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Human immunodeficiency virus disease: changing patterns of intraocular inflammation
1National Eye Institute, National Institutes of Health, Bethesda, Maryland 20892, USA. rnq@helix.nih.gov
Purpose:
To evaluate and put into perspective five articles in this issue of the AMERICAN JOURNAL OF OPHTHALMOLOGY that discuss ocular inflammatory disorders in patients with human immunodeficiency virus (HIV) disease.
Methods:
We drew upon recent observations concerning the effect of HIV disease on the immune system in an attempt to understand the current reports describing intraocular inflammation.
Results:
Intraocular inflammation appears to be dependent on several factors, including specific antigenic stimuli and the state of the host immune system. During dynamic changes in these factors, conditions may arise that favor inflammatory reactions. Use of antiretroviral therapies is one mechanism that can effect these dynamics.
Conclusions:
As the immune system equilibrates at one extreme or the other (depletion or reconstitution), conditions favoring inflammation appear to dissipate. Restoration of immune function by the use of combination antiretroviral therapy, including protease inhibitors, may lead to additional cases of transient intraocular inflammation in the future.