Journal Article

Clinical manifestations and immune markers of non-HIV-related CMV retinitis

Hoogewoud, Florence, Passarin, Olga, Guex-Crosier, Yan, Manuel, Oriol

2024

Overview

Background Since the HIV epidemic in the 1980s, CMV retinitis has been mainly reported in this context. CMV retinitis in persons living with HIV is usually observed when CD4 + cells are below 50 cells/mm3. This study aims to describe the immune markers of non-HIV-related CMV retinitis as well as to describe its clinical manifestations and outcomes. Methods Retrospective chart review of consecutive patients with CMV retinitis not related to HIV seen at the uveitis clinic of Jules Gonin Eye Hospital between 2000 and 2023. We reported the clinical manifestations and outcomes of the patients. We additionally assessed immune markers during CMV retinitis (leukocyte, lymphocyte, CD4 + cell and CD8 + cell counts as well as immunoglobulin levels). Results Fifteen patients (22 eyes) were included. Underlying disease was hematologic malignancy in 9 patients, solid organ transplant in 3 patients, rheumatic disease in 2 patients and thymoma in one patient. The median time between the onset of underlying disease and the diagnosis of retinitis was 4.8 years. Lymphopenia was observed in 8/15 patients (mild = 3, moderate = 4, severe = 1), and low CD4 counts were observed in 9/12 patients, with less than 100 cells/mm3 in 4 patients. Hypogammaglobulinemia was detected in 7/11 patients. Retinitis was bilateral in 7/15 patients, and severe visual loss was frequent (5/19 eyes). Disease recurrence was seen in 7/13 patients at a median time of 6 months after initial diagnosis. No differences in immune markers were observed in patients with vs. without recurrence. Conclusion CMV retinitis is a rare disorder that can affect patients suffering any kind of immunodeficiency. It is associated with a high visual morbidity despite adequate treatment. CD4 + cell counts are usually higher than those in HIV patients, but B-cell dysfunction is common.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Adult / Aged / Biological markers / Biomarkers - blood / Blood cancer / Care and treatment / CD4 + lymphocytes / CD4 antigen / CD4 Lymphocyte Count / CD4-Positive T-Lymphocytes - immunology / CD8 antigen / CD8-Positive T-Lymphocytes - immunology / CMV retinitis / Cytomegalovirus / Cytomegalovirus infections / Cytomegalovirus Retinitis - complications / Cytomegalovirus Retinitis - immunology / Cytomegaloviruses / Development and progression / Diagnosis / Disease / Diseases / Eye / Female / Health aspects / HIV / HIV (Viruses) / HIV Infections - complications / HIV Infections - immunology / HIV patients / Human immunodeficiency virus / Humans / Hypogammaglobulinemia / Immune response / Immunodeficiency / Immunoglobulins / Immunotherapy / Infections / Infectious Diseases / Internal Medicine / Ischemia / Leukocytes / Leukopenia / Lymphocyte count / Lymphocytes / Lymphocytes B / Lymphopenia / Male / Malignancy / Medical Microbiology / Medical research / Medicine / Medicine & Public Health / Medicine, Experimental / Middle Aged / Morbidity / Parasitology / Patient outcomes / Patients / Physiological aspects / Recurrence / Relapse / Retinal detachment / Retinal diseases / Retinitis / Retrospective Studies / Rheumatic diseases / Thymoma / Transplantation of organs, tissues, etc / Transplants & implants / Tropical Medicine / Uveitis / Visual observation