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Related Experiment Videos

Microsporidial keratoconjunctivitis after HAART.

A D Gajdatsy1, M L Tay-Kearney

  • 1Royal Perth Hospital, Western Australia, Australia. gajdatsy@global.net.au

Clinical & Experimental Ophthalmology
|November 27, 2001
PubMed
Summary

Highly active antiretroviral therapy (HAART) can unmask opportunistic infections like corneal microsporidiosis in HIV patients. This case highlights the importance of considering immune reconstitution inflammatory syndrome in patients starting HAART.

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Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Immunology

Background:

  • Corneal microsporidiosis is an opportunistic infection that can affect immunocompromised individuals.
  • Highly Active Antiretroviral Therapy (HAART) has revolutionized HIV treatment but can sometimes lead to immune reconstitution inflammatory syndrome (IRIS).

Observation:

  • A 44-year-old HIV-positive man on HAART presented with bilateral punctate corneal epitheliopathy.
  • Initial lubricant therapy failed, and corneal biopsy confirmed microsporidiosis.
  • Despite HAART initiation, the patient remained anergic with an unchanged CD4 count, but showed a viral load decrease.

Findings:

  • The patient's ocular symptoms resolved completely with albendazole treatment.
  • The microsporidiosis was identified as a pre-existing opportunistic infection.

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  • The condition's presentation was linked to immune restoration induced by HAART.

    • Implications:

    • This case suggests that HAART can unmask pre-existing opportunistic infections, even without significant CD4 count changes.
    • Clinicians should consider IRIS in HIV patients presenting with new or worsening infections after starting HAART.
    • Prompt diagnosis and treatment of corneal microsporidiosis are crucial for visual recovery.