AIDS related eye disease in Burundi, Africa

Abstract

Aims-To determine the prevalence of ocular manifestations in AIDS patients hospitalised in Bujumbura, Burundi, according to their CD4+ lymphocyte count, serological status for CMV and VZV, and general health status. Methods-Prospective study of 154 consecutive patients who underwent general and ophthalmological examinations, including dilated fundus examination. AIDS was diagnosed on the basis of Bangui criteria and HIV-1 seropositivity. CD4+ lymphocyte counts were determined by the Capcellia method. CMV and VZV antibodies were detected with ELISA methods. Results-The mean age was 37 (SD 9) years and 65% of the patients were male. Active tuberculosis was the most frequent underlying disease (61%). Almost all the patients (99%) were seropositive for CMV and VZV. Among the 115 patients for whom CD4+ lymphocyte counts were available, 86 (75%) had more than 100 cells ×10 6 /l. Ocular involvement comprised 16 cases of microangiopathy, six of opalescence of the anterior chamber, five of retinal perivasculitis, two of zoster ophthalmicus, two of viral retinitis, and one of opalescence of the vitreous. Conclusion-In Africa, the prevalence of ocular involvement in HIV infection is far lower than in Europe and the United States, possibly because most African patients die before ocular opportunistic infections occur. (Br J Ophthalmol 1999;83:339-342)

Ocular manifestations in HIV-AIDS patients in a Nigerian community

“…Studies carried out in Burundi and Malawi have revealed a prevalence of HIV-/AIDS-associated ocular manifestations of 19% and 20%, respectively. 12,14 Another Nigerian study, carried out by Kehinde et al, reported HIV-/ AIDS-associated ocular manifestations in 12.3% of their study population. 23 In a similar study conducted in India among HIV/AIDS patients on HAART, only eight per cent of the study population had ocular manifestations of the disease.…”

“…10 The patterns of ocular diseases in HIV-infected patients in developed countries differ from those in developing countries. 8,11,12 Antibodies against cytomegalovirus (CMV) are detectable in 90% of people living with HIV-AIDS, but CMV retinitis is rare (< 5%) in…”

Review of Human Immunodeficiency Virus Type 1–Related Opportunistic Infections in Sub‐Saharan Africa

“…The prevalence of oral and esophageal candidiasis ranged from 14% in pregnant women with HIV [81] to 67% of Senegalese inpatients with AIDS [22,24,82,83]. Incidence rates are presented in table 2 [30,31,38].…”

“…tuberculosis. Tuberculosis was diagnosed in 27%-34% of consecutive HIV-1-infected patients admitted to hospitals in Kenya [21] and South Africa [22], 39% of rural Tanzanians presenting with respiratory symptoms [23], and 61% of Burundian patients with AIDS [24]. Tuberculosis was diagnosed by smear or culture of a sputum sample and/or bronchoalveolar lavage or transbronchial biopsy in 23% of smear-negative Rwandan patients [25], 27% of inpatients in Burundi [26], 51% of patients in a respiratory ward in Abidjan [27], and 69% of highly selected patients in Tanzania [28].…”

Eye examination for early diagnosis of disseminated tuberculosis in patients with AIDS

“…Published work is uneven and inconsistent, particularly with regard to Africa, 31,32,34,38,39 for reasons that remain unclear. Studies are diffi cult to compare because of diff erences in design, patient population, and reporting of HIV status.…”