Thierfelder S, Linnert D
Universitäts-Augenklinik Würzburg.
Klin Monbl Augenheilkd. 1996 Mar;208(3):157-60. doi: 10.1055/s-2008-1035190.
The etiology of HIV-related retinal microangiopathy syndrome is yet unknown. Several authors postulate direct endothelial-cell infection, an immunocomplex vasculitis caused by HIV-related hypergammaglobulinemia or an increased serum concentration of endothelin as its origin.
118 patients infected by HIV-1 have been examined (CDC I: 1; CDC II: 42; CDC III: 7; CDC IV: 68). 49 out of them were also infected by hepatitis-C-virus (CDC I: 0; CDC II: 16; CDC III: 4; CDC IV: 29).
26 out of 49 patients with hepatitis-C-co-infection showed HIV-related retinal microangiopathy syndrome (CDC I: 0/0; CDC II: 8/16; CDC III: 2/4; CDC IV: 16/29). In 69 patients without hepatitis-C-infection, HIV-related retinal microangiopathy syndrome was found five times (CDC I: 0/1; CDC II: 2/26; CDC III: 0/3; CDC IV: 3/39).
Co-infection with hepatitis-C-virus is supposed to enhance the development of retinal microangiopathy syndrome in patients infected by HIV-1.
HIV相关视网膜微血管病变综合征的病因尚不清楚。几位作者推测其起源为内皮细胞直接感染、由HIV相关高丙种球蛋白血症引起的免疫复合物性血管炎或内皮素血清浓度升高。
对118例HIV-1感染者进行了检查(疾病控制中心I级:1例;疾病控制中心II级:42例;疾病控制中心III级:7例;疾病控制中心IV级:68例)。其中49例还感染了丙型肝炎病毒(疾病控制中心I级:0例;疾病控制中心II级:16例;疾病控制中心III级:4例;疾病控制中心IV级:29例)。
49例合并丙型肝炎感染的患者中有26例出现HIV相关视网膜微血管病变综合征(疾病控制中心I级:0/0;疾病控制中心II级:8/16;疾病控制中心III级:2/4;疾病控制中心IV级:16/29)。在69例未感染丙型肝炎的患者中,发现5例出现HIV相关视网膜微血管病变综合征(疾病控制中心I级:0/1;疾病控制中心II级:2/26;疾病控制中心III级:0/3;疾病控制中心IV级:3/39)。
合并丙型肝炎病毒感染可能会促进HIV-1感染者视网膜微血管病变综合征的发展。