Cataract may occur earlier in AIDS patients

The results of this prospective cohort study suggest that cataract may occur earlier in AIDS patients free of ocular opportunistic infections than in the general population.

The researchers enrolled 1,606 participants (3,212 eyes) between 1998 and 2008 who had AIDS and were 13 years of age or older and free of ocular opportunistic infections.

Of these participants, 1.9% were observed to have cataract or prior cataract surgery. Among the 2,812 eyes initially free of cataract and followed longitudinally (median follow-up, 4.6 years), the incidence of cataract was 0.37%/eye-year.

In addition to age, significant risk factors for cataract included prior cataract in the contralateral eye, anterior segment inflammation, prior retinal detachment and vitreous inflammation. Detectable HIV RNA in peripheral blood was associated with lower risk of cataract at enrollment but not of incident cataract. The age-specific prevalence and incidence of cataract in this AIDS cohort was higher than in one of two population-based studies with similar definitions of cataract.

The authors conclude that while the relationship between cataract risk and age was similar qualitatively to that observed in the general population, the prevalence of cataract was higher when compared with age-matched HIV-uninfected populations. The study’s results are consistent with the hypothesis of accelerated aging in AIDS patients.