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A recent study reports some good news for young patients with perinatally acquired HIV: Those who receive highly active antiretroviral therapy (HAART) and survive into adolescence may avoid the ocular diseases typically found in adults with chronic HIV.1 In the United States, most children affected by perinatal HIV receive HAART; this has been the care standard since 1999.
Eye findings in young HIV patients. The study by Tina Rutar, MD, and colleagues found that when HAART treatment results in long-term survival in these patients, most are likely to avoid cytomegalovirus (CMV) retinitis, HIV retinopathy, and keratoconjunctivitis sicca into their teen years and possibly beyond. Dr. Rutar is a pediatric ophthalmologist with the Cataract and Laser Institute, Medford, Ore.; at the time of the study, she was associate professor of ophthalmology and pediatrics at the University of California, San Francisco (UCSF), where the study was performed.
The researchers examined 22 patients, treated at the UCSF pediatric HIV clinic, who had survived to age 12 years or older (range, 12-23 years) to determine whether they had ophthalmic manifestations of HIV. All but one of the patients had a CD4 count of at least 200 cells/μL, and five had an AIDS-defining illness. Surprisingly, the researchers found no CMV retinitis or HIV retinopathy, little vision-threatening disease, and generally good visual acuity (mean best-corrected visual acuity, 20/22).
Unanswered questions. In an unexpected result, “We did find that 18 percent of these patients had strabismus, which is higher than the general U.S. prevalence,” said Dr. Rutar. “Also, we noted that, worldwide, the visual health of millions of children with perinatally acquired HIV is likely to be impacted by whether they receive early, intensive treatment that enables long-term survival. Both questions warrant further study.”
—Mary Wade
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1 Rutar T et al. Br J Ophthalmol. 2014 Nov. 21. [Epub ahead of print.] doi:10.1136/bjophthalmol-2014-305557.
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Dr. Rutar reports no related financial interests.
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