Development of cytomegalovirus retinitis after negative conversion of cytomegalovirus antigenemia due to systemic antivi
- PDF / 361,284 Bytes
- 8 Pages / 595.276 x 790.866 pts Page_size
- 30 Downloads / 181 Views
INFLAMMATORY DISORDERS
Development of cytomegalovirus retinitis after negative conversion of cytomegalovirus antigenemia due to systemic antiviral therapy Kayo Suzuki 1 & Kenichi Namba 1 & Kazuomi Mizuuchi 1 & Daiju Iwata 1 & Takako Ito 1,2 & Keitaro Hase 1 & Nobuyoshi Kitaichi 1,2 & Susumu Ishida 1 Received: 3 August 2020 / Revised: 18 October 2020 / Accepted: 6 November 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020, corrected publication 2020
Abstract Purpose Cytomegalovirus (CMV) antigenemia assays have been widely used as adjunct tests to diagnose tissue invasive CMV diseases, including cytomegalovirus retinitis (CMVR). In this study, we examined CMVR cases to assess the presence of CMV in sera and aqueous humor and antiviral therapy received prior to the onset of CMVR. Methods A total of 37 eyes from 26 different cases of CMVR in patients who visited Hokkaido University Hospital between 2007 and 2015 were enrolled. The diagnosis of CMVR was established based on characteristic ophthalmoscopic findings and the presence of local and/or systemic CMV infection. Among the 26 cases, 3 cases (12%) were HIV-positive, while the other 23 cases (88%) were HIV-negative. The records of clinical and laboratory results were reviewed from clinical charts retrospectively. Results CMV antigenemia was positive at the onset of CMVR in 14 cases (53.8%) and negative in the other 12 cases. In 9 cases among the antigenemia-negative cases (75.0%), the antigenemia had been previously positive and had turned negative before the onset of CMVR. In 12 of the 14 antigenemia-positive cases (85.7%) and in 8 of the 9 antigenemia-negative cases (88.9%) that were previously positive, systemic antiviral therapies had never been used or had been used before but had been discontinued prior to the onset of CMVR. Conclusion Even if viremia turns negative, the risk of developing CMVR exists for more than several weeks after the completion of systemic therapy. Keywords Cytomegalovirus retinitis . Cytomegalovirus antigenemia . Cytomegalovirus viremia . Ganciclovir intravitreal injection
Key Message: Administration of antiviral therapy for active cytomegalovirus (CMV) infections is guided by the clinical and virologic response, as marked by CMV antigenemia. However, we found that there are a certain proportion of cases in which CMV retinitis (CMVR) develops after turning negative of CMV antigenemia due to antiviral therapy for systemic CMV infection in this study. Even after CMV antigenemia turns negative due to antiviral therapies, much attention should be paid to the risk of CMVR development after the discontinuation of antiviral therapy.
* Kenichi Namba [email protected] 1
Department of Ophthalmology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, N-15, W-7, Kita-ku, Sapporo, Hokkaido 060-8638, Japan
2
Department of Ophthalmology, Health Sciences University of Hokkaido, Sapporo, Japan
Introduction Cytomegalovirus (CMV) infection, which can affect various organs (e.g., the colon, lungs, liver
Data Loading...
