HIV-induced Retinitis

ABSTRACT

Purpose

To provide an overview of the current knowledge on the Human Immunodeficiency Virus (HIV)-associated retinopathies.

Methods

A PubMed search was performed, using the key terms “HIV Retinopathy OR Retinitis” and “HIV AND Retinitis” to find manuscripts published within the last ten years.

Results

If left untreated, HIV infection causes a progressive immunodeficiency caused by depletion of CD4-positive T lymphocytes. Noninfectious HIV retinopathy, clinically manifested by cotton wool spots. Once the CD4 count drops below 200 c/μl, immunodeficiency creates a vulnerability for systemic opportunistic infections. Within the posterior segment of the eye, cytomegalovirus (CMV) retinitis has to be distinguished from infections with other members of the herpes virus family, as well as from toxoplasmosis, tuberculosis, and syphilis. Upon restoration of the immune system, immune recovery uveitis may manifest in one third of CMV affected eyes.

Conclusion

Targeted antiviral treatment and secondary recurrence prophylaxis prevent vision loss of the retina prior to immune recovery.

KEYWORDS:

• Viral retinitis
• cytomegalovirus
• CMV
• varicella-zoster virus
• VZV
• herpes simplex virus
• HSV
• HIV retinopathy
• HIV microangiopathy
• antivirals

Financial disclosures

The authors have neither financial nor other conflicts of interest with the data that are presented in this article.

Conflict of interest

JGG advises several pharmaceutical companies (Alcon, Allergan, Bayer, Novartis) and participates in a number of international, multicentre clinical studies that are sponsored by companies (Chengdu Kanghong, Novartis, and Bayer) active in the fields of AMD and diabetic retinopathy. These activities had no bearing on the study that gave rise to the submitted article for which JGG received neither direct nor indirect financial support; nor does he have any conflicts of interest regarding any of the presented data. In the last 12 months, JHK has served as DSMC Chair for Gilead Sciences, Inc. (California, USA), and has received grants/contracts from the National Institutes of Health, Sight, for Souls, and Christoffel Blindenmission. The other authors have no potential conflicts of interest to report.