Predictive value of CD4+ and CD8+ lymphocyte counts for cytomegalovirus retinitis in AIDS patients

We reviewed the clinical records of 52 patients with AIDS who showed CD4+ lymphocyte counts of less than 50 cells per mm³. All the patients were seen at the San Francisco General Hospital. Cytomegalovirus retinitis developed in 30 patients within 8 weeks after lymphocyte subset analysis. There was no difference in CD8+ counts between patients with and without retinitis. In 27 patients with retinitis, CD8+ count was significantly lower in 14 patients with zone 1 retinal involvement than in 13 without, as CD8+ lymphocyte count was less than 220 per mm³ in 64% of patients with zone 1 involvement and in 15% of patients without. These findings indicate that CD8+ lymphocyte depletion and decreased CD4+ count may be a predictor of zone 1 cytomegalovirus retinitis. We recommend more frequent funduscopic control of AIDS patients with CD4+ lymphocyte counts of less than 50 per mm³ and CD8+ less than 200 per mm³.