Abstract
Purpose: :
To investigate the association between human immunodeficiency virus (HIV) ocular microangiopathy (cotton-wool spots and/or retinal hemorrhages) and systemic complications in acquired immune deficiency syndrome (AIDS) patients.
Methods: :
A retrospective study based on chart review was conducted using consecutive 247 AIDS patients treated with highly active antiretroviral therapy (HAART) at Tokyo Metropolitan Cancer and Infectious diseases Center Komagome Hospital between 2003 and 2008. The association between HIV microangiopathy and systemic complications at the commencement of HAART was analyzed. The study was approved by IRB of the hospital.
Results: :
HIV microangiopathy was observed in 49 patients (19.8%). The presence of HIV microangiopathy was statistically correlated with the presence of pneumocystis jiroveci pneumonia (p<0.05), mycobacterium avium complex infection (p<0.05), systemic infection of cytomegalovirus (p<0.05), candidosis (p<0.01) and malignant lymphoma (p<0.05). There was no statistical association between HIV microangiopathy and tuberculosis (p=0.08), syphilis (p=0.1), systemic infection of herpes simplex virus or varicella-zoster virus (p=0.2), cryptococcosis (p=0.4), toxoplasmosis (p=1), amebiasis (p=0.2), Kaposi sarcoma (p=0.6) and HIV encephalopathy (p=0.4).
Conclusions: :
In AIDS patients, the presence of HIV microangiopathy was significantly related with the presence of several major systemic complications. These results suggest that HIV microangiopathy, disease detected by ophthalmologists, can be an indicator of systemic complications in HIV infected patients.
Keywords: AIDS/HIV • clinical (human) or epidemiologic studies: prevalence/incidence • retina