Click here to view next page of this article

 

Cytomegalovirus Infections

Cytomegalovirus (CMV) infection is extremely common in patients with AIDS, and it can cause retinitis, colitis, esophagitis and, rarely, pneumonitis. Clinical disease occurs in more than 40% of persons with advanced HIV infection, occurring primarily when the CD4+ cell count drops below

Retinitis (actually a chorioretinitis) is the most common manifestation of CMV disease, accounting for 75-80% of all CMV disease in AIDS. Retinitis progresses over weeks to a few months and, if untreated, inexorably leads to blindness.

Gastrointestinal involvement is the second most common manifestation, most commonly appearing as esophagitis or colitis, but CMV also affects the stomach and

Cytomegalovirus disease of the nervous system occurs less often and characterized by polyradiculopathy, encephalitis, or myelitis. cytomegavirus

Diagnosis of CMV Retinitis

Persistent visual disturbances are indicative of retinitis and should be evaluated with a dilated eye exam by an ophthalmologist.

Routine Cytomegalovirus, CMV screening of patients with dilated, funduscopic examinations should be initiated when the CD4 cell counts decline less than