What impact has HAART had on cytomegalovirus retinitis?
With HAART (Highly Active Anti-Retroviral Therapy), a dramatic decline in the incidence of cytomegalovirus retinitis (CMVR) has been seen. The link between HAART and the decline of CMVR is an indirect one. The decline results from the dramatic reduction in the numbers of patients with low CD4 counts (less than 50). The estimated decrease in the incidence of CMVR has ranged from 75 to 90 percent! Intraocular infections have been found in patients who are on HAART and have discontinued anti-CMVR therapy. No cases of activation of CMVR have been noted, but cases of immune recovery uveitis have been seen. Also occurring have been instances of anterior uveitis, cataracts, vitritis, CME, epiretinal membranes, and disc edema. Substantial inflammation has occurred as well, resulting in decreased visual acuity.
