BMC ophthalmology · 2026
Risk factors for ocular complications in HIV/AIDS patients: a retrospective analysis of ophthalmology consultations in a tertiary hospital in Central China.
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Zhang Renfan, Zheng Tian, Chen Xiaomin, Yang Lin, Zeng Wen, Ke Min
Аннотация
BACKGROUND: Acquired immunodeficiency syndrome (AIDS) affects 39.9 million people worldwide. Despite antiretroviral therapy, sight-threatening ocular complications, such as cytomegalovirus retinitis (CMVR), remain common, yet contemporary incidence data from Asian populations are scarce.
PURPOSE: To quantify the incidence of fundus lesions and identify independent predictors of ocular lesions among HIV-positive inpatients referred for ophthalmologic evaluation at a tertiary center in Central China.
METHODS: All consecutive HIV-1-positive inpatients aged ≥ 18 years who underwent standardized ophthalmic screening from 19 November 2019 to 9 June 2023 were included. Data on demographic, systemic, and ocular characteristics were collected. Binary logistic regression models were used to identify factors associated with fundus lesions.
RESULTS: Of 345 eligible individuals, 117 had fundus lesions, classified into three main types. The distribution was 35.9% for opportunistic infections, 59.8% for HIV-related microangiopathy, and 4.3% for syphilis-related uveitis. The opportunistic infections group was common among the youngest age group [median age: 41.5 years, IQR: 32-54 years], with 38.1% reporting blurred vision. Patients in the microangiopathy group had the lowest CD4+ T cell count [median count: 18.5 cells/µL, IQR: 5-40.25 cells/µL] and the shortest duration of HIV/AIDS [median month: 0.7 months, IQR: 0-6.5 months]. The syphilis-related uveitis group had the longest duration of HIV/AIDS [median month: 24 months, IQR: 8.125-54 months], the highest CD4+ T cell count [median count: 166 cells/µL, IQR: 41-224.5 cells/µL], and the most frequent complaint of blurred vision (80%).
CONCLUSION: In this contemporary Central-Chinese cohort, CMVR remains the leading ocular sequela despite widespread HAART. Age, nadir CD4+ < 50 cells/µL, and symptomatic visual loss are independent red flags. We propose routine dilated fundus examinations every 3 months for patients with any of these predictors and immediate ophthalmic referral at the onset of visual symptoms.
PURPOSE: To quantify the incidence of fundus lesions and identify independent predictors of ocular lesions among HIV-positive inpatients referred for ophthalmologic evaluation at a tertiary center in Central China.
METHODS: All consecutive HIV-1-positive inpatients aged ≥ 18 years who underwent standardized ophthalmic screening from 19 November 2019 to 9 June 2023 were included. Data on demographic, systemic, and ocular characteristics were collected. Binary logistic regression models were used to identify factors associated with fundus lesions.
RESULTS: Of 345 eligible individuals, 117 had fundus lesions, classified into three main types. The distribution was 35.9% for opportunistic infections, 59.8% for HIV-related microangiopathy, and 4.3% for syphilis-related uveitis. The opportunistic infections group was common among the youngest age group [median age: 41.5 years, IQR: 32-54 years], with 38.1% reporting blurred vision. Patients in the microangiopathy group had the lowest CD4+ T cell count [median count: 18.5 cells/µL, IQR: 5-40.25 cells/µL] and the shortest duration of HIV/AIDS [median month: 0.7 months, IQR: 0-6.5 months]. The syphilis-related uveitis group had the longest duration of HIV/AIDS [median month: 24 months, IQR: 8.125-54 months], the highest CD4+ T cell count [median count: 166 cells/µL, IQR: 41-224.5 cells/µL], and the most frequent complaint of blurred vision (80%).
CONCLUSION: In this contemporary Central-Chinese cohort, CMVR remains the leading ocular sequela despite widespread HAART. Age, nadir CD4+ < 50 cells/µL, and symptomatic visual loss are independent red flags. We propose routine dilated fundus examinations every 3 months for patients with any of these predictors and immediate ophthalmic referral at the onset of visual symptoms.