Skip to main content Accessibility help
×
Home

HIV-infected individuals on long-term antiretroviral therapy are at higher risk for ocular disease

  • E. SCHAFTENAAR (a1) (a2), N. S. KHOSA (a2), G. S. BAARSMA (a3), C. MEENKEN (a4), J. A. McINTYRE (a2) (a5), A. D. M. E. OSTERHAUS (a6), G. M. G. M. VERJANS (a1) (a6) and R. P. H. PETERS (a2) (a7)...

Summary

Introduction of antiretroviral therapy (ART) has dramatically reduced the incidence of infectious ocular diseases in human immunodeficiency virus (HIV)-infected individuals. However, the effects of long-term ART and chronic HIV infection on the eye are ill-defined. This study determined the occurrence and severity of ocular diseases among 342 participants in a rural South African setting: HIV-naïve (n = 105), HIV-infected ART-naïve (n = 16), HIV-infected on ART for <12 months (short-term ART; n = 56) and HIV-infected individuals on ART for >36 months (long-term ART; n = 165). More HIV-infected participants presented with an external eye condition, in particular blepharitis, than HIV-naïve individuals (18% vs. 7%; age-adjusted odds ratio (aOR) = 2·8, P < 0·05). Anterior segment conditions (particularly keratoconjunctivitis sicca and pterygium) were also more common (50% vs. 27%; aOR = 2·4; P < 0·01). Compared with individuals on short-term ART, participants receiving long-term ART were more likely to have clinically detectable cataract (57% vs. 38%; aOR = 2·2, P = 0·01) and posterior segment diseases, especially HIV retinopathy (30% vs. 11%; aOR = 3·4, P < 0·05). Finally, long-term ART was significantly associated with presence of HIV retinopathy (P < 0·01). These data implicate that ocular disease is more common and of more diverse etiology among HIV-infected individuals, especially those on long-term ART and suggest that regular ophthalmological monitoring of HIV-infected individuals on ART is warranted.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      HIV-infected individuals on long-term antiretroviral therapy are at higher risk for ocular disease
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      HIV-infected individuals on long-term antiretroviral therapy are at higher risk for ocular disease
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      HIV-infected individuals on long-term antiretroviral therapy are at higher risk for ocular disease
      Available formats
      ×

Copyright

Corresponding author

*Author for correspondence: R. P. H. Peters, Anova Health Institute, 12 Sherborne Road, Johannesburg, South Africa. (Email: peters@anovahealth.co.za)

References

Hide All
1. Joint United Nations Programme on HIV/AIDS (UNAIDS). The Gap report. Geneva: UNAIDS, 2014.
2. Cunningham, ET Jr., Margolis, TP. Ocular manifestations of HIV infection. New England Journal of Medicine 1998; 339: 236244.
3. Robinson, MR, Ross, ML, Whitcup, SM. Ocular manifestations of HIV infection. Current Opinion in Ophthalmology 1999; 10: 431437.
4. Kestelyn, PG, Cunningham, ET. Jr. HIV/AIDS and blindness. Bulletin of the World Health Organization 2001; 79: 208213.
5. Freeman, WR, et al. A prospective study of the ophthalmologic findings in the acquired immunodeficiency syndrome. American Journal of Ophthalmology 1984; 97: 133142.
6. Salzberger, B, et al. Incidence and prognosis of CMV disease in HIV-infected patients before and after introduction of combination antiretroviral therapy. Infection 2005; 33: 345349.
7. Accorinti, M, et al. Changing patterns of ocular manifestations in HIV seropositive patients treated with HAART. European Journal of Ophthalmology 2006; 16: 728732.
8. Otiti-Sengeri, J, et al. Ocular immune reconstitution inflammatory syndromes. Current Opinion in HIV and AIDS 2008; 3: 432437.
9. Pathai, S, et al. Increased ocular lens density in HIV-infected individuals with low nadir CD4 counts in South Africa: evidence of accelerated aging. Journal of Acquired Immune Deficiency Syndromes 2013; 63: 307314.
10. Jabs, DA, et al. Prevalence of intermediate-stage age-related macular degeneration in patients with acquired immunodeficiency syndrome. American Journal of Ophthalmology 2015; 159: 11151122.
11. Guaraldi, G, et al. Premature age-related comorbidities among HIV-infected persons compared with the general population. Clinical Infectious Diseases 2011; 53: 11201126.
12. Phillips, AN, Neaton, J, Lundgren, JD. The role of HIV in serious diseases other than AIDS. AIDS 2008; 22: 24092418.
13. Langelaan, M, et al. Impact of visual impairment on quality of life: a comparison with quality of life in the general population and with other chronic conditions. Ophthalmic Epidemiology 2007; 14: 119126.
14. World Health Organisation. ICD-10 Classifications of Mental and Behavioural Disorder: Clinical Descriptions and Diagnostic Guidelines. Geneva: World Health Organisation, 2015.
15. The American Academy of Ophthalmology. Basic and Clinical Science Course, Section 1–13, 2015–2016. The American Academy of Ophthalmology (http://www.aao.org).
16. Lemp, MA, et al. The definition and classification of dry eye disease: report of the definition and classification subcommittee of the international dry eye WorkShop (2007). Ocular Surface 2007; 5: 7592.
17. Jeng, BH, et al. Anterior segment and external ocular disorders associated with human immunodeficiency virus disease. Survey of Ophthalmology 2007; 52: 329368.
18. Biswas, J, Sudharshan, S. Anterior segment manifestations of human immunodeficiency virus/acquired immune deficiency syndrome. Indian Journal of Ophthalmology 2008; 56: 363375.
19. Engstrom, RE Jr., et al. Hemorheologic abnormalities in patients with human immunodeficiency virus infection and ophthalmic microvasculopathy. American Journal of Ophthalmology 1990; 109: 153161.
20. Agarwal, A, et al. Ocular manifestations in patients with human immunodeficiency virus infection in the Pre-HAART versus the HAART Era in the North Indian population. Ocular Immunology and Inflammation 2016: 19.
21. Rasmussen, LD, et al. Risk of cataract surgery in HIV-infected individuals: a Danish Nationwide Population-based cohort study. Clinical Infectious Diseases 2011; 53: 11561163.
22. Lecuona, K, Cook, C. South Africa's cataract surgery rates: why are we not meeting our targets? South African Medical Journal 2011; 101: 510512.
23. Mertzanis, P, et al. The relative burden of dry eye in patients’ lives: comparisons to a U.S. normative sample. Investigative Ophthalmology and Visual Science 2005; 46: 4650.

Keywords

Related content

Powered by UNSILO

HIV-infected individuals on long-term antiretroviral therapy are at higher risk for ocular disease

  • E. SCHAFTENAAR (a1) (a2), N. S. KHOSA (a2), G. S. BAARSMA (a3), C. MEENKEN (a4), J. A. McINTYRE (a2) (a5), A. D. M. E. OSTERHAUS (a6), G. M. G. M. VERJANS (a1) (a6) and R. P. H. PETERS (a2) (a7)...

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed.