Retinal Microvasculopathy Is Common in HIV/AIDS Patients: A Cross-Sectional Study at the Cape Coast Teaching Hospital, Ghana
Identifieur interne : 000461 ( Pmc/