HIV Digest	HIV Digest Archive

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Between 70% and 80% of HIV positive patients may experience one or more ocular disorders as a result of their disease.

Specific ocular disturbances most often reported to occur in HIV-infected patients are asymptomatic conjunctival microvascular changes in 70% to 80%; HIV retinopathy in 50% to 70%; Kaposi's sarcoma in 25%; and cytomegalovirus retinitis in 30% to 40% of patients in developed countries.

Disorders are likely to occur as the CD4+ T-lymphocyte count falls. However, in patients who have benefited from highly active antiretroviral therapy, "reconstituted" CD4+ T cells may not be protective. Thus, clinicians who use CD4+ T-cell counts to predict a patient's risk of ocular complications should probably consider the patient's lowest recorded count.

Healthcare providers should also watch for ocular toxicity in patients they are treating for opportunistic infections. Rifabutin and cidofovir, for example, have been associated with iridocyclitis, uveitis, and low intraocular pressure (hypotony). Mild uveitis responds to topical corticosteroids, but severe cases, as well as hypotony, can cause permanent damage, and the offending medication should be discontinued.

Editor's Note: from Clinician Reviews