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Cytomegalovirus retinitis associated with high CD4 counts and DHEA abuse
Gan Yuen Keat1, Syed Shoeb Ahmad1, Suresh Subramaniam1
1Department of Ophthalmology, Queen Elizabeth Hospital, Kota Kinabalu, Malaysia.
Abstract:
The most frequent ocular manifestation of acquired immunodeficiency syndrome (AIDS) is cytomegalovirus retinitis (CMVR). This infection is reportedly inversely proportional to the CD4 counts. Usually CMVR develops once the CD4 counts fall below 50/mm3. Our case report documents an AIDS patient who developed CMVR despite CD4 counts being persistently >200/mm3. The patient was self-administering dehydroepiandrosterone, high dose Vitamin C, testosterone and hydrocortisone. This case report describes a unique case of pharmacologically induced elevated CD4 counts, which however, did not prevent the development of CMVR in the patient.
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