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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Burden of HIV-Related cytomegalovirus retinitis in resource-limited settings: A systematic review
Clinical Infectious Diseases, Volume 57, No. 9, Year 2013
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Description
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 We conducted a systematic review and meta-analysis of published and unpublished studies reporting prevalence of CMV retinitis in low- and middle-income countries.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/L 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. © 2013 The Author 2013. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup. com.
Authors & Co-Authors
Ford, Nathan P.
Switzerland, Geneva
Unaids
Shubber, Zara
United Kingdom, London
Imperial College London
Saranchuk, Peter
Switzerland, Geneva
Medecins Sans Frontieres
Pathai, Sophia
Australia, Sydney
Unsw Sydney
Durier, Nicolas
Thailand, Bangkok
The Foundation for Aids Research
O'Brien, Daniel Patrick
Switzerland, Geneva
Medecins Sans Frontieres
Australia, Melbourne
Royal Melbourne Hospital
Mills, Edward J.
Canada, Ottawa
University of Ottawa
Holland, Gary N.
United States, Los Angeles
University of California, Los Angeles
Heiden, David
United States, San Francisco
California Pacific Medical Center
United States, Berkeley
Seva Foundation
Statistics
Citations: 71
Authors: 9
Affiliations: 11
Identifiers
Doi:
10.1093/cid/cit494
ISSN:
15376591
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Cross Sectional Study
Cohort Study
Study Approach
Systematic review