cytomegalovirus which can cause an opportunistic infection (see Opportunistic Diseases). The virus is very common.
You see, between 50% and 85% of the US population are CMV positive at 40 years old. A healthy immune system keeps this virus under control.
When immune defenses are weak, CMV can attack various parts of the body.
And please note that this may have cause in several diseases, including HIV infection. Combined antiretroviral therapy (ART) has reduced the rate of CMV in people with HIV in 75%.
However, about 5% of people with HIV may still develop CMV disease.
The most common disease caused by CMV is retinitis. This causes the death of cells in the retinas at the back of the eye.
This virus can cause blindness quickly, unless it is treated. Do not mess with Cytomegalovirus
CMV can spread throughout the body and infect multiple organs at once. The risk of cytomegalovirus disease is greater when CD4 cell counts (see 124 datasheet) are below 50. It is rare in people with 100 or more CD4 cells.
To illustrate I tell, taped something that I saw and witnessed in two emblematic cases.
A "certain girl", very good-humored, told me, twenty-five years ago, that "at least one eye remained" and thus, "I could still drive." I decided to test this and, in fact, she could. In the gale that was happening in my life I lost sight of it in those days and, disastrously, I never saw it again. ANDu hate loosing people's eyesight! I worry about them and, I do not know, this mania to be aware of. Poutz ...
Loss of sight is almost instantaneous! 72 Hours
The other, well, this person did not see much grace in all that. He got sick on a Sunday, went into the CRTA on Monday and Tuesday morning was blind.
Well, simple as that! Irrevocably blind the young man who, until a weekend ago was a driver and the details and lessons of this I leave you.
And all because in PS was not observed what follows below:
Signs of infection by this virus
The first signs of CMV retinitis are vision problems, such as moving black dots. These are called "flying flies."
I always treated them like "little mosquitoes. After these two cases I always think of anti-aircraft guns in my vicinity.
They may indicate an inflammation of the retina. Patients may also notice flashes of light, diminished or distorted vision or blind spots.
And you see, some doctors recommend eye exams to detect CMV retinitis. The exams are done by an ophthalmologist; the examination is the fundus of the eye.
Where to Find Good Professionals My Lord?
Well, good professionals can detect the presence of the toxoplasmosis in this exam .... The difficult thing is to know if the professional in question is good!
Look at this. I treat my eyes at a specialized ophthalmology hospital near Tucuruvi, Zona Norte de Sampa, and there is a "very distinguished ophthalmologist" whom I have visited some (almost ten) years ago because of some vision problems.
And, keep in mind, at all times in narration that my chart is there!
Patient documented, or with their documentation, is patient with better possibilities. For the mere fact that I warned that I had two pulmonary embolisms already puts all the doctors I have consulted since then of "warning".
They see him before someone who has escaped death twice.
Doctors do not like it, I know, I've seen, I've heard and witnessed things, they and they do not like to lose patients ....
Maybe I am a distressing cause for many! But I am giving myself an absurd importance!
Resilience must precede abandonment always and always, until God says no!
Well, twice is what they know in that immediate moment. But this Drª seems to have ignored my medical records!
And after three weeks and I just "Condemned" the word is mine, chosen by me, to spend the rest of my life, and I was less than 50 years at this time, with 45% of eyesight left eye!
It may sound like bullshit, but it's a serious, very serious loss, and if I've escaped death for, say, three times, that's not just because things are simple.
I do not give up, this summer I do not conjugate in the first person singular in the "Present".
Resilience is built! They gave me six months
Resilience is born of Persistence. She is born and is being hurt day after day
Learn Not To Give Up, Not To Give Up The game only ends when it ends and as the ball flies toward the basket, there is still hope!
At the same clinic, the chart is there, I went to another doctor, explained the situation and he went on to the clinical analysis.
And it was, well, well, an hour and bring it there that he used and told me no, I was not doomed. And explained that in some patients, and how I am oc *** of the 64 class.
