Uveitis in human immunodeficiency virus-infected persons with CD4+ T-lymphocyte count over 200 cells/mL
Uveitis in human immunodeficiency virus-infected persons with CD4+ T-lymphocyte count over 200 cells/mL
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DOI：
10.1111/ceo.12141
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发表时间：
2014-03-01
影响因子：
4
通讯作者：
Smith, Justine R.
中科院分区：
文献类型：
--
作者：
Rose-Nussbaumer, Jennifer;Goldstein, Debra A.;Smith, Justine R.
背景高效抗逆转录病毒治疗的引入通过升高CD 4 + T淋巴细胞水平改变了人类免疫缺陷病毒感染者的病程。一般医学文献中报道了人类免疫缺陷病毒阳性个体遇到的全身性疾病谱的变化。设计回顾性病例系列。当外周血CD 4 + T淋巴细胞计数超过200个细胞/μ L时出现葡萄膜炎的患者。主要指标葡萄膜炎的标准化、解剖学分类和描述、葡萄膜炎的病因和视力。结果外周血CD 4 + T细胞计数在207和1777之间（中位数？=？421)细胞/μ L。葡萄膜炎在解剖学上分为前葡萄膜炎（47.5%）、中间葡萄膜炎（6.6%）、前/中间葡萄膜炎（16.4%）、后葡萄膜炎（14.8%）和泛葡萄膜炎（14.8%）。葡萄膜炎的具体原因包括感染（34.4%），其中梅毒占所有病例的16.4%，以及明确的免疫系统疾病（27.0%）; 34.4%的人没有确定炎症的原因。93眼中66.7%的患者视力高于6/15，11.8%的患者视力低于6/60，随访1年时，34只眼中有82.4%的患者视力优于6/15，8.8%的患者视力低于6/60。感染性葡萄膜炎发生在感染了人免疫缺陷病毒并保持或恢复了外周CD 4 + T细胞水平的个体中。人类免疫缺陷病毒阳性并存在葡萄膜炎的个体应该以评估所有葡萄膜炎患者的相同方式进行评估。
BackgroundIntroduction of highly active antiretroviral therapy has altered the course of disease for persons infected with human immunodeficiency virus by elevating CD4+ T-lymphocyte levels. Changes in the spectrum of systemic diseases encountered in human immunodeficiency virus-positive individuals are reported in the general medical literature.DesignRetrospective case series.ParticipantsSixty-one individuals infected with human immunodeficiency virus, who presented with uveitis when the peripheral CD4+ T-lymphocyte count was over 200 cells/mu L.MethodsStandardized data collection at seven tertiary-referral inflammatory eye disease clinics.Main Outcome MeasuresStandardization of Uveitis Nomenclature anatomic classification and descriptors, cause of uveitis, and visual acuityResultsPeripheral CD4+ T cell counts varied between 207 and 1777 (median?=?421) cells/mu L at the time of diagnosis of uveitis. Uveitis was classified anatomically as anterior (47.5%), intermediate (6.6%), anterior/intermediate (16.4%), posterior (14.8%) and pan (14.8%). Specific causes of uveitis included infections (34.4%), with syphilis responsible for 16.4% of all cases, and defined immunological disorders (27.0%); no cause for the inflammation was identified in 34.4% of persons. Visual acuity was better than 6/15 in 66.7% and 6/60 or worse in 11.8% of 93 eyes at presentation, and better than 6/15 in 82.4% and 6/60 or worse in 8.8% of 34 eyes at 1 year of follow-up.ConclusionsBoth infectious and non-infectious forms of uveitis occur in individuals who are infected with human immunodeficiency virus and have preserved or restored peripheral CD4+ T cell levels. Individuals who are human immunodeficiency virus-positive and present with uveitis should be evaluated in the same way all patients with uveitis are assessed.