Ophthalmic manifestations of perinatally acquired HIV in a US cohort of long-term survivors

Tina Rutar; Jiwon Youm; Travis Porco; Nicole Tilton; Mica Muskat; Nancy McNamara; Diane Wara

doi:10.1136/bjophthalmol-2014-305557

Ophthalmic manifestations of perinatally acquired HIV in a US cohort of long-term survivors

Br J Ophthalmol. 2015 May;99(5):650-3. doi: 10.1136/bjophthalmol-2014-305557. Epub 2014 Nov 21.

Authors

Tina Rutar¹, Jiwon Youm², Travis Porco³, Nicole Tilton⁴, Mica Muskat⁴, Nancy McNamara⁵, Diane Wara⁴

Affiliations

¹ Department of Ophthalmology, University of California San Francisco, San Francisco, California, USA Department of Pediatrics, University of California San Francisco, San Francisco, California, USA.
² University of California San Francisco School of Medicine, San Francisco, California, USA.
³ Department of Ophthalmology, University of California San Francisco, San Francisco, California, USA Francis I. Proctor Institute for Research in Ophthalmology, University of California San Francisco, San Francisco, California, USA Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA.
⁴ Department of Pediatrics, University of California San Francisco, San Francisco, California, USA.
⁵ Department of Ophthalmology, University of California San Francisco, San Francisco, California, USA Francis I. Proctor Institute for Research in Ophthalmology, University of California San Francisco, San Francisco, California, USA.

PMID: 25416182
DOI: 10.1136/bjophthalmol-2014-305557

Abstract

Background/aims: To determine the ophthalmic manifestations of HIV in a cohort of long-term survivors of perinatally acquired HIV.

Methods: Twenty-two patients with perinatally acquired HIV who were aged ≥12 years were prospectively studied at a university clinic. They underwent complete ophthalmic examinations and fundus photography. Their medical histories, medications and CD4 counts were abstracted from the medical records. To evaluate for keratoconjunctivitis sicca, both HIV patients and 44 healthy controls (matched by age, gender and contact lens wear) underwent Schirmer testing and ocular surface staining.

Results: Nine male and 13 female HIV patients with mean age of 16.6 years (SD, 3.4) were examined. Of the 22 HIV patients, 21 had been treated with highly active antiretroviral therapy (HAART). Only one patient had a CD4 count nadir of <200 cells/µL. The mean visual acuity of the eyes of the HIV subjects was 20/22 (SD, 1.6 lines). No patient had cytomegalovirus retinitis. Four of the 22 (18%) HIV patients had strabismus. HIV subjects and controls had similar rates of abnormal Schirmer (9% and 14%, p=0.62) and ocular staining scores (p=0.29).

Conclusions: In the post-HAART era, long-term survivors of perinatally acquired HIV exhibited little vision-threatening disease, but had a high prevalence of strabismus.

Keywords: Child health (paediatrics); Infection.

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Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Antiretroviral Therapy, Highly Active
CD4 Lymphocyte Count
Child
Cohort Studies
Eye Infections, Viral / drug therapy
Eye Infections, Viral / mortality
Eye Infections, Viral / transmission*
Female
HIV Infections / drug therapy
HIV Infections / mortality
HIV Infections / transmission*
Humans
Infant, Newborn
Infectious Disease Transmission, Vertical*
Keratoconjunctivitis Sicca / diagnosis*
Keratoconjunctivitis Sicca / physiopathology
Male
Prospective Studies
Strabismus / diagnosis*
Strabismus / physiopathology
Survivors
United States
Visual Acuity / physiology
Young Adult

Abstract

Publication types

MeSH terms

Grants and funding