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Ethan K Sobol, Robert Fargione, Marianna Atiya, Jose Diaz, Jonathan Powell, David C Gritz; A Case-Control Study of Herpes Simplex Eye Disease: Bronx Epidemiology of HIV Eye Studies (BEHIVES). Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1859.
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© ARVO (1962-2015); The Authors (2016-present)
To determine whether HIV/AIDS, diabetes mellitus, and atopic disease are associated with active herpes simplex virus (HSV) eye disease.
This retrospective case-control study utilized Montefiore’s Clinical Looking Glass software to capture cases and controls from the entire hospital system from June 1, 2010 through May 31, 2014. Case inclusion criteria were the clinical diagnosis of HSV eye disease and residency in the Bronx, NY. A hospital-based control group was randomly chosen using a 4:1 ratio of controls to cases. Medical records were reviewed to confirm inclusion criteria and gather demographic and clinical data. HIV/AIDs, diabetes mellitus, and atopic disease diagnosis (including asthma and atopic dermatitis) were noted for the study participants. Odds ratio (OR) estimates and 95% confidence intervals (95% CI) were calculated for potential risk factors.
HSV eye disease was confirmed in 70 patients, who were compared to 280 controls. Patients with ocular HSV had a greater prevalence of HIV/AIDS compared to controls (8.6 and 2.9%, respectively). Cases had a higher prevalence of diabetes with chronic complications than controls (12.9% and 10%, respectively), although the association was not significant (p=0.67). Cases had an increased prevalence of atopic disease (28.6% and 21.7%, respectively), although significance was not established (p=0.27). Univariate analysis identified atopic dermatitis (OR 4.2, 95% CI: 1.3 to 14.1) and HIV (OR 3.2, 95% CI: 1.1 to 9.3) as significant risk factors for the presence of HSV eye disease. Using multivariate analyses to control for age and gender, atopic dermatitis was no longer significant (OR 3.0, 95% CI: 0.85 to 10.4), while HIV remained significant (OR 3.5, 95% CI: 1.2 to 10.5). Among the HIV-positive group of HSV eye disease patients 5 (n=6, 83.3%) were on HAART therapy and 6 (100%) presented with a form of keratitis or retinitis.
The multivariate analysis of potential risk factors provides evidence for an increased risk of active HSV eye disease for individuals with HIV when controlling for age and gender. To our knowledge, this study represents the first time strength of association has been calculated for HIV and HSV eye disease.
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