Abstract
Purpose: :
To analyze immunologic characteristics of the ocular surface in patients with HIV/AIDS infection, with and without clinical signs of dry eye, and to determine relation between systemic condition, clinical degree of dry eye and immune local condition of the ocular surface.
Methods: :
This is a prospective, transversal, observational and comparative study where we included patients with HIV/AIDS, in the period from August to October of 2005. Clinical information, slit lamp examination and tests to determine degree of dry eye (schirmer test, break up time, and fluorescein / lissamine green dye) were taken in all patients. Patients were divided into 2 groups: group 1 without dry eye and group 2 with dry eye, the last one was divided into 2 subgroups: A mild and B moderate. Only one eye, the most affected, was included. We obtained an epithelial conjunctival cell sample (Brignole, F, et al.) for processing by flow cytometry [Altra Epics (Coulter, USA), Expo Altra 2.0] to determine antibodies to HLA–DR and ICAM–1 through immunofluorescence technique. We also obtained the CD–4 cell count of all patients. Analysis of variance between groups and correlation analysis were performed.
Results: :
We analyze 38 eyes (38 patients), 21 % in group 1 and 79 % in group 2. From group 2, 23 % had mild dry eye and 77 % moderate dry eye. We found in average an expression of HLA–DR and ICAM–1 markers of 31.4 % and 20.5 % respectively in group 2 versus 22.8 % and 12.5 % in group 1 (p = 0.15 and p=0.08). There was a variability of values on each group. There was no correlation between CD–4 cell count and HLA–DR and ICAM–1 markers (R2=0.0005 and R2=0.0416), but we did find a relation between cell count and severity of clinical dry eye.
Conclusions: :
There were no differences in the expression of the inflammatory markers of the ocular surface in patients with HIV/AIDS with and without dry eye. The systemic condition did not have relation with the local immunologic state of the ocular surface.
Keywords: AIDS/HIV • cornea: tears/tear film/dry eye • cytology