HIV-induced Retinitis

Ocul Immunol Inflamm. 2020 Nov 16;28(8):1259-1268. doi: 10.1080/09273948.2020.1808225. Epub 2020 Sep 23.

Abstract

Purpose: To provide an overview of the current knowledge on the Human Immunodeficiency Virus (HIV)-associated retinopathies.

Methods: A PubMed search was performed, using the key terms "HIV Retinopathy OR Retinitis" and "HIV AND Retinitis" to find manuscripts published within the last ten years.

Results: If left untreated, HIV infection causes a progressive immunodeficiency caused by depletion of CD4-positive T lymphocytes. Noninfectious HIV retinopathy, clinically manifested by cotton wool spots. Once the CD4 count drops below 200 c/μl, immunodeficiency creates a vulnerability for systemic opportunistic infections. Within the posterior segment of the eye, cytomegalovirus (CMV) retinitis has to be distinguished from infections with other members of the herpes virus family, as well as from toxoplasmosis, tuberculosis, and syphilis. Upon restoration of the immune system, immune recovery uveitis may manifest in one third of CMV affected eyes.

Conclusion: Targeted antiviral treatment and secondary recurrence prophylaxis prevent vision loss of the retina prior to immune recovery.

Keywords: CMV; HIV microangiopathy; HIV retinopathy; HSV; VZV; Viral retinitis; antivirals; cytomegalovirus; herpes simplex virus; varicella-zoster virus.

Publication types

  • Review

MeSH terms

  • Antiviral Agents / therapeutic use
  • Chorioretinitis / diagnosis
  • Chorioretinitis / drug therapy
  • Chorioretinitis / virology*
  • Cytomegalovirus Retinitis / diagnosis
  • Cytomegalovirus Retinitis / drug therapy
  • Cytomegalovirus Retinitis / virology*
  • Diagnostic Techniques, Ophthalmological
  • Eye Infections, Viral / diagnosis
  • Eye Infections, Viral / drug therapy
  • Eye Infections, Viral / virology*
  • HIV Infections / complications*
  • HIV Infections / diagnosis
  • HIV Infections / drug therapy
  • Humans
  • Retinal Necrosis Syndrome, Acute / diagnosis
  • Retinal Necrosis Syndrome, Acute / drug therapy
  • Retinal Necrosis Syndrome, Acute / virology*
  • Varicella Zoster Virus Infection / diagnosis
  • Varicella Zoster Virus Infection / drug therapy
  • Varicella Zoster Virus Infection / virology*

Substances

  • Antiviral Agents