Uveitis in human immunodeficiency virus-infected persons with CD4+ T-lymphocyte count over 200 cells/mL

作者:Rose Nus**aumer Jennifer; Goldstein Debra A; Thorne Jennifer E; Arantes Tiago E; Acharya Nisha R; Shakoor Akbar; Jeng Bennie H; Yeh Steven; Rahman Hassan; Vemulakonda G Atma; Flaxel Christina J; West Sarah K; Holland Gary N; Smith Justine R*
来源:Clinical and Experimental Ophthalmology, 2014, 42(2): 118-125.
DOI:10.1111/ceo.12141

摘要

Background %26lt;br%26gt;Introduction of highly active antiretroviral therapy has altered the course of disease for persons infected with human immunodeficiency virus by elevating CD4+ T-lymphocyte levels. Changes in the spectrum of systemic diseases encountered in human immunodeficiency virus-positive individuals are reported in the general medical literature. %26lt;br%26gt;Design %26lt;br%26gt;Retrospective case series. %26lt;br%26gt;Participants %26lt;br%26gt;Sixty-one individuals infected with human immunodeficiency virus, who presented with uveitis when the peripheral CD4+ T-lymphocyte count was over 200 cells/mu L. %26lt;br%26gt;Methods %26lt;br%26gt;Standardized data collection at seven tertiary-referral inflammatory eye disease clinics. %26lt;br%26gt;Main Outcome Measures %26lt;br%26gt;Standardization of Uveitis Nomenclature anatomic classification and descriptors, cause of uveitis, and visual acuity %26lt;br%26gt;Results %26lt;br%26gt;Peripheral CD4+ T cell counts varied between 207 and 1777 (median?=?421) cells/mu L at the time of diagnosis of uveitis. Uveitis was classified anatomically as anterior (47.5%), intermediate (6.6%), anterior/intermediate (16.4%), posterior (14.8%) and pan (14.8%). Specific causes of uveitis included infections (34.4%), with syphilis responsible for 16.4% of all cases, and defined immunological disorders (27.0%); no cause for the inflammation was identified in 34.4% of persons. Visual acuity was better than 6/15 in 66.7% and 6/60 or worse in 11.8% of 93 eyes at presentation, and better than 6/15 in 82.4% and 6/60 or worse in 8.8% of 34 eyes at 1 year of follow-up. %26lt;br%26gt;Conclusions %26lt;br%26gt;Both infectious and non-infectious forms of uveitis occur in individuals who are infected with human immunodeficiency virus and have preserved or restored peripheral CD4+ T cell levels. Individuals who are human immunodeficiency virus-positive and present with uveitis should be evaluated in the same way all patients with uveitis are assessed.

  • 出版日期2014-3