HIV-infected individuals on long-term antiretroviral therapy are at higher risk for ocular disease

ntroduction of antiretroviral therapy (ART) has dramatically reduced the incidence of infectiousocular diseases in human immunodeficiency virus (HIV)-infected individuals. However, the effectsof long-term ART and chronic HIV infection on the eye are ill-defined. This study determinedthe occurrence and severity of ocular diseases among 342 participants in a rural South Africansetting: HIV-naïve (n= 105), HIV-infected ART-naïve (n= 16), HIV-infected on ART for <12months (short-term ART;n= 56) and HIV-infected individuals on ART for >36 months (long-term ART;n= 165). More HIV-infected participants presented with an external eye condition,in particular blepharitis, than HIV-naïve individuals (18%vs. 7%; age-adjusted odds ratio(aOR) = 2·8,P< 0·05). Anterior segment conditions (particularly keratoconjunctivitis sicca andpterygium) were also more common (50%vs. 27%; aOR = 2·4;P< 0·01). Compared withindividuals on short-term ART, participants receiving long-term ART were more likely to haveclinically detectable cataract (57%vs. 38%; aOR = 2·2,P= 0·01) and posterior segment diseases,especially HIV retinopathy (30%vs. 11%; aOR = 3·4,P< 0·05). Finally, long-term ART wassignificantly associated with presence of HIV retinopathy (P< 0·01). These data implicate thatocular disease is more common and of more diverse etiology among HIV-infected individuals,especially those on long-term ART and suggest that regular ophthalmological monitoring ofHIV-infected individuals on ART is warranted

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