Uveitis in human immunodeficiency virus‐infected persons with CD4+ T‐lymphocyte count over 200 cells/mL

Abstract

Both infectious and non-infectious forms of uveitis occur in individuals who are infected with human immunodeficiency virus and have preserved or restored peripheral CD4+ T cell levels. Individuals who are human immunodeficiency virus-positive and present with uveitis should be evaluated in the same way all patients with uveitis are assessed.

Uveitis in Human Immunodeficiency Virus–infected Individuals

“…While infectious uveitis accounts for the vast majority of cases in persons with relatively low CD4+ T cell levels, for the group with peripheral CD4+ T cell count above 200 cells/μl, approximately 35% of uveitis is reported to be undifferentiated or idiopathic. 3 …”

“…5 In immune recovered HIV-positive individuals with CD4+ T cell counts over 200 cells/μl, approximately 15% of all uveitis may caused by this syndrome. 3 Immune recovery uveitis is manifest as anterior and/or intermediate uveitis, and the inflammation may be unilateral or bilateral, depending on the laterality of previous CMV retinitis. A CD4+ T lymphocyte count above 100 cells/μl predicts the risk of uveitis.…”

“…The typical HLA-B27 syndrome of recurrent, unilateral alternating, acute, anterior uveitis is reported in patients infected with HIV. 3 Infection with HIV appears to facilitate the development of HLA-B27-related diseases, including both the sero-negative spondyloarthropathies and uveitis. 7,8 Sarcoidosis-Related Uveitis…”

“…9 Indeed, sarcoidosis is reported as a cause of non-infectious uveitis in patients with relative immune competence. 3 Interestingly, the onset of typical bilateral, granulomatous panuveitis, along with skin lesions that were histopathologically diagnosed as sarcoidosis, has been temporally linked to the commencement of HAART. 10 Other Non-Infectious Uveitic Diseases Drug-induced intraocular inflammation is an important subset of HIV infectionassociated uveitis.…”

“…Panuveitis with retinal vasculitis plus/minus retinal infiltrates in affected patients has been described in two reports. 3,16 Infectious uveitis …”