Alisi Ludovico, Armentano Marta, Visioli Giacomo, Mingaine Mpekethu Sam, Albanese Giuseppe Maria, Lucchino Luca, Bruscolini Alice
Department of Sense Organs, Sapienza University of Rome, Rome, Italy.
AINA Children's Home, Meru Town, Kenya.
Clin Ophthalmol. 2025 Jul 8;19:2143-2151. doi: 10.2147/OPTH.S530332. eCollection 2025.
Human Immunodeficiency Virus (HIV) remains a global health concern, particularly in Africa. Highly Active Antiretroviral Therapy (HAART) has transformed HIV into a manageable chronic condition, but potential side effects, including ocular manifestations, are recognized. While ophthalmic complications in the pre-HAART era are well-documented, the current landscape in perinatally acquired HIV requires further investigation. This study aims to report the prevalence of ocular involvement in a cohort of children with perinatally acquired HIV.
This cross-sectional study recruited 73 HIV-positive and 59 HIV-negative age-matched children in Kenya. All HIV+ children were on HAART. Comprehensive ophthalmological examinations included visual acuity, stereopsis, ocular motility assessment, tear film tests (BUT, Schirmer, Oxford staining), corneal esthesiometry, and an ocular allergy questionnaire. Clinical data on HIV parameters and HAART regimens were collected for the HIV+ group.
Visual acuity was comparable between groups. Both groups' ocular surface parameters (BUT, Schirmer, Oxford score) were within normal limits. Ocular allergy prevalence was similar, but HIV+ children reported fewer symptoms (p=0.030). Strabismus was significantly more frequent in the HIV+ group (24.7% vs 8.5%, p=0.015), particularly in patients in treatment with abacavir (p=0.026). No significant correlation was found between HIV-related parameters and ocular surface findings.
This study suggests that in the HAART era, perinatally HIV-infected children with well-managed viral loads show visual function and largely normal ocular surface health, contrasting with pre-HAART literature. The increased frequency of strabismus in HIV+ children and its potential association with abacavir warrant further investigation into HAART-related ocular motility side effects.
人类免疫缺陷病毒（HIV）仍然是一个全球健康问题，在非洲尤为如此。高效抗逆转录病毒疗法（HAART）已将HIV转变为一种可控制的慢性病，但包括眼部表现在内的潜在副作用已得到认识。虽然HAART时代之前的眼科并发症已有充分记录，但围产期感染HIV的当前情况需要进一步研究。本研究旨在报告一组围产期感染HIV儿童的眼部受累患病率。
这项横断面研究在肯尼亚招募了73名HIV阳性和59名年龄匹配的HIV阴性儿童。所有HIV阳性儿童均接受HAART治疗。全面的眼科检查包括视力、立体视、眼球运动评估、泪膜测试（泪液分泌试验、Schirmer试验、牛津染色）、角膜感觉测量和眼部过敏问卷。收集HIV阳性组关于HIV参数和HAART方案的临床数据。
两组之间的视力相当。两组的眼表参数（泪液分泌试验、Schirmer试验、牛津评分）均在正常范围内。眼部过敏患病率相似，但HIV阳性儿童报告的症状较少（p = 0.030）。HIV阳性组斜视明显更常见（24.7%对8.5%，p = 0.015），特别是在接受阿巴卡韦治疗的患者中（p = 0.026）。未发现HIV相关参数与眼表检查结果之间存在显著相关性。
本研究表明，在HAART时代，病毒载量得到良好控制的围产期感染HIV的儿童视觉功能良好，眼表健康在很大程度上正常，这与HAART时代之前的文献形成对比。HIV阳性儿童斜视频率增加及其与阿巴卡韦的潜在关联值得进一步研究HAART相关的眼球运动副作用。
