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Rebecca L. Sorenson, Bennie H. Jeng; Ophthalmic Manifestations of Human Immunodeficiency Virus Infection in the Era of Highly Active Antiretroviral Therapy. Invest. Ophthalmol. Vis. Sci. 2011;52(14):2978.
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Before the advent of highly active antiretroviral therapy (HAART), the rate of ophthalmic manifestations of human immunodeficiency virus (HIV) was very high. We sought to determine if the rate of opportunistic infection has decreased at our institution since the widespread use of HAART. We also sought to compare our findings with those of recent studies from tertiary care centers in India.
In this follow-up study to one performed at the same institution prior to the HAART-era, we retrospectively reviewed the charts of all HIV-positive patients who presented to the Eye Clinic of San Francisco General Hospital, a large, urban, tertiary care medical center with a comprehensive HIV treatment center, from July 1, 2008 to June 30, 2009. Charts were reviewed for diagnoses of active ophthalmic manifestations of HIV infection, including HIV retinopathy, opportunistic infections, uveitis, and neoplasms.
The charts of 187 HIV-positive patients were available for review. HIV retinopathy was found in 7 patients (3.7%). There was one patient (0.5%) presenting with neurosyphilis with ocular involvement, but no cases of active cytomegalovirus (CMV) retinitis or varicella zoster virus (VZV) keratitis were found. Uveitis was found in 8 patients (4.3%), and ocular surface neoplasms were found in 2 patients (1.1%), including 1 case of conjunctival Kaposi sarcoma and 1 case of conjunctival squamous cell carcinoma.
With an aggressive HIV treatment program in place utilizing HAART, the rates of CMV retinitis and VZV keratitis appear to be lower than those previously reported in the same hospital population in the pre-HAART era. Compared to recent findings from similar studies at tertiary care centers in India, our hospital population had lower rates of CMV retinitis and HIV retinopathy.
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