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Abstract
Ophthalmic manifestations in HIV infections in India in the era of highly active antiretroviral therapy: a period of transition
Gharai S.1, Garg S.P.1, Venkatesh P.1, Sharma S.K.2, Vohra R.1
Objectives: To evaluate ophthalmic manifestations in patients with HIV infection in the era of HAART at the apex institute for healthcare in India.
Methods: A complete ophthalmological examination was performed on each patient between September 2004 and September 2006.
Results: One hundred thirty five consecutive HIV infected patients (269 eyes) were examined for ophthalmic manifestations. Of these 20% had category A HIV infection (asymptomatic or acute HIV or persistent generalized lymphadenopathy), 23.7% had category B HIV infection (symptomatic, not A or C), 56.3% had category C HIV infection (AIDS indicator condition).74% were male and 26% were female. The median age of patients was 34 yr and 50.4% were in the 4th decade of age.62.2% patients were on HAART. 44% patients had ophthalmic manifestation, the most common being cytomegalovirus retinitis (18.5%), which was also the most common cause of visual morbidity. Retinal detachment was seen in 68% of CMV retinitis patients. HIV vasculopathy was seen in 9.6% of patients. Other lesions included immune recovery uveitis(~3.7%), acute retinal necrosis(~3.7%), tubercular choroiditis (~3.7%), cryptococcal choroiditis(0.7%), neuro-ophthalmic manifestations(~11.1%) and anterior segment manifestations(~11.1%). 9% patients had ocular lesions without any ophthalmic symptom. 7% patients presented to us with ophthalmic manifestation as initial presenting sign of HIV infection. Amongst those who had ophthalmic involvement, 44.4% had CD4 count <100 cells/µl and 70.3% had CD4 count <200 cells/µl.
Conclusions: There seems to be an increased risk of developing ocular opportunistic infections like CMV retinitis and its complications , neuro-ophthalmological complications and anterior segment complications, with the introduction of providing low cost or free HAART in India, due to increase in life expectancy and immune recovery, which are potentially blinding and for which the treatment is very expensive. Hence an urgent need to develop affordable treatments for vision threatening ophthalmic manifestations of HIV exists.
4th IAS Conference on HIV Pathogenesis, Treatment and Prevention
Abstract no.
MOPEB101
Suggested Citation
"GharaiS., et al.
Ophthalmic manifestations in HIV infections in India in the era of highly active antiretroviral therapy: a period of transition.
Poster exhibition:
4th IAS Conference on HIV Pathogenesis, Treatment and Prevention:
Abstract no.
MOPEB101"
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