Prophylaxis Against Cytomegalovirus (CMV) Retinitis in HIV Patient

 

Criteria for starting prophylaxis: documented CMV retinitis

 

Findings in CMV retinitis:

(1) painless blurring or loss of vision

(2) fluffy white exudates with "brush fire" appearance on fundoscopic examination

 

Criteria for discontinuation of prophylaxis:

(1) CD4 count > 100 to 150 per µL for >= 6 months

(2) asymptomatic

(3) regular ophthalmologic examinations with no evidence of active disease

 

Criteria for restarting prophylaxis: CD4 count < 100 to 150 per µL (most patients with CMV retinitis have CD4 counts < 50 per µL)

 

where:

• A person with symptoms and/or evidence of active disease on ophthalmic examinations would require therapy rather than prophylaxis.