"Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
"Prof. Dr. Matei Balş" National Institute for Infectious Diseases, Bucharest, Romania.
Rom J Ophthalmol. 2024 Apr-Jun;68(2):202-209. doi: 10.22336/rjo.2024.38.
Management of patients living with Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (AIDS) (PLWHA) still represents a challenge for doctors in various medical fields. The presence of co-infections, with different degrees of immune system impairment, raises the need for a multi-disciplinary approach to the PLWHA. In this paper, we present three cases of PLWHA with various ophthalmological conditions, who were admitted to "Prof. Dr. Matei Balș" National Institute for Infectious Diseases (INBIMB). Three of them were late presenters, recently diagnosed with AIDS. All three were in immuno-virological failure. The ophthalmic conditions were either related to the HIV infection, or the result of other complications. The diversity and complexity of ocular involvement in PLWHA were deeply linked to the patient's immunological status at the ophthalmological evaluation moment. Thus, antiretroviral therapy (ART) played an important immune status recovery role. Encountered ocular conditions vary, some being directly caused by the presence of the virus, and the others were the result of opportunistic infections (cytomegalovirus, Varicella virus) or other co-infections (Treponema pallidum). Neurological conditions disturbing the natural defense mechanism, prolonged hospital stay, and exposure to multiple antibiotic regimens are risk factors for difficult-to-treat eye infections with multidrug-resistant bacteria. Some ocular conditions can be the reason that leads to HIV infection diagnosis, while others can appear during the time, especially in patients with low ART adherence. The prognostic is conditioned by the early recognition and correct management of the disease and the immunological status recovery under ART. Correct and early diagnosis of HIV-related eye conditions is mandatory to establish the most appropriate medical management to obtain an increase in the quality of life of the patient. HIV = Human Immunodeficiency Virus, AIDS = Acquired Immunodeficiency Syndrome, ART = Antiretroviral Therapy.
管理人类免疫缺陷病毒/获得性免疫缺陷综合征（艾滋病）（PLWHA）患者仍然是各医学领域医生面临的挑战。合并感染的存在，伴有不同程度的免疫系统损害，需要对 PLWHA 采取多学科方法。在本文中，我们介绍了 3 例患有各种眼科疾病的 PLWHA 患者，他们被收入“Matei Balș”国家传染病研究所（INBIMB）。他们中的 3 人是最近才被诊断出艾滋病的晚期患者。这 3 人都处于免疫病毒学失败状态。眼科状况要么与 HIV 感染有关，要么是其他并发症的结果。PLWHA 眼部受累的多样性和复杂性与患者在眼科评估时的免疫状态密切相关。因此，抗逆转录病毒治疗（ART）在恢复免疫状态方面发挥了重要作用。所遇到的眼部疾病各不相同，有些是由病毒直接引起的，有些是机会性感染（巨细胞病毒、水痘病毒）或其他合并感染（苍白密螺旋体）的结果。影响自然防御机制的神经状况、住院时间延长和暴露于多种抗生素方案是导致耐多药细菌感染难以治疗的危险因素。一些眼部疾病可能是导致 HIV 感染诊断的原因，而另一些则可能在治疗过程中出现，尤其是在 ART 依从性低的患者中。预后取决于疾病的早期识别和正确管理以及 ART 下免疫状态的恢复。正确和早期诊断与 HIV 相关的眼部疾病对于制定最合适的医疗管理方案以提高患者的生活质量至关重要。HIV = 人类免疫缺陷病毒，AIDS = 获得性免疫缺陷综合征，ART = 抗逆转录病毒治疗。
