Eye, Endocrine system, Hematopoietic system, CVS and Dermatological system In HIV
Ophthalmologic problems:
- Ophthalmologic problems occur in approximately half of patients with advanced HIV infection
- Ocular lesions may occur in patients suffering from AIDS
- Viral, bacterial & fungal infection,
- Kaposi sarcoma
- CMV retinitis
- lymphoma are the Ocular manifestation of HIV
- Central toxoplasma chorioretinitis
- CMV retinitis,
- Candida endophthalmitis
The most common abnormal findings on funduscopic examination :
- cotton-wool spots.
- (hard white spots that appear on the surface of the retina and often have an irregular edge.)
- Represent areas of retinal ischemia secondary to microvascular disease.
CMV retinitis:
- Most frequent and serious ocular opportunistic infection
- Leads to blindness in AIDS patients.
- Occur in patients with a CD4 + T-cell count < 50/uL.
- Therapy : intravenous ganciclovir or foscarnet, with cidofovir as an alternative.
‘Acute Retinal Necrosis Syndrome’
- Both HSV and varicella zoster virus
- Rapidly progressing, bilateral necrotizing retinitis
Endocrine System Manifestations
- MC is lipodystrophy secondary to ART
- Thyroid function altered
- Hypogonadism
Hematopoietic system Manifestations
- Anemia
- Thrombocytopenia
- Lymphadenopathy
- Leukopenia
CVS manifestations
- HIV associated cardiomyopathy
- Pericardial effusion, cardiac tamponade
- Pericarditis, non-bacterial thrombolic endocarditis
- Lipodystraphy syndrome
- adverse effect of antiretroviral therapy.
Dermatological Manifestations
- Folliculitis
- Most common
- CD4 + T cell counts < 200
- Seborrheic dermatitis
- Psoriasis and ichthyosis
- HSV infection
Exam Question
- CMV retinitis is the most frequent and serious ocular opportunistic infection and is the leading cause of blindness in AIDS patients.
- Viral, bacterial & fungal infection, Kaposi sarcoma, CMV retinitis, lymphoma are the Ocular manifestation of HIV
- Commonest opportunistic organism to cause ocular inflammation in AIDS is Cytomegalovirus
- Central toxoplasma chorioretinitis , CMV retinitis, Candida endophthalmitis are the ocular lesions may occur in patients suffering from AIDS
- Vision loss in HIV is commonly due to infection with Cytomegalovirus
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