Seroreversion in HIV-Associated Bilateral CMV Retinitis: A Challenging Case Report

Ocul Immunol Inflamm. 2024 Aug 9:1-5. doi: 10.1080/09273948.2024.2385606. Online ahead of print.

Abstract

Purpose: To report a case of seroreversion in a patient with HIV-associated bilateral CMV retinitis and the challenges associated with detection of this phenomenon in late stages of HIV.

Method: Retrospective single case report.

Results: The clinical picture of the patient on presentation was suggestive of viral retinitis. PCR confirmed a diagnosis of CMV retinitis. Serology for HIV-1 & 2 was negative. A viral load of HIV and CD-4 count confirmed his sero status to be positive for HIV. Improvement in visual acuity and slow resolution of the lesion was noted with both anti-viral for CMV and HIV. A repeat HIV-1 testing was positive with an improvement in CD4 count.

Conclusion: In highly suspicious individual, with a negative serology (post screening test) for HIV, the disease status should be confirmed by testing the individual for HIV viral load and CD4 count.

Keywords: CD4 count; CMV retinitis; HIV seroreversion; HIV testing; screening test.