CD4 counts: a strong indicator of retinal and ocular lesions in HIV disease

Kumar, Poninder; Vats, DP; Mishra, Sanjay Kumar; Makkar, Anuradha; Banarji, Ajay; Patyal, Sagarika; Gurunadh, V.S.

doi:10.1016/s0377-1237(11)60083-x

Cited by 8 publications

(12 citation statements)

References 10 publications

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“…There was no significant association between neuroophthalmic lesions and CD4-count of the patient. Like in studies by Bekele et al and Kumar et al, in our study too neuroophthalmic lesions were seen in the entire spectrum of CD4-count [ 26 , 29 ].…”

Section: Discussionsupporting

confidence: 86%

Ophthalmic Manifestations of HIV Patients in a Rural Area of Western Maharashtra, India

Gogri

Misra

Kothari

et al. 2014

International Scholarly Research Notices

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Introduction. HIV/AIDS is one of twenty first century's biggest global challenges to mankind with protean manifestations affecting all organs of our body, not even sparing the eyes. The purpose of this study was to determine the pattern of ocular manifestations of HIV/AIDS and their correlation with CD4-count in a rural area of India. Methods. A hospital based observational cross-sectional study was done on 40 HIV-positive patients presenting to ART center with ocular complaints. Data were collected using face-to-face interview, clinical examination, slit lamp examination, fundus examination, and laboratory investigations. Results. Out of 40 patients, 21 were males and 19 were females with mean age of 38.75 ± 13.9 years. HIV retinopathy was the most common HIV-associated ophthalmic lesion while anterior uveitis was the most common anterior segment finding. Posterior segment lesions showed significant association (P < 0.05) with low CD4-count of the patient. CMV retinitis, retinal detachment, tubercular chorioretinitis, and acute retinal necrosis were all seen in patients with CD4-count less than 100 cells/mm3. Conclusions. HIV retinopathy, CMV retinitis, herpes zoster ophthalmicus, and anterior uveitis are common ocular manifestations associated with HIV infection. Low CD4-count is a risk as well as predictor for ocular manifestations. There needs to be awareness of ocular involvement among HIV infected individuals and an increased emphasis on regular ophthalmic examination.

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Section: Discussionsupporting

confidence: 86%

Ophthalmic Manifestations of HIV Patients in a Rural Area of Western Maharashtra, India

Gogri

Misra

Kothari

et al. 2014

International Scholarly Research Notices

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“…In a study conducted by Kumar et al 18 on 125 patients on HAART, 43.9% had ocular manifestations and their CD4 count was less than 200 cells/mm 3 . They concluded that low CD4 count is strongly related to the increased prevalence of ocular lesions as well as ocular symptoms.…”

Section: Discussionmentioning

confidence: 98%

Evaluation of Fundoscopic Findings in HIV Positive Patients in Relation to HAART and CD4 Count

Joshi¹

2018

DJO

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Aim: To evaluate the fundus findings in patients with HIV in correlation to highly active antiretroviral therapy (HAART) and CD4 count. Materials and Methods: It was a hospital based observational study. It was conducted from December 2014 to September 2016 in the Ophthalmology Department, Bharati Hospital, Sangli. A total of 195 registered HIV patients on HAART were selected for the study. Informed written consent of the subjects to participate in the study was taken. Patients of both sexes of any age group were included. Patients who did not give consent for the study were excluded. Result: The mean age of study subjects was 40.49 years. 83.6% subjects had a best corrected visual acuity (BCVA) between 6/6 to 6/9 in the right eye, 82.6% had BCVA between 6/6 to 6/9 in the left eye. Visual acuity was below 6/60 in 5.1% subjects. The most common anterior segment pathology was cataract (8.2%), corneal opacity (2.1%), pterygium (2.1%) and pseudophakia. CD4 count above 500 cells/mm 3 was seen in 28.7% cases while below 250 cells/mm 3 was seen in 29.3% cases. The mean age of study subjects was 40.49 years with 51.8% between 21-40 years. Female predominance was observed in study group with 57.9% females to 42.1% males. The prevalence of ophthalmic manifestations in HIV patients on HAART was observed as 37.9%. Prevalance of posterior segment manifestations was 19.5%. Prevalance of ophthalmic pathology increased as CD4 count decreased (250 cells/mm 3). Conclusion: In the present study, significant posterior segment manifestations were seen in HIV positive patients on HAART. Low CD4 count is a risk as well as predictor for ocular manifestations. Advent of HAART has reduced the prevalence of ocular manifestations. Routine referral system for ocular evaluation from other medical departments is mandatory for timely diagnosis of the vision threatening conditions. It is therefore recommended that eye care should be a part of medical care in the management of patients on HAART.

