Uveitis in human immunodeficiency virus-infected persons with CD4+ T-lymphocyte count over 200 cells/mL

Jennifer Rose-Nussbaumer, Debra Goldstein, Jennifer Thorne, Tiago Arantes, Nisha Acharya, Akbar Shakoor, Bennie Jeng, S Yeh, Hassan Rahman, G Vemulakonda, C Flaxel, Sarah West, Gary Holland, Justine Smith

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    Abstract

    Background: Introduction of highly active antiretroviral therapy has altered the course of disease for persons infected with human immunodeficiency virus by elevating CD4+ T-lymphocyte levels. Changes in the spectrum of systemic diseases encountered in human immunodeficiency virus-positive individuals are reported in the general medical literature. Design: Retrospective case series. Participants: Sixty-one individuals infected with human immunodeficiency virus, who presented with uveitis when the peripheral CD4+ T-lymphocyte count was over 200cells/μL. Methods: Standardized data collection at seven tertiary-referral inflammatory eye disease clinics. Main Outcome Measures: Standardization of Uveitis Nomenclature anatomic classification and descriptors, cause of uveitis, and visual acuity Results: Peripheral CD4+ T cell counts varied between 207 and 1777 (median=421) cells/μL at the time of diagnosis of uveitis. Uveitis was classified anatomically as anterior (47.5%), intermediate (6.6%), anterior/intermediate (16.4%), posterior (14.8%) and pan (14.8%). Specific causes of uveitis included infections (34.4%), with syphilis responsible for 16.4% of all cases, and defined immunological disorders (27.0%); no cause for the inflammation was identified in 34.4% of persons. Visual acuity was better than 6/15 in 66.7% and 6/60 or worse in 11.8% of 93 eyes at presentation, and better than 6/15 in 82.4% and 6/60 or worse in 8.8% of 34 eyes at 1 year of follow-up. Conclusions: Both infectious and non-infectious forms of uveitis occur in individuals who are infected with human immunodeficiency virus and have preserved or restored peripheral CD4+ T cell levels. Individuals who are human immunodeficiency virus-positive and present with uveitis should be evaluated in the same way all patients with uveitis are assessed.

    Original languageEnglish
    Pages (from-to)118-125
    Number of pages8
    JournalClinical and Experimental Ophthalmology
    Volume42
    Issue number2
    DOIs
    Publication statusPublished - 2014

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    Rose-Nussbaumer, J., Goldstein, D., Thorne, J., Arantes, T., Acharya, N., Shakoor, A., Jeng, B., Yeh, S., Rahman, H., Vemulakonda, G., Flaxel, C., West, S., Holland, G., & Smith, J. (2014). Uveitis in human immunodeficiency virus-infected persons with CD4+ T-lymphocyte count over 200 cells/mL. Clinical and Experimental Ophthalmology, 42(2), 118-125. https://doi.org/10.1111/ceo.12141