Effect of potent antiretroviral therapy on recurrent cytomegalovirus retinitis treated with the ganciclovir implant

Janet L Davis, Homayoun Tabandeh, William J Feuer, Seema Kumbhat, Daniel B. Roth, Nauman A. Chaudhry

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

PURPOSE: To determine the effect of highly active antiretroviral therapy on cytomegalovirus (CMV) retinitis treated with ganciclovir implants. METHODS: A retrospective cohort study was performed of 15 patients with recurrent CMV retinitis treated with the ganciclovir implant and highly active antiretroviral therapy (cases) and 38 patients with recurrent retinitis treated with ganciclovir implants before availability of improved antiretroviral therapy (controls). Progression was defined as occurrence of new lesions in the treated eye or advancement of the retinitis border by more than 750 μm. RESULTS: Cases and controls were statistically similar in age, ethnicity, and duration of acquired immunodeficiency syndrome (AIDS). Controls had received intravenous ganciclovir for 9.5 ± 9.5 months vs 3.5 ± 4.6 months in cases (P = .003). The mean (± SE) time to progression of retinitis after implantation of the device was 26.7 ± 2.4 months (95% confidence interval, 22.1 to 31.3) in the cases receiving highly active antiretroviral therapy vs 6.2 ± 0.9 months (95% confidence interval, 4.5 to 7.9) in the controls (P = .001). Multivariate analysis, adjusted for preoperative variables, confirmed a significantly prolonged time to progression in patients receiving highly active antiretroviral therapy (P = .0003). The odds ratio for progression in the cases vs controls was 0.034 (95% confidence interval, 0.003 to 0.350). Cases had higher CD4+ T- lymphocyte counts (P = .004) and longer survival (P < .001) than controls. CONCLUSION: Highly active antiretroviral therapy is associated with improved outcomes in patients with AIDS and recurrent CMV retinitis treated with the ganciclovir implant.

Original languageEnglish
Pages (from-to)283-287
Number of pages5
JournalAmerican Journal of Ophthalmology
Volume127
Issue number3
DOIs
StatePublished - Mar 1 1999

Fingerprint

Cytomegalovirus Retinitis
Ganciclovir
Highly Active Antiretroviral Therapy
Retinitis
Confidence Intervals
Acquired Immunodeficiency Syndrome
Therapeutics
CD4 Lymphocyte Count
Cohort Studies
Multivariate Analysis
Retrospective Studies
Odds Ratio
T-Lymphocytes
Equipment and Supplies
Survival

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Effect of potent antiretroviral therapy on recurrent cytomegalovirus retinitis treated with the ganciclovir implant. / Davis, Janet L; Tabandeh, Homayoun; Feuer, William J; Kumbhat, Seema; Roth, Daniel B.; Chaudhry, Nauman A.

In: American Journal of Ophthalmology, Vol. 127, No. 3, 01.03.1999, p. 283-287.

Research output: Contribution to journalArticle

Davis, Janet L ; Tabandeh, Homayoun ; Feuer, William J ; Kumbhat, Seema ; Roth, Daniel B. ; Chaudhry, Nauman A. / Effect of potent antiretroviral therapy on recurrent cytomegalovirus retinitis treated with the ganciclovir implant. In: American Journal of Ophthalmology. 1999 ; Vol. 127, No. 3. pp. 283-287.
@article{812f92a554474bab9f6ad4a96473a9bc,
title = "Effect of potent antiretroviral therapy on recurrent cytomegalovirus retinitis treated with the ganciclovir implant",
abstract = "PURPOSE: To determine the effect of highly active antiretroviral therapy on cytomegalovirus (CMV) retinitis treated with ganciclovir implants. METHODS: A retrospective cohort study was performed of 15 patients with recurrent CMV retinitis treated with the ganciclovir implant and highly active antiretroviral therapy (cases) and 38 patients with recurrent retinitis treated with ganciclovir implants before availability of improved antiretroviral therapy (controls). Progression was defined as occurrence of new lesions in the treated eye or advancement of the retinitis border by more than 750 μm. RESULTS: Cases and controls were statistically similar in age, ethnicity, and duration of acquired immunodeficiency syndrome (AIDS). Controls had received intravenous ganciclovir for 9.5 ± 9.5 months vs 3.5 ± 4.6 months in cases (P = .003). The mean (± SE) time to progression of retinitis after implantation of the device was 26.7 ± 2.4 months (95{\%} confidence interval, 22.1 to 31.3) in the cases receiving highly active antiretroviral therapy vs 6.2 ± 0.9 months (95{\%} confidence interval, 4.5 to 7.9) in the controls (P = .001). Multivariate analysis, adjusted for preoperative variables, confirmed a significantly prolonged time to progression in patients receiving highly active antiretroviral therapy (P = .0003). The odds ratio for progression in the cases vs controls was 0.034 (95{\%} confidence interval, 0.003 to 0.350). Cases had higher CD4+ T- lymphocyte counts (P = .004) and longer survival (P < .001) than controls. CONCLUSION: Highly active antiretroviral therapy is associated with improved outcomes in patients with AIDS and recurrent CMV retinitis treated with the ganciclovir implant.",
author = "Davis, {Janet L} and Homayoun Tabandeh and Feuer, {William J} and Seema Kumbhat and Roth, {Daniel B.} and Chaudhry, {Nauman A.}",
year = "1999",
month = "3",
day = "1",
doi = "10.1016/S0002-9394(98)00442-5",
language = "English",
volume = "127",
pages = "283--287",
journal = "American Journal of Ophthalmology",
issn = "0002-9394",
publisher = "Elsevier USA",
number = "3",