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“…9 Ocular lesions were more common when CD4+ cell count was less than 200 cells/mm. 3 There seemed significant correlation between low CD4 and severe ocular manifestations. 10 CMV retinitis, progressive outer retinal necrosis, acute retinal necrosis and orbital cellulitis were seen if CD4 was less than 200.…”

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confidence: 97%

“…2 World Health Organization (WHO) estimate of total HIV burden in the world is approximately 33.2 million. 3 The life time cumulative rate of developing ocular lesions in HIV patients is 52-100% in various studies. 1 Ocular involvement in AIDS is very common and includes various clinical presentations including both anterior and posterior segment, most of the manifestations are those of the posterior segment like HIV retinopathy, opportunistic infections, neuro ophthalmic lesions and unusual neoplasms.…”

mentioning

confidence: 99%

“…Immune recovery uveitis and drug reactions are associated with drugs like nevirapine and indinavir in Highly Active Antiretroviral Therapy (HAART). 3,4 Even in the HAART era many patients with HIV infection have visual symptoms in the absence of active opportunistic infection. 5 The main mode of transmission being sexual transmission 6,7,8 and the diagnosis was made with ELISA /WESTERN BLOT.…”

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confidence: 99%

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Ocular Findings of Hiv/Aids Patients and Their Correlation With Cd4 Count

Narasimhaiah¹,

Naik²,

Swamy³

et al. 2018

jebmh

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BACKGROUND Ocular involvement in HIV/AIDS includes various clinical presentations including both anterior and posterior segment, most of the manifestations are those of the posterior segment. The severity of these posterior segment changes increases with decreased CD4 count. Aim of the study is to look for severity of ocular manifestations in correlation with CD4 count. MATERIALS AND METHODS A cross sectional study of ocular changes in 360 cases of HIV/AIDS patients between October 2016-May 2018. All patients underwent thorough ophthalmic evaluation including BCVA, Anterior segment examination with slit lamp biomicroscopy and posterior segment examination with Indirect ophthalmoscopy, CD4 count was noted and patients were categorised based on CD4 count and correlation of severity of ocular manifestations with CD4 count done with statistical software SPSS. RESULTS Out of 360 patients, 267 were on HAART. 54.4 % were males and 45.6% females. Maximum number of patients were in the age group of 31-40 years. Ocular manifestations were present in 252(70%) patients. Most common manifestation was HIV retinopathy (18.8%) followed by dry eye (6.9%), cataract (5.5%), CMV retinitis (5.2%), choroiditis (3.6%). CMV retinitis, choroiditis and orbital cellulitis were common in patients with CD4+count<50. Severity of ocular manifestations involving posterior segment and orbital cellulitis increased with decrease in CD4 count. There was statistically significant association between severity of ocular manifestations with CD4 count (P<0.001), and vision with CD4 count (P<0.001). CONCLUSION Patients with low CD4 count are at increased risk of acquiring severe manifestations such as posterior segment changes and orbital cellulitis. Complete ocular evaluation is must in all patients with HIV/AIDS for early diagnosis and treatment of sight threatening complications.

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CD4 counts: a strong indicator of retinal and ocular lesions in HIV disease

Cited by 8 publications

References 10 publications

Ophthalmic Manifestations of HIV Patients in a Rural Area of Western Maharashtra, India

Ophthalmic Manifestations of HIV Patients in a Rural Area of Western Maharashtra, India

Evaluation of Fundoscopic Findings in HIV Positive Patients in Relation to HAART and CD4 Count

Ocular Findings of Hiv/Aids Patients and Their Correlation With Cd4 Count

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