title: Retinal Structure and Function in Perinatally HIV-Infected and cART-Treated Children: A Matched Case-Control Study.
abstract: OBJECTIVE
  Subtle structural and functional neuroretinal changes have been described in human immunodeficiency virus (HIV)-infected adults without retinitis treated with combination antiretroviral therapy (cART). However, studies on this subject in HIV-infected children are scarce. This study aimed to assess the presence of (neuro)retinal functional and structural differences between a group of perinatally HIV-infected children on cART and age-, sex-, ethnicity-, and socioeconomically matched healthy controls.
  
  
  METHODS
  All participants underwent an extensive ophthalmological examination, including functional tests as well as optical coherence tomography, to measure individual retinal layer thicknesses. Multivariable mixed linear regression models were used to assess possible associations between HIV status (and other HIV-related parameters) and ocular parameters, while accounting for the inclusion of both eyes and several known confounders.
  
  
  RESULTS
  Thirty-three HIV-infected children (median age 13.7 years [interquartile range (IQR), 12.2-15.8], median CD4+ T-cell count 760 cells/mm3, 82% with an undetectable HIV viral load [VL]), and 36 controls (median age 12.1 years [IQR, 11.5-15.8]) were included. Contrast sensitivity (CS) was significantly lower in the HIV-infected group (1.74 vs. 1.76 logCS; P = 0.006). The patients had a significantly thinner foveal thickness (-11.2 μm, P = 0.012), which was associated with a higher peak HIV VL (-10.3 μm per log copy/mL, P = 0.016).
  
  
  CONCLUSIONS
  In this study, we found a decrease in foveal thickness in HIV-infected children, which was associated with a higher peak VL. Longitudinal studies are warranted to confirm our findings and to determine the course and clinical consequences of these foveal changes.
authors.affiliation: Department of Ophthalmology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Nazli
authors.initials: N
authors.lastname: Demirkaya
authors.affiliation: Department of Pediatric Hematology, Immunology, and Infectious Diseases, Emma Children's Hospital, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Sophie
authors.initials: S
authors.lastname: Cohen
authors.affiliation: Department of Global Health, Academic Medical Center, University of Amsterdam, and Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands 4Department of Internal Medicine, Division of Infectious Diseases, Center for Infection an.
authors.forename: Ferdinand W N M
authors.initials: FW
authors.lastname: Wit
authors.affiliation: Department of Ophthalmology and Visual Sciences, Stephen A. Wynn Institute for Vision Research, University of Iowa, Iowa City, Iowa, United States 6Department of Biomedical Engineering and Department of Electrical and Computer Engineering, University of I.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Abramoff
authors.affiliation: Department of Ophthalmology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands 8Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands.
authors.forename: Reinier O
authors.initials: RO
authors.lastname: Schlingemann
authors.affiliation: Department of Pediatric Hematology, Immunology, and Infectious Diseases, Emma Children's Hospital, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Taco W
authors.initials: TW
authors.lastname: Kuijpers
authors.affiliation: Department of Global Health, Academic Medical Center, University of Amsterdam, and Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands 4Department of Internal Medicine, Division of Infectious Diseases, Center for Infection an.
authors.forename: Peter
authors.initials: P
authors.lastname: Reiss
authors.affiliation: Department of Pediatric Hematology, Immunology, and Infectious Diseases, Emma Children's Hospital, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Dasja
authors.initials: D
authors.lastname: Pajkrt
authors.affiliation: Department of Ophthalmology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands 10Department of Biomedical Engineering and Physics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Frank D
authors.initials: FD
authors.lastname: Verbraak
mesh_terms: D000293:Adolescent; D023241:Antiretroviral Therapy, Highly Active; D016022:Case-Control Studies; D002648:Child; D003118:Color Perception / Q000502:physiology; D015350:Contrast Sensitivity / Q000502:physiology; D005260:Female; D005584:Fovea Centralis / Q000502:physiology; D015658:HIV Infections / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009412:Nerve Fibers / Q000502:physiology; D012160:Retina / Q000473:pathology / Q000503:physiopathology*; D014786:Vision Disorders / Q000503:physiopathology; D014794:Visual Fields / Q000502:physiology