Clinical Features and CD4+ T Cells Count in AIDS Patients with CMV Retinitis: Correlation with Mortality

Area of Science:

• Ophthalmology
• Infectious Diseases
• Immunology

Background:

• Cytomegalovirus (CMV) retinitis (CMVR) is a significant opportunistic infection in patients with acquired immune deficiency syndrome (AIDS).
• Understanding factors influencing mortality in AIDS patients with CMVR is crucial for improving patient outcomes.

Purpose of the Study:

• To investigate the all-cause mortality in patients diagnosed with both AIDS and CMVR.
• To identify clinical factors associated with mortality in this patient cohort.

Main Methods:

• A retrospective cohort study was conducted.
• Data from 144 patients with CMVR treated at a tertiary referral center in Singapore between 2004 and 2015 were analyzed.

Main Results:

• Of 144 patients, 46 died during the study period.
• Bilateral CMVR and a CD4+ T cell count < 50 cells/mm³ at six-month follow-up were associated with significantly shorter survival times (p < .001 and p = .043, respectively).
• Baseline CD4+ T cell count, retinitis lesion characteristics, retinitis recurrence, and combined antiretroviral therapy (cART) timing did not show a significant association with mortality.

Conclusions:

• Bilateral ocular involvement in CMVR is a key predictor of reduced survival in AIDS patients.
• Lack of immune recovery, indicated by low CD4 counts, is strongly linked to shorter survival times in AIDS patients with CMVR.