HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Kempen, J.H. Search for Related Content PubMed Articles by Kempen, J.H.

The Impact of Cytomegalovirus Retinitis on the Quality of Life of Patients with the Acquired Immune Deficiency Syndrome

¹ Ophthalmology, Epidemiology, Johns Hopkins University, Baltimore, MD, United States
² Epidemiology, Johns Hopkins University, Baltimore, MD, United States
³ Health Policy & Management, Medicine, Epidemiology, Johns Hopkins University, Baltimore, MD, United States
⁴ Ophthalmology, Louisiana State University, New Orleans, LA, United States
⁵ Ophthalmology, Johns Hopkins University, Baltimore, MD, United States
⁶ Ophthalmology, Medicine, Epidemiology, Johns Hopkins University, Baltimore, MD, United States

Commercial Relationships: J.H. Kempen, None; B.K. Martin, None; A.W. Wu, None; B. Barron, None; J.E. Thorne, None; D.A. Jabs, None.

Grant Identification: Support: NIH Cooperative Agreements U10 EY08052, U10 EY08057, U10 EY08067

Abstract

Purpose: To determine the impact of cytomegalovirus (CMV) retinitis on the quality of life (QOL) of patients with the Acquired Immune Deficiency Syndrome (AIDS).
Methods: Nine hundred seventy-one patients with AIDS were enrolled at 19 centers throughout the United States: 212 (22%) with longstanding CMV retinitis, 50 (5%) with newly diagnosed CMV retinitis, and 709 (73%) without CMV retinitis. Vision-related QOL was assessed using the Studies of Ocular Complications of AIDS instrument, designed for patients with CMV retinitis. General health-related QOL was measured using a modification of the Medical Outcomes Survey-HIV instrument. Health utility measurements were taken using the EuroQol EQ-5D and thermometer techniques. Cytomegalovirus retinitis status was determined ophthalmoscopically, by a certified ophthalmologist.
Results: Vision-related QOL scores were substantially lower among patients with CMV retinitis than those without CMV retinitis, but results were similar among patients with newly diagnosed and longstanding CMV retinitis. For most general health-related QOL domains and health utility measures, the longstanding CMV retinitis group and the group without CMV retinitis had similar results, whereas the newly diagnosed CMV retinitis group scored substantially worse on most of these scales. In multiple regression analysis of representative scale scores, most observed differences in general health-related QOL and health utility were attenuated by adjusting for differences in demographic characteristics, CD4+ T cell count, HIV viral load, and current use of highly active antiretroviral therapy (HAART). However, the association of CMV retinitis with lower vision-related QOL was independent of differences in these characteristics.
Conclusions: In the era of HAART, CMV retinitis is associated with substantially lower vision-related quality of life, even among patients with longstanding disease who otherwise have general health-related QOL and health utility similar to that of patients never diagnosed with CMV retinitis.

Keywords: AIDS/HIV • cytomegalovirus • quality of life

© 2003, The Association for Research in Vision and Ophthalmology, Inc., all rights reserved. For permission to reproduce any part of this abstract, contact the ARVO Office at arvo{at}arvo.org.