Title:Discordance of Aqueous/Plasma HIV Replication on ART
Volume: 22
Issue: 1
Author(s): Xin Che, Luoziyi Wang, Weimei Ma, Rui Wang and Zhiliang Wang*
Affiliation:
- Department of Ophthalmology, Huashan Hospital of Fudan University, Shanghai, China
Keywords:
HIV, aqueous HIV load, HIV-associated ocular complications, intraocular HIV repository, repository, central nervous system, antiretroviral treatment.
Abstract:
Background: The study was conducted to analyze HIV dynamics across blood–retinal
barrier (BRB) and the relevant risk factors for HIV-associated ocular complications.
Methods: This study included a case series of 40 HIV-positive patients with ocular lesions, which
were studied retrospectively. Clinical and laboratory examinations included plasma and intraocular
viral load (VL).
Results: HIV VL on paired aqueous/plasma samples was available for 40 patients. Aqueous VL
was negatively associated with antiretroviral treatment (ART) duration (p = 0.02 and p < 0.05),
and plasma VL was independent of ART duration (p = 0.53). An aqueous/plasma discordance was
found in 19/40 (47.5%) patients, eight of whom (20%) had detectable aqueous VL despite a suppressed
plasma VL (escape). There were significant differences in CD4+ T-lymphocyte levels (p =
0.011 and p < 0.05) and ART duration (p = 0.007 and p < 0.05) between the patients with HIV-associated
ocular complications and the patients without.
Conclusion: This study provides a rationale for initiating ART early in the course of infection to
reduce HIV VL in the aqueous humor, and raises the possibility of the ocular sanctuary where
HIV replicates. Meanwhile, early and standard ART would be an optimal option to protect against
ocular opportunistic infection.
