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[Cytomegalovirus retinitis in children with AIDS acquired through materno-fetal transmission]
D Bremond-Gignac1, D Aron-Rosa, P Rohrlich
1Service d'Ophtalmologie, Hôpital Robert Debré, Paris.
Insights
Cytomegalovirus (CMV) retinitis can affect children with vertically transmitted HIV, often presenting asymptomatically. Early screening in immunocompromised children is crucial for timely diagnosis and management of this vision-threatening condition.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Pediatrics
Background:
- Vertically transmitted HIV infection poses significant health risks to children.
- Cytomegalovirus (CMV) retinitis is a serious opportunistic infection that can affect individuals with compromised immune systems.
Observation:
- This study reports on five cases of CMV retinitis in children with vertically transmitted HIV.
- The children's ages ranged from eight months to seven and a half years, with a median diagnosis age of 52 months.
- Clinical presentation varied, with some cases showing only a red eye, while others exhibited signs similar to adult CMV retinitis.
Findings:
- CMV retinitis in this pediatric population can manifest early in childhood.
- Diagnosis was often delayed, highlighting a difference from adult presentations.
- The mean follow-up period was 8 months, with 3 out of 5 patients surviving.
Implications:
- Systematic screening for CMV retinitis is recommended in children with vertically transmitted HIV, particularly those with low CD4 counts.
- Early detection and intervention are vital to prevent vision loss and manage CMV retinitis effectively in pediatric HIV patients.
- Understanding the clinical features and outcomes is essential for improving patient care and management strategies.
Purpose:
To describe the clinical feature and the outcome of CMV retinitis in children with vertically transmitted HIV infection.
Results:
Five case-reports of cytomegalovirus retinopathy are described. These children from eight month-old to seven and a half year-old (median age at diagnosis 52 months) had been perinatally contaminated by the human immuno-deficiency virus. The ophthalmic signs included only a red eye for one patient. The clinical signs were similar to the adult's retinopathy. At the opposite the differences were emphasized like the clinical onset with a delayed diagnosis. Mean follow-up since diagnosis is 8 months with 3 patients still alive.
Conclusion:
CMV retinitis in vertically transmitted AIDS can occur early in childhood and must be checked systematically in the patients with low CD 4 count because of the usual asymptomatic onset.