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    Jan 16, 2021
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    Burden of HIV-Related Cytomegalovirus Retinitis in Resource-Limited Settings: A Systematic Review

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    Authors
    Ford, Nathan
    Shubber, Zara
    Saranchuk, Peter
    Pathai, Sophia
    Durier, Nicolas
    O'Brien, Daniel P
    Mills, Edward J
    Pascual, Fernando
    Hoen, Ellen 't
    Holland, Gary N
    Heiden, David
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    Affiliation
    Department of HIV/AIDS, World Health Organization, Geneva, Switzerland.
    Issue Date
    2013-09-02
    Submitted date
    2013-08-07
    
    Metadata
    Show full item record
    Journal
    Clinical Infectious Diseases: an official publication of the Infectious Diseases Society of America
    Abstract
    Background. Cytomegalovirus (CMV) is a late-stage opportunistic infection in people living with human immunodeficiency virus (HIV)/AIDS. Lack of ophthalmological diagnostic skills, lack of convenient CMV treatment, and increasing access to antiretroviral therapy have all contributed to an assumption that CMV retinitis is no longer a concern in low- and middle-income settings. Methods. We conducted a systematic review and meta-analysis of published and unpublished studies reporting prevalence of CMV retinitis in low- and middle-income countries. Eligible studies assessed the occurrence of CMV retinitis by funduscopic examination within a cohort of at least 10 HIV-positive adult patients. Results. We identified 65 studies from 24 countries, mainly in Asia (39 studies, 12 931 patients) and Africa (18 studies, 4325 patients). By region, the highest prevalence was observed in Asia with a pooled prevalence of 14.0% (11.8%-16.2%). Almost a third (31.6%, 95% confidence interval [CI], 27.6%-35.8%) had vision loss in 1 or both eyes. Few studies reported immune status, but where reported CD4 count at diagnosis of CMV retinitis was <50 cells/µL in 73.4% of cases. There was no clear pattern of prevalence over time, which was similar for the period 1993-2002 (11.8%; 95% CI, 8%-15.7%) and 2009-2013 (17.6%; 95% CI, 12.6%-22.7%). Conclusions. Prevalence of CMV retinitis in resource low- and middle-income countries, notably Asian countries, remains high, and routine retinal screening of late presenting HIV-positive patients should be considered. HIV programs must ensure capacity to manage the needs of patients who present late for care.
    Publisher
    Oxford University Press
    URI
    http://hdl.handle.net/10144/303526
    DOI
    10.1093/cid/cit494
    PubMed ID
    23899681
    Additional Links
    http://cid.oxfordjournals.org//cgi/reprint/57/9/1351?ijkey=56xNTA/HM44tA&keytype=ref&siteid=cid
    Language
    en
    Description
    To access this article, click on "Additional Links"
    ISSN
    1537-6591
    ae974a485f413a2113503eed53cd6c53
    10.1093/cid/cit494
    Scopus Count
    Collections
    HIV/AIDS

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