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HIV and Its Ocular Manifestations

We’ve covered a number of sexually transmitted diseases (STDs) recently across Media MICE’s various publications with conditions ranging from herpes to syphilis, and indeed they have become synonymous with your current writer (for better or worse). Now you know us, we like to keep things light and whimsical and maintain a certain level of irreverence throughout our content — it’s just our style. We can kind of get away with it when it comes to most STDs as there’s something objectively absurd about them, even as serious as the implications of the diseases are.

But when it comes to HIV however, that’s perhaps not the tone we want to take, as the disease is still one of only two ongoing epidemics at the moment (we’re pretty sure you can guess what the other one is…). HIV is no longer a completely fatal condition of course, and with proper treatment, most patients will live long lives relatively free of complications (of which there are many). That, of course, depends on being able to access effective treatment, but even with access to the best antiretroviral treatment available, ocular manifestations can still present themselves.

The Eye and HIV

Ocular manifestations of HIV is a term that is going to immediately grab the attention of the editing team, so let’s take a look into the issue. First of all, what exactly is the prevalence of HIV-associated ocular manifestations? According to Ocular Manifestation and Their Associated Factors Among HIV/AIDS Patients Receiving Highly Active Antiretroviral Therapy in Southern Ethiopia, a study was carried out at Hawassa University Referral Hospital, the level of ocular manifestations amongst a group of 240 students was 14.2%.1

What is particularly interesting to note is that there seems to be a change underway in the rate of ocular manifestations in HIV patients. According to Ethiopian researchers, “there has been a dramatic change in the pattern and prevalence of HIV-related ocular manifestation from region to region. The prevalence is more predominant in Sub-Saharan Africa where an absolute majority of HIV/AIDS patients live.”

However, it’s important to note this picture in the context of the introduction of highly active antiretroviral therapy (HAART) in the 1990s, which dramatically reduced the rates of ocular manifestations of HIV. In Ethiopia alone, the occurrence of ocular manifestation in general has decreased from 60% in the pre-HAART era to less than 25.7% in the HAART era. Kudos indeed, therefore, that the Hawassa University Referral Hospital researchers have observed a roughly 10% drop in manifestations!

Now onto the meat of the matter for Media MICE, that being the most commonly associated ocular manifestations of HIV. Since the introduction of HAART treatment, retinal microvasculopathy, keratoconjunctivitis sicca, squamoid conjunctival growth, conjunctival squamous cell carcinoma, uveitis, ophthalmic herpes zoster, seborrheic blepharitis and Molluscum contagiosum have been the most common ocular manifestations. So, if we know the complications to look out for in HIV patients, at what rate can we expect them?

Who’s got what exactly?

Let’s check out another study from Ethiopia, only this time from the other side of the country. Predictors of HIV/AIDS-Related Ocular Manifestations among HIV/AIDS Patients in Felege Hiwot Referral Hospital, Northwest Ethiopia was carried out by researchers based at the aforementioned medical facility. This particular piece of research offers real and considerable insight into the specific rates of some ocular manifestations.

In their own pool of 370 patients, this second group of researchers found that 25.4% of the participants had a history of eye problems and overall, 89.5% reported normal visual acuity. The most frequent ocular manifestations were squamoid conjunctival growth (26.9%) and ophthalmic herpes zoster (22.1%). Molluscum contagiosum (0.7%) and vernal conjunctivitis (0.7%) were among the less frequent ocular manifestations.2

The point we’d like to conclude on here however, is not more insight from either of these interesting studies but rather to comment on the relative lack of research into these subjects. Sure, there are papers on the ocular manifestations of HIV as you can see, but not nearly as many as we’d like —  as surely they would help patient outcomes. Therefore if you should decide to launch a study yourself, then do please drop us a line.

References

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