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Published on: September 20, 2021
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Corneal Involvement in HIV-infected Individuals
Naveen Radhakrishnan1, Derrick Smit2, N Venkatesh Prajna1
1Cornea and Refractive Surgery, Aravind Eye Care System, Madurai, India.
Ocular Immunology and Inflammation
|July 7, 2021
Summary
Corneal diseases in individuals with human immunodeficiency virus (HIV) are typically infectious, including viral, bacterial, fungal, and protozoal infections. Non-infectious causes and severe presentations also warrant suspicion of HIV.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Immunology
Background:
- Corneal involvement is a significant clinical manifestation in individuals with human immunodeficiency virus (HIV).
- These manifestations can be broadly categorized into infectious and non-infectious etiologies, with infectious causes being more prevalent.
- Recognizing specific presentations is crucial for early diagnosis of underlying HIV infection.
Purpose of the Study:
- To review and highlight the spectrum of corneal diseases in HIV-infected individuals.
- To differentiate between infectious and non-infectious causes of corneal pathology in this population.
- To identify clinical signs that should prompt suspicion of HIV infection.
Main Methods:
- Review of literature on corneal manifestations in HIV-infected patients.
- Classification of corneal diseases into infectious (viral, bacterial, fungal, protozoal) and non-infectious categories.
- Discussion of specific pathogens and conditions relevant to HIV-associated ocular disease.
Main Results:
- Infectious keratitis is the predominant form, with herpes simplex virus being a common viral cause.
- Bacterial keratitis can be caused by Staphylococcus epidermidis, Staphylococcus aureus, Pseudomonas aeruginosa, and others.
- Fungal keratitis is geographically dependent, while Microsporidia and Acanthamoeba are notable protozoal causes.
- Non-infectious causes include peripheral ulcerative keratitis, keratoconjunctivitis sicca, and conjunctival squamous cell carcinoma.
- Unusually severe or minimally reactive corneal presentations may indicate immunosuppression.
Conclusions:
- Corneal diseases in HIV-infected individuals encompass a wide range of infectious and non-infectious conditions.
- Prompt recognition of specific infectious agents and inflammatory patterns is essential for timely diagnosis and management.
- Ocular findings, particularly severe or atypical keratitis, can serve as an important clinical clue to undiagnosed or progressing HIV infection.
