scholarly journals Cytomegalovirus uveitis in HIV-infected patients: course and outcomes

2020 ◽  
Vol 12 (4) ◽  
pp. 45-50
Author(s):  
T. D. Sizova ◽  
V. M. Khokkanen ◽  
D. A. Gusev ◽  
E. V. Boyko
Keyword(s):  
Antiretroviral Therapy ◽  
Retinal Detachment ◽  
Hiv Infection ◽  
Linear Relationship ◽  
Vision Loss ◽  
Number Of Patients ◽  
Department Of Ophthalmology ◽  
Eye Damage ◽  
Medical University ◽  
And Control

Cytomegalovirus uveitis is one of the AIDS marker diseases, develops with severe immunodeficiency and is the main cause of blindness in HIV-infected patients.The aim of our work is to study the course and outcomes of CMV uveitis in patients with HIV infection over the past 10 years.Materials and methods. The study was conducted at the St. Petersburg Center for the Prevention and Control of AIDS and Infectious Diseases and at the Department of Ophthalmology of North-Western State Medical University named after I.I. Mechnikov. The analysis of statistical data of HIV Newsletters in St. Petersburg for 2009-2019 was carried out, as well as the Journal of Ophthalmologist Examination of the AIDS Center to assess the long-term dynamics of detection of CMV uveitis, CMV associated retinal detachment, and cases of vision loss.Results. On average, CMV eye damage occurred in 1.65% of patients. In most cases, the involvement of the retina was predominantly peripheral (50-89%). Neuritis, panuveitis, cystic macular edema and retinal detachment were also registered. A positive strong linear relationship was found between the number of new cases of HIV infection already detected in the AIDS stage and new cases of cytomegalovirus damage to the organ of vision. There is a very strong inverse linear relationship between the frequency of detection of CMV uveitis and the amount of antiretroviral therapy provided.Conclusion. Conducting antiretroviral therapy and providing it to an increasing number of patients helps to reduce the incidence of HIV infection in St. Petersburg and probably secondary CMV infection with damage to the organ of vision. 

To the question of retinal detachment in cytomegalovirus uveitis in HIV-infected patients: treatment outcomes

2021 ◽  
pp. 17-19
Author(s):  
T.D. Sizova ◽  
◽  
V.M. Khokkanen ◽  
F.O. Kasymov ◽  
E.V. Boyko ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Hiv Infection ◽  
Vision Loss ◽  
Acute Retinal Necrosis ◽  
Study Group ◽  
Ophthalmological Examination ◽  
Complex Treatment ◽  
Key Words Cytomegalovirus ◽  
Common Causes

Cytomegalovirus uveitis (CMV-uveitis) is one of the most common causes of vision loss in HIV-infected patients. The purpose is to characterize the clinical features of the course of retinal detachment in HIV infection. Material and methods. The study group included 29 patients, 34 eyes (9 men and 20 women). All patients underwent a standard routine ophthalmological examination. To confirm the diagnosis, an ultrasound of the eyeball was performed. Results. The following forms of retinal detachment were identified: acute retinal necrosis, regmatogenic and traction detachment. In 50% of cases, the disease occurred as acute retinal necrosis of CMV-etiology. Visual acuity in the group of patients with operated retinal detachment became significantly lower after complex treatment. Conclusions. CMV-uveitis has a chronic sluggish course, despite multicomponent treatment. Key words: cytomegalovirus, uveitis, HIV, HIV-infection, AIDS, retinal detachment.

scholarly journals Аntiretroviral therapy for HIV in clinical practice

2020 ◽  
Vol 12 (3) ◽  
pp. 59-68
Author(s):  
L. V. Lukashova ◽  
I. A. Deev ◽  
Ye. S. Kulikov ◽  
Yu. K. Plotnikova ◽  
S. E. Skudarnov ◽  
...  
Keyword(s):  
Viral Load ◽  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Undetectable Viral Load ◽  
Inclusion Criteria ◽  
Demographic Indicators ◽  
Group I ◽  
Severe Immunodeficiency ◽  
Regional Centers ◽  
And Control

Objective: this study aims to analyze the use of antiretroviral therapy and its efficacy in HIV-infected patients in 5 regions of Russian Federation.Materials and methods: the research protocol included a retrospective analysis of the regional Centers for the Prevention and Control of AIDS registers and medical records of patients. Inclusion criteria were a verified diagnosis of HIV infection. The first group included patients (n=1161) receiving antiretroviral therapy regimens at the latest by 01/01/2015, the second group included patients with no antiretroviral therapy before 01/01/2015 (n=1366). The groups were compared with each other by socio-demographic indicators and characteristics of HIV infection, including infection routes, stage of the disease and its natural course.Results: Group I showed a higher prevalence of patients with an undetectable viral load (60,7%) comparing to group II (p<0,05) where a low (70,9%) and high (8,5%) viral load was observed. There was a dynamic decrease in patients’ numbers with severe immunodeficiency by 12.6% and an increase in the average amount of CD4+ in group I.

