Immune Recovery Vitritis and Uveitis in Aids

Karavellas, Marietta P.; Azen, Stanley P.; Macdonald, Jonathan; Shufelt, Chrisandra; Lowder, Careen Y.; Plummer, Daniel J.; Glasgow, Ben J.; Torriani, Francesca J.; Freeman, William R.

doi:10.1097/00006982-200102000-00001

Cited by 129 publications

(35 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is still unclear why only some patients develop IRU. A recent study found that patients with more than 30% of retinal involvement with CMV retinitis were at the highest risk of developing IRU [14]. However, CMV genome was not detected in the aqueous humor, or vitreous, of the 5 participants of our study presenting IRU.…”

Section: Discussioncontrasting

confidence: 52%

PCR with the Aqueous Humor, Blood Leukocytes and Vitreous of Patients Affected by Cytomegalovirus Retinitis and Immune Recovery Uveitis

Siqueira

Cunha²,

Oréfice

et al. 2003

Ophthalmologica

View full text Add to dashboard Cite

Purpose: To detect the cytomegalovirus (CMV) genome by PCR in the aqueous humor, blood leukocytes and vitreous of patients affected by retinitis and immune recovery uveitis (IRU). Methods: A PCR for CMV genome detection was carried out with the aqueous humor, vitreous and blood leukocytes of 54 patients with retinitis, including 25 HIV-infected patients presenting CMV retinitis in different stages (active lesion 6 cases, healed lesion 14 cases and IRU 5 cases), and 29 non-HIV-infected patients (retinitis unrelated to CMV) as negative controls. Results: The CMV genome was detected in the vitreous, aqueous humor and blood leukocytes of 3 out of 6 HIV-infected patients, presenting active lesions in the retina. No CMV genome was detected in the vitreous, aqueous humor and blood leukocytes of the 5 HIV-infected patients presenting IRU. Conclusions: CMV genome detection by PCR in aqueous humor could be used as a specific and highly predictive technique for confirmation of this infection in the retina. The absence of CMV, based on the results of PCR done in clinical samples of the 5 IRU cases, does not confirm the hypothesis of a viral replication in the vitreous body and aqueous humor of these patients.

show abstract

Section: Discussioncontrasting

confidence: 52%

PCR with the Aqueous Humor, Blood Leukocytes and Vitreous of Patients Affected by Cytomegalovirus Retinitis and Immune Recovery Uveitis

Siqueira

Cunha²,

Oréfice

et al. 2003

Ophthalmologica

View full text Add to dashboard Cite

show abstract

“…IRU may cause vision loss from vitritis, retinal membrane formation, cystoid macular edema, or cataract. The larger the area of CMV retinitis, the greater the risk of both retinal detachment and IRU [23,24], again providing a compelling rationale for the benefit of early diagnosis and treatment.…”

Section: Diagnosis and Clinical Course Of CMV Retinitismentioning

confidence: 99%

Cytomegalovirus Retinitis: The Neglected Disease of the AIDS Pandemic

Heiden¹,

Ford²,

Wilson³

et al. 2007

PLoS Med

115

144

View full text Add to dashboard Cite

show abstract

Section: Immunopathogenesis Of Ird Associated With Infectious Agentsmentioning

confidence: 99%

“…The composition of the inflammatory cell infiltrate in the vitreous humor of patients with IRU was studied in three patients undergoing vitrectomy [71,99]. Immunohistochemical examination of the epimacular membrane showed a mixed cell population comprising 60% T-cells and <10% plasma cells [71]. In a different patient, the T-cell infiltrate contained a diverse population of CD8+ T-cells with most (57%) able to lyse CMV-infected fibroblasts, suggesting that they were CMV-specific cytotoxic T-cells [99].…”

Section: Immunopathogenesis Of Ird Associated With Infectious Agentsmentioning

confidence: 99%

Immune Restoration Disease: A Consequence of Dysregulated Immune Responses After HAART

Stone¹,

Price²,

French

2004

CHR

View full text Add to dashboard Cite

Immune Restoration Diseases (IRD) are a collection of atypical 'opportunistic infections' and inflammatory diseases seen in human immunodeficiency virus (HIV) patients after HIV viraemia is suppressed by highly active antiretroviral therapy (HAART). IRD probably reflect dysregulated immune responses against pre-existing infections by opportunistic pathogens, with different immunopathological mechanisms for different pathogens. For example, mycobacterial IRD are associated with delayed type hypersensitivity (DTH) responses to mycobacterial antigens, whereas patients who experience cytomegalovirus (CMV) IRD have elevated plasma levels of soluble CD30, a marker of a T2 cytokine environment expressed by activated CD8 T-cells. As IRD are often compartmentalised to organs, monitoring serological markers such as pathogen-specific IgG antibody, may be informative, as demonstrated for CMV and hepatitis C virus (HCV)-associated IRD. Genetic studies have provided evidence of distinct immunopathological mechanisms and inherited susceptibility to IRD associated with mycobacterial and herpesviridae infections. The expansion of HAART in the developing world where many HIV patients have low CD4+ T-cell counts and high rates of concomitant infections will place a large number of patients at-risk of developing IRD. It is therefore important to understand the immunopathology so that prevention, diagnosis and treatment can be improved.

show abstract

Immune Recovery Vitritis and Uveitis in Aids

Cited by 129 publications

References 15 publications

PCR with the Aqueous Humor, Blood Leukocytes and Vitreous of Patients Affected by Cytomegalovirus Retinitis and Immune Recovery Uveitis

PCR with the Aqueous Humor, Blood Leukocytes and Vitreous of Patients Affected by Cytomegalovirus Retinitis and Immune Recovery Uveitis

Cytomegalovirus Retinitis: The Neglected Disease of the AIDS Pandemic

Immune Restoration Disease: A Consequence of Dysregulated Immune Responses After HAART

Contact Info

Product

Resources

About