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REVIEW ARTICLE
Year : 2020  |  Volume : 68  |  Issue : 9  |  Page : 1787-1798

Human immunodeficiency virus and intraocular inflammation in the era of highly active anti retroviral therapy – An update


1 Department of Uveitis, Medical Research Foundation, Chennai, Tamil Nadu, India
2 André Luiz Land Curi, National Institute of Infectious Diseases - INI/ Fiocruz; Clinical Research Laboratory of Infectious, Diseases in Ophthalmology - INI / Fiocruz, Brazil
3 Banker's Retina Clinic and Laser Centre, Ahmedabad, Gujarat, India
4 Department of Ophthalmology, Massachusetts Eye and Ear and Harvard Medical School; Schepens Eye Research Institute, Boston, Massachusetts, USA; MCM Eye Unit, MyungSung Christian Medical Center (MCM) General Hospital and MyungSung Medical College, Addis Ababa, Ethiopia

Correspondence Address:
Dr. Sridharan Sudharshan
Medical Research Foundation, 18, College Road, Sankara Nethralaya, Chennai - 600 006, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_1248_20

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Intraocular inflammation in patients with human immunodeficiency virus (HIV) infection is commonly due to infectious uveitis. Ocular lesions due to opportunistic infections (OI) are the most common and have been described extensively in the pre highly active antiretroviral therapy (HAART) era. Many eye lesions were classified as acquired immunodeficiency syndrome (AIDS) defining illnesses. HAART-associated improvement in immunity of the individual has changed the pattern of incidence of these hitherto reported known lesions leading to a marked reduction in the occurrence of ocular OI. Newer ocular lesions and newer ocular manifestations of known agents have been noted. Immune recovery uveitis (IRU), the new menace, which occurs as part of immune recovery inflammatory syndrome (IRIS) in the eye, can present with significant ocular inflammation and can pose a diagnostic and therapeutic challenge. Balancing the treatment of inflammation with the risk of reactivation of OI is a task by itself. Ocular involvement in the HAART era can be due to the adverse effects of some systemic drugs used in the management of HIV/AIDS. Drug-associated retinal toxicity and other ocular side effects are being increasingly reported. In this review, we discuss the ocular manifestations in HIV patients and its varied presentations following the introduction of HAART, drug-associated lesions, and the current treatment guidelines.


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