Retinal manifestations of HIV‐1 and HIV‐2 infections among hospital patients in The Gambia, West Africa

• Published in: Tropical medicine & international health Vol. 4; no. 7; pp. 487 - 492
• Main Authors: Jaffar, Shabbar, Ariyoshi, Koya, Frith, Peggy, Okouchi, Yuka, Sabally, Sehu, Ajewole, Tunde, Bailey, Robin, Lee, Pak, Corrah, Tumani, Johnson, Gordon, Faal, Hannah, Whittle, Hilton
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01-07-1999
• Subjects: Adolescent; Adult; Aged; AIDS-Related Opportunistic Infections - epidemiology; AIDS/HIV; CMV retinitis; Cross-Sectional Studies; Cytomegalovirus Retinitis - epidemiology; Female; Gambia - epidemiology; HIV Infections - complications; HIV Infections - epidemiology; HIV-1; HIV-2; Humans; Male; Middle Aged; Retinal Diseases - complications; Retinal Diseases - epidemiology; retinal manifestations; The Gambia; Gambia
• ISSN: 1360-2276; 1365-3156
• DOI: 10.1046/j.1365-3156.1999.00425.x

Summary
background In developed countries, 50–75% of AIDS patients develop retinal complications and about 20–40% acquire cytomegalavirus (CMV) retinitis. We conducted a cross‐sectional survey to determine prevalence of these in The Gambia where both HIV‐1 and HIV‐2 infection are present and the prevalence of HIV‐1 is rising.
method All patients attending hospital whose percentage CD4 + cells (CD4%) was below 14, the level associated typically with an AIDS diagnosis, and one half of those whose CD4% was 14 or above were asked to join the study. Fifty‐six HIV‐1, 52 HIV‐2 and 12 dually infected patients were recruited. Photographs of the fundi were taken and interpreted independently. The findings were related to the patients' percentage CD4 + cells.
results The CD4% was < 14 in 40 patients and < 7 in 17 patients. Thirty‐six patients were male. No cases of CMV retinitis were found. Four patients whose CD4% were 4, 5, 11 and 23 had cotton wool spots ranging in number from 1 to 14 for any one patient. The prevalence of cotton wool spots was 8% (95% CI, 0–16%) among patients with CD4% below 14 and 12% (95% CI, 0–27) among patients with CD4% below 7. One of the 4 patients had associated microaneurysm and blot haemorrhages typical of more advanced HIV microvasculopathy.
conclusion CMV retinitis is less common in The Gambia than in developed countries. Non‐infectious retinopathy may also be less common.