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

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 eno

Contact: Karen Blum
Johns Hopkins Medical Institutions

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