Keratoconjunctivitis sicca in female patients infected with human immunodeficiency virus.

We recently reported keratoconjunctivitis sicca (KCS) occurring as a single entity in approximately 20% of male patients testing positive for human immunodeficiency virus (HIV). In a subsequent study of HIV-positive females (n = 59; age range: 23 to 42 years), ten were found to have clinical signs and symptoms of KCS. The Schirmer test without anesthetic was performed on these patients, as well as on ten HIV negative females in the same age range. Reported as mean +/- 1 standard deviation, the result of the Schirmer test was 5.6 +/- 4.1 mm of wetting in the HIV-positive group, and 15.6 +/- 7.8 mm of wetting in the control group. The mean tear osmolarity test value of the HIV-positive patients was 318.8 +/- 9.5 mOsm/L, with 18 of the 20 suspect eyes testing positive for KCS. The tear osmolarity value among the female control patients was 304.1 +/- 5.9 mOsm/L, with one of the 20 eyes testing positive for KCS. We conclude from the data that KCS occurs at a significantly greater rate in HIV positive females than in the general population.