Ocular problems in AIDS
Kestelyn, P.
International Ophthalmology 14(3): 165-172
1990
ISSN/ISBN: 0165-5701 PMID: 2188917 DOI: 10.1007/bf00158314Document Number: 373205
In the late 1980s, HIV seroprevalence in Rwanda stood at 17.8% in urban areas and 1.3% in rural areas. Adult symptoms of AIDS are generally different than those of children. For example, worldwide, the most prevalent symptom (about 50% of patients) of HIV infection among adults is cotton wool spots, fluffy white superficial retinal lesions. In a sample of 110 seropositive children in Rwanda, however, cotton wool spots' prevalence was very low (.9%). Further, 20-40% of all AIDs patients worldwide experience small retinal hemorrhages (.8% for 110 seropositive children in Rwanda), an advanced stage of microvasculopathy, 8% of the children had other microvascular conditions. Researchers have isolated HIV in the aqueous humor of 3 patients in Rwanda with retinal perivasculitis indicating that it may contribute to this disease's etiology. Moreover, 46% of the Rwandan children with AIDs experienced perivasculitis and/or sheathing. HIV has also been found in tears, the conjunctiva, the cornea, the retinal vascular endothelium, and from multiple ocular tissues. Even though cytomegalovirus retinitis is the leading opportunistic infection (26%- 40%) of the eye and the major cause of blindness among AIDS patients in Europe and the US, it only appeared in 5% of AIDS patients in a Rwandan study. Physicians have found herpes simplex keratitis to be more resistant to treatment and recurred more often in AIDS patients than in immunocompetent patients. They have also learned that other infectious diseases of the eyes manifest themselves differently between the 2 groups. Kaposi's sarcoma, B-cell lymphoma, and squamous cell carcinoma are often present in patients with AIDS.
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