Current Research on HIV/AIDS (ISSN: 2575-7105)

research article

Risk Factors for Premature Nuclear Cataract Formation in Human Immunodeficiency Virus (HIV) Infected Individuals Receiving Antiretroviral Therapy

Megan K Morales1,4, Linda Nabha1, Brian Toussaint2, Richard Teran1, Jillian E Raybould1, W Vanessa Fan3, Princy N Kumar1, Shmuel Shoham4, Michael Summerfield2, Joseph G Timpone1 

1Division of Infectious Diseases, MedStar Georgetown University Hospital.

2Washington Eye Institute, MedStar Washington Hospital Center.

3Department of Internal Medicine, MedStart Georgetown University Hospital.

4Transplant and Oncology Infectious Diseases, Johns Hopkins University.

*Corresponding author: Megan K. Morales, MD, Division of Infectious Diseases, MedStar Georgetown University Hospital, 3800 Reservoir Rd, NW, 5-PHC. Tel: 202-444-0086; Fax 877-665-8072; Email: megan.k.morales@gunet.georgetown.edu.

Received Date: 08 December, 2016; Accepted Date: 26 December, 2016; Published Date: 02 January, 2017

Background

Antiretroviral therapy (ART) has resulted in a dramatic decrease in AIDS-associated morbidity and mortality including ocular opportunistic infections. However, despite its advantages, the use of ART has been associated with metabolic and end organ dysfunction, with ocular complications remaining ill-defined in this group.

Methods – A retrospective chart review was performed in an outpatient HIV clinic to include all patients receiving ART who had ophthalmologic evaluation between January 2006 to November 2010. All had a CD4 count and HIV viral load within six months preceding or 1 month after the visit. The selected charts were evaluated for demographic information, ocular diagnosis and any medical comorbidities.

Statistical analysis identified independent variables in patients with and without cataracts.  Unadjusted and adjusted prevalence odd ratios and 95% confidence intervals were calculated for correlates associated with nuclear cataracts.

Findings

A total of 102 patients were identified, the majority of whom (80%) were African American and had a median CD4 count of 441 cells/µL. 41.2% (42/102) were diagnosed with nuclear cataracts while infectious etiologies were low. Comorbidities significantly associated with cataract diagnosis included hypertension (p<0.0283), diabetes mellitus (p<0.0249), and HIV retinopathy (p<0.0490). There was no statistically significant association between ART regimen, CD4 count or race with the development of nuclear cataracts. Cataract development was 15-fold higher than the general US population amongst patients aged 40-49 years.

Interpretation

Premature nuclear cataract formation is common amongst HIV-infected persons receiving ART and may warrant more regular ophthalmologic evaluation in this patient group.

 


Copyright and Licensing: This is an Open Access Journal Article Published Under Attribution-Share Alike CC BY-SA: Creative Commons Attribution-Share Alike 4.0 International License. With this license readers can share, distribute, download, even commercially, as long as the original source is properly cited. Read More.