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Seroreversion in HIV-Associated Bilateral CMV Retinitis: A Challenging Case Report.
Radhika Sriram1, Padmamalini Mahendradas1, Prathiba Hande2
1Department of Uveitis and Ocular Immunology Services, Narayana Nethralaya, Bangalore, India.
Ocular Immunology and Inflammation
|August 9, 2024
Summary
This case report details HIV seroreversion in a patient with CMV retinitis. Early detection of human immunodeficiency virus (HIV) requires viral load and CD4 count testing, even with negative initial serology.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Virology
Background:
- Cytomegalovirus (CMV) retinitis is a serious complication in advanced HIV.
- Accurate diagnosis of HIV is crucial for effective management.
Observation:
- A patient presented with symptoms suggestive of viral retinitis.
- Initial HIV serology was negative, but PCR confirmed CMV retinitis.
- HIV viral load and CD4 count confirmed HIV positivity.
Findings:
- The patient showed improvement in visual acuity and lesion resolution with antiviral treatment for both CMV and HIV.
- A subsequent HIV-1 test became positive, coinciding with an improved CD4 count, indicating seroreversion.
Implications:
- This case highlights the possibility of HIV seroreversion, particularly in late-stage HIV.
- Confirmatory testing using HIV viral load and CD4 counts is essential for diagnosing HIV in individuals with negative serology but high clinical suspicion.
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