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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.
Purpose:
To report a case of seroreversion in a patient with HIV-associated bilateral CMV retinitis and the challenges associated with detection of this phenomenon in late stages of HIV.
Method:
Retrospective single case report.
Results:
The clinical picture of the patient on presentation was suggestive of viral retinitis. PCR confirmed a diagnosis of CMV retinitis. Serology for HIV-1 & 2 was negative. A viral load of HIV and CD-4 count confirmed his sero status to be positive for HIV. Improvement in visual acuity and slow resolution of the lesion was noted with both anti-viral for CMV and HIV. A repeat HIV-1 testing was positive with an improvement in CD4 count.
Conclusion:
In highly suspicious individual, with a negative serology (post screening test) for HIV, the disease status should be confirmed by testing the individual for HIV viral load and CD4 count.
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