Uveitis in human immunodeficiency virus-infected persons with CD4+ T-lymphocyte count over 200 cells/mL

Jennifer Rose-Nussbaumer, Debra A. Goldstein, Jennifer E. Thorne, Tiago E. Arantes, Nisha R. Acharya, Akbar Shakoor, Bennie H. Jeng, Steven Yeh, Hassan Rahman, G. Atma Vemulakonda, Christina Flaxel, Sarah K. West, Gary N. Holland, Justine R. Smith

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background: Introduction 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. Design: Retrospective case series. Participants: Sixty-one individuals infected with human immunodeficiency virus, who presented with uveitis when the peripheral CD4+ T-lymphocyte count was over 200cells/μL. Methods: Standardized data collection at seven tertiary-referral inflammatory eye disease clinics. Main Outcome Measures: Standardization of Uveitis Nomenclature anatomic classification and descriptors, cause of uveitis, and visual acuity Results: Peripheral CD4+ T cell counts varied between 207 and 1777 (median=421) cells/μL 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. Conclusions: Both 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.

Original languageEnglish (US)
Pages (from-to)118-125
Number of pages8
JournalClinical and Experimental Ophthalmology
Volume42
Issue number2
DOIs
StatePublished - 2014

Fingerprint

Uveitis
CD4 Lymphocyte Count
HIV
T-Lymphocytes
Visual Acuity
Eye Diseases
Highly Active Antiretroviral Therapy
Syphilis
Terminology
Referral and Consultation
Outcome Assessment (Health Care)
Inflammation
Infection

Keywords

  • Acquired immunodeficiency syndrome
  • AIDS
  • HIV
  • Human immunodeficiency virus
  • Uveitis

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Rose-Nussbaumer, J., Goldstein, D. A., Thorne, J. E., Arantes, T. E., Acharya, N. R., Shakoor, A., ... Smith, J. R. (2014). Uveitis in human immunodeficiency virus-infected persons with CD4+ T-lymphocyte count over 200 cells/mL. Clinical and Experimental Ophthalmology, 42(2), 118-125. https://doi.org/10.1111/ceo.12141

Uveitis in human immunodeficiency virus-infected persons with CD4+ T-lymphocyte count over 200 cells/mL. / Rose-Nussbaumer, Jennifer; Goldstein, Debra A.; Thorne, Jennifer E.; Arantes, Tiago E.; Acharya, Nisha R.; Shakoor, Akbar; Jeng, Bennie H.; Yeh, Steven; Rahman, Hassan; Vemulakonda, G. Atma; Flaxel, Christina; West, Sarah K.; Holland, Gary N.; Smith, Justine R.

In: Clinical and Experimental Ophthalmology, Vol. 42, No. 2, 2014, p. 118-125.

Research output: Contribution to journalArticle

Rose-Nussbaumer, J, Goldstein, DA, Thorne, JE, Arantes, TE, Acharya, NR, Shakoor, A, Jeng, BH, Yeh, S, Rahman, H, Vemulakonda, GA, Flaxel, C, West, SK, Holland, GN & Smith, JR 2014, 'Uveitis in human immunodeficiency virus-infected persons with CD4+ T-lymphocyte count over 200 cells/mL', Clinical and Experimental Ophthalmology, vol. 42, no. 2, pp. 118-125. https://doi.org/10.1111/ceo.12141
Rose-Nussbaumer, Jennifer ; Goldstein, Debra A. ; Thorne, Jennifer E. ; Arantes, Tiago E. ; Acharya, Nisha R. ; Shakoor, Akbar ; Jeng, Bennie H. ; Yeh, Steven ; Rahman, Hassan ; Vemulakonda, G. Atma ; Flaxel, Christina ; West, Sarah K. ; Holland, Gary N. ; Smith, Justine R. / Uveitis in human immunodeficiency virus-infected persons with CD4+ T-lymphocyte count over 200 cells/mL. In: Clinical and Experimental Ophthalmology. 2014 ; Vol. 42, No. 2. pp. 118-125.
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abstract = "Background: Introduction 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. Design: Retrospective case series. Participants: Sixty-one individuals infected with human immunodeficiency virus, who presented with uveitis when the peripheral CD4+ T-lymphocyte count was over 200cells/μL. Methods: Standardized data collection at seven tertiary-referral inflammatory eye disease clinics. Main Outcome Measures: Standardization of Uveitis Nomenclature anatomic classification and descriptors, cause of uveitis, and visual acuity Results: Peripheral CD4+ T cell counts varied between 207 and 1777 (median=421) cells/μL 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. Conclusions: Both 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.",
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AU - Goldstein, Debra A.

AU - Thorne, Jennifer E.

AU - Arantes, Tiago E.

AU - Acharya, Nisha R.

AU - Shakoor, Akbar

AU - Jeng, Bennie H.

AU - Yeh, Steven

AU - Rahman, Hassan

AU - Vemulakonda, G. Atma

AU - Flaxel, Christina

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N2 - Background: Introduction 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. Design: Retrospective case series. Participants: Sixty-one individuals infected with human immunodeficiency virus, who presented with uveitis when the peripheral CD4+ T-lymphocyte count was over 200cells/μL. Methods: Standardized data collection at seven tertiary-referral inflammatory eye disease clinics. Main Outcome Measures: Standardization of Uveitis Nomenclature anatomic classification and descriptors, cause of uveitis, and visual acuity Results: Peripheral CD4+ T cell counts varied between 207 and 1777 (median=421) cells/μL 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. Conclusions: Both 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.

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