T/Giorgis Abeba, Melka Fikru, G/Mariam Agazi
Department of Ophthalmology, Faculty of Medicine, Addis Ababa University. P.O. Box 8079, Addis Ababa, Ethiopia.
Ethiop Med J. 2007 Oct;45(4):327-34.
The eye is one of the commonly affected organs by HIV/AIDS. However, data on HIV/AIDS related ophthalmic lesion is scarce in Ethiopia and in other sub-Saharan Africa countries, where two-third of the world-infected people are living.
To determine the proportion, describe the pattern, and assess the visual impairment of AIDS related ophthalmic lesions in comparison to CD+ T-lymphocyte count.
This is a cross-sectional descriptive study conducted on AIDS patients. Consecutive patients whose CD4+ T-lymphocyte count was 200 cell/microl and below, diagnosed to have AIDS and not started on Antiretroviral therapy (ART) were evaluated for ophthalmic lesions over a period of one year.
A total of 186 (26 females and 160 males) with mean age 34.3 +/- 7.6 years were examined CD4+ T-lymphocyte was ranging from 1 to 200 cell/microl. Sixty-one (32.8%) patients were found to have HIV/AIDS related ophthalmic lesions. Four of them had more than one lesion. Among the lesions, microvasculopathy (64% of them having CD4 less than 50) was by far the commonest accounting for 25/65 (38.1%), followed by Molluscum contageosum of the eyelids 10/65 (15%). Herpes Zoster Opthalmicus (HZO), uveitis, CMV retinitis were next common 4/65 (6.2% each). Eleven unilaterally and two bilaterally were blind. The leading cause of blindness was cytomegalovirus retinitis followed by HZO, uveitis and presumed toxoplasmisis chorioretinitis. The likelihood of having HIV/AIDS related lesion was higher among cases with CD4+ T-lymphocyte count of 50 and below (Adjusted OR = 12.25; 95% CI; 1.09, 4.63).
The presence of visual threatening ophthalmic lesions in highly immunocompromised AIDS patient shows the importance of early detection and treatment. ART could have impact on the pattern of the ophthalmic lesions, hence further study is recommended.
眼睛是受人类免疫缺陷病毒/获得性免疫综合征（HIV/AIDS）影响的常见器官之一。然而，在埃塞俄比亚以及世界上三分之二HIV感染者所在的其他撒哈拉以南非洲国家，关于HIV/AIDS相关眼部病变的数据却很匮乏。
确定与CD+ T淋巴细胞计数相比，AIDS相关眼部病变的比例、描述其模式并评估视觉损害情况。
这是一项针对AIDS患者的横断面描述性研究。对连续入选的CD4+ T淋巴细胞计数为每微升200个细胞及以下、被诊断为AIDS且尚未开始抗逆转录病毒治疗（ART）的患者，在一年时间内进行眼部病变评估。
共检查了186例患者（26例女性和160例男性），平均年龄34.3±7.6岁，CD4+ T淋巴细胞计数范围为每微升1至200个细胞。发现61例（32.8%）患者患有HIV/AIDS相关眼部病变。其中4例有不止一种病变。在这些病变中，微血管病变（其中64%的患者CD4低于50）是最常见的，占25/65（38.1%），其次是眼睑传染性软疣，占10/65（15%）。眼部带状疱疹（HZO）、葡萄膜炎、巨细胞病毒性视网膜炎次之，各占4/65（6.2%）。11例单侧失明，2例双侧失明。失明的主要原因是巨细胞病毒性视网膜炎，其次是HZO、葡萄膜炎和推测的弓形虫性脉络膜视网膜炎。CD4+ T淋巴细胞计数为50及以下的患者发生HIV/AIDS相关病变的可能性更高（调整后的比值比=12.25；95%置信区间：1.09，4.63）。
在免疫功能严重受损的AIDS患者中存在威胁视力的眼部病变，表明早期检测和治疗的重要性。ART可能会对眼部病变模式产生影响，因此建议进一步研究。
