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Norio Takeda, Shigeko Yashiro, Yosuke Nakamura, Natsuyo Yoshida; Analysis of Ophthalmic Surgery and Rates of Mixed Infection with Syphilis and Hepatitis in Individuals with Human Immunodeficiency Virus. Invest. Ophthalmol. Vis. Sci. 2012;53(14):6222.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the epidemiology of ophthalmic surgery and the rates of mixed infection with syphilis, hepatitis B and hepatitis C in individuals with human immunodeficiency virus (HIV).
Age, sex, disease, operative method, CD4+ T-lymphocyte count, serum HIV RNA level were investigated retrospectively in 65 ophthalmic surgeries of 43 HIV-positive individuals between 2001 and 2011 (group A). To study the rate of mixed infection with other infectious disease, results of rapid plasma reagin (RPR) and Treponema pallidum hemagglutination assay (TPHA) for syphilis, HBs antigen for hepatitis B and HCV antiody for hepatitis C were also investigated. These results were statistically compared with 3,232 HIV-negative individuals who underwent ophthalmic surgeries between 2001 and 2008. To analyze the rate of mixed infection with many cases, results of RPR, TPHA, HBs antigen and HCV antibody were investigated retrospectively in 1,491 HIV-positive individuals who underwent initial ophthalmological examination between June 2001 and May 2010 (group B).
The group A was comprised of 88.4% males and 11.6% females. Subject age ranged from 25 to 77 years; mean age was 52.0 years. Diseases included cataract (64.6%), rhegmatogenous retinal detachment (13.8%), chalazion (9.2%), conjunctival tumor (4.6%), eyelid tumor (3.1%), etc. Operative methods included cataract surgery (46 times), conjunctival and eylid surgery (12 times), vitreous surgery (7 times), scleral buckling surgery (3 times), etc. HIV-related diseases were 29.2% while 70.8% of the diseases were not related to the HIV infection. CD4+ T-lymphocye was under 200/µl in 41.5%. Serum HIV RNA level was 50 copies/ml or less in 67.2%. Positive reaction rates of syphilis, hepatitis B and Hepatitis C were significantly higher in HIV-positive individuals than in HIV-negative individuals. The group B was comprised of 92.9% males and 7.1% females. Subject age ranged from 10 to 82 years; mean age was 37.8 years. Positive reaction rate was 31.6% for RPR, 44.1% for TPHA, 7.7% for HBs antigen and 6.1% for HCV antibody. These results were high as compared to usual reports. Analyses by age group showed no statistically significant difference.
Cataract was the most common disease which required ophthalmic surgery and many diseases which required ophthalmic surgeries were not related to HIV infection in HIV-positive individuals. Rates of mixed infection with syphilis, hepatitis B and hepatitis C were higher in HIV-positive individuals than in HIV-negative individuals. High rates of mixed infection with syphilis, hepatitis B and hepatitis C were also revealed by the analysis of many HIV-positive individuals.
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