Title:New Insights into Ocular Complications of Human Immunodeficiency Virus Infection
Volume: 19
Issue: 6
Author(s): Luoziyi Wang, Xin Che, Jing Jiang, Yiwen Qian and Zhiliang Wang*
Affiliation:
- Department of Ophthalmology, Huashan Hospital, Fudan University, 12, Middle Urumqi Road, Shanghai, 200040,China
Keywords:
Human Immunodeficiency Virus (HIV), ocular opportunistic infections, highly active antiretroviral therapy, ocular
manifestations, incidence rate, HIV reservoir.
Abstract: HIV/AIDS continues to be a major global public health issue, affecting multiple organs,
such as the eyes. With the advent of Highly Active Antiretroviral Therapy (HAART), the incidence
has dropped but HIV ocular complications still remain a major cause of vision impairment in HIVpositive
individuals. Since modern medical interventions nowadays can change this previously fatal
infection into a chronic disease and enable people living with HIV for relatively long and
healthy lives, recent studies update the incidence of HIV-related ocular manifestations, which has
reached 70% among HIV patients. The primary ocular disorders induced by HIV are various and
the clinical ocular findings are similar, which may be a problem to diagnose in the setting of disease.
In our discussion, these complications are classified by etiology, for example noninfectious
microvasculopathy resulting from direct invasion of the HIV, HIV-associated opportunistic infections
caused by a virus, such as cytomegalovirus and varicella-zoster virus, fungus for example,
candida and cryptococcus, bacteria like mycobacterium, parasites, such as toxoplasma and pneumocystis,
and other pathogens, and infiltration lesions like lymphoma and Kaposi sarcoma. In order to
get a better understanding of HIV ocular complications, we focus on HIV-related ocular complications
in the HAART era with an emphasis on current incidence, clinical manifestations, ocular examination
findings, differential diagnosis, treatment, and prognosis. In addition, we discuss the possibility
of virus reservoir in the eyes, which makes HIV-related oculopathy still ubiquitous even after
successful systemic treatment.