title: Uveitis as an initial manifestation of acquired immunodeficiency syndrome.
abstract: Human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) is a multisystem disease that can involve the human eyes. Using ophthalmic examination records from January 2006 to November 2015, we retrospectively reviewed all patients who were diagnosed with HIV/AIDS in our hospital. The study was performed at a tertiary referral center in southern Taiwan. Data included age, gender, ophthalmic examinations, systemic conditions, CD4 cell counts, course, and treatment. Eleven patients were identified as having AIDS with uveitis as their presenting manifestation. All were men, with a mean age of 39.5 ± 11.4 years (range 24-56). The mean CD4+T-cell counts were 91.7 ± 50.3 cells/μl (range 27-169). Ocular diagnoses included cytomegalovirus (CMV) retinitis in five patients, ocular syphilis in four patients, and ocular toxoplasmosis in two patients. Uveitis resolved in all patients after medical treatment. However, a retinal detachment developed in two eyes in CMV retinitis and one eye in ocular syphilis. Ocular manifestations are among the most common clinical features in patients with HIV/AIDS who have varying clinical presentations that affect almost all ocular structures. This study demonstrated that ocular findings could be an initial manifestation of an underlying disease. Awareness of ocular lesions in HIV/AIDS is important for early recognition and management.
authors.affiliation: 1 Department of Ophthalmology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
authors.forename: Chui-Lien
authors.initials: CL
authors.lastname: Tsen
authors.affiliation: 1 Department of Ophthalmology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
authors.forename: Shih-Chou
authors.initials: SC
authors.lastname: Chen
authors.affiliation: 2 Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.|3 School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Yao-Shen
authors.initials: YS
authors.lastname: Chen
authors.affiliation: 1 Department of Ophthalmology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.|3 School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Shwu-Jiuan
authors.initials: SJ
authors.lastname: Sheu
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy / Q000209:etiology*; D000163:Acquired Immunodeficiency Syndrome; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D000998:Antiviral Agents / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D017726:Cytomegalovirus Retinitis / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013587:Syphilis / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D014126:Toxoplasmosis, Ocular / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D014605:Uveitis / Q000209:etiology*
chemical_list: D000998:Antiviral Agents
keywords: Acquired immunodeficiency syndrome; cytomegalovirus; human immunodeficiency virus; syphilis; uveitis