Département d'Ophtalmologie, Fondation Adolphe de Rothschild, Paris, France.
Service d'Ophtalmologie, APHP, Hôpital Bichat-Claude-Bernard, Paris, France.
PLoS One. 2020 Mar 10;15(3):e0229977. doi: 10.1371/journal.pone.0229977. eCollection 2020.
To compare peripapillary retinal nerve-fiber-layer (pRNFL) thickness, total retina macular volume, and ganglion-cell-layer (GCL) macular volume and thickness between persons living with HIV (PLHIVs) with well-controlled infections and good immune recovery, and sex- and age-matched HIV-uninfected controls (HUCs).
This prospective cross-sectional study (www.clinicaltrials.gov identifier: NCT02003989) included 56 PLHIVs, infected for ≥10 [median 20.2] years and with sustained plasma HIV-load suppression on combined antiretroviral therapy (cART) for ≥5 years, and 56 matched HUCs. Participants underwent spectral-domain optical coherence tomography (SD-OCT) with thorough ophthalmological examinations and brain magnetic resonance imaging (MRI). Their overall and quadrant pRNFL thicknesses, total macular volumes, and GCL macular volumes and thicknesses were compared. Cerebral small-vessel diseases (CSVD) complied with STRIVE criteria.
Median [interquartile range, IQR] ages of PLHIVs and HUCs, respectively, were 52 [46-60] and 52 [44-60] years. Median [IQR] PLHIVs' nadir CD4+ T-cell count and current CD4/CD8 T-cell ratio were 249/μL [158-350] and 0.95 [0.67-1.10], respectively; HIV-seropositivity duration was 20.2 [15.9-24.5] years; cART duration was 16.8 [12.6-18.6] years; and aviremia duration was 11.4 [7.8-13.6] years. No significant between-group pRNFL thickness, total macular volume, macular GCL-volume and -thickness differences were found. MRI-detected CSVD in 21 (38%) PLHIVs and 14 (25%) HUCs was associated with overall thinner pRNFLs, and smaller total retina and GCL macular volumes, independently of HIV status.
SD-OCT could not detect pRNFL thinning or macular GCL-volume reduction in well-sustained, aviremic, cART-treated PLHIVs who achieved good immune recovery. However, CSVD was associated with thinner pRNFLs and GCLs, independently of HIV status.
比较经抗逆转录病毒治疗（cART）病毒抑制良好且免疫重建良好的 HIV 感染者（PLHIVs）与性别和年龄匹配的 HIV 未感染者（HUCs）的视盘周围视网膜神经纤维层（pRNFL）厚度、全视网膜黄斑体积、节细胞层（GCL）黄斑体积和厚度。
这是一项前瞻性的病例对照研究（www.clinicaltrials.gov 标识符：NCT02003989），纳入了 56 名 PLHIVs，他们感染 HIV 时间≥10 年[中位数 20.2]年，cART 治疗≥5 年且病毒载量持续抑制。还纳入了 56 名匹配的 HUCs。参与者接受了频域光学相干断层扫描（SD-OCT），并进行了全面的眼科检查和脑磁共振成像（MRI）。比较了他们的整体和象限 pRNFL 厚度、全视网膜黄斑体积、GCL 黄斑体积和厚度。脑小血管疾病（CSVD）符合 STRIVE 标准。
PLHIVs 和 HUCs 的中位[四分位间距，IQR]年龄分别为 52[46-60]岁和 52[44-60]岁。PLHIVs 的中位[IQR]最低 CD4+T 细胞计数和当前 CD4/CD8 T 细胞比值分别为 249/μL[158-350]和 0.95[0.67-1.10]，HIV 血清阳性时间为 20.2[15.9-24.5]年，cART 时间为 16.8[12.6-18.6]年，病毒载量抑制时间为 11.4[7.8-13.6]年。两组间 pRNFL 厚度、全视网膜黄斑体积、GCL 黄斑体积和厚度无显著差异。MRI 检测到的 21 名（38%）PLHIVs 和 14 名（25%）HUCs 的 CSVD 与全视网膜 pRNFL 变薄以及总视网膜和 GCL 黄斑体积减小有关，与 HIV 状态无关。
SD-OCT 无法检测到经抗逆转录病毒治疗且病毒载量抑制良好、免疫重建良好的 PLHIVs 出现 pRNFL 变薄或 GCL 黄斑体积减小。然而，CSVD 与 pRNFL 和 GCL 变薄有关，与 HIV 状态无关。
