Ocular Manifestations Among HIV/AIDS Patients; A case of Muhimbili National Hospital, Tanzania

Abstract

Objective: About 70-80% of HIV/AIDS patients develop an ocular complication at some point of their illness, at times causing blindness, ocular damage and even death. This study was conducted to determine the pattern of ocular manifestations of HIV/AIDS and their relationship to Highly-Active-Anti-Retroviral-Therapy and CD4+Tcells-count among HIV/AIDS patients at Muhimbili National Hospital.
Methods: Cross-sectional study among 296 systematically sampled HIV/AIDS patients. Data collection was by history taking, clinical examination, laboratory investigations and review of case notes. Analysis was aided by using SPSS version 17 software. Inferential statistics was performed and a p<0.05 was considered significant.
Results: Of the 296 patients, 165(56%) were females. About 153(51.7%) patients were using Highly-Active-Anti-Retroviral-Therapy, 164(55.4%) and 66(20.3%) had CD4+Tcells-counts of >350cells/μL and <200cell/mm3 respectively. Ocular manifestations affected 124/296 (41.9%) patients. The prevalence of ocular manifestations was significantly higher among those not on Highly-Active-Anti-Retroviral-Therapy (67.1% vs 18.3%, x2=66.79, p<0.01) and among patients with CD4+Tcells-count <200cells/μL (73.3% vs 29.9%, x2=34.1, p<0.05). The commonest manifestations among 592 eyes were optic atrophy 5.4(9.1%), cataract 25(4.2%), keratitis 23(3.8%), HIV-retinopathy 21(3.5%) and squamous cell carcinoma of the conjunctiva 16(2.7%).
Conclusion: Despite introduction of HAART, the prevalence of ocular manifestations in Dar-es-Salaam is still high. Further research on optic nerve disorders; awareness creation to inform patients, health personnel and the community; and to screen HIV patients for ocular manifestations are recommended.