A Cytomegalovirus Retinitis Screening Program: Evaluation of Enrollment Criteria for HIV Patients in Singapore

作者：Shah Jinesh M; Leo Seo W; Lee Tian L; Tan Xiu L; Pan James C; Wong Elizabeth P; Yong Vernon K; Lim Tock H; Teoh Stephen C^*

来源：Ocular Immunology and Inflammation, 2015, 23(5): 362-370.

DOI：10.3109/09273948.2014.902472

• Acquired immune deficiency syndrome
• AIDS-defining illness
• cytomegalovirus retinitis
• enrollment
• fundus photography
• screening

Purpose: Identification of optimal enrollment criteria for a CMVR screening program suitable for a resource-limited environment.
Methods: A prospective audit was performed on newly diagnosed HIV patients referred for CMVR screening with any of the following four criteria: (1) visual symptoms, (2) low CD4(+) counts (<50 cells/mu L), (3) AIDS-defining illnesses (ADI), and/or (4) opportunistic infections (OI). Odds ratios for each of the demographic factors and enrollment criteria were calculated. Sensitivities, specificities, and workload reduction for the various combinations were determined.
Results: A total of 348 screening visits for 176 HIV patients were performed. While individually only ADI was statistically significant for increased CMVR risk, the combination of CD4(+) counts <50 cells/mu L with either ADI or visual symptoms or all 3 criteria were also statistically significant. Two enrollment criteria, ADI and ADI with CD4+ <50 cells/mu L, demonstrated good sensitivities, specificities, and workload reduction.
Conclusion: We propose ADI and possibly CD4+ counts <50 cells/mu L as enrollment criteria for CMVR screening.

• 出版日期2015