Human immunodeficiency virus and its effects on the visual system

Stewart, Michael W.

doi:10.4081/idr.2012.e25

Cited by 15 publications

(18 citation statements)

References 113 publications

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“…Previous studies have shown that HIV could be recovered from multiple ocular tissues, such as the retina, conjunctiva, cornea, and iris of patients with AIDS [23, 24]. We documented the presence of intraocular HIV RNA in 32% of consecutive HIV-infected patients with intraocular inflammation.…”

Section: Introductionmentioning

confidence: 71%

Genetic analyses of HIV env associated with uveitis in antiretroviral-naive individuals

Williams-Wietzikoski

Bull

et al. 2017

Aids

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OBJECTIVE To analyze and compare human immunodeficiency virus type-1 (HIV) env sequences from the eye to those from the blood of individuals with uveitis attributed to HIV with the goal of gaining insight into the pathogenesis of HIV-associated eye disease. DESIGN A prospective case series of five HIV-infected antiretroviral (ARV)-naïve individuals with uveitis negative for other pathogens. METHODS RNA from blood plasma and ocular aqueous humor was reverse transcribed using random hexamers. HIV env C2–V5 (HXB2: 6990–7668) sequences were generated by single-genome-amplification (SGA) using nested polymerase-chain-reaction (PCR) followed by bi-directional Sanger sequencing. Sequence analyses by Geneious, Geno2Pheno, N-GLYCOSITE, DIVEIN, and HyPhy evaluated relationships between HIV in plasma and aqueous humor. RESULTS A median of 20 (range: 13–22) plasma and 15 (range: 9–18) aqueous humor sequences were generated from each individual. The frequencies of sequences with predicted-N-linked-glycosylation-sites (PNLGS) and C-X-C chemokine receptor type 4 (CXCR4) were comparable in aqueous humor and plasma of all five subjects. Aqueous humor sequences had lower median genetic diversity compared to plasma across all subjects, but similar divergence, in 4 of 5 subjects. Aqueous humor HIV sequences were compartmentalized from plasma across subjects by Critchlow correlation coefficient, Slatkin and Maddison, nearest-neighbor statistic, and Fixation index. CONCLUSIONS Among ARV-naïve individuals with uveitis attributed to HIV, the universal compartmentalization and decreased diversity of eye compared to blood sequences suggests time-limited passage of a small subset of variants from each subject’s viral population into the eye tissues, followed by limited immune selection despite the inflammatory uveitis.

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Section: Introductionmentioning

confidence: 71%

Genetic analyses of HIV env associated with uveitis in antiretroviral-naive individuals

Williams-Wietzikoski

Bull

et al. 2017

Aids

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“…On the other hand, to our knowledge, this is the first study to report a significant association between old age and HIV retinopathy. HIV retinopathy is a well-known ocular disease characterized by micro aneurysms, telangiectasia, retinal hemorrhages, and CWS [ 7 ]. Pathogenesis and clinical significance of HIV retinopathy are not fully understood, and number of probable etiologies or associated factors, including viral immune complex, direct HIV infection of endothelial cells, and hyperviscosity due to red cell aggregation, have been suggested [ 7 , 26 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

“…CMV retinitis which fulfilled the standard ACTG criteria of “confirmed CMV retinitis” was included as CMV retinitis cases which required a diagnosis by an experienced ophthalmologist and documentation of CMV retinitis by retinal photography [ 13 ]. The diagnosis of HIV retinopathy was based on the findings of microaneurysms, telangiectasia, retinal hemorrhages, and cotton wool spots (CWS) [ 7 ]. The diagnosis of ocular syphilis was based on 1) ophthalmological examination documenting findings specific to ocular syphilis and 2) evidence of syphilis infection defined by a positive serum quantitative rapid plasma reagin (RPR) (titer ≥8) and positive Treponema pallidum hemagglutination assay [ 14 , 15 ].…”

Section: Methodsmentioning

confidence: 99%

“…HIV-1-infected patients are prone to develop ocular opportunistic infections, such as cytomegalovirus (CMV) retinitis, cryptococcosis, toxoplasmosis, and tuberculosis [ 4 – 6 ]. HIV retinopathy can also occur in patients with HIV-1 infection [ 7 ]. Of these ocular opportunistic infections, CMV retinitis occurs among patients with severely advanced HIV-1 infection, and can result in total blindness and increased mortality even in the ART era [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

