Dr.MANDABI SENGUPTA

Dr. DIPANKAR DAS, Dr.PUNEET MISRA, Dr.SUSMITA PAUL

Abstract

Immune recovery uveitis (IRU) is a common ocular manifestation in HIV-infected patients with cytomegalovirus (CMV) retinitis who are receiving highly active antiretroviral therapy (HAART).

Here we report a case of a 48 year old male patient presenting with gradual diminution of vision and pain in left eye since 2 months. He was a diagnosed case of HIV-1 since 9 years with poor adherence to HAART. HAART was restarted along with anti-tubercular treatment after he was diagnosed to have central nervous system tuberculosis 6 months back. Clinical and laboratory evaluation revealed features of uveitis and active CMV retinitis with an increased CD4+ T lymphocyte count. Thus we came to a diagnosis of IRU associated with active CMV retinitis and patient was started on topical steroid and oral anti-CMV therapy.

Although IRU is commonly seen in inactive CMV retinitis, rarely it may present incase of active CMV retinitis, particularly when HAART therapy is initiated without treating CMV retinitis.