Abstract
Background: The ocular manifestations of HIV may lead to visual impairment or blindness. In Ethiopia, patients typically initiate antiretroviral treatment (ART) with low CD4 cell counts when the risk of ocular complications may be high. Objective: To determine the prevalence and types of HIV associated ocular conditions in patients referred for on HAART in Ethiopia. Methods: This cross-sectional study was undertaken between March 2010 and August 2010 at the ART clinic of Gondar University Hospital, Northwest Ethiopia. Ophthalmic examinations were performed on all consecutive patients satisfying the criteria for enrolment into the ART clinic irrespective of the presence or absence of ophthalmic/visual symptoms. Results: Enrolled patients (n = 126), of these 70 (57.6%) were females with male to female ratio of 1:1.25 and had a median CD4 cell count of 183 cell/μL (inter-quartile range [IQR], 105-253 cells/μL). About 76.2% of the patients had either Stage I or II. Ninety one (72.3%) of the patients had a CD4 count more than 200 cells/μL at the time of examination. The prevalence of HIV-associated ocular disease was 21.4%. Retinal Microvasculopathy was the commonest finding seen in 9 (7%). The other ocular manifestations noted included: uveitis 4 (3.2%), ophthalmic Herpes Zoster 3 (2.4%), Seborrheic blepharitis 3 (2.4%) and Molluscum contagiosum 3 (2.4%). One patient was found to have disseminated Kaposi sarcoma that had involved the eyelids. Conclusion: The study demonstrates that HIV/AIDS affects the eyes patients on HAART. It is, hence, recommended that eye care should be a part of the package of medical care in the management of patients on HAART.
Highlights
The HIV/AIDS pandemic continues to present a major health challenge for sub-Saharan Africa, In Ethiopia, adult HIV prevalence in 2009 was estimated to be between 1.4% and 2.8%.[1,2]
As highly active antiretroviral therapy (HAART) becomes more available in this region, we expect the prevalence of HIV-related ocular complications to reduce as seen in the developed world
The spectrum of HIV-related disease appears to differ by geographic location, with reports suggesting that infection-related retinitis is not as common in sub-Saharan Africa compared to industrialized countries and South Asia [4,5,6]
Summary
The HIV/AIDS pandemic continues to present a major health challenge for sub-Saharan Africa, In Ethiopia, adult HIV prevalence in 2009 was estimated to be between 1.4% and 2.8%.[1,2]. HIV-related eye disease may affect 50-75% of HIV infected people worldwide at some point during the course of their illness [3]. This generally takes the form of opportunistic infections that can affect any of the ocular tissues, from the eyelids to the retina. Those conditions affecting the retina may lead to chronic visual impairment or blindness. The spectrum of HIV-related disease appears to differ by geographic location, with reports suggesting that infection-related retinitis is not as common in sub-Saharan Africa compared to industrialized countries and South Asia [4,5,6]. In Ethiopia, patients typically initiate antiretroviral treatment (ART) with low CD4 cell counts when the risk of ocular complications may be high
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