ABSTRACT
BACKGROUND: Non-infectious retinal disease, even in the HAART era, continues to be one of the most common diagnoses in patients with HIV, with prevalences of up to 27% of cases. This study aims to characterize the association between demographic variables and their role. As a risk factor for the development of non-opportunistic non-infectious retinal disease in patients with HIV/AIDS. METHODS: An integrative review of the literature was carried out according to Arksey O'Malley's approach, based on the PICO methodology and following the PRISMA recommendations; An exhaustive search was carried out in databases of articles that were filtered using established criteria, with their extraction and analysis carried out qualitatively. RESULTS: Ocular manifestations from any cause develop from 35 years of age in patients with HIV/AIDS, with the highest risk for age-related macular degeneration over the fourth decade of life and for the development of neuroretinal disorder on the fifth decade of life; some studies report a slight tendency to diagnose macular degeneration in women and those who acquired AIDS through sexual contact; data contrasted with increased risk for diagnosing neuroretinal disorder in homosexual men who also use intravenous drugs, possibly due to oversampling in studies; non-Hispanic whites and African Americans were the races most commonly affected by neuroretinal disease; the means between the 11.3-14.5 years elapsed since the HIV diagnosis were more frequently associated with cognitive impairment and both in those with high or low CD4 counts, and in patients with high or low viral loads, neuroretinal disease without Statistically significant differences. Adherence and early initiation of HAART had a modest impact on the development of neuroretinal disease. DISCUSSION: Even in the HAART era, non-infectious neuroretinal disease and cytomegalovirus retinitis remain the most frequent ocular diagnoses, however, different studies argue an increase in age-related non-infectious retinal diseases in patients with HIV, theories that are may explain by the increase in life expectancy, the metabolic effects of HAART itself or the generalized pro-inflammatory state in this group of patients, it is essential to recognize this new diagnostic challenge in order to direct preventive efforts through the use of cost-effective sociodemographic risk predictors towards that technological tools for diagnosis and treatment can be targeted. CONCLUSIONS: HIV/AIDS patients who present at the ophthalmological consultation with the suggested sociodemographic predictors have a high risk of visual impairment due to non-infectious retinopathy, therefore prevention, diagnosis and treatment efforts directed at these diseases should be increased.
Subject(s)
Acquired Immunodeficiency Syndrome , Eye Infections, Viral , Retinal Diseases , Acquired Immunodeficiency Syndrome/complications , Acquired Immunodeficiency Syndrome/drug therapy , Adolescent , Antiretroviral Therapy, Highly Active/adverse effects , CD4 Lymphocyte Count , Child , Eye Infections, Viral/epidemiology , Female , Humans , Male , Retinal Diseases/drug therapy , Retinal Diseases/epidemiology , Retinal Diseases/etiologyABSTRACT
Antecedentes La enfermedad retiniana no infecciosa, aun en la era del tratamiento antirretroviral de gran actividad (TARGA), continúa siendo uno de los diagnósticos más comunes en pacientes con el virus de la inmunodeficiencia humana (VIH), con prevalencias hasta del 27% de los casos. Este estudio se propone caracterizar la asociación entre unas variables demográficas y su papel como factor de riesgo para el desarrollo de la enfermedad retiniana no infecciosa no oportunista en pacientes con VIH/SIDA. Método Se realizó una revisión integrativa de la literatura, según el planteamiento de OMalley, partiendo de la metodología PICO y siguiendo las recomendaciones elementos de informes preferidos para revisiones sistemáticas y metanálisis (PRISMA); se realizó una búsqueda exhaustiva en bases de datos de artículos que se filtraron mediante criterios establecidos, con la extracción y análisis de los mismos efectuada de forma cualitativa. Resultados Las manifestaciones oculares por cualquier causa se desarrollan desde los 35 años de edad en los pacientes con VIH/SIDA, con el mayor riesgo para la degeneración macular relacionada con la edad sobre la cuarta década de vida y para el desarrollo de trastorno neurorretiniano sobre la quinta; algunos estudios reportan una ligera tendencia para diagnosticar la degeneración macular en mujeres y en aquellas personas que adquirieron SIDA por contacto sexual; estos datos contrastan con un mayor riesgo para diagnosticar el trastorno neurorretiniano en los hombres homosexuales que también usan drogas intravenosas, posiblemente debido un sobremuestreo en los estudios; los blancos no hispánicos y los afroamericanos fueron las razas más comúnmente afectadas por la enfermedad neurorretiniana; las medias entre los 11,3 a 14,5 años transcurridos desde el diagnóstico de VIH se asociaron más frecuentemente con un trastorno cognitivo y tanto en aquellos con recuentos CD4 altos o bajos como en pacientes con cargas (AU)