}

TY - JOUR

T1 - Effect of potent antiretroviral therapy on recurrent cytomegalovirus retinitis treated with the ganciclovir implant

AU - Davis, Janet L

AU - Tabandeh, Homayoun

AU - Feuer, William J

AU - Kumbhat, Seema

AU - Roth, Daniel B.

AU - Chaudhry, Nauman A.

PY - 1999/3/1

Y1 - 1999/3/1

N2 - PURPOSE: To determine the effect of highly active antiretroviral therapy on cytomegalovirus (CMV) retinitis treated with ganciclovir implants. METHODS: A retrospective cohort study was performed of 15 patients with recurrent CMV retinitis treated with the ganciclovir implant and highly active antiretroviral therapy (cases) and 38 patients with recurrent retinitis treated with ganciclovir implants before availability of improved antiretroviral therapy (controls). Progression was defined as occurrence of new lesions in the treated eye or advancement of the retinitis border by more than 750 μm. RESULTS: Cases and controls were statistically similar in age, ethnicity, and duration of acquired immunodeficiency syndrome (AIDS). Controls had received intravenous ganciclovir for 9.5 ± 9.5 months vs 3.5 ± 4.6 months in cases (P = .003). The mean (± SE) time to progression of retinitis after implantation of the device was 26.7 ± 2.4 months (95% confidence interval, 22.1 to 31.3) in the cases receiving highly active antiretroviral therapy vs 6.2 ± 0.9 months (95% confidence interval, 4.5 to 7.9) in the controls (P = .001). Multivariate analysis, adjusted for preoperative variables, confirmed a significantly prolonged time to progression in patients receiving highly active antiretroviral therapy (P = .0003). The odds ratio for progression in the cases vs controls was 0.034 (95% confidence interval, 0.003 to 0.350). Cases had higher CD4+ T- lymphocyte counts (P = .004) and longer survival (P < .001) than controls. CONCLUSION: Highly active antiretroviral therapy is associated with improved outcomes in patients with AIDS and recurrent CMV retinitis treated with the ganciclovir implant.

AB - PURPOSE: To determine the effect of highly active antiretroviral therapy on cytomegalovirus (CMV) retinitis treated with ganciclovir implants. METHODS: A retrospective cohort study was performed of 15 patients with recurrent CMV retinitis treated with the ganciclovir implant and highly active antiretroviral therapy (cases) and 38 patients with recurrent retinitis treated with ganciclovir implants before availability of improved antiretroviral therapy (controls). Progression was defined as occurrence of new lesions in the treated eye or advancement of the retinitis border by more than 750 μm. RESULTS: Cases and controls were statistically similar in age, ethnicity, and duration of acquired immunodeficiency syndrome (AIDS). Controls had received intravenous ganciclovir for 9.5 ± 9.5 months vs 3.5 ± 4.6 months in cases (P = .003). The mean (± SE) time to progression of retinitis after implantation of the device was 26.7 ± 2.4 months (95% confidence interval, 22.1 to 31.3) in the cases receiving highly active antiretroviral therapy vs 6.2 ± 0.9 months (95% confidence interval, 4.5 to 7.9) in the controls (P = .001). Multivariate analysis, adjusted for preoperative variables, confirmed a significantly prolonged time to progression in patients receiving highly active antiretroviral therapy (P = .0003). The odds ratio for progression in the cases vs controls was 0.034 (95% confidence interval, 0.003 to 0.350). Cases had higher CD4+ T- lymphocyte counts (P = .004) and longer survival (P < .001) than controls. CONCLUSION: Highly active antiretroviral therapy is associated with improved outcomes in patients with AIDS and recurrent CMV retinitis treated with the ganciclovir implant.

UR - http://www.scopus.com/inward/record.url?scp=0033106330&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0033106330&partnerID=8YFLogxK

U2 - 10.1016/S0002-9394(98)00442-5

DO - 10.1016/S0002-9394(98)00442-5

M3 - Article

C2 - 10088737

AN - SCOPUS:0033106330

VL - 127

SP - 283

EP - 287

JO - American Journal of Ophthalmology

JF - American Journal of Ophthalmology

SN - 0002-9394

IS - 3

ER -