For I was among them, those who developed, after a cataract removal surgery, surgery that was IN THE PRONOUNSER, can develop, explanations of it, a relative opacity in the film that has a name.
This one that, well, if I could remember, it would not be me, Claudio, but he told me and said with certainty, that two laser sessions would solve this.
CMV, Cytomegalovirus, did not seem to be covered and ... Well!
It was a commercial fight to get these two laser sessions!
But, since I do not conjugate that verb, after I send a rough draft of the matter, it is quite degrading.
This would be a text that I would divulge in my blog and in another newspaper.
I was grateful for what was necessary, and two weeks after starting treatment, I had regained normal vision.
And so, I went back to my prophesy and asked her, please, a new examination, to see if there were hopes.
She was tired and unwilling.
Bad Medicinal Will
But she acquiesced, and 20 minutes later I left her room, with her quite confused by everything she saw and heard.
But she was certainly less arrogant, and curiously, she was reading my chart. It was the last time she saw him!
The story looks like a Punisher thing, but it's not.
People often need to be called upon to observe their limitations, especially when they are doctors and doctors, in the house of arrogance or, even worse, when they suffer from that sad Spiritual Disease!
One of the saddest, which I named "Deity Syndrome".
Mania to be God, and I make myself thus understood among the greatest victims of it!
Let's go back to Cytomegalovirus
If your CD4 count is less than 100 and you have any vision problems, tell your doctor immediately.
Some patients who have recently started using ART with very low CD4 counts may have inflammation of the eyes.
And it can cause vision loss. This is called the immune reconstitution inflammatory syndrome (IRIS), see 483 fact sheet (in translation).
How is Cytomegalovirus treated?
Early treatments for CMV required daily intravenous infusions. Most people had a permanent "port" of medication inserted into the chest or arm.
People had to continue taking anti-CMV medications for life. CMV treatments have improved dramatically in recent years.
With strong ARTs, patients can stop taking CMV the CD4 cell count is greater than 150 and remain so for at least three months.
However, there are two special cases: immune restoration syndrome can cause severe inflammation in the eyes of people with HIV, even if they do not have CMV before.
The usual treatment is to add anti-CMV drugs to the patient's ARVs. If the CD4 count drops below 50, there is an increased risk of developing CMV disease.
Can we avoid Cytomegalovirus?
The best way to prevent CMV disease is to get tested and start HIV treatment before CD4 counts are low.
Ganciclovir has been approved for prevention (prophylaxis) of CMV. However, many health professionals do not prescribe this. They do not want to add up to 12 capsules a day to their patients. Also, it is unclear if this does any good.
Two major studies came to different conclusions. Lastly, strong ARVs keep the CD4 count of most people high enough that they do not get CMV.
HOW DO I CHOOSE A TREATMENT FOR CMV?
Seek an Immediatly Doctor, I'm not in a hurry.
There are several issues to consider when choosing a treatment for CMV-active disease:
Is your vision at risk? You need to take quick steps to save your vision.
CMV retinitis can progress rapidly and lead to blindness.
For this reason, it is treated aggressively when it first appears (the human being is an 85% dependent on the eyes).
Note, however, that CMV may also appear elsewhere in the body. To control CMV in the rest of the body, you will need systemic (full-body) therapy. Intravenous medication or pills will need to be used.
What are the side effects?
Some CMV medications can damage the bone marrow or kidneys.
This may require additional medication. Does it sound like a novelty?
Other drugs require infusions that can take a long time. Discuss the side effects of any CMV treatment with your doctor.
What do the guidelines say? Recently, several sets of professional guidelines have recommended valganciclovir as a preferred treatment for patients who are at no immediate risk of losing vision.
If the CD4 cell count is below 100, talk to your doctor about CMV prevention and a regular schedule of eye exams. If you have a low CD4 cell count and experience ANY unusual vision problems, seek immediate medical attention.