Comparison and correlation of ophthalmic and systemic manifestations with respect to CD4 counts in HIV infected adults

  • Dr. Dinesh R B. Consultant, Department of Vitreo Retina, Karnataka Institute of Endocrinology and Research (Autonomous institute of Dept of Medical Education, Govt of Karnataka), SJICR campus, Jayanagar 9th block, Bangalore, India
  • Dr. Krishna R Murthy Consultant , Vitreo retina, Prabha Eye Clinic and Research centre, Jayanagar 8th block, Bangalore, India
  • Dr. K. R. Murthy Consultant, Prabha Eye Clinic and Research centre, Jayanagar 8th block, Bangalore, Karnataka, India
Keywords: CD4 counts, Pulmonary TB, CMV retinitis, HIV retinopathy

Abstract

Purpose: To compare and correlate ophthalmic and systemic manifestations with respect to CD4 counts in HIV infected adults.

Materials and Methods: In a prospective clinical study, 182 HIV positive patients were evaluated for their ophthalmic findings. All patients underwent complete ophthalmic examination including detailed history, best corrected visual acuity, slit lamp examination, indirect ophthalmoloscopy and +90D lens biomicroscopy. Fundus photographs were taken in patients with ocular manifestations. Routine blood tests including total and differential count, Hb levels, erythrocyte sedimentation rate, erythrocyte and platelet counts were done. Serologic tests (ELISA for IgM antibody) for toxoplasma, cytomegalovirus was done in clinically suspicious cases. VDRL, and chest x-ray was performed in cases suspected to have syphilis and tuberculosis respectively.

Results: 182 patients were examined, 65.9% male and 34.1% being female patients. Most common systemic manifestation was pulmonary TB (39.1%) (p <0.001), second common being oral candidiasis (16.5%) (p <0.001) followed by abdominal TB (15.5%). Also, 37.9% patients had ocular lesions out of which 15.4% had HIV retinopathy, second common was CMV retinitis(9.3%) followed by HIV optic neuropathy(3.8%). 34.1% had CD4<100, 44% between 01-100 and 22% had CD4 >200. . Twenty five % of patients with pulmonary TB had HIV retinopathy and 12% with pulmonary TB had CMV retinitis. Among the 30 oral candidiasis patients 8(26.6%) developed HIV retinopathy, where as 10% developed CMV retinitis. Fifty seven % of patients with HIV retinopathy had CD4<100, 28.6% with CD4 between 101-200 and 14.3% with CD4 >200. Similarly 47.1% with CMV retinitis had CD4 <100, 52.9% had CD4 101-200. None with CD4 >200 developed CMV retinitis.

Conclusions: Study shows an increased prevalence of systemic diseases along with ocular diseases with decreased CD4 counts, particularly <100. Pulmonary TB is seen more frequently with CD4<200 and is also seen to be associated increasingly with ocular manifestations and more so when CD4 <100.

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Comparison and correlation of ophthalmic and systemic manifestations with respect to CD4 counts in HIV infected adults
CITATION
DOI: 10.17511/ijmrr.2017.i06.01
Published: 2017-06-30
How to Cite
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R B. D, R Murthy K, Murthy KR. Comparison and correlation of ophthalmic and systemic manifestations with respect to CD4 counts in HIV infected adults. Int J Med Res Rev [Internet]. 2017Jun.30 [cited 2024Mar.29];5(6):538-46. Available from: https://ijmrr.medresearch.in/index.php/ijmrr/article/view/878
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