。新诊断或偶发的疱疹性视网膜炎和脉络膜炎患者的死亡率较高（发生率分别为21.7例死亡/100 PY [P = .02]和12.8例死亡/100 PY [P = .04]）（4.1例死亡/100 PY）;弓形体视网膜炎似乎与更高的死亡率无关（6.4/100 PY，P = 0.47）。新诊断的疱疹性视网膜炎患者视力预后差，视力损害发生率高（37.9/100 PY）和失明（17.5/100 PY），而脉络膜炎眼的结局似乎较低（分别为2.3/100 PY和0/100 PY）。结论：虽然不常见，但非CMV眼部机会性感染可能与高视力丧失率和/或死亡率相关。(Am J Ophthalmol 2013;155：206-212. (c)2013年，Elsevier Inc.版权所有© 2016
PURPOSE: To report the incidence and clinical outcomes of non-cytomegalovirus (non-CMV) ocular opportunistic infections in patients with acquired immunodeficiency syndrome (AIDS) in the era of highly active antiretroviral therapy.DESIGN: Multicenter, prospective, observational study of patients with AIDS.METHODS: Medical history, ophthalmologic examination, and laboratory tests were performed at enrollment and every 6 months subsequently. Once an ocular opportunistic infection was diagnosed, patients were seen every 3 months for outcomes.RESULTS: At enrollment, 37 non-CMV ocular opportunistic infections were diagnosed: 16 patients, herpetic retinitis; 11 patients, toxoplasmic retinitis; and 10 patients, choroiditis. During the follow-up period, the estimated incidences (and 95% confidence intervals [CI]) of these were: herpetic retinitis, 0.007/100 person-years (PY) (95% CI 0.0004, 0.039); toxoplasmic retinitis, 0.007/100 PY (95% CI 0.004, 0.039); and choroiditis, 0.014/ 100 PY (95% CI 0.0025, 0.050). The mortality rates appeared higher among those patients with newly diagnosed or incident herpetic retinitis and choroiditis (rates = 21.7 deaths/100 PY [P = .02] and 12.8 deaths/100 PY [P = .04]), respectively, than those for patients with AIDS without an ocular opportunistic infection (4.1 deaths/100 PY); toxoplasmic retinitis did not appear to be associated with greater mortality (6.4/100 PY, P = .47). Eyes with newly diagnosed herpetic retinitis appeared to have a poor visual prognosis, with high rates of visual impairment (37.9/100 PY) and blindness (17.5/100 PY), whereas those outcomes in eyes with choroiditis appeared to be lower (2.3/100 PY and 0/100 PY, respectively).CONCLUSIONS: Although uncommon, non-CMV ocular opportunistic infections may be associated with high rates of visual loss and/or mortality. (Am J Ophthalmol 2013;155:206-212. (c) 2013 by Elsevier Inc. All rights reserved.)