I have a friend in Peru just diagnosed with AIDS (CD4 below 50 and 500,000 VL) and CMV retinitis (blurred vision in one eye). He is receiving mixed information about when to start HAART: has been said that HAART can cause more vision complications. Can he start HAART right away, while starting treatment for CMV infection? How long should he wait for HAART to start?
Assuming your friend is being treated for his CMV retinitis, it is recommended to being HAART a couple of weeks after starting treatment for CMV. There should be close monitoring of his response to HIV treatment as well as the treatment response to the CMV in the eye. The eye doctor should be kept informed once HAART has been initiated.