Di Yu, Zhao Xin-Yu, Ye Jun-Jie, Li Bing, Ma Nan
Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China.
Department of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.
Int J Ophthalmol. 2019 Sep 18;12(9):1438-1443. doi: 10.18240/ijo.2019.09.11. eCollection 2019.
To investigate the fundus manifestations and human immunodeficiency virus (HIV) viral loads of acquired immune deficiency syndrome (AIDS) patients before and after highly active antiretroviral therapy (HAART).
This retrospective study included 21 AIDS patients (42 eyes) who presented to the Department of Ophthalmology, Peking Union Medical College Hospital, from 2007 to 2011. Among the patients, 16 showed a good response to HAART, 3 presented drug resistance and 2 were pre-HAART. All patients underwent comprehensive ophthalmic examinations. The HIV viral loads and the CD4 T-cell counts were also determined.
The best-corrected visual acuity (BCVA) of 38 eyes (19 patients) was improved, and cytomegalovirus retinitis (CMVR) in 5 eyes (3 patients) regressed after HAART. Furthermore, 16 patients treated with effective HAART had decreased plasma HIV viral loads (<78 copies/mL) and increased CD4 T-cell counts (343±161 cells/µL, <0.005), but the HIV viral load in tears was still detected at 2404 copies/mL. The CD4 T-cell count was lower in the CMVR group than in the non-CMVR group (=0.022), but the HIV viral load in the tears was not significantly different between the two groups (=0.439).
Most patients with AIDS show a good viral response with a decreased HIV viral load and an increased CD4 T-cell count in plasma after HAART. However, the HIV viral load remain quite high in the tear samples. Based on our results, we suggest that AIDS patients undergo long-term HAART that should not be interrupted.
探讨获得性免疫缺陷综合征（AIDS）患者在高效抗逆转录病毒治疗（HAART）前后的眼底表现及人类免疫缺陷病毒（HIV）病毒载量。
这项回顾性研究纳入了2007年至2011年在北京协和医院眼科就诊的21例AIDS患者（42只眼）。其中，16例对HAART反应良好，3例出现耐药，2例处于HAART治疗前阶段。所有患者均接受了全面的眼科检查。同时还测定了HIV病毒载量和CD4 T细胞计数。
38只眼（19例患者）的最佳矫正视力（BCVA）得到改善，5只眼（3例患者）的巨细胞病毒性视网膜炎（CMVR）在HAART后消退。此外，16例接受有效HAART治疗的患者血浆HIV病毒载量降低（<78拷贝/mL），CD4 T细胞计数增加（343±161个细胞/µL，<0.005），但泪液中的HIV病毒载量仍为2404拷贝/mL。CMVR组的CD4 T细胞计数低于非CMVR组（=0.022），但两组泪液中的HIV病毒载量无显著差异（=0.4
