[Characteristics of ophthalmic symptoms in the 278 patients with human immunodeficiency virus].

OBJECTIVE: To investigate the characteristics of ophthalmic symptoms of patients with human immunodeficiency virus (HIV) and to provide reference for early diagnosis and treatment of HIV. METHODS: The clinical data of 278 patients with HIV, including ophthalmic symptoms and general condition collected from September 2002 to July 2004, were analyzed retrospectively. These patients were from the Central African Republic. RESULTS: Among the 278 patients with HIV, 102 had pathologic changes in the eyes and were accompanied with chronic dissipative symptoms and decreased CD4 cell counts. The pathogen of 278 patients with HIV at the initial reception were airway infection (n = 87, 31.3%), digestive tract infection (n = 65, 23.4%), skin symptoms (n = 55, 19.8%), multiple organ failure (n = 51, 18.4%) and ophthalmic symptoms (n = 20, 7.2%). Ophthalmic symptoms manifested as opportunistic infection and sarcoma formation, such as HIV retinopathy, chronic uveitis, external ophthalmoplegia, ocular herpes, and Kaposi's sarcoma in the eyelid. HIV-related retinopathy was not specific, which manifested as retinal hemorrhage, cotton wool spots, vascular occlusion, retinal necrosis, retinal detachment and ocular nerve atrophy. CONCLUSIONS: Many kinds of ophthalmic symptoms might appear in patients with HIV. Severe retinopathy and uveitis are the main causes of ablepsia. Because of neglecting the ophthalmic symptoms in the early stage, many HIV patients suffer from decreased visual acuity, which may severely affect the quality of their lives. Consequently, ophthalmologists should pay more attention to patients in the early stage of HIV.

Stevens-Johnson syndrome and toxic epidermal necrolysis in sub-Saharan Africa: a multicentric study in four countries.

OBJECTIVE: The purpose of this study was to document the clinical profile, etiologies, and outcomes of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) in hospitals in four sub-Saharan African countries. PATIENTS AND METHODS: A retrospective study on cases of SJS/TEN treated in dermatology departments and/or intensive care units in four sub-Saharan African countries (Benin, Burkina Faso, Central African Republic, and Togo) from 2000 to 2010. The study focuses on variables such as age, sex, type of SJS/TEN, epidermal detachment of the skin surface, HIV status, drug(s) involved, and outcomes (death and sequelae). RESULTS: This study identified 177 cases of SJS/TEN from 2000 to 2010: 129 with SJS; 37 TEN; and 11 overlapping SJS/TEN. The average age of patients was 32.3 ± 15.4 years, and the sex ratio (M/F) was 0.6. HIV serology was positive in 69 (54.8%) of the 126 patients tested. Antibacterial sulfonamides (38.4%) were the most commonly used drugs followed by nevirapine (19.8%) and tuberculosis drugs (5.6%). We recorded 22 deaths (i.e. six cases of SJS, 15 of TEN, and one of overlapping SJS/TEN). Of the 22 patients who died, 16 were infected with HIV; among them, seven had an opportunistic infection (four cases of cerebral toxoplasmosis and three of pulmonary tuberculosis). Twenty-seven cases of sequelae were noted with a large part of eye complications. CONCLUSION: This study has highlighted: (i) the high proportion of patients infected with HIV among patients who had SJS/TEN in sub-Saharan Africa; (ii) the high frequency of antiretroviral drugs as new SJS/TEN causes in sub-Saharan Africa; and (iii) the impact of HIV infection on morbidity and mortality of these affections.

Evaluation of the diethylcarbamazine patch to evaluate onchocerciasis endemicity in Central Africa.

OBJECTIVE: As part of a baseline data collection for assessing the impact of the African Programme for Onchocerciasis Control, to evaluate the diethylcarbamazine (DEC) patch test in determining the endemicity of onchocerciasis. METHOD: A total of 226 untreated children aged 3-5, living in four selected endemic foci, in Cameroon, Gabon and Central African Republic, were tested. Observed graded skin reactions to the patch were analysed and compared with the prevalence of onchocercal nodules and reactive skin disease in the corresponding community. RESULTS: The proportion of children who tested positive ranged from 25.0% to 77.1%. The values were closely correlated with the prevalence of nodules, i.e. the level of endemicity for onchocerciasis. CONCLUSION: The DEC patch test, which has been so far used only in West African foci of onchocerciasis, can also constitute a valuable tool to evaluate the levels of endemicity of onchocerciasis in Central Africa, and to follow-up the intensity of transmission of Onchocerca volvulus.

Human herpesvirus 8 serological markers and viral load in patients with AIDS-associated Kaposi's sarcoma in Central African Republic.

Epidemic Kaposi's sarcoma (KS) is one of the most frequent types of cancer in several African countries; however, very few data are available on human herpesvirus 8 (HHV-8) markers in KS patients from Central Africa. In a series of 36 AIDS-KS cases from Central African Republic, we showed, using a real-time PCR quantitative assay, the high frequency (82%) of detectable HHV-8 DNA in peripheral blood mononuclear cells (PBMCs). We also found that the level of antibodies directed against lytic or latent HHV-8 antigens is not correlated to the amount of HHV-8 viral load in the PBMCs, and finally, we demonstrated a much higher viral load in tumoral skin lesions (6.07 log copies/mug DNA) than in unaffected skin (2.93 log copies/mug DNA) or in PBMCs (2.55 log copies/mug DNA).