Ocular Findings in HIV-Positive Children in Two Hospital Facilities in Yaoundé, Cameroon

Abstract

Background: HIV infection in children as well as adults remain a disease with potential multisystemic disorders despite the increased use of Highly Active Antiretroviral Therapy (HAART). The aim of this work was to determine the profile of eye diseases among HIV-positive children aged 5 to 15 years in the Mother and Child Centre of the Chantal Biya Foundation and the University Hospital Centre (UHC) in Yaounde. Materials and Methods: an analytical study was conducted from June 1, to July 31, 2019. Our sample consisted of all children aged 5 - 18 years who were HIV positive and whose parent or legal guardian gave his or her consent. A complete clinical examination was performed. The following variables were collected: socio-demographic data, Immunological data. A comprehensive eye exam was also performed. Data were analysed by the Epi info 3.5.4 software. Results: A total of 53 children were retained for the study. The population consisted of 28 boys (52.3%), for a sex ratio of 1.12. The mean age was 12.7 ± 4.2 years [5 - 18 years]. And 84.9% of children had normal immune status. The average duration of HAART was 8.3 ± 3.9 years [0 to 16 years] with more than half (50.9%) of the children on treatment for more than 8 years. The main eye complaints were pruritus (11.32%), eye pain (11.32%) and tingling (9.43%). The frequency of ophthalmological manifestations was 52.8% with adnexal involvement the most frequent (34%), followed by anterior (7.5%) and posterior segment involvement (1.9%). Anterior segment involvement was marked by granulomatous anterior uveitis, keratouveitis and corneal ulcer. A cytomegalovirus retinitis and a macular scar of a unilateral retinitis were found in 2 patients. In a multivariate analysis, elevated CD4 count (>500) was associated with ocular manifestations. Conclusion: In the HAART era, an ocular examination is mandatory to prevent harmful eye diseases among children because ophthalmological diseases remain frequent. Although they are most often lesions of the annexes, corneal and chorioretinal involvement can be detrimental for the vision.