Cytomegalovirus (CMV) retinitis can be a devastating infection in patients with HIV disease. Prophylaxis can be effective in preventing disease in susceptible patients. Patients receiving highly active antiretroviral therapy (HAART) may be able to stop prophylaxis if certain criteria are met.


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)



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


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