Miscellaneous ophthalmic conditions related to low CD4 cell count in HIV-positive patients

TL;DR

This paper discusses various eye conditions in HIV-positive patients with low CD4 cell counts, emphasizing the importance of early diagnosis and treatment for better outcomes.

Contribution

The study highlights the link between low CD4 cell counts and diverse ophthalmic conditions in HIV-positive patients, emphasizing the role of ART in recovery.

Findings

Ocular conditions in HIV-positive patients are closely tied to their immunological status.

Opportunistic infections like cytomegalovirus and Varicella virus contribute to eye complications in these patients.

Early diagnosis and ART adherence improve prognosis and quality of life in HIV-related eye conditions.

Abstract

Introduction: 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.

Methods: 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.

Discussion: 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.

Conclusions: 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.

Abbreviations: HIV = Human Immunodeficiency Virus, AIDS = Acquired Immunodeficiency Syndrome, ART = Antiretroviral Therapy

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