Correlation between CD4+ counts and prevalence of cytomegalovirus retinitis and human immunodeficiency virus-related noninfectious retinal vasculopathy in patients with acquired immunodeficiency syndrome.
Correlation between CD4+ counts and prevalence of cytomegalovirus retinitis and human immunodeficiency virus-related noninfectious retinal vasculopathy in patients with acquired immunodeficiency syndrome.
复制标题
获得性免疫缺陷综合征患者中 CD4 计数与巨细胞病毒视网膜炎和人类免疫缺陷病毒相关非感染性视网膜血管病变患病率之间的相关性。
DOI：
10.1016/s0002-9394(14)71453-9
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发表时间：
1993
影响因子：
4.2
通讯作者：
Freeman,WR
中科院分区：
文献类型：
--
作者：
Kuppermann,BD;Petty,JG;Richman,DD;Mathews,WC;Fullerton,SC;Rickman,LS;Freeman,WR
我们前瞻性研究了132例获得性免疫缺陷综合征（AIDS）患者，以确定巨细胞病毒视网膜炎的横断面患病率。所有患者均行血清CD 4+淋巴细胞计数以判断免疫功能紊乱程度。CD 4+细胞计数、巨细胞病毒视网膜炎或人类免疫缺陷病毒（HIV）相关的非感染性视网膜血管病变与眼部症状之间存在相关性。研究发现，132例艾滋病患者中有26例（20%）患有巨细胞病毒性视网膜炎。然而，根据CD 4+细胞计数进行的亚群分析显示，在CD 4+细胞计数为50个/mm 3或更少的患者中，87例患者中有26例（30%）患有巨细胞病毒视网膜炎，而在CD 4+细胞计数为50个/mm 3或更高的患者中，45例患者中无一例患有巨细胞病毒视网膜炎。同样，132例患者中有46例（35%）患有HIV相关的非感染性视网膜血管病变，其患病率呈增加趋势，与CD 4+计数下降相关。在CD 4+细胞计数为50个/mm 3或更低的患者中，87例患者中有39例（45%）患有HIV相关的非感染性视网膜血管病变，而CD 4+细胞计数为50个/mm 3或更高的45例患者中有7例（16%）出现这些变化。我们证实了巨细胞病毒性视网膜炎和HIV相关的非感染性视网膜血管病变是AIDS晚期表现的临床印象，证明了低CD 4+计数患者的风险增加，并提出了巨细胞病毒性视网膜炎的一致性化学预防和筛查策略的基础。
We prospectively studied 132 patients with acquired immunodeficiency syndrome (AIDS) to determine the cross-sectional prevalence of cytomegalovirus retinitis. All patients had serum CD4+ lymphocyte counts to determine the degree of immune dysfunction. Correlations between CD4+ counts, the presence of cytomegalovirus retinitis or human immunodeficiency virus (HIV)--related noninfectious retinal vasculopathy, and ocular symptoms were made. The study disclosed that 26 of 132 patients with AIDS (20%) had cytomegalovirus retinitis. However, subset analysis according to CD4+ count disclosed that in patients with CD4+ counts of 50 cells/mm3or less, 26 of 87 (30%) had cytomegalovirus retinitis, whereas in patients with CD4+ counts of 50 cells/mm3or more, none of 45 was noted to have cytomegalovirus retinitis. Similarly, 46 of 132 patients (35%) were noted to have HIV-related noninfectious retinal vasculopathy, with a trend toward increasing prevalence associated with declining CD4+ count. In patients with CD4+ counts of 50 cells/mm3or less, 39 of 87 (45%) had HIV-related noninfectious retinal vasculopathy, whereas seven of 45 patients (16%) with CD4+ counts of 50 cells/mm3or more were noted to have these changes. We confirmed the clinical impression that cytomegalovirus retinitis and HIV-related noninfectious retinal vasculopathy are late manifestations of AIDS, demonstrated an increased risk for patients with low CD4+ counts, and suggested a basis for coherent chemoprophylaxis and screening strategies for cytomegalovirus retinitis.