Photo Credit: Dr Microbe

The following is a summary of “Clinical manifestations and immune markers of non-HIV-related CMV retinitis,” published in the August 2024 issue of Infectious Disease by Passarin et al.

Cytomegalovirus (CMV) retinitis primarily affected HIV-positive individuals with CD4+ cell counts below 50 cells/mm3 since the 1980s HIV epidemic.

Researchers conducted a retrospective study to characterize immune markers, clinical features, and outcomes of non-HIV-related CMV retinitis.

They analyzed consecutive patients with CMV retinitis not related to HIV at the Jules Gonin Eye Hospital’s uveitis clinic (2000 to 2023), reporting on clinical manifestations and outcomes and assessing immune markers, including leukocyte, lymphocyte, CD4+ cell, and CD8+ cell counts, and immunoglobulin levels.

The results showed 15 patients (22 eyes), with 9 having hematologic malignancy, 3 having solid organ transplants, 2 having rheumatic disease, and 1 having thymoma. The median interval between the onset of the underlying disease and CMV retinitis diagnosis was 4.8 years. Lymphopenia was found in 8 out of 15 patients (mild in 3, moderate in 4, severe in 1), and low CD4 counts were present in 9 out of 12 patients, including 4 with counts below 100 cells/mm3. Hypogammaglobulinemia occurred in 7 out of 11 patients. Bilateral retinitis was observed in 7 out of 15 patients, and severe visual loss was noted in 5 out of 19 eyes. Recurrence of the disease was seen in 7 out of 13 patients, with a median interval of 6 months post-diagnosis. No significant differences in immune markers were found between patients with and without recurrence.

Investigators concluded that CMV retinitis was a rare disease affecting individuals who were immunocompromised, often with B-cell dysfunction and high visual morbidity despite treatment, unlike HIV-associated cases with lower CD4+ counts.

Source: bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-024-09653-x