HIV/AIDS in ophthalmic patients: The Guinness Eye Centre Onitsha experience.
OBJECTIVE
To determine the incidence and pattern of ocular problems of HIV/AIDS at the Guinness Eye Centre Onitsha, Nigeria.


METHODS
The case files of all patients who had HIV test at the Guinness Eye Centre Onitsha over a 6-year period were examined. Those who tested positive for HIV were further analysed. Information obtained included patients' demographic characteristics, clinical diagnosis, ocular and systemic co-morbidity, visual acuity and follow-up.


RESULTS
Of 1011 patients, 100 (9.9%), 51 males and 49 females, were confirmed HIV-positive. The age range was 21 - 80 years; median -31 years. Fifty-five patients (55%) were or had been married; 45 (45%) were single. Herpetic eye disease constituted 50% of the cases with herpes zoster ophthalmicus accounting for 48%. Bilateral ocular disease occurred in 19 patients (19%) viz: cytomegalovirus (CMV) retinitis (6%); corneal ulcers (6%); uveitis (4%); ocular motor palsy (2%) and ocular gunshot injury (1%). Non-HIV ocular lesions occurred in 20 patients (20%) as follows: bacterial corneal ulcer (8%); globe laceration (6%); non-CMV associated rhegmatogenous retinal detachment, cataract, and secondary orbital tumour (2% each). Systemic co-morbidities were present in 10 patients (10%), namely, emaciation (6%), pulmonary tuberculosis and abdominal malignancy with orbital metastases (2% each). Twenty three patients (23%) had bilateral blindness; 45 (45%) had uniocular blindness; 73.4% of the affected eyes were blind at presentation with 25% having no light perception (NPL).


CONCLUSIONS
The incidence of HIV seropositivity doubled in the hospital over nearly 10-year period. Herpes zoster ophthalmicus remains the commonest ocular manifestation although CMV retinitis is becoming common. Since 20% of the patients had non-HIV ocular lesions, eye-health workers are advised to always take universal precautions in order to prevent the spread of the infection within and outside the hospital.
Nwosu
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Guinness Eye Center Onitsha Nigeria. sabenwosu@yahoo.com
D017088:AIDS-Related Opportunistic Infections / Q000150:complications / Q000453:epidemiology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005128:Eye Diseases / Q000150:complications* / Q000453:epidemiology*; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006563:Herpes Zoster Ophthalmicus / Q000150:complications / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D012164:Retinal Diseases / Q000150:complications / Q000453:epidemiology