Background Non-infectious retinal disease, even in the HAART era, continues to be one of the most common diagnoses in patients with HIV, with prevalences of up to 27% of cases. This study aims to characterize the association between demographic variables and their role. as a risk factor for the development of non-opportunistic non-infectious retinal disease in patients with HIV/AIDS Methods An integrative review of the literature was carried out according to Arksey OMalley's approach, based on the PICO methodology and following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) recommendations; An exhaustive search was carried out in databases of articles that were filtered using established criteria, with their extraction and analysis carried out qualitatively. Results Ocular manifestations from any cause develop from 35 years of age in patients with HIV/AIDS, with the highest risk for age-related macular degeneration over the fourth decade of life and for the development of neuroretinal disorder on the fifth decade of life; some studies report a slight tendency to diagnose macular degeneration in women and those who acquired AIDS through sexual contact; data contrasted with increased risk for diagnosing neuroretinal disorder in homosexual men who also use intravenous drugs, possibly due to oversampling in studies; non-Hispanic whites and African Americans were the races most commonly affected by neuroretinal disease; the means between the 11.3 to 14.5 years elapsed since the HIV diagnosis were more frequently associated with cognitive impairment and both in those with high or low CD4 counts, and in patients with high or low viral loads, neuroretinal disease without Statistically significant differences. Adherence and early initiation of HAART had a modest impact on the development (AU)
Subject(s)
Humans , Retinal Diseases/complications , Acquired Immunodeficiency Syndrome/complications , Antiretroviral Therapy, Highly Active , CD4 Lymphocyte Count , Socioeconomic Factors , Risk FactorsABSTRACT
BACKGROUND: Non-infectious retinal disease, even in the HAART era, continues to be one of the most common diagnoses in patients with HIV, with prevalences of up to 27% of cases. This study aims to characterize the association between demographic variables and their role. as a risk factor for the development of non-opportunistic non-infectious retinal disease in patients with HIV/AIDS METHODS: An integrative review of the literature was carried out according to Arksey O'Malley's approach, based on the PICO methodology and following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) recommendations; An exhaustive search was carried out in databases of articles that were filtered using established criteria, with their extraction and analysis carried out qualitatively. RESULTS: Ocular manifestations from any cause develop from 35 years of age in patients with HIV/AIDS, with the highest risk for age-related macular degeneration over the fourth decade of life and for the development of neuroretinal disorder on the fifth decade of life; some studies report a slight tendency to diagnose macular degeneration in women and those who acquired AIDS through sexual contact; data contrasted with increased risk for diagnosing neuroretinal disorder in homosexual men who also use intravenous drugs, possibly due to oversampling in studies; non-Hispanic whites and African Americans were the races most commonly affected by neuroretinal disease; the means between the 11.3 to 14.5 years elapsed since the HIV diagnosis were more frequently associated with cognitive impairment and both in those with high or low CD4 counts, and in patients with high or low viral loads, neuroretinal disease without Statistically significant differences. Adherence and early initiation of HAART had a modest impact on the development of neuroretinal disease. DISCUSSION: Even in the HAART era, non-infectious neuroretinal disease and cytomegalovirus retinitis remain the most frequent ocular diagnoses, however, different studies argue an increase in age-related non-infectious retinal diseases in patients with HIV, theories that are may explain by the increase in life expectancy, the metabolic effects of HAART itself or the generalized pro-inflammatory state in this group of patients, it is essential to recognize this new diagnostic challenge in order to direct preventive efforts through the use of cost-effective sociodemographic risk predictors towards that technological tools for diagnosis and treatment can be targeted. CONCLUSIONS: HIV/AIDS patients who present at the ophthalmological consultation with the suggested sociodemographic predictors have a high risk of visual impairment due to non-infectious retinopathy, therefore prevention, diagnosis and treatment efforts directed at these diseases should be increased.
