Keywords
Cataract
HAART
HIV/AIDS
Optic atrophy
Ocular manifestations
Categories
How to Cite
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.
References
WHO/UNAIDS/UNICEF. Global HIV/AIDS Response: Epidemic update and health sector progress towards Universal Access . 2011.
UNAIDS. UNAIDS ‘UNAIDS report on the global AIDS epidemic’. 2010.
UNAIDS. World AIDS Day Report: Results; 2012.
Emmett T, Todd P. Ocular manifestation of HIV infection: current concepts. New Eng J Med. 1998; 339:236–344.
Yeni D, Ratna S, Lukman E, Zubairi D. Ocular diseases among HIV/AIDS patients in Jakarta. South East Asian J Trop Med Public Health. 2013; 44(1): 62-69.
Shah SU, Kerkar SP, Pazare AR. Evaluation of ocular manifestation and blindness in HIV/AIDS patients on HAART in tertiary care hospital in western India. Br J Ophthalmol. 2009; 93:88–90.
Venkatesh KT, Biswas J, Kumarasamy, N. Impact of highly active antiretroviral therapy on ophthalmic manifestations in human immunodeficiency virus /acquired immune deficiency syndrome. Indian J Ophthalmol. 2008; 56(5): 391–393.
Kahinde AV, Samalia E, Eni RN. Ocular aids: Experience at Guiness Ophthalmic Unit. AJOL. 2005; 7: 3.
Kone AD, Dembele A, Coulibaly M. Ophthalmologic manifestations of human immunodeficiency virus /AIDS in Mali : Is there a interrelation with the CD4 count? JPCS. 2011; 2: 9-12.
Assefa Y, Yohannes G,Melese A. Ocular manifestations of HIV/AIDS patients in Gondar.Ethiop. Health Dev. 2006; 20(3): 166-169.
Listo BN, Kollmann KHM, Kimani K, Owino C. Ocular manifestations of HIV/AIDS at Moi Teaching and Referral Hospital (AMPATH Clinic). East Afr J Ophthalmol. 2009; 15(1): 27-34.
Sahoo, S. HIV/AIDS related ocular manifestations. Malys J Med Sci. 2010; 17(1): 12-16.
Poninder K,DP Vats, Sanjay M, ,Sagarika P. CD4 counts: a strong indicator of retinal and ocular lesions in HIV disease. Med J Armed Forces India. 2011; 67 (4): 354-357.
Azonobi RI, Udoye E , Tebepah T , Opubiri I. Ocular manifestation of HIV/AIDS infection among patients receiving highly active anti retro viral therapy (HAART) in a tertiary eye care centre. J AIDS HIV Res. 2013; 5(9) 322-327, September, DOI 10.5897/JAHR2013.0238 ISSN 2141-2359 © 2013 Academic Journals http://www.academicjournals.org/JAHR
Bekele S, Gelaw Y, and Tessema F. Ocular manifestation of HIV/AIDS and correlation with cd4+ cells count among adult HIV/AIDS patients in Jimma town, Ethiopia: a cross sectional study. BMC Ophthalmol. 2013; 13: 20.
Ndoye NB, Sow PS, Ba EA, Ndiaye MR, Wade A, Coll-seck AM. Ocular manifestations of AIDS in Dakar. Dakar Med. 1993; 38(1):97-100.
Valathuru V, Kambar C, Pisipati R, Desai S. Ocular manifestations in HIV/AIDS- Prevalence in South India. Ophthalmol Res. 2014; 2(3): 165-176.
Sang JK, Sang JP, Hyeong GY, et al. Ocular manifestations of acquired immunodeficiency Syndrome in Korea J Korean Med Sci. 2012 ; 27(5): 542–546. doi: 10.3346/jkms.2012.27.5.542
Biswas PN, Saha B, Ghosh S, et al. Ophthalmic manifestations in people living with HIV attending a tertiary care centre of Eastern India. J Indian Med Ass. 2008; 106(5): 292-294.
Goldsmith P, Jones RE, Ozuzu GE, Richardson J, et al. Optic neuropathy as a presenting feature of HIV infection: recovery of vision with highly active anti-retroviral-therapy. Br J Ophthalmol. 2000; 84(5): 551-553.
Wani MGA. Eye complications of acquired immune deficiency syndrome (AIDS) Part 1. Ocular surface and anterior segment manifestations. South Sudan Med J. 2009; 2(2): 1-4.
Rasmussen LD, Kesse L, Molander LD, et al. Risk of cataract surgery in HIV infected individuals. A Danish natural population based cohort study. Clin Infect Dis. 2011; 53(11):1156 - 1163.