title: Clinical manifestations of human immunodeficiency virus-induced uveitis.
abstract: OBJECTIVE
  To describe the clinical manifestations of patients with human immunodeficiency virus (HIV)-induced uveitis in Thailand.
  
  
  METHODS
  Prospective cohort study of 6 patients with HIV-induced uveitis.
  
  
  METHODS
  Six patients (8 eyes) with HIV-induced uveitis who had an extremely high intraocular: plasma HIV-1 RNA ratio.
  
  
  METHODS
  The clinical manifestations and laboratory findings are reported of 6 consecutive patients with HIV-induced uveitis who had an extremely high intraocular-to-plasma HIV-1 RNA ratio and were diagnosed between July 2009 and May 2011.
  
  
  METHODS
  Clinical manifestations and laboratory findings.
  
  
  RESULTS
  Human immunodeficiency virus-induced uveitis was diagnosed in 4 men and 2 women with an average age of 41 years at presentation. None of the patients were receiving highly active anti-retroviral therapy (HAART) or had clinical or laboratory evidence, or both, of opportunistic infections. The mean plasma load was 218 688 copies/ml (median, 137 500 copies/ml; range, 24 900-540 000 copies/ml), and the mean intraocular HIV load was 20 937 755 copies/ml (median, 7 499 000 copies/ml; range, 2 460 000-89 800 000 copies/ml). The average CD4 cell count was 192 cells/μl (median, 248 cells/μl; range, 5-342 cells/μl). All the patients had decreased vision, and none had conjunctival hyperemia. The anatomic location of uveitis was anterior in all patients, and associated vitreitis was present in 4 patients; none exhibited retinal lesions or scars. Anterior segment inflammation and keratic precipitates were observed in all patients, and none responded to topical corticosteroid therapy. After the administration of HAART, the intraocular inflammation disappeared entirely within several weeks in all of the patients and the intraocular and plasma HIV loads decreased.
  
  
  CONCLUSIONS
  Human immunodeficiency virus-induced uveitis should be suspected in HAART-naïve, HIV-positive patients or in those in whom this treatment fails and who have anterior uveitis without any retinal lesions and exhibit no response to topical corticosteroids. The concurrent determination of HIV load in the intraocular fluids and plasma may clarify the cause of HIV-associated uveitis.
authors.affiliation: Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. pkunavis@mail.med.cmu.ac.th
authors.forename: Paradee
authors.initials: P
authors.lastname: Kunavisarut
authors.forename: Wasna
authors.initials: W
authors.lastname: Sirirungsi
authors.forename: Kessara
authors.initials: K
authors.lastname: Pathanapitoon
authors.forename: Aniki
authors.initials: A
authors.lastname: Rothova
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D015828:Eye Infections, Viral / Q000175:diagnosis* / Q000821:virology; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000821:virology; D015497:HIV-1 / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood; D060888:Real-Time Polymerase Chain Reaction; D014606:Uveitis, Anterior / Q000175:diagnosis* / Q000821:virology; D019562:Viral Load
chemical_list: D012367:RNA, Viral