A survey of eye disease in a high risk HIV group - Commercial Sex Workers in Majengo Nairobi, Kenya

Abstract

Introduction: HIV infection is an important cause of morbidity and mortality worldwide. It has several associated eye afflictions, many leading to blindness. The study was done to determine the prevalence and magnitude of eye disease in a group at high risk for HIV: the Majengo commercial sex worker (CSW) cohort. Previous studies done have not examined high risk groups. This study was done to determine the prevalence of such effects and see if high risk people differ from the normal population. Method: A cross sectional survey was done in the CSW clinic at Majengo, Nairobi. This is an open cohort of CSWs on follow-up by the department of Microbiology, University ofNairobi. The study period was between November 2003 and December 2003. Results: There are over 600 CSWs on regular follow-up at the Majengo clinic. 151 subjects aged between 21 years and 56 years were examined.l07 were Kenyan, 40 Tanzanian, 3 Ugandan and 1 Rwandese. 72 were HIV +ve and 79 were HIV -ve. Only 13.9 % of the HIV+ve CSWs examined were on HAART. The prevalence of general eye disease in the HIV+ve andmv negative subsets was 86.1% and 69.6% respectively. . The prevalence of HIV related eye illnesses in the HIV+ve CSWs was 18.1% with choroidal lesions being the most common. Profound .immw10deficiency characterized by a CD4 count less than 50 was observed in 4 CSWs. While 3 of these CSWs were assymptomatic, one had a retinal hemorrhage and tortuous blood vessels suggestive of HIV retinopathy. Discussion: Studies done in non-high risk groups found prevalence of HIV related eye illness ranging between 30-80%. The lower prevalence in the C.S.W cohort can be attributed to the fact that some members of this cohort have special immunity to HIV as characterized by HIV specific cytotoxic Tvlymphocytes and genital mucosal antibodies. Thus, a close follow-up is needed to document ocular findings in these CSWs at regular intervals.