HIV-infected individuals on long-term antiretroviral therapy are at higher risk for ocular disease

E Schaftenaar, N S Khosa, G S Baarsma, C Meenken, J A McINTYRE, A D M E Osterhaus, G M G M Verjans, R P H Peters

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Introduction of antiretroviral therapy (ART) has dramatically reduced the incidence of infectious ocular diseases in human immunodeficiency virus (HIV)-infected individuals. However, the effects of long-term ART and chronic HIV infection on the eye are ill-defined. This study determined the occurrence and severity of ocular diseases among 342 participants in a rural South African setting: HIV-naïve (n = 105), HIV-infected ART-naïve (n = 16), HIV-infected on ART for 36 months (long-term ART; n = 165). More HIV-infected participants presented with an external eye condition, in particular blepharitis, than HIV-naïve individuals (18% vs. 7%; age-adjusted odds ratio (aOR) = 2·8, P < 0·05). Anterior segment conditions (particularly keratoconjunctivitis sicca and pterygium) were also more common (50% vs. 27%; aOR = 2·4; P < 0·01). Compared with individuals on short-term ART, participants receiving long-term ART were more likely to have clinically detectable cataract (57% vs. 38%; aOR = 2·2, P = 0·01) and posterior segment diseases, especially HIV retinopathy (30% vs. 11%; aOR = 3·4, P < 0·05). Finally, long-term ART was significantly associated with presence of HIV retinopathy (P < 0·01). These data implicate that ocular disease is more common and of more diverse etiology among HIV-infected individuals, especially those on long-term ART and suggest that regular ophthalmological monitoring of HIV-infected individuals on ART is warranted.

Original languageEnglish
Pages (from-to)2520-2529
Number of pages10
JournalEpidemiology and Infection
Issue number12
Publication statusPublished - Sept 2017


  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Retroviral Agents/administration & dosage
  • Eye Diseases/epidemiology
  • Female
  • HIV Infections/drug therapy
  • Humans
  • Male
  • Middle Aged
  • Odds Ratio
  • Risk Factors
  • Rural Population
  • South Africa/epidemiology
  • Young Adult


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