About half of the general population and 90% of patients with HIV/AIDS

CMV Retinitis

About half of the general population and 90% of patients with HIV/AIDS harbor a virus known as cytomegalovirus, or CMV. As with all opportunistic infections, people do not get sick from it unless their immune system is seriously compromised. Patients with HIV/AIDS are at risk for developing CMV when their CD4 count falls below 100 cells per cc.

CMV most commonly affects the eye. CMV retinitis is an inflammation of the retina. The initial symptom of CMV retinitis is "floaters," moving black spots in the field of vision. Patients who have a CD4 count below 200 and experience vision problems should contact their physician or other health care provider immediately. An ophthalmologist (an eye specialist) should be able to diagnose CMV upon examination. If left untreated, CMV retinitis can lead to blindness within 2 weeks.

Thankfully, CMV is rare among patients who are on antiretroviral therapy. It is usually diagnosed in patients who are not taking antiretrovirals or who have recently begun therapy.

Patients who have CMV should discuss the advantages and disadvantages of various treatment options with their physician or other health care provider. Treatment may involve intravenous (IV) administration of medications such as ganciclovir (Cytovene®) or foscarnet (Foscavir®), oral medications, or the surgical placement of a ganciclovir implant in the eye. Although not a cure, medication often can control the infection. As with all HIV-related infections and illnesses, antiretroviral therapy is an essential part of treatment. Antiretrovirals can prevent infection from spreading, and can help the immune system fight an existing infection.