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抗逆转录病毒疗法(CART)治疗后 HIV(人类免疫缺陷病毒)感染患者的眼部表现。

Ocular Manifestations in Patients of HIV(Human Immunodeficiency Virus) Infection on Combined Anti-Retroviral Therapy (CART).

机构信息

Department of Ophthalmology, Guru Nanak Eye Centre, Maulana Azad Medical College, Delhi University, New Delhi, India.

Department of Medicine, Nodal Officer, ART Centre, Maulana Azad Medical College and Associated Lok Nayak Hospital, Delhi University, New Delhi, India.

出版信息

Ocul Immunol Inflamm. 2022 Aug;30(6):1399-1407. doi: 10.1080/09273948.2021.1881562. Epub 2021 Apr 1.

Abstract

AIM

To determine the prevalence and spectrum of ocular manifestations in PLHIV (people living with Human Immunodeficiency Virus) on cART (combined Antiretroviral Therapy) and correlate them with WHO clinical staging, CD4 count, duration & type of cART.

METHODS

Observational cross-sectional study. Ophthalmic evaluation of 350 PLHIV on cART (at least 6 months) was done. Logistic regression was done to correlate ocular findings with different variables. Results: Prevalence of ocular, anterior & posterior segment manifestations was 15.71%, 10.86%, and 4.00%, respectively. Dry eye(8.00%) being the most common finding. PLHIV with CD4 count ≤350 (OR = 3.1, < 0.001), in WHO stage 3 (OR = 26.9, = 0.004) & 4(OR = 60.7, < 0.001) & on 3lineART were at much higher risk of ocular manifestations as compared to those on 2 (OR = 2.83) and 1line (OR = 6.6) of therapy. Duration of treatment had a protective ( = 0.01) effect on bilateral manifestations.

CONCLUSION

With early initiation of ART, there is significant reduction in the overall prevalence of ocular findings, in the number of opportunistic ophthalmic infections and blinding disorders. Of all the reported ocular findings, anterior segment disorder emerged more often.

摘要

目的

确定接受 cART(联合抗逆转录病毒疗法)的 PLHIV(人类免疫缺陷病毒感染者)眼部表现的患病率和谱,并将其与 WHO 临床分期、CD4 计数、cART 的持续时间和类型相关联。

方法

这是一项观察性的横断面研究。对 350 名接受 cART(至少 6 个月)的 PLHIV 进行眼科评估。采用逻辑回归分析将眼部发现与不同变量相关联。

结果

眼部、前节和后节表现的患病率分别为 15.71%、10.86%和 4.00%。干眼症(8.00%)是最常见的表现。与 CD4 计数≤350(OR=3.1,<0.001)、WHO 分期 3(OR=26.9,=0.004)和 4(OR=60.7,<0.001)和 3 线 ART 治疗的患者相比,接受 2 线(OR=2.83)和 1 线(OR=6.6)治疗的患者发生眼部表现的风险更高。治疗时间的延长具有保护作用(=0.01)。

结论

早期开始 ART 可显著降低眼部表现的总体患病率、机会性眼部感染和致盲性疾病的数量。在所有报告的眼部发现中,前节障碍更为常见。

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