Prevalence of ocular manifestations of HIV/AIDS among patients attending adult infectious disease centre(AIDC)of excellence at the University Teaching Hospital in Lusaka,Zambia

Abstract

Prevalence of ocular manifestations of HIV/AIDS among patients attending Adult Infectious Disease Centre (AIDC) of excellence at UTH, Lusaka. HIV and AIDS related ocular manifestations may affect 50-75% of HIV positive patients at some point in the course of their illness. Zambia has an HIV prevalence rate of 13.0%. This study was conducted in order to establish the prevalence and types of ocular manifestations in HIV/AIDS patients. This study was undertaken in order to determine the prevalence of ocular manifestations of HIV/AIDS in patients attending AIDC at UTH in Lusaka Zambia as well as to establish the types and categorize the HIV/AIDS ocular manifestations. Hospital based cross-sectional study. Adult Infectious Disease Centre (AIDC) of excellence at UTH, Lusaka. A total of 385 HIVAIDS patients attending routine clinic at the AIDC were randomly sampled and enrolled for the study. Patient’s medical records were used to obtain information on age, sex, HIV stage and CD4-T cell count. Ophthalmic examination included visual acuity assessment, anterior segment examination with slit-lamp biomicroscope and posterior segment examination using indirect ophthalmoscope and with the help of a 20D lens. Histopathological examinations were conducted on the specimen excised from patients who had conjunctival growths that were suspicious for Squamous Cell Carcinoma (SCC). The Statistical Package for Social Scientists (SPSS) version 22 was used to store and analyze the data. Inferential statistics was performed and a p<0.05 was considered significant. Ethical approval was obtained from UNZA Biomedical Research and Ethics Committee. The prevalence of ocular manifestations in this study was 74.0%. Out of the 385 participants (64.0%) were female and (36.0%) were males. Three hundred and Seventy Three 373 (96.9%) participants were on HAART for an average period of 7.8 months. A total of 211 (54.8%) participants had CD4 T-cell count ≥ 350 cells/μL, 79 (20.5%) had CD4 T- cell count between 200-350, and 88 (22.9%) had CD4 T-cell count below 200 cells/μL.

The most common ocular manifestations were anterior segment seen in 89.6% which included Keratoconjunctivitis sicca 50.4% and conjunctival microvasculopathy 27.5%. Other manifestations were, retinal microvasculopathy, 8.8%, and uveitis, 6.0%. Cytomegalovirus (CMV) retinitis was noted in 2.1% of the patients and it was the cause of blindness in 1.6% of the participants. Age above 40 years was associated with an increase in the prevalence of ocular manifestations with a p-value of 0.000288. The prevalence of ocular manifestations of HIV/AIDS at AIDC of excellence at UTH was 74.0%. These included anterior segment manifestations, 89.6%, posterior segment, 13.5%, adnexae, 6.0% and neuro-ophthalmic manifestations, 2.2%. In terms of specificity, the most common ocular manifestations noted were keratoconjunctivitis sicca, conjunctival microvasculopathy, retinal microvasculopathy, cataracts and uveitis.