Study of prevalence of ocular manifestations in HIV positive patients

Abstract

Introduction: HIV/AIDS is a disorder which affects multiple systems in our body but ophthalmic manifestations do occur in 70-80% of patients sometime during their lifetime. Eye is affected either directly by HIV virus or indirectly through various opportunistic infections. HIV related ophthalmic manifestations are wide and can affect any part of eye from a dnexal disorders to posterior segment diseases including the optic nerve and the optic tract. This study was done to know the prevalence of ocular manifestations in the known HIV positive case & to correlate the ocular manifestations in HIV positive patients with their CD4+ lymphocyte count and duration of disease.
 Material & Methods: In the present study, we examined 200 known cases of HIV infection who attended the Out Patient Department of Government Eye Hospital, Amritsar, Punjab. Detailed ocular examination was done and the findings were correlated with CD4+ count and duration of the disease.
 Result: In the present study it was found that dry eye and HIV retinopathy were amongst the most common ocular manifestations accounting for 20.5% and 20% of the total cases. Next in the series was neuro ophthalmic complications which include dpapilledema, optic nerve atrophy, papillitis and also third nerve abnormalities. It consisted of 5.5% of the total cases. Almost equal in incidence was anterior uveitis consisting of 5% of the total. Next of importance was CMV retinitis of which 5 cases were seen which constituted 2.5% of the total and all these cases were observed in the patients with CD4+ count less than 50/mm3. p value for this was 0.008 which was statistically significant. Few cases of blephar it is, conjunctivitis, cellulitis, herpes zoster ophthalmic us and keratitis were also found which consisted of 2.5%, 0.5%, 1%,3%, and 2% respectively.
 Conclusion: Any HIV-infected person who at any stage experiences ocular symptoms also should get competent ophthalmologic care at the earliest. Any delay in treatment can lead to permanent visual loss. An improved coordination between two branches of ophthalmology and HIV medicine will need long coordination against this dreadful disease.

Ocular manifestations of people living with HIV in Tunisia

“…Indeed, the risk of developing ocular disease in PLWH is increased when the CD4 count is < 200 cells/µL. 2,13 This is consistent with our findings. Although sufficient care is generally provided in our country, patients often do not adhere to treatment and to follow-up.…”

“…During the course of the disease, the prevalence of ophthalmic manifestations in PLWH ranged from 19% to 70%. 2 , 12 It differs by geographic region, which is related to regional HIV prevalence. 12 Although it has been considerably reduced by the introduction of ART, it may still be high, especially in areas with high HIV prevalence such as sub-Saharan Africa.…”

“…Human immunodeficiency virus classification was determined according to the Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) Staging Systems. 2 , 10 Patients with other causes of immunodeficiency and those with additional medical problems that may overlap with ocular manifestations were excluded from our study.…”

“…1 Immunodeficiency caused by the virus results in increased susceptibility to opportunistic infections and neoplasms. 2 By increasing access to antiretroviral drugs, this disorder changed from a high-mortality disease to a manageable chronic disease, which may affect every organ system. 3 In Tunisia, HIV prevalence was 0.016% and patients were mainly infected with HIV-1.…”

Seroprevalence of HIV infection among cataract surgery patients in south-east Nigeria: A retrospective cross-sectional study

“…This high volume of cataract surgeries increases the risk of contracting blood borne diseases like HIV from patients by eye care staff, especially the surgical team. The availability of HAART has helped many HIV positive patients to overcome deadly opportunistic infections thereby living longer and adding to the cataract burden This risk of transmission is even higher where the seroprevalence of HIV cataract patients is not known, especially in low income countries like Nigeria with high burden of both HIV and cataract [7]. Therefore, awareness of HIV seroprevalence of booked cataract patients will help the cataract surgical team to engage universal precautions against HIV infections.…”