Ocular findings in HIV-l and HIV-2 patients in Cote d'Ivoire; West Africa

Abstract

A cross sectional study was conducted to describe ocular findings in HIV -1 and HIV-2 patients attending the HIV clinic at Dabou Mission Hospital in Cote Ivoire (West Africa). The objective was to determine the prevalence and pattern of ocular findings among HIV-I, HIV-2 and dually infected patients. Methods: All HIV positive patients more than 2 years old with a CD4 count, attending the HIV clinic during the study period were enrolled. The following clinical examinations were done; visual acuity, anterior segment and posterior segment with a slit lamp and fundus examination with dilated pupils. Data was collected using a questionnaire and analyzed using SPSS version 12.0. A significance level of95% was used. Result: A total of 397 HIV positive patients were enrolled in the study; 279 females (70%) and 118 males (30%). The distribution of the study population by HIV type was as follows: HIV-I, 332 patients (84%); HIV-2, 17 (4%) and dually infected 48 (12%). The prevalence of HI V related eye disease was 34.3% in HIV-I group, 47.1% in HIV-2 group and 50% in the dually infected group. The difference was not statistically significant. The prevalence of ocular findings was 42.8% while the prevalence of HIV related eye disease was 36.8%. The mean absolute CD4 count was higher in HIV-2 patients (386 cells/mm3) followed by dually infected patients (295.9 cells/mrn) and HIVI group (231.28 cells/mm3). There was more adnexal HIV related eye disease (29.5%) than anterior segment (\.8%) and posterior segment (11.1 %). HIV retinopathy was more in HIV-2 (17.6%) than HIV-I (5.7%) and HIV-I&2 (4.2%). However this was not statistically significant. CMV retinitis was seen only in HIV-I (1.8%) and dual infection (4.2%). Conclusion: A relatively low prevalence of HIV related eye disease noted may be due to the fact that 75% of the study group was on HAART. The level ofCD4 count plays a more important role in the development of ocular morbidity than the type of HIV.