Eye diseases in a high HIV-risk group; the Majengo commercial sex workers in Nairobi, Kenya

Abstract

Objective: To determine the prevalence and magnitude of eye disease in a group at high risk for HIV: the Majengo commercial sex worker (CSW) cohort and see how it differs from the general population. Design: Cross sectional study Setting: Commercial sex workers (CSW) clinic, Majengo slums, Nairobi in November and December 2003. Subjects: An open cohort of CSWs on follow-up by the department of Microbiology, University of Nairobi. Results: There are over 600 CSWs on regular follow-up at the Majengo clinic. 151 aged between 21 years and 56 years were examined. 107 were Kenyan, 40 Tanzanian, 3 Ugandan and 1 Rwandese. 72 were HIV +ve and 79 were HIV –ve. 13.9 % of the HIV+ve CSWs examined were on HAART. The prevalence of general eye disease in the HIV+ve and HIV 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 immunodefi ciency 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. Conclusion: In this C.S.W cohort HIV specifi c cytotoxic T-lymphocytes and genital mucosal antibodies may have caused the lower prevalence of ocular manifestations than that reported in studies in non-high risk groups (30-80%). Some members of this cohort have special immunity to HIV.