Retinal microangiopathy in human immunodeficiency virus infection is related to higher human immunodeficiency virus-1 load in plasma.
OBJECTIVE
To evaluate the prevalence of retinal microangiopathy in human immunodeficiency virus (HIV)-1-infected patients and its association with virologic, immunologic, and sociodemographic parameters.


METHODS
Single-center cross-sectional study.


METHODS
One hundred eighty-eight HIV-1-positive individuals from a single outpatient clinic.


METHODS
Human immunodeficiency virus-positive patients were screened for signs of HIV-associated retinal angiopathy. Plasma HIV-1 RNA and CD4-positive cell counts were monitored within 3 months of the ophthalmologic assessment. The absence or presence of angiopathy or of opportunistic viral retinitis was then correlated to data respecting CD4-positive cell count, plasma viral load of HIV-1, and sociodemographic parameters.


METHODS
Association between CD4-positive cell count, HIV-1 plasma viral load, sociodemographic parameters, and the manifestation of retinal microangiopathy.


RESULTS
At the baseline consultation, 130 (69%) patients exhibited no retinal pathologic features, 45 (24%) manifested retinal angiopathy, and 13 (7%) had opportunistic viral retinitis. In univariate analysis, retinal angiopathy was associated with lower CD4-positive cell count and higher HIV-1 plasma viral load. In a multivariate logistic model, the presence of retinal microangiopathy was associated with higher age (P = 0.02) and higher viral load of HIV-1 (P < 0.005), but not with lower CD4 cell counts (P > 0.05).


CONCLUSIONS
Human immunodeficiency virus-associated retinal microangiopathy is likely a multifactorial condition. Its presence is associated with higher age and higher replication of HIV-1 as measured by plasma HIV-1 RNA levels. In contrast to opportunistic infectious retinitis, the degree of immunodeficiency does not seem to be independently correlated with retinal angiopathy.
Furrer
Hansjakob
H
Division of Infectious Diseases, University Hospital Bern, Inselspital PKT2 B, CH-3010 Bern, Switzerland. hansjakob.furrer@insel.ch
Barloggio
Antonio
A
Egger
Martin
M
Garweg
Justus G
JG
D000328:Adult; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D003430:Cross-Sectional Studies; D015828:Eye Infections, Viral / Q000097:blood / Q000821:virology*; D005260:Female; D005434:Flow Cytometry; D015658:HIV Infections / Q000097:blood / Q000821:virology*; D015497:HIV-1 / Q000302:isolation & purification / Q000502:physiology*; D006801:Humans; D008297:Male; D015995:Prevalence; D012367:RNA, Viral / Q000097:blood*; D012171:Retinal Vessels / Q000473:pathology*; D012173:Retinitis / Q000097:blood / Q000821:virology*; D019562:Viral Load; D014779:Virus Replication
D012367:RNA, Viral