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HIV 相关性视网膜炎。

HIV-induced Retinitis.

机构信息

Berner Augenklinik Am Lindenhofspital , Bern, Switzerland.

MCM Eye Unit, MyungSung Christian Medical Center (MCM) General Hospital and MyungSung Medical College , Addis Ababa, Ethiopia.

出版信息

Ocul Immunol Inflamm. 2020 Nov 16;28(8):1259-1268. doi: 10.1080/09273948.2020.1808225. Epub 2020 Sep 23.

Abstract

PURPOSE

To provide an overview of the current knowledge on the Human Immunodeficiency Virus (HIV)-associated retinopathies.

METHODS

A PubMed search was performed, using the key terms "HIV Retinopathy OR Retinitis" and "HIV AND Retinitis" to find manuscripts published within the last ten years.

RESULTS

If left untreated, HIV infection causes a progressive immunodeficiency caused by depletion of CD4-positive T lymphocytes. Noninfectious HIV retinopathy, clinically manifested by cotton wool spots. Once the CD4 count drops below 200 c/μl, immunodeficiency creates a vulnerability for systemic opportunistic infections. Within the posterior segment of the eye, cytomegalovirus (CMV) retinitis has to be distinguished from infections with other members of the herpes virus family, as well as from toxoplasmosis, tuberculosis, and syphilis. Upon restoration of the immune system, immune recovery uveitis may manifest in one third of CMV affected eyes.

CONCLUSION

Targeted antiviral treatment and secondary recurrence prophylaxis prevent vision loss of the retina prior to immune recovery.

摘要

目的

概述人类免疫缺陷病毒(HIV)相关视网膜病变的现有知识。

方法

使用关键词“HIV 视网膜病变或视网膜炎”和“HIV 和视网膜炎”在 PubMed 上进行搜索,以查找过去十年内发表的文献。

结果

如果未经治疗,HIV 感染会导致 CD4 阳性 T 淋巴细胞耗竭引起的进行性免疫缺陷。非感染性 HIV 性视网膜病变,临床上表现为棉絮斑。一旦 CD4 计数降至 200 个/μl 以下,免疫缺陷会使全身机会性感染变得脆弱。在后节眼部,巨细胞病毒(CMV)视网膜炎必须与疱疹病毒家族的其他成员的感染、弓形体病、结核病和梅毒相区别。随着免疫系统的恢复,三分之一的 CMV 受累眼中可能会出现免疫恢复性葡萄膜炎。

结论

靶向抗病毒治疗和二级复发预防可防止免疫恢复前视网膜的视力丧失。

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