Ocular disorders among persons living with HIV/AIDS in Osun State, Nigeria: a cross-sectional study

Abstract

HIV/AIDS affects all the structures of the eye and the orbit with grave implications on vision and quality of life. More than half of persons living with HIV/AIDS (PLWHA) are at risk of developing at least one HIV-related ocular disorder in a lifetime. This study aims to determine the prevalence, spectrum, and correlates of ocular disorder among PLWHA in Osun State, Nigeria. A multicentre cross-sectional study of a randomly selected sample of PLWHA in Osun State. Participants were interviewed using semi-structured questionnaires and underwent detailed ophthalmologic clinical examinations. The outcome variables were presence or absence of ocular disorders and visual impairment. Descriptive statistics, Chi square test and binary logistic regression were used to analyse data using SPSS version 20. A total of 505 PLWHA (80% female) aged 3.5–80 years (median, 40.0) were enrolled. They had lived with HIV/AIDS for a median period of 3.0 years (range: 0-12.8), and over 90% were on highly active anti-retroviral therapy. Their median CD4 + T lymphocyte count was 400 cells/ µl (range: 8-1977). Prevalence of any ocular disorder was 53.9% (95% C.I. =49.6%-58.2%), while the prevalence of HIV-related ocular disorders was 5.4% (95% C.I. =3.4%-7.4%). Common HIV-related ocular disorders were uveitis (1%), presumed toxoplasmosis (0.8%) and neuro-ophthalmic disorders (0.8%), and Cytomegalovirus (CMV) retinitis (0.4%). Prevalence of visual impairment in the sample was 4.4%, and refractive errors (50.0%) and cataract (13.6%) were the common causes. Participants with CD4 + count of at least 500 cells/µl (OR = 0.24; 95% C.I.=0.07–0.89; p = 0.03); those without visual impairment (OR = 0.25; 95% C.I.=0.08–0.80; p = 0.02) and those without eye complaints (OR = 0.35; 95% C.I.=0.15–0.83; p = 0.02) were less likely to have HIV-related ocular disorders. Ocular disorders were common among PLWHA in Osun State although the prevalence of HIV- related ocular disorders was low. Moreover, there appeared to be emergence of previously rare and potentially blinding disorders such as CMV retinitis.