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[Acute retinal necrosis and HIV infection]
W Pfäffl1, E M Fabricius, K Scheidegger
1Augenabteilung Städtischen Krankenhauses München-Harlaching, Bundesrepublik Deutschland.
Fortschritte Der Ophthalmologie : Zeitschrift Der Deutschen Ophthalmologischen Gesellschaft
|January 1, 1991
Summary
Acute retinal necrosis (ARN) is a growing concern in HIV patients, often caused by varicella-zoster virus (VZV) or herpes simplex virus (HSV). Patients with AIDS experiencing VZV/HSV infections may benefit from maintenance antiviral therapy to prevent ARN.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Virology
Background:
- Acute retinal necrosis (ARN) is an opportunistic infection increasingly observed in patients with Human Immunodeficiency Virus (HIV).
- Varicella-zoster virus (VZV) and herpes simplex virus (HSV) are the primary etiologic agents identified in ARN cases.
- Understanding the prevalence and risk factors for ARN in HIV-infected populations is crucial for effective management.
Observation:
- A study followed 538 HIV-infected patients (261 with Acquired Immunodeficiency Syndrome - AIDS) between 1985 and 1990.
- ARN was diagnosed in 4 cases, with 3 of these patients having AIDS.
- ARN represented the third most frequent retinitis in AIDS patients (1.1% prevalence), following Cytomegalovirus (CMV) retinitis (17.2%) and toxoplasmosis-retinochorioiditis (2.7%).
Findings:
- The study details the clinical course of ARN in four patients with AIDS, supported by fundus photographs.
- Patients with AIDS who have a history of VZV or HSV infection requiring high-dose systemic aciclovir therapy are identified as being at risk for developing ARN.
- ARN can be a significant cause of vision loss in immunocompromised individuals.
Implications:
- The findings suggest a need for vigilant monitoring of HIV/AIDS patients with a history of VZV or HSV infections.
- Prophylactic or maintenance antiviral therapy (virustatic therapy) is recommended for at-risk patients to prevent ARN development.
- Early detection and intervention are critical to preserve vision in patients with ARN.