Effect of highly active antiretroviral therapy (HAART) on cytomegalovirus retinitis

Aim A patient was till now considered at high risk of developping a cytomegalovirus retinitis when the CD4+ cells were under 100/mm(3). The risk was major when the CD4+ were under 50/mm(3). With the onset of a Highly Active Antiretroviral Therapy (HAART) the follow-up of AIDS patients has changed. The introduction of a HAART is associated with an increase in CD4+ cells. The aim of the study was to highlight clinical modifications of classical AIDS associated ocular diseases. Materials and methods clinical observations will be correlated to recent data published in literature. Results An immune response can be present against opportunitic infections. Cytomegalovirus retinitis can present an atypical pattern: The host immune response can be responsible for an increase of ocular inflammation, a hypopyon can even be seen. An intense vitritis can be present and frosted angiitis syndrome can be observed. A severe macular edema can be present and has to be treated with posterior sub-Tenon's steroid injections. Conclusion with the restoration of an immune response under HAART therapy, clincial manifestation of AIDS associated ocular diseases has changed and the differential diagnosis of ocular lesions must include endogenous uveitis.