Ocular problems in Brazilian patients with AIDS before and in highly active antiretroviral therapy (HAART) era.

This study determined the total frequency of patients with AIDS and ophthalmologic problems before and after the introduction of combined highly active antiretroviral therapy (HAART), regardless of the use of this treatment; it also determined the frequency of external ocular diseases, intraocular infections and inflammations, and problems of the anterior portion of the optic nerve in these two groups of patients; and it determined the differences in the frequency of ophthalmologic problems in patients receiving HAART or not. This was a retrospective study of 207 patients examined using the same protocol, from June 1995 to February 1998 (n=58, pre-HAART era) and from March 1998 to May 2005 (n=149, HAART era). The frequency of ophthalmologic problems was significantly higher in the pre-HAART group, with a predominance of intraocular infections and inflammations. Comparison of patients receiving HAART or not revealed that ocular involvement tended to be reduced in the treated group and that treatment was effective in preventing infectious diseases; however, the prevalence of external ocular diseases was similar in the patients receiving HAART or not. As a consequence of HAART, we observed a reduction in the frequency of ocular problems, especially intraocular infections and inflammations. However, this benefic influence was less important in the ocular surface or in external ocular disease.

Ocular problems in brazilian patients with AIDS before and in highly active antiretroviral therapy (HAART) era

This study determined the total frequency of patients with AIDS and ophthalmologic problems before and after the introduction of combined highly active antiretroviral therapy (HAART), regardless of the use of this treatment; it also determined the frequency of external ocular diseases, intraocular infections and inflammations, and problems of the anterior portion of the optic nerve in these two groups of patients; and it determined the differences in the frequency of ophthalmologic problems in patients receiving HAART or not. This was a retrospective study of 207 patients examined using the same protocol, from June 1995 to February 1998 (n=58, pre-HAART era) and from March 1998 to May 2005 (n=149, HAART era). The frequency of ophthalmologic problems was significantly higher in the pre-HAART group, with a predominance of intraocular infections and inflammations. Comparison of patients receiving HAART or not revealed that ocular involvement tended to be reduced in the treated group and that treatment was effective in preventing infectious diseases; however, the prevalence of external ocular diseases was similar in the patients receiving HAART or not. As a consequence of HAART, we observed a reduction in the frequency of ocular problems, especially intraocular infections and inflammations. However, this benefic influence was less important in the ocular surface or in external ocular disease.

Estudo da síndrome da ceratoconjuntivite seca de pacientes soropositivos para o vírus da imunodeficiência adquirida humana tipo 1 e com síndrome da imunodeficiência adquirida, em uso ou não de terapia anti-retroviral combinada (HAART) / Study of keratoconjunctivitis sicca in patients infected with the human immunodeficiency virus type 1 and acquired immune deficiency syndrome, in use or not of highly active anti-retroviral therapy (HAART)

OBJETIVOS: Verificar a presença de olho seco e de alterações no epitélio conjuntival em pacientes com sorologia positiva para o HIV-1 e com AIDS; relacionar as eventuais alterações com as características e com outras condições oculares e sistêmicas dos pacientes; estudar a influência da terapia anti-retroviral combinada na ceratoconjuntivite seca (KCS), nos pacientes com AIDS. MÉTODOS: Foram estudados pacientes com confirmação laboratorial da infecção pelo HIV, divididos em 2 grupos: I. HIV+ (sem diagnóstico clínico e com contagem de CD4+ acima de 200 células/mm ) e II. pacientes com AIDS (contagem de CD4+ abaixo de 200 células e/ou manifestação clínica). Foram estudadas alterações oculares, dados laboratoriais, análise do filme lacrimal e estudo da citologia de impressão conjuntival. Método estatístico: qui-quadrado. RESULTADOS: Incluídos 43 pacientes do grupo I e 77 do grupo II. Após a introdução do HAART houve queda significativa das manifestações oculares internas; entretanto, o mesmo não ocorreu com as externas. Dos pacientes que apresentaram quadro clínico de olho seco, 65,1 por cento eram do sexo masculino. As alterações do teste de Schirmer e tempo de ruptura do filme lacrimal não estiveram relacionados com a gravidade da doença pelo HIV e nem com a contagem de CD4+.Todos os pacientes com alterações na citologia de impressão apresentavam KCS e 88,8 por cento pertenciam ao grupo II. Observou-se aumento da freqüência dessas alterações nos pacientes com tempo de doença superior a 4 anos. CONCLUSAO: O decréscimo da produção lacrimal não esteve relacionado com a gravidade da infecção pelo HIV e a introdução do HAART não interferiu na freqüência da síndrome de olho seco nos pacientes HIV positivos.