Ocular manifestations of people living with HIV in Tunisia

Abstract

Background: Ocular involvement is a common complication of human immunodeficiency virus (HIV). Knowledge about this topic in Tunisia is limited.Objective: To investigate ophthalmic manifestations in patients living with HIV in Tunisia.Method: This was an observational study, performed between January 2007 and December 2016. We included patients with ocular disorders related to HIV. The data were recorded retrospectively from chart review.Results: Amongst 98 people living with HIV (PLWH), 36 participants (55 eyes) had ocular manifestations. The mean age was 32.2 ± 5.6 years. Twenty-four patients were men and 12 were women. The mean value of CD4+ T-cell count was 156.5 ± 4.2 cells/µL. Bilateral lesions were found in 19 eyes. Best corrected visual acuity was better than 6/12 in 36 eyes. The most common ocular finding was dry eye syndrome (22%), cotton-wool spots (20%) and retinal haemorrhage (16%) followed by cytomegalovirus (CMV) retinitis (9%), anterior uveitis (7%), toxoplasmosis (4%) and tuberculosis retinochoroiditis (7%) Herpetic keratitis (5%), Herpes zoster ophthalmicus (2%) and syphilitic chorioretinitis (2%). Papilledema was found in three eyes (5%). Panuveitis was observed in four eyes (7%): three of them were associated with chorioretinal toxoplasmosis, syphilitic chorioretinitis and CMV retinitis. The fourth was attributable to immune recovery uveitis. A CD4+ T-cell count of ≤ 200 cells/µL was found to be an independent risk factor for developing posterior segment manifestations.Conclusion: Various ophthalmic manifestations were observed in PLWH. The most common lesion was retinopathy. Ocular involvement can be serious leading to poor visual prognosis, which requires close collaboration between the ophthalmologist and infectious disease physician.

Ophthalmic Manifestations among HIV Patients at the Main Tertiary Hospital in Freetown, Sierra Leone: A Cross-Sectional Study

“…Unlike reports in other studies, opportunistic ocular infections were rarely reported in our study [27]. This is expected because, as previously reported, many of the patients in this study were virologically suppressed, and their ocular abnormalities may be explained by a combination of factors, including the toxicity of antiretroviral therapy and the drugs used to treat OIs [28].…”

Human Immunodeficiency Virus and Uveitis

“…Actually, the involvement of the anterior segment is more common than that of the posterior segment in the post-ART era. According to a study from Tunisia, dry eye (8%) is the most common manifestation in the anterior segment [ 14 ]. The prevalence of uveitis in patients with HIV is 1.1–24% [ 4 , 7 , 14 ].…”

“…According to a study from Tunisia, dry eye (8%) is the most common manifestation in the anterior segment [ 14 ]. The prevalence of uveitis in patients with HIV is 1.1–24% [ 4 , 7 , 14 ]. However, considering that two-thirds of PLWH live in HIV high-burden countries [ 3 ], where the awareness of uveitis still needs to be improved, it is still an emergency for ophthalmologists to have more access to patients with HIV-related uveitis.…”

Incidence and Risk Factors of Bilateral Herpetic Keratitis: 2022 Update

“…Herpes Simplex is usually diagnosed clinically and requires no laboratory confirmation. If the diagnosis is in doubt, the following tests may assist: [5,9,21] 1.…”

“…Herpes Simplex Keratitis was found in 5% of those patients. The risk of developing ocular disease in PLWH is higher when the CD4+ count is <200 cells/µL [21].…”