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    Jan 26, 2021
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    CMV retinitis in China and SE Asia: the way forward

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    Authors
    Heiden, David
    Saranchuk, Peter
    Affiliation
    Department of Ophthalmology, California Pacific Medical Center, San Francisco, CA, USA; Seva Foundation, Berkeley, CA, USA; South African Medical Unit, Operational Centre Brussels, Medicines Sans Frontieres, Cape Town, South Africa
    Issue Date
    2011-11-24
    
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    Journal
    BMC Infectious Diseases
    Abstract
    AIDS-related CMV retinitis is a common clinical problem in patients with advanced HIV/AIDS in China and Southeast Asia. The disease is causing blindness, and current clinical management, commonly characterized by delayed diagnosis and inadequate treatment, results in poor clinical outcomes: 21% - 36% of eyes with CMV retinitis are already blind at the time the diagnosis is first established by an ophthalmologist. CMV retinitis also identifies a group of patients at extraordinary risk of mortality, and the direct or indirect contribution of extraocular CMV disease to AIDS-related morbidity and mortality is currently unmeasured and clinically often overlooked. The obvious way to improve clinical management of CMV retinitis is to screen all patients with CD4 counts < 100 cells/μL with indirect ophthalmoscopy at the time they first present for care, and to provide systemic treatment with oral valganciclovir when active CMV retinitis is detected. Treatment of opportunistic infections is an integral part of HIV management, and, with appropriate training and support, CMV retinitis screening and treatment can be managed by the HIV clinicians, like all other opportunistic infections. Access to ophthalmologist has been problematic for HIV patients in China, and although non-ophthalmologists can perform screening, sophisticated ophthalmological skills are required for the management of retinal detachment and immune recovery uveitis, the major complications of CMV retinitis. CMV retinitis has been clinically ignored, in part, because of the perceived complexity and expense of treatment, and this obstacle can be removed by making valganciclovir affordable and widely available. Valganciclovir is an essential drug for developing successful programs for management of CMV retinitis in China and throughout SE Asia.
    Publisher
    BioMed Central
    URI
    http://hdl.handle.net/10144/213250
    DOI
    10.1186/1471-2334-11-327
    Additional Links
    http://www.biomedcentral.com/1471-2334/11/327
    Type
    Article
    Language
    en
    ISSN
    1471-2334
    ae974a485f413a2113503eed53cd6c53
    10.1186/1471-2334-11-327
    Scopus Count
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