Title : Prevalence and correlates of cytomegalovirus retinitis among newly diagnosed HIV/AIDS patients in a level III government hospital in the philippines
Abstract:
The Philippines is facing the fastest upsurge of HIV cases in Southeast Asia. Cytomegalovirus retinitis is the leading cause of blindness that primary affects immunocompromised individuals with HIV. Data on the scale of CMV retinitis problem in developing countries is limited as screening examinations are not routinely done. In this study, we determine the prevalence and identify the association of demographic characteristics, personal and social risk factors, CD4 T-cell count, blood examination, ocular symptoms, and visual acuity to CMV retinitis. This is a single center, analytical cross-sectional study. Patients enrolled from December 1, 2021 to July 31, 2022 at the HIV Hub at a provincial tertiary hospital in the Philippines were screened. A total of 115 patients were screened from December 2021 to July 2022, but only 91 were included in the study. From the 91 patients, there were 9 patients diagnosed with cytomegalovirus (CMV) retinitis in the right or left eye, with a prevalence of 9.89%. Determining such risk factors will permit earlier detection, appropriate referral and can be a guide to formulation of local screening guidelines. In the study, test of association showed that having a visual complaint, symptom of blurring of vision and visual acuity of less than 20/20 is significantly associated with CMV retinitis. On logistic regression analysis, demographic profile, personal and social risk factors, CD4 T-cell count, blood examination and best corrected visual acuity are not significant predictors of CMV retinitis among newly diagnosed HIV patients. Presence of visual complaints and a symptom of blurred vision were the only found significant predictors of CMV retinitis in our study. The significant predictors of CMV retinitis in the study were the presence of visual complaints, specifically, blurring of vision. It can be inferred that a good history taking is beneficial. Knowing such predictors would support a baseline CMV retinitis screening to all patients newly diagnosed with HIV regardless of clinical and immunological status.
Audience takeaway:
- The scale of CMV retinitis problem in developing regions is still not known as most cases are not diagnosed and screening examinations are rarely done in resource-limited areas.
- There has been no ocular symptom that is highly sensitive in screening CMV retinitis. Thus, CMV retinitis is detected late.
- Given these realities, identifying the clinical variables that elevate the risk of CMV retinitis will be helpful for creating guidelines for CMV screening and early detection.
- Formulation of said guidelines will help health policy experts in developing logical algorithm that permit early detection, allow early referral and possible prophylactic therapy to patients at risk.
