Clinical characteristics of a group of HIV patients with ocular lesions

Abstract

Abstract Background: The study was to analyze HIV dynamics across BRB and the relevant risk factors for HIV-associated ocular complications. Methods: This study included a prospective case series of 40 HIV-positive patients with ocular lesions. Clinical and laboratory examinations included plasma and intraocular VL were evaluated. Results: HIV VL on paired aqueous/plasma samples was available for 40 patients. Aqueous VL was negatively associated with ART duration (p = 0.02 and p < 0.05), plasma VL was independent of ART duration (p = 0.53). An aqueous/plasma discordance was found in 19/40 (47.5%) patients, eight of whom (20%) had detectable aqueous VL despite a suppressed plasma VL (escape). There were significant differences in CD4+ T-lymphocyte levels (p=0.012 and p < 0.05) and ART duration (p=0.007 and p < 0.05) between the patients with HIV-associated ocular complications and the patients without. Conclusion: This study provides rationale for initiating ART early in the course of infection to reduce HIV VL in the aqueous humor, and raises the possibility of the ocular sanctuary where HIV replicate. Meanwhile, early and standard ART would be optimal option to protect against ocular opportunistic infection. Trial registration: Participants enrolled in the research signed informed consent and the study was approved by the institutional ethics committee of Huashan Hospital affiliated with Fudan University (protocol number: KY2021-837).