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Anales de la Sociedad Mexicana de Oftalmología y Archivos de la Asociación Para Evitar la Ceguera en México

2006, Número 4

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Rev Mex Oftalmol 2006; 80 (4)


Tratamiento de la retinitis por citomegalovirus en pacientes con SIDA con terapia anti-CMV antes del inicio de la terapia antirretroviral altamente efectiva

Ortega-Larrocea G

Idioma: Español
Referencias bibliográficas: 27
Paginas: 210-213
Archivo PDF: 41.53 Kb.


RESUMEN

Objetivo: La uveítis por reconstitución immune (URI) se presenta en pacientes con SIDA y retinitis por citomegalovirus (RCMV). Conocer si la URI es más frecuente cuando se inicia el tratamiento antiviral altamente activo (HAART), antes o simultáneamente a la terapia anti-CMV.
Pacientes y métodos: De 125 pacientes con SIDA/ RCMV se seleccionaron aquellos con sobrevida ›12 meses y se dividieron en dos grupos de acuerdo con la terapia antiretroviral que recibieron. Grupo I: HAART antes o al mismo tiempo que el tratamiento anti-CMV; grupo 2: terapia antiretroviral de baja potencia antes o al mismo tiempo que la terapia anti-CMV. Estadística descriptiva y no paramétrica.
Resultados: Se incluyeron 55 adultos con RCMV activa con linfocitos TCD4+ de 27 (sd±36). La prevalencia de URI fue de 56.3% con linfocitos TCD4+ de 318 (sd±72). Grupo I: de 36 pacientes con HAART, 25 (69.4%) tuvieron URI a los 8.7 meses (sd±8.1) después del diagnóstico de RCMV. Grupo 2: de 19 con terapia antiretroviral no potente 6 (14%) tuvieron URI a los 12 meses (sd±9) después de cambiar a terapia HAART. El RR= 6.3, CI 95% 1.09-24.7; pMH= 0.01.
Conclusion: la URI es mas frecuente en pacientes que inician terapia HAART al momento de diagnóstico de RCMV o antes.


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