Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Anti-HIV drugs save vision, improve outlook for AIDS patients

14.05.2003


A new study from Johns Hopkins researchers shows the multiple anti-HIV drug regimen called highly active antiretroviral therapy (HAART) saves eyesight as well as lives. A second study led by Johns Hopkins researchers finds that among AIDS patients with longstanding vision problems, those who took HAART reported higher overall quality of life.



The Johns Hopkins team reported in the April issue of Archives of Ophthalmology that AIDS patients who received HAART had a 75 percent lower risk of visual impairment than those who did not. In the second, multicenter study, published in the May issue of the journal Ophthalmology, AIDS patients with vision loss reported a lower vision-related quality of life, although those who took HAART reported higher overall quality of life than those who did not.

AIDS patients are at high risk of vision loss from cytomegalovirus (CMV) retinitis, an infectious disease of the retina. Symptoms include "floaters" and permanent loss of central vision. With HAART, which became available in 1995, many patients’ immune systems seem to recover enough to control CMV retinitis. The condition at one time affected 30 percent of patients at some point during their lives, but has probably decreased to 7.5 percent with the advent of HAART, says John H. Kempen, M.D., Ph.D., lead author of both studies and assistant professor of ophthalmology and epidemiology. By the time CMV is diagnosed, Kempen says, many AIDS patients are already legally blind or have significant vision loss.


"AIDS patients should take HAART as soon as and as much as they can," he says. "HAART often can save both their life and their vision."

In the Archives study, Kempen and his team evaluated 648 AIDS patients seen at the Wilmer Eye Institute at Johns Hopkins between August 1983 and March 2000. Seventeen percent had 20/200 vision (the definition of legal blindness) at the time of diagnosis, while 33 percent had 20/50 vision -- poor enough to restrict their ability to drive. Whites were less likely to have visual impairment, while injection drug users had a higher prevalence of visual impairment. Patients were followed monthly for disease progression.

One year later, 42 percent of 426 patients lost visual acuity equivalent to three lines on the vision chart, 30 percent lost the equivalent of six lines on the chart and 23 percent lost the equivalent of 10 lines on the chart. By one year after CMV retinitis diagnosis, the incidence of vision loss to the level of 20/50 vision was 34 percent and the incidence of vision loss to the level of 20/200 vision was 24 percent. Thus, within the first year after being diagnosed with CMV retinitis, over half (56 percent) had vision loss to the level of 20/50, and about a third (37 percent) were legally blind.

Ninety-three patients (126 eyes) received HAART during the study’s follow-up. Of these, 46 patients (64 eyes) had substantial improvement in their immunity, while 47 (62 eyes) did not. Those who received HAART had a much lower incidence of visual acuity loss compared with patients who did not receive the therapy, especially those who had improvement of their immunity.

In the second study, a report from the Longitudinal Study of Ocular Complications of AIDS, researchers at Johns Hopkins and 18 other centers across the country questioned 971 AIDS patients ages 13 and up about their quality of life related to vision and overall health. Patients were enrolled between September 1998 and March 2001. Fifty patients had newly diagnosed CMV retinitis, 212 patients had longstanding CMV retinitis of an average three years’ duration, and 709 patients had no CMV retinitis. Newly diagnosed patients tended to be female, younger and African-American. They were more likely to have detectable CMV DNA in their blood and had been diagnosed with AIDS more recently, so were less likely to be taking HAART.

The longstanding and newly diagnosed CMV retinitis groups scored substantially worse in vision-related quality of life than the group without CMV retinitis. However, general health-related quality of life scores for the longstanding CMV retinitis group tended to be similar to, or better than, those for patients without CMV retinitis, mostly due to the effects of HAART. Patients with newly diagnosed CMV retinitis tended to score worse on the general health-related quality of life scale.



The risk of vision loss study was supported by the National Eye Institute. Co-authors were Douglas A. Jabs, M.D., M.B.A.; Laura A. Wilson, M.Sc.; James P. Dunn, M.D.; Sheila K. West, Ph.D.; and James A. Tonascia, Ph.D.

