Objective: To determine the prevalence and pattern of ocular conditions in HIV/AIDS patients attending HIV/AIDS care clinic (AMPATH).
Design: Hospital-based cross sectional study.
Setting: Moi Teaching and Referral Hospital (AMPATH CLINIC) ,Eldoret, Kenya.
Subjects: HIV/AIDS patients seen at AMPATH, clinic.
Results: Two hundred patients with HIV/AIDS were examined. The overall prevalence of ocular findings was 154 patients (77%). One hundred and eighteen patients (59%) were on ARV therapy. The main findings were posterior segment lesions (53%), anterior segment disorders (26.5%). Posterior segment findings included; Retinal microvasculopathy (75 patients ,37.5%), chorioretinitis (9 patients ,4.5%), vitreous opacities (8 patients, 4%), macula edema (8 patients, 4%) and CMV retinitis (5 patients ,2.5%). Fibrous membrane attached to the iris mostly near the pupillary margin (37 patients, 18.5%) and iridocyclitis (11 patients, 5.5%) were the main anterior segment findings. Conjunctival growths (13 patients, 6,5%) and Kaposi (10 patients, 5%), conjunctival microvasculopathy (8 patients, 4%) and molluscum contagiosum (5 patients, 2.5%) were the main ocular adnexal findings. Tuberculosis was the main systemic findings (53%). This study found that ocular findings are directly related to the severity of clinical disease staging (e.g. WHO stages III and IV) and severity of immune suppression (CD4+ count).
Conclusion: The results of this study suggest a high prevalence of ocular findings in adolescents and adults with HIV/AIDS. Retinal microvasculopathy was the commonest posterior segment finding observed. Further studies are needed to investigate the unusual findings of the fibrous membrane attached to the iris observed in this study.
UNAIDS/WHO report on the global HIV/AIDS epidemic. Geneva: World Health Organization, December 2003.
National AIDS/STD Control Programme (NASCOP): Research monitoring and evaluation unit Ministry of Health. 2003 National HIV surveillance.
T/Giorgis, A., Melka, F. and G/Morion, A. Ophthalmic manifestations of AIDS in Armed Forces General Teaching Hospital, Addis Ababa. Ethiop. Med. J. 2007: 45(4):3.
Mvogo, E. C., Ellong, A., Bella, A.C., et al. Ocular complications of HIV/AIDS in Cameroon: Is there is any correlation with the level of CD4 lymphocyte: Bull. Soc. Belge. Ophthalmo. 2007: (305):7-12.
Ndoye, N.B., Sow, P.S., Ba, E.A., et al. Ocular manifestatios of AIDS in Dakar. Dakar Med. J. 1993; 38(1):97.
Ah-Fat, F. G. and Balterburg, M. Ophthalmic complications of HIV/AIDS. Postgrad. Med. J. 1996; 72(854):725-730.
Jabs, D.A., Van Natta, M.l., Holbrook, J.T., et al. Studies of the ocular complications of AIDS: Ocular diagnoses at enrollement. Ophthalmology 2007; 114(4):780-786.
Assefa, Y., Yohannes, A.G. and Melese, A. Ocular manifestations of HIV/AIDS patients in Gondar University Hospital, North West Ethiopia. Ethiopia J. Health Development, 2006; 20(3): 166-169.
Jaffar, S., Ariyoshi. K., Frith. P., et al. Retinal manifestations of HIV-1 and HIV-2 infections among hospital patients in the Gambia, West Africa. Trop. Med. (int) Health 1999; 4(7): 487-492.
Msosa, Adala, H and Kollmann, K. H. M. Prevalence, complications and associations of herpes zoster ophthalmicus at Kenyatta National Hospital. MMed dissertation 1999, University of Nairobi.
Chisi, S.K., Kollman, K. H. M. and Karimurio J. Conjunctival squamous cell carcinoma in patients with human immunodeficiency virus infection at two hospitals in Kenya. East Afr. Med. J. 2006; 83(5): 267-270.
Guech-Ongey, M., Engels, E.A., Goedert, J.J. and Biggar, R.J. Elevated risk for squamous cell carcinoma of the conjunctiva among adults with AIDS in the United States. Intern. J. Cancer. 2008: 122(11): 2590-2593.
Beare, N.A.V., Kublin, J.G., Lewis, D.K., et al. Ocular disease in patients with tuberculosis and HIV presenting with fever in Africa. Brit. J. Ophthalmol. 2002; 86:1076-1079.