Molluscum contagiosum, involving the upper eyelids, in a child infected with HIV-1.
BACKGROUND
Infection with molluscum contagiosum has been reported in pediatric and adult patients with acquired immune deficiency syndrome (AIDS), but rarely affecting eyelids. We have studied the viral phenotype, HIV-1 plasma viremia, p24 antigenemia, alterations of cellular immune function, and the ophthalmological status in a 5-year old human immunodeficiency virus type 1 (HIV-1)-infected girl, who developed multiple molluscum lesions, bilaterally involving upper eyelids with extension over the face and nose.


METHODS
Detailed ophthalmological examination and immunological and virological studies were performed in a pediatric patient with HIV-1 vertical infection having extensive infection with molluscum contagiosum.


RESULTS
The pediatric patient was emetropic; tricomegalia was present bilaterally, and alteration of the microvessels of the conjunctiva (microangiopathy) was observable in both eyes and structural (fibrilar) degeneration of the vitreous architecture in both eyes. There was no ophthalmoscopic sign of infectious retinitis or retinal microangiopathy. She had lymphopenia, very low percentage and absolute number of CD4+ T cells but increased percentage of CD8+ T cells. The in vitro lymphocyte proliferative response to phytohemagluttinin (PHA) was depressed as compared to healthy controls. She had high levels of viral HIV RNA in her plasma and of p24 antigen in her serum, and the phenotype of the isolated HIV-1 was determined to be syncytium-inducing (SI).


CONCLUSIONS
Although healthy persons may develop molluscum contagiosum, usually unilateral, as far as we are aware this report is the first to document a case of molluscum contagiosum with bilateral eyelid involvement in an HIV-1-infected pediatric patient. Our observations suggest that this type of infection may be present in HIV-infected children, associated with high viral load and possibly an SI viral phenotype, severe immunoregulatory abnormalities, and poor clinical status.
Peláez
C A
CA
Division of Ophthalmology, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid.
Gurbindo
M D
MD
Cortés
C
C
Muñoz-Fernández
M A
MA
D017088:AIDS-Related Opportunistic Infections / Q000821:virology*; D002675:Child, Preschool; D017679:Cryotherapy; D005141:Eyelid Diseases / Q000628:therapy / Q000821:virology*; D005260:Female; D015497:HIV-1 / Q000145:classification; D006801:Humans; D008976:Molluscum Contagiosum / Q000628:therapy / Q000821:virology*; D012008:Recurrence; D012703:Serotyping; D019562:Viral Load