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International Journal of STD & AIDS

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Int J STD AIDS 2008;19:4-11
doi:10.1258/ijsa.2007.005666
© 2008 Royal Society of Medicine Press

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REVIEW - CONTINUING EDUCATION (CPD)

What you can see in your patient's eyes? Review of ocular manifestations of HIV in HAART era

A Nasoodi MD MRCP *, L T Lim MRCSEd (Ophth) {dagger}, A Al-Ani FRCSG (Ophth) {dagger}, S Quah MRCP MRCOG * and W W Dinsmore MD FRCP {dagger}

* Genitourinary Department, Royal Victoria Hospital, Belfast BT12 6BA; {dagger} Tennent Institute of Ophthalmology, Glasgow, UK

Correspondence to: Dr A Nasoodi Email: a.nasoodi{at}ntlworld.com

The early diagnosis and treatment of ocular disease to prevent morbidity and mortality of patients with human immunodeficiency virus (HIV) is of paramount importance. Since the advent of highly active antiretroviral therapy (HAART), the incidence of ocular complications of HIV has decreased and their manifestations and natural course are also modified. This has been observed in the face of emerging immune recovery, which per se has brought new difficulties in the process of diagnosing and management of the ocular disease. Conditions such as immune recovery uveitis could affect eyes with history of opportunistic disease with a potential to cause vision loss; with this regard, differentiation of the inflammatory process from infective causes is essential. The other sexually contracted diseases are also to be included in this complex picture because of their contribution to the clinical picture and also sharing common routes of transmission with HIV. There is very little doubt that visual deterioration would further deteriorate the already compromised quality of life of this group of patients. In this review, authors wish to provide evidence available in the medical literature around the visual health issues in HIV-infected patients and raise awareness towards the changing pattern of the ocular disease in the HAART era.

Key Words: HIV • eye • immune reconstitution syndrome • cytomegalovirus (CMV) • HAART • ophthalmopathy • HSV • uveitis • syphilis • toxoplasmosis • Kaposi's sarcoma


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