The quality of life study also was supported by the National Eye Institute, as well as the National Center for Research Resources. Co-authors were Barbara K. Martin, Ph.D.; Albert W. Wu, M.D., M.P.H.; Bruce Barron, M.D.; Jennifer E. Thorne, M.D.; and Douglas A. Jabs, M.D., M.B.A.

Kempen, J.H. et al, "Risk of Vision Loss in Patients with Cytomegalovirus Retinitis and the Acquired Immunodeficiency Syndrome," Archives of Ophthalmology, April 2003; Vol. 121: pages 466-476.

Kempen, J.H. et al, "The Effect of Cytomegalovirus Retinitis on the Quality of Life of Patients with the Acquired Immune Deficiency Syndrome in the Era of Highly Active Anti-retroviral Therapy," Ophthalmology, May 2003.

Karen Blum | EurekAlert!
Further information:
http://www.wilmer.jhu.edu
http://archopht.ama-assn.org/
http://www.nei.nih.gov

More articles from Health and Medicine:

nachricht Infants later diagnosed with autism follow adults’ gaze, but seldom initiate joint attention
24.05.2019 | Schwedischer Forschungsrat - The Swedish Research Council

nachricht When wheels and heads are spinning - DFG research project on motion sickness in automated driving
22.05.2019 | Technische Universität Berlin

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: New studies increase confidence in NASA's measure of Earth's temperature

A new assessment of NASA's record of global temperatures revealed that the agency's estimate of Earth's long-term temperature rise in recent decades is accurate to within less than a tenth of a degree Fahrenheit, providing confidence that past and future research is correctly capturing rising surface temperatures.

The most complete assessment ever of statistical uncertainty within the GISS Surface Temperature Analysis (GISTEMP) data product shows that the annual values...

Im Focus: The geometry of an electron determined for the first time

Physicists at the University of Basel are able to show for the first time how a single electron looks in an artificial atom. A newly developed method enables them to show the probability of an electron being present in a space. This allows improved control of electron spins, which could serve as the smallest information unit in a future quantum computer. The experiments were published in Physical Review Letters and the related theory in Physical Review B.

The spin of an electron is a promising candidate for use as the smallest information unit (qubit) of a quantum computer. Controlling and switching this spin or...

Im Focus: Self-repairing batteries

UTokyo engineers develop a way to create high-capacity long-life batteries

Engineers at the University of Tokyo continually pioneer new ways to improve battery technology. Professor Atsuo Yamada and his team recently developed a...

Im Focus: Quantum Cloud Computing with Self-Check

With a quantum coprocessor in the cloud, physicists from Innsbruck, Austria, open the door to the simulation of previously unsolvable problems in chemistry, materials research or high-energy physics. The research groups led by Rainer Blatt and Peter Zoller report in the journal Nature how they simulated particle physics phenomena on 20 quantum bits and how the quantum simulator self-verified the result for the first time.

Many scientists are currently working on investigating how quantum advantage can be exploited on hardware already available today. Three years ago, physicists...

Im Focus: Accelerating quantum technologies with materials processing at the atomic scale

'Quantum technologies' utilise the unique phenomena of quantum superposition and entanglement to encode and process information, with potentially profound benefits to a wide range of information technologies from communications to sensing and computing.

However a major challenge in developing these technologies is that the quantum phenomena are very fragile, and only a handful of physical systems have been...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

SEMANTiCS 2019 brings together industry leaders and data scientists in Karlsruhe

29.04.2019 | Event News

Revered mathematicians and computer scientists converge with 200 young researchers in Heidelberg!

17.04.2019 | Event News

First dust conference in the Central Asian part of the earth’s dust belt

15.04.2019 | Event News

 
Latest News

On Mars, sands shift to a different drum

24.05.2019 | Physics and Astronomy

Piedmont Atlanta first in Georgia to offer new minimally invasive treatment for emphysema

24.05.2019 | Medical Engineering

Chemical juggling with three particles

24.05.2019 | Life Sciences

VideoLinks
Science & Research
Overview of more VideoLinks >>>