Pagani Jean Marie, Duan Jennifer Qian
Pennsylvania College of Optometry at Salus University, The Eye Institute, Philadelphia, Pennsylvania 19141-3399, USA.
Optometry. 2011 Feb;82(2):77-82. doi: 10.1016/j.optm.2010.07.030. Epub 2010 Dec 13.
With the introduction of highly active antiretroviral therapy (HAART), the incidence of opportunistic infections in human immunodeficiency virus (HIV)-positive patients has dramatically decreased; however, clinicians should be made aware of the clinical presentation of immune recovery-mediated HAART-induced ocular inflammation. This case report discusses the correlation of HAART induction with immune recovery and ocular inflammation in an HIV-positive patient with a history of herpes zoster ophthalmicus (HZO).
An HIV-positive man presented with a chief complaint of headache, severe facial pain, swollen eyelid, and light sensitivity in the right eye. The patient indicated the ocular discomfort was similar to his HZO outbreak treated successfully 3 months prior. He recently was initiated on HAART by his infectious disease specialist. The patient's diagnosis was immune recovery-mediated HAART-induced ocular inflammation associated with HZO.
HAART has significantly reduced HIV-related morbidity and mortality, but new complications have emerged. Recognition of immune reconstitution inflammatory syndrome and the correlation with ocular inflammation is critical because treatment is based on protecting the patient against the effects of the inflammatory response without compromising antimicrobial or antiviral therapy.
随着高效抗逆转录病毒疗法（HAART）的引入，人类免疫缺陷病毒（HIV）阳性患者中机会性感染的发生率已大幅下降；然而，临床医生应了解免疫恢复介导的HAART诱导的眼部炎症的临床表现。本病例报告讨论了一名有眼部带状疱疹（HZO）病史的HIV阳性患者中HAART诱导与免疫恢复及眼部炎症之间的相关性。
一名HIV阳性男性，主要主诉为头痛、严重面部疼痛、眼睑肿胀及右眼畏光。患者表示眼部不适与3个月前成功治疗的HZO发作相似。他最近由传染病专科医生开始接受HAART治疗。患者的诊断为免疫恢复介导的HAART诱导的与HZO相关的眼部炎症。
HAART显著降低了与HIV相关的发病率和死亡率，但也出现了新的并发症。认识免疫重建炎症综合征及其与眼部炎症的相关性至关重要，因为治疗的基础是在不影响抗菌或抗病毒治疗的情况下保护患者免受炎症反应的影响。
