Ocular manifestations of people living with HIV in Tunisia.

Sameh Aissa,Lamia Ammari,El Afrit Mohamed Ali,Yosra Yahyaoui,Khaoula Ben Mansour,Hanene Tiouri,Dorsaf Saadouli,Salem Yahyaoui

doi:10.4102/sajhivmed.v22i1.1193

Abstract

BackgroundOcular involvement is a common complication of human immunodeficiency virus (HIV). Knowledge about this topic in Tunisia is limited.ObjectiveTo investigate ophthalmic manifestations in patients living with HIV in Tunisia.MethodThis was an observational study, performed between January 2007 and December 2016. We included patients with ocular disorders related to HIV. The data were recorded retrospectively from chart review.ResultsAmongst 98 people living with HIV (PLWH), 36 participants (55 eyes) had ocular manifestations. The mean age was 32.2 ± 5.6 years. Twenty-four patients were men and 12 were women. The mean value of CD4+ T-cell count was 156.5 ± 4.2 cells/µL. Bilateral lesions were found in 19 eyes. Best corrected visual acuity was better than 6/12 in 36 eyes. The most common ocular finding was dry eye syndrome (22%), cotton-wool spots (20%) and retinal haemorrhage (16%) followed by cytomegalovirus (CMV) retinitis (9%), anterior uveitis (7%), toxoplasmosis (4%) and tuberculosis retinochoroiditis (7%) Herpetic keratitis (5%), Herpes zoster ophthalmicus (2%) and syphilitic chorioretinitis (2%). Papilledema was found in three eyes (5%). Panuveitis was observed in four eyes (7%): three of them were associated with chorioretinal toxoplasmosis, syphilitic chorioretinitis and CMV retinitis. The fourth was attributable to immune recovery uveitis. A CD4+ T-cell count of ≤ 200 cells/µL was found to be an independent risk factor for developing posterior segment manifestations.ConclusionVarious ophthalmic manifestations were observed in PLWH. The most common lesion was retinopathy. Ocular involvement can be serious leading to poor visual prognosis, which requires close collaboration between the ophthalmologist and infectious disease physician.

Highlights

Human immunodeficiency virus (HIV) is a major global public health problem.[1]Immunodeficiency caused by the virus results in increased susceptibility to opportunistic infections and neoplasms.[2]
Of the 98 patients living with HIV who underwent an ophthalmic examination, 36 cases (55 eyes) (36.7%.) had http://www.sajhivmed.org.za
It has been considerably reduced by the introduction of antiretroviral therapy (ART), it may still be high, especially in areas with high HIV prevalence such as sub-Saharan

Summary

Introduction

Human immunodeficiency virus (HIV) is a major global public health problem.[1]Immunodeficiency caused by the virus results in increased susceptibility to opportunistic infections and neoplasms.[2]. Ocular complications often reflect systemic disease and have become more common and occur in approximately 70% – 80% of people living with HIV (PLWH).[1] It has been shown that the prevalence of ocular problems in PLWH is higher than in uninfected patients.[6,7] the clinical features of these ocular manifestations differ between countries, especially between high-income and low to middle-income countries.[8] This is because of improved accessibility to healthcare and to antiretroviral therapy (ART), which has shifted the spectrum of the disease from infectious to non-infectious affections. Ocular involvement is a common complication of human immunodeficiency virus (HIV). Knowledge about this topic in Tunisia is limited

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Conclusion