Uveitis presenting with iris bombe in a patient with HIV: the importance of multi-disciplinary management — a case study

Abstract

This case study concerns a 53-year-old female presenting to an eye-hospital in London with uveitis, on a background of well-controlled HIV. After investigation, no cause for the uveitis was found other than the HIV itself, and the patient was treated with immunosuppressants. Because of the nature of her underlying HIV infection, help was sought from HIV specialists, who gave advice on the management, including alteration of corticosteroid dosing due to the risk of drug-interactions between her uveitis and HIV treatments. Of particular concern was the risk of cytochrome P450 3A inhibition by cobicistat and the potential for iatrogenic Cushing syndrome through elevated steroid doses. This case is used as an example to highlight the importance of the multi-disciplinary team in the management of complex conditions, as well as to add to the literature in support of the HIV virus itself as a cause of uveitis.