{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T18:29:29Z","timestamp":1793730569496,"version":"4.6.1"},"reference-count":43,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T00:00:00Z","timestamp":1779840000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To assess ocular findings in treatment-na\u00efve people living with HIV (PLWH), focusing on posterior segment involvement, and to identify key virologic and immunologic predictors, including cytomegalovirus (CMV) retinitis and HIV-related retinopathy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Prospective cross-sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This study included 124 treatment-na\u00efve PLWH who were referred for ophthalmologic screening at the time of HIV diagnosis. All participants underwent a comprehensive ophthalmic examination. Demographic and clinical data were collected, along with key immunologic and virologic markers: CD4+ and CD8+ T-cell counts, CD4\/CD8 ratio, and plasma viral loads for both HIV and CMV, all measured prior to initiation of antiretroviral therapy. The primary outcome was the identification of posterior segment involvement, specifically CMV retinitis and HIV-related retinopathy, in relation to CD4 count, CD4\/CD8 ratio, and CMV plasma load.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Posterior segment involvement was observed in 29% of patients, most commonly CMV retinitis. Univariate analysis showed significant associations with age, CD4 count, CD4\/CD8 ratio, log\u2081\u2080HIV plasma load, and log\u2081\u2080CMV plasma load. Multivariate analysis revealed that log\u2081\u2080CMV plasma load remained the strongest independent predictor of posterior segment involvement (OR: 1.630,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.003). CMV retinitis was significantly associated with log\u2081\u2080CMV plasma load (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), with a threshold of 44.5 IU\/mL (log\u2081\u2080 = 1.6470) demonstrating high sensitivity (85.7%) and negative predictive value (97.8%). For a higher threshold of 1370 IU\/mL (log\u2081\u2080 = 3.1294), specificity was higher (90.0%) with a positive predictive value of 47.6%. HIV-related retinopathy correlated inversely with CD4\/CD8 ratio (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.030).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Early ophthalmologic screening is essential in PLWH with advanced immunosuppression. CMV DNA plasma load, CD4 count, and CD4\/CD8 ratio are useful markers to identify patients at risk of vision-threatening complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijo.ijo_1957_25","type":"journal-article","created":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T05:00:30Z","timestamp":1779858030000},"page":"901-907","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Beyond CD4: Posterior segment findings and virologic-immunologic predictors in highly active antiretroviral therapy-na\u00efve HIV patients"],"prefix":"10.4103","volume":"74","author":[{"given":"Serife Ciloglu","family":"Hayat","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuf Cem","family":"Yilmaz","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alper","family":"Gunduz","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Clinical Microbiology, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merve","family":"Uran","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sad\u0131k A","family":"Ozal","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,5,27]]},"reference":[{"key":"R1-20261103","doi-asserted-by":"crossref","first-page":"1815","DOI":"10.1097\/00002030-199814000-00013","article-title":"Opportunistic infections occurring during highly active antiretroviral treatment","volume":"12","author":"Michelet","year":"1998","journal-title":"AIDS"},{"key":"R2-20261103","doi-asserted-by":"crossref","first-page":"1399","DOI":"10.1080\/09273948.2021.1881562","article-title":"Ocular manifestations in patients of HIV (Human Immunodeficiency Virus) \u0131nfection on combined anti-retroviral therapy (CART)","volume":"30","author":"Arora","year":"2022","journal-title":"Ocul Immunol Inflamm"},{"key":"R3-20261103","doi-asserted-by":"crossref","first-page":"396","DOI":"10.3109\/09273948.2015.1133837","article-title":"Ocular manifestations in patients with human \u0131mmunodeficiency virus \u0131nfection in the pre-HAART versus the HAART era in the North Indian population","volume":"25","author":"Agarwal","year":"2017","journal-title":"Ocul Immunol Inflamm"},{"key":"R4-20261103","doi-asserted-by":"crossref","first-page":"1725","DOI":"10.1016\/S0140-6736(98)03201-2","article-title":"Changing patterns of mortality across Europe in patients infected with HIV-1. 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