[Cytomegalovirus retinitis in pediatric patients with AIDS receiving highly active antiretrovirus therapy]

To describe three cases of cytomegalovirus retinitis occurring in HIV-infected children taking protease inhibitors combined with transcriptase inhibitors (HAART).

Three cases of HIV-infected children taking highly active antiretrovirus therapy (HAART) underwent an ocular examination at a university referral center-UNIFESP.

The average age was 6 years (10 months to 13 years old), and all of them were C3 (CDC-Atlanta-EUA 1994). Median CD4 cell count and plasma HIV RNA were 67 cells/mm3 (43-98 cells/mm3) and 190.000 copies/ml (53.600-460.000 copies/ml). The three patients presented HAART failure and all of them were treated with anti-CMV agents without success.

The unprecedented benefits resulting from highly active antiretroviral therapy (HAART) have been well described. However, treatment failure has become increasingly complex, because of the aggressive forms of opportunistic diseases like CMV retinitis, despite anti-CMV agents. Prompt diagnosis and treatment are essential to minimize the risk of long-term loss of vision for these infected children.