This systematic review and meta-analysis looked at people living with HIV in sub-Saharan Africa. The researchers combined data from 1,931 participants to understand how often cytomegalovirus retinitis occurs in this population. They also examined factors that might increase the risk of this eye condition.
The study found that the overall prevalence was 3%, but the rate varied significantly by region. Less than 1% of cases were found in West Africa, while rates reached 7% in East Africa. Other areas showed rates between 3% and 6%.
The strongest risk factor identified was profound immunosuppression, specifically when CD4 counts were below 50 cells per microliter. Other markers included not being on antiretroviral therapy, poor adherence to treatment, and having advanced AIDS-defining illnesses. The authors note that substantial variation exists between different regions.
Systematic retinal screening is important for people with low CD4 counts. Expanded HIV care and treatment services are also needed to prevent blindness. Readers should be aware that these findings apply to sub-Saharan Africa and may differ from earlier cohorts in Asia.