Intraocular and plasma HIV-1 RNA loads and HIV uveitis


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Abstract

Objective:The objective of this study was to analyze human immunodeficiency virus (HIV) dynamics across the blood–retinal barrier and to determine whether the high levels of HIV in the eye are associated with any ocular disorders in HIV-infected patients.Design:This study included a prospective case series of 40 HIV-positive patients with uveitis.Intervention:Clinical and laboratory examinations included plasma and intraocular HIV-1 RNA loads as well as the clinical manifestations of uveitis.Results:Intraocular HIV-1 RNA was detected in 32% (13/40) of HIV-positive patients with uveitis. Intraocular HIV-1 RNA loads were associated with high HIV-1 RNA plasma loads (P < 0.001) and not being on HAART therapy (P = 0.005). In addition, detectable intraocular HIV-1 RNA levels were higher in patients with the absence of retinal lesions (P = 0.008). In three patients, the HIV load in the eye largely exceeded that of plasma. These three patients had all bilateral anterior uveitis and/or vitritis without retinal lesions and exhibited no evidence of other intraocular infectious agents causing uveitis than HIV itself.Conclusion:The eye can form a sanctuary where HIV might replicate and cause an inflammatory reaction.

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