New Insights into Ocular Complications of Human Immunodeficiency Virus Infection

Abstract

: HIV/AIDS continues to be a major global public health issue, affecting multiple organs such as the eyes. With the advent of highly active antiretroviral therapy (HAART), the incidence has dropped but HIV ocular complications still remain a major cause of vision impairment in HIV-positive individuals. Since modern medical interventions nowadays can change this previously fatal infection into a chronic disease and enable people living with HIV for relatively long and healthy lives, recent studies update the incidence of HIV-related ocular manifestations which has reached 70% among HIV patients. The primary ocular disorders induced by HIV are various and the clinical ocular findings are similar which may be a problem to diagnose in the setting of disease. In our discussion, these complications are classified by etiology, for example noninfectious microvasculopathy resulting from direct invasion of the HIV, HIV-associated opportunistic infections caused by virus such as cytomegalovirus and varicella-zoster virus, fungus for example candida and cryptococcus, bacteria like mycobacterium, parasites such as toxoplasma and pneumocystis, and other pathogens, and infiltration lesions like lymphoma and Kaposi sarcoma. In order to get a better understanding of HIV ocular complications, we focus on HIV-related ocular complications in the HAART era with an emphasis on current incidence, clinical manifestations, ocular examination findings, differential diagnosis, treatment, and prognosis. In addition, we discuss the possibility of virus reservoir in eyes which makes HIV-related oculopathy still ubiquitous even after successful systemic treatment.

Treatment outcomes amongst older people with HIV infection receiving antiretroviral therapy

“…This has been observed in our previous studies using SIVmac239-infected macaques, where older macaques exhibited rapid development of HIV associated with preinfection immunosenescence characteristics, such as low naive CD4 + T cells and accumulated memory T cells [ 27 , 28 ]. Thirdly, CD4 + T cells in older individuals show elevated levels of immune activation [ 29 ], apoptosis, and depletion [ 30 , 31 ]. Additionally, disorders in secondary lymphoid tissues, dysregulated T-cell subsets, imbalanced cytokine levels, and chronic inflammation may further impede immune recovery in older participants [ 32 ].…”

Tenofovir Concentration Is Not Enough in Intraocular Tissues of Patients With HIV infection

“…For instance, noninfectious microvasculopathy resulting from direct invasion of HIV and HIV-associated opportunistic infections are caused by viruses such as cytomegalovirus and varicella zoster virus. 5 In a study of 787 patients with HIV treated with cART in China, we found a high prevalence of ocular complications (26.3%); among them, cytomegalovirus retinitis (CMVR) had the highest prevalence (10.6%), followed by ocular microangiopathy (9.4%). 6 The blood-retinal barrier (BRB) is particularly tight and restrictive and is a physiologic barrier that maintains the eye as a privileged site.…”

Protective Efficacy of Anti-Hyr1p Monoclonal Antibody against Systemic Candidiasis Due to Multi-Drug-Resistant Candida auris

“…Agglutinin-like sequence protein (Als) family and hyphal-regulated (Hyr/Iff)-like proteins are two of the major proteins which are known for adhesion/invasion of host tissues and evasion of host immune defense, respectively [ 28 , 29 , 30 , 31 ]. The N-terminal of these proteins is predominantly conserved and forms a β-helical structure followed by an α-crystallin domain and shows structural similarities with different bacterial adhesins [ 32 , 33 , 34 ].…”