Cytomegalovirus retinitis in post HAART era in the north eastern India

HIV prevalence in India is estimated at 0.26% in 2015 with 0.30% among males and at 0.22% among females. Manipur being the highest estimated adult HIV prevalence among all states/UTs (1.15%) in India, Cytomegalovirus (CMV) retinitis and its consequent blindness is still a major challenge demanding early diagnosis and treatment.

Prevalence of CMV retinitis between the groups of AIDS patients according to their different levels of CD4 T lymphocyte counts

Retrospective, descriptive study.

A total of 682 HIV patients with mean age of 33 years were evaluated. CD4 count and treatment status including best corrected visual acuity and examination of anterior and posterior segment by slit lamp biomicroscope, IDO and fundus photography were done. Confirmed cases of CMV retinitis was excluded from other HIV retinopathy.

by using Chi (χ2) square test and simple Statistical tools

Of the 682 person examined CMV retinitis was diagnosed in 24 patients, of which 20 patients were on ART. Prevalence of CMV retinitis in the study was 3.51%. Three cases (2.6%) of CMV retinitis out of 122 patients were observed within CD4 count between 100–299 cells/μl. Nine cases (7.6%) of CMV retinitis were observed out of 71 patients with CD4 count between 50–99 cell/μl. 12 cases (11.2%) of CMV retinitis was diagnosed out of 107 patients with CD4 count < 50 cells/μl. Bilateral CMV retinitis was seen in four patients (0.6%). Optic neuritis was seen in one patient.

Prevalence of CMV Retinitis is common in patients with CD4+ T lymphocytes < 50 cells/μl. Ocular symptoms and poor visual acuity may be misleading as sole criteria indicates the presence of CMV retinitis and advocate a systemic screening of all HIV patients with CD4 count < 100 cells/μl to detect the ocular changes due to CMV retinitis for early prevention from severe visual impairment.