Evaluation of ocular manifestations and blindness in HIV/AIDS patients on HAART in a tertiary care hospital in western India.

BACKGROUND: HIV has various ocular manifestations and with the widespread introduction of highly active antiretroviral therapy (HAART), their pattern and prevalence is expected to change. Therefore, we evaluated the HIV/AIDS patients on HAART for ocular manifestations and blindness.
METHODS: In this cross-sectional study, 112 HIV-positive patients on HAART presenting to the HIV clinic with CD4 count <or=200 cells/microl were enrolled. The WHO clinical stage, CD4 count, duration of HIV and HAART were recorded. An ocular examination was conducted, and the prevalence of ocular manifestations and blindness was determined.
RESULTS: The prevalence of ocular manifestations in HIV/AIDS patients on HAART was 8% (nine out of 112). Seven (6%) of the patients had visual impairment including one patient with blindness. The ocular manifestations included HIV retinopathy (5%), immune recovery uveitis (3%), immune recovery vitritis (3%) and Cytomegalovirus retinitis (2%). The prevalence of ocular manifestations and visual impairment was higher with the CD4 count of 0-100 cells/microl (p = 0.002). The prevalence of ocular manifestations was also higher in patients with WHO clinical stages 3 and 4 (p = 0.017).
CONCLUSIONS: HAART may be the cause for decline in the prevalence of ocular diseases and visual impairment in HIV/AIDS patients. CD4 count and WHO clinical stage may help predict their occurrence.