scholarly journals Refractory Myopic Retinal Detachment and Macular Hole Closure with Autologous Neurosensory Retinal Free Flap

2019 ◽  
Vol 10 (2) ◽  
pp. 160-164 ◽  
Author(s):  
Filipe Sousa Neves ◽  
Joana Braga ◽  
Paula Sepúlveda ◽  
Miguel Bilhoto
Keyword(s):  
Retinal Detachment ◽  
Macular Hole ◽  
Free Flap ◽  
Vision Loss ◽  
Silicone Oil ◽  
Modified Technique ◽  
Alternative Approach ◽  
Retinal Atrophy ◽  
One Year ◽  
Hole Closure

The purpose of this case report is to describe a modified technique involving the use of an autologous neurosensory retinal free flap for closure of a macular hole (MH) during retinal detachment (RD) surgery. A 50-year-old female presented with sudden vision loss (light perception only) and a recurrent myopic RD associated with an MH. An autologous neurosensory retinal free flap was obtained and moved toward the MH. Silicone oil was used as an endotamponade and removed after 6 months. Two months after oil removal visual acuity improved to 20/400 and remained stable thereafter; however, the patient developed central retinal atrophy. One year after surgery the MH was closed and the retina attached. This modified technique with the use of an autologous neurosensory retinal flap provides an alternative approach for recurrent MH in RD procedures.

scholarly journals Hematological Profile of HIV-Infected Patients on First-Line Highly Active Antiretroviral Therapy and Its Correlation With CD4 Count

2021 ◽  
Author(s):  
John Jospeh Diamond Princy ◽  
Kshetrimayum Birendra Singh ◽  
Ningthoujam Biplab ◽  
Ningthoukhongjam Reema ◽  
Rajesh Boini ◽  
...  
Keyword(s):  
Platelet Count ◽  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Highly Active Antiretroviral Therapy ◽  
Cd4 Count ◽  
Total Leukocyte Count ◽  
Hiv Patients ◽  
Positive Correlation ◽  
Highly Active ◽  
The Mean

Abstract Introduction Human immunodeficiency virus (HIV) infection is a state of profound immunodeficiency. Disorders of hematopoietic system are a common but often overlooked complication of HIV infection. This can manifest at any stage of the disease but more commonly in the advanced stage with low CD4 count. Anemia is the most common hematological abnormality in HIV patients and prevalence ranges from 1.3 to 95%. As HIV disease progresses, the prevalence and severity of anemia also increase. Hence, this study was undertaken to assess the hematological parameters of HIV-infected patients on highly active antiretroviral therapy (HAART) at different treatment durations with the hope to improve the HAART outcome in HIV patients and its correlation with CD4 count. Methods This prospective longitudinal study enrolled 134 HIV-infected patients admitted to or attending the OPD in the Department of Medicine or Antiretroviral Therapy (ART) Center (Center of Excellence), Regional Institute of Medical Sciences (RIMS), Imphal, Manipur, from 2018 to 2020. Complete hemogram, CD4 count, and other related-blood investigations were studied. Results The mean age of the study population was 39.9 ± 11.04 years. Of the 134 patients, 75 (56%) were males and 59 (44%) were females. Twelve (9%) patients had a history of injecting drug use (IDU). TLE (tenofovir, lamivudine, efavirenz) regimen was started on 112 (83.6%) patients and the majority of them (69/134 [51.5%]) had a CD4 count of 200 to 499 cells/mm3, which increased significantly 6 months after HAART to 99 to 1,149 cells/mm3, with a mean of 445 ± 217 cells/mm3. There were significant improvements in hemoglobin (Hb) levels, total leukocyte count (TLC), absolute neutrophil count (ANC), and absolute lymphocyte count (ALC) after HAART indicating a positive correlation with CD4 count (p < 0.05). Thrombocytopenia was observed higher after HAART when compared to baseline. There was a positive correlation between platelet count and CD4 count. However, the mean corpuscular volume (MCV) and erythrocyte sedimentation rate (ESR) had a negative correlation with CD4 count. Conclusion The study inferred a strong positive correlation between CD4 and Hb levels, TLC, ANC, ALC, and platelet count after HAART with improvement in these values as CD4 count increases. Specific treatment intervention based on the changes in the immunohematological profile trends can help prevent most of the adverse effects on HIV patients in our community.

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