Title:Herpetic (Non-Cytomegalovirus) Retinal Infections in Patients with the Acquired Immunodeficiency Syndrome
Volume: 11
Issue: 3
Author(s): Michael W. Stewart
Affiliation:
Keywords:
Acute retinal necrosis, cytomegalovirus, epstein barr virus, herpes simplex, progressive outer retinal necrosis,
varicella zoster virus.
Abstract: Human herpes viruses cause significant morbidity in patients with the acquired immunodeficiency syndrome.
Even after the introduction of highly active anti-retroviral therapy (HAART), herpes viruses remain the leading causes of
blindness in AIDS patients. Cytomegalovirus (CMV) retinitis and the closely-related immune reconstitution uveitis
syndrome are the most common causes of blindness, but progressive outer retinal necrosis and acute retinal necrosis due
to varicella zoster and herpes simplex are also important causes of vision loss. Successful treatment of these conditions
requires an aggressive approach with multi-drug intravenous therapy or repeated intravitreal antiviral injections. Since the
rate of retinal detachment is alarmingly high despite successful antiviral therapy, internists and ophthalmologists must
work closely together to recognize and treat complications as they arise. Fortunately, Epstein-Barr virus is a rare cause of
retinal infection and human herpes virus (HHV)-6, HHV-7, and HHV-8 do not appear to be primary pathogens. However,
increasing evidence suggests that HHV-6 and HHV-7 play important roles in modulating the immune system and
potentiating infection by CMV.
