Wednesday, January 4, 2012

Ocular Manifestations of HIV


This morning I woke up with mild pink eyes (i.e. sore eyes here in the Philippines). My previous doctor in PGH -SAGIP said that the eyes can also by the  weakened immune system. So I did my research and I got this article from the web:

Ocular manifestations of human immunodeficiency virus (HIV) infection are common. Approximately 70-80% of HIV-infected patients will be treated for an HIV-associated eye disorder during the course of their illness.

In general, the CD4+ T-lymphocyte count has been used to predict the onset of certain ocular infections in patients who are HIV positive. A CD4+ T-cell count below 500/mL is associated with Kaposi sarcoma, lymphoma, and tuberculosis. A CD4+ T-cell count below 250/mL is associated with pneumocystosis and toxoplasmosis. A CD4+ T-cell count less than 100/mL is associated with the following:
  • Retinal or conjunctival microvasculopathy
  • Cytomegalovirus (CMV) retinitis
  • Varicella-zoster virus (VZV) retinitis
  • Mycobacterium avium complex infection
  • Cryptococcosis
  • Microsporidiosis
  • HIV encephalopathy
  • Progressive multifocal leukoencephalopathy
The predictive value of the CD4+ T-cell count for ocular complications in HIV infection has been called into question by reports of CMV retinitis in patients with CD4+ cell counts higher than 200 cells/mL. These patients reportedly were taking highly active antiretroviral therapy (HAART). While such findings may argue against the protective effect of an increased CD4+ cell count, the possibility that the CMV retinitis preceded the recovery of CD4+ cell count was not ruled out. Thus, whether a reconstituted T-cell count will serve as a better predictor of specific ocular infection is under active evaluation.

Despite these uncertainties, the CD4+ cell count has remained the predicting parameter for the occurrence of specific ocular infection in patients who are HIV positive, at least until antigen-specific tests of T-lymphocyte function become widely available.




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