Association of Host Genetic Risk Factors With the Course of Cytomegalovirus Retinitis in Patients Infected With Human Immunodeficiency Virus

作者：Sezgin Efe^*; van Natta Mark L; Ahuja Alka; Lyon Alice; Srivastava Sunil; Troyer Jennifer L; O'Brien Stephen J; Jabs Douglas A

来源：American Journal of Ophthalmology, 2011, 151(6): 999-1006.

DOI：10.1016/j.ajo.2010.11.029

PURPOSE: To evaluate the effects of previously reported host genetics factors that influence cytomegalovirus (CMV) retinitis incidence, progression to acquired immune deficiency syndrome (AIDS), and efficacy of highly active antiretroviral therapy (HAART) for mortality, retinitis progression, and retinal detachment in patients with CMV retinitis and AIDS in the era of HAART.
DESIGN: Prospective, multicenter, observational study.
METHODS: Cox proportional hazards model based genetic association tests examined the influence of IL-10R1_S420L, CCR5-Delta 32, CCR2-V64I, CCR5 promoter, and SDF-3'A polymorphisms among patients with mortality, retinitis progression, and retinal detachment. Participants were 203 European-American and 117 African-American patients with AIDS and CMV retinitis.
RESULTS: European-American patients with the CCR5 + .P1. + promoter haplotype showed increased risk for mortality (hazard ratio [HR] = 1.83; 95% confidence interval [CI]: 1.00-3.40; P = .05). Although the same haplotype also trended for increased risk for mortality in African-American patients, the result was not significant (HR = 2.28; 95% CI: 0.93-5.60; P = .07). However, this haplotype was associated with faster retinitis progression in African Americans (HR = 5.22; 95% CI: 1.54-17.71; P = .007). Increased risk of retinitis progression was also evident for African-American patients with the SDF1-3'A variant (HR = 3.89; 95% CI: 1.42-10.60; P = .008). In addition, the SDF1-3'A variant increased the retinal detachment risk in this patient group (HR = 3.05; 95% CI: 1.01-9.16; P = .05).
CONCLUSION: Besides overall immune health, host genetic factors influence mortality, retinitis progression, and retinal detachment in patients with AIDS and CMV retinitis that are receiving HAART. (Am J Ophthalmol 2011;151:999-1006. Published by Elsevier Inc.)

• 出版日期2011-6
• 单位西北大学