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Cytomegalovirus Retinitis Is Neglected HIV Complication

Researchers urge improved strategies for saving the sight of HIV patients in developing countries

MONDAY, Dec. 3 (HealthDay News) -- In developing nations, cytomegalovirus (CMV) retinitis is a commonly overlooked but highly treatable complication of HIV infection, according to a report published in the December issue of PLoS Medicine.

David Heiden, M.D., of the California Pacific Medical Center in San Francisco, collected preliminary data based on clinical experience from Doctors Without Borders HIV/AIDS projects in Cambodia, South Africa, Lesotho, Myanmar, Thailand and China, on field assessments of four of these programs, and other programs at other resource-poor locations.

The researchers evaluated 325 patients with CD4 counts below 50 cells per microliter and found that 20 percent of them had CMV retinitis, which usually had not been previously diagnosed. Their additional research showed that 37 percent of CMV retinitis-infected individual eyes had been blinded by the infection. The authors recommend that all high-risk patients -- especially those with low CD4 counts -- undergo a retinal screening examination with the pupil fully dilated with an indirect ophthalmoscope -- and receive treatment with valganciclovir for CMV retinitis.

"Simple and effective management of CMV disease in resource-poor settings is a realistic goal, and one that has been overlooked in the scale-up of HIV treatment worldwide," the authors conclude. "Ongoing CMV-related mortality should no longer go unrecognized or be accepted as part of advanced HIV mortality. Patients should not be left vulnerable to blindness while clinicians are in the process of treating and controlling the underlying infection with HIV."

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