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Routine Eye Screening by an Ophthalmologist Is Clinically Useful for HIV-1-Infected Patients with CD4 Count Less than 200 /μL

et al. 2015

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ObjectiveTo investigate whether routine eye screening by an ophthalmologist in patients with HIV-1 infection is clinically useful.MethodsA single-center, retrospective study in Tokyo, Japan. HIV-1-infected patients aged over 17 years who visited our clinic for the first time between January 2004 and December 2013 and underwent full ophthalmologic examination were enrolled. At our clinic, ophthalmologic examination, including dilated retinal examination by indirect ophthalmoscopy was routinely conducted by ophthalmologists on the first visit. The prevalence of ophthalmologic diseases and associated factors including the existence of ocular symptoms were analyzed.ResultsOf the 1,515 study patients, cytomegalovirus retinitis (CMV-R) was diagnosed in 24 (2%) patients, HIV retinopathy (HIV-R) in 127 (8%), cataract in 31 (2%), ocular syphilis in 4 (0.3%), and uveitis with unknown cause in 8 (0.5%). Other ocular diseases were diagnosed in 14 patients. The CD4 count was <200 /μL in all CMV-R cases and 87% of HIV-R. The prevalence of any ocular diseases, CMV-R, and HIV-R in patients with CD4 <200 /μL were 22%, 3%, and 15%, respectively, whereas for those with CD4 ≥200 /μL were 5%, 0%, and 2%, respectively. No ocular symptoms were reported by 71% of CMV-R cases and 82% of patients with any ocular diseases.ConclusionsRoutine ophthalmologic screening is recommended for HIV-1-infected patients with CD4 <200 /μL in resource-rich settings based on the high prevalence of ocular diseases within this CD4 count category and because most patients with ocular diseases, including those with CMV-R, were free of ocular symptoms.

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“…HIV-related MVR refers to non-infectious retinal vascular changes. The diagnosis was based on the findings of microaneurysms, telangiectasia, retinal hemorrhages, and cotton wool spots (CWS) [11] . One assumption regarding the pathogenesis of HIV/AIDS-related retinopathy is that HIV-1 can induce an inflammatory state in human retinal pigment epithelial (HRPE) cells, which results in impairment of HRPE barrier function [12] .…”

Section: Discussionmentioning

confidence: 99%

The retinal lesions in ultra-wide-field retinal imaging and the consistency of different fundus screening methods in HIV/AIDS patients

Chen

Guo

et al. 2019

Preprint

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Background: To observe the retinal lesions in HIV/AIDS patients and to evaluate the consistency of non-mydriatic ultra-wide-field (UWF) retinal imaging and mydriatic slit lamp biomicroscope with Superfield lens. Methods: 193 eyes of 98 consecutive HIV/AIDS patients were enrolled. The retinal lesions in each patients were observed through UWF fundus imaging and slit lamp biomicroscopic with Superfield lens whose consistency was analyzed. Results: 100 eyes (51.8%） had fundus lesions, 20 eyes (20%) presented posterior microvascular retinopathy (MVR), 19 eyes (19%) presented peripheral MVR, 15 eyes (15%) presented early stage cytomegalovirus retinitis (CMVR), 6 eyes showed initial stage CMVR, and 51 eyes showed other changes (papilledema, etc.). The consistency of two methods was moderate in detecting the isolated peripheral lesions (Kappa = 0.445) or HIV-related MVR (Kappa = 0.513), and high in inspecting the posterior/posterior involved lesions (Kappa = 0.831) or CMVR (Kappa = 1.0). The detection rate of UWF retinal imaging and slit lamp biomicroscopic were 15.5%（30/193）and 17.6%（34/193）(P=0.557＞0.05) for HIV-related MVR, 7.8% (15/193) (P=1.000＞0.05) for CMVR, 37.3% (72/193) and 33.7% (65/193) (P=0.118＞0.05) for posterior/posterior involved lesions, 8.8% (17/193) and 17.6% (34/193) (P=0.001＜0.05) for isolated peripheral lesions , respectively. Conclusions: The HIV-related MVR can be posterior or peripheral. Various fundus changes appear in HIV/AIDS patients, not only MVR or CMVR. The non-mydriatic UWF fundus imaging system and mydriatic slit lamp biomicroscope exhibited good consistency and nondiscriminatory detection rate for CMVR, HIV-related MVR and posterior lesions, but not for isolated peripheral lesions.

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Human immunodeficiency virus and its effects on the visual system

Cited by 15 publications

References 113 publications

Genetic analyses of HIV env associated with uveitis in antiretroviral-naive individuals

Genetic analyses of HIV env associated with uveitis in antiretroviral-naive individuals

Routine Eye Screening by an Ophthalmologist Is Clinically Useful for HIV-1-Infected Patients with CD4 Count Less than 200 /μL

The retinal lesions in ultra-wide-field retinal imaging and the consistency of different fundus screening methods in HIV/AIDS patients

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