Journal Article

Rapidly Progressive Herpetic Retinal Necrosis: A Blinding Disease Characteristic of Advanced AIDS

L. David Ormerod, Julie A. Larkin, Curtis A. Margo, Peter R. Pavan, Matthew M. Menosky, Daniel O. Haight, Jeffrey P. Nadler, Bienvenido G. Yangco, Scott M. Friedman, Robert Schwartz and John T. Sinnott

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 26, issue 1, pages 34-35
Published in print January 1998 | ISSN: 1058-4838
Published online January 1998 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/516285
Rapidly Progressive Herpetic Retinal Necrosis: A Blinding Disease Characteristic of Advanced AIDS

More Like This

Show all results sharing these subjects:

  • Infectious Diseases
  • Immunology
  • Public Health and Epidemiology
  • Microbiology

GO

Show Summary Details

Preview

Eleven patients with rapidly progressive herpetic retinal necrosis (RPHRN) complicating AIDS were investigated retrospectively to study the disease spectrum, systemic involvement, and therapy. The meanCD4 cell count was 24/ μL. There was a characteristic disease pattern withrapidprogression, 82% bilaterality, relative resistance to intravenous antiviral therapy, and 70% retinal detachment. Varicella-zoster virus was the probable cause in 10 patients (detected by polymerase chain reactionintwo eyes investigated), andherpes simplex virus was the probable cause inone. Cutaneous zoster occurredpreviously in73%but was not concurrent. Seventy-three percent hadcentral nervous systemdisease, possibly virus-related. RPHRNmay be a local herpetic recrudescence inanimmuneprivileged site with transneural spread. Only four of 20 affected eyes retained useful vision. Poor ocular bioavailability, retinal ischemia, acquired drug resistance, and strain pathogenicity may underlie treatment failure. Acyclovir therapy appears relatively ineffective. Combined intravenous and intravitreal therapy with foscarnet and ganciclovir may be the best current management. Research advances are needed urgently.

Journal Article.  0 words. 

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

Full text: subscription required

How to subscribe Recommend to my Librarian

Users without a subscription are not able to see the full content. Please, subscribe or login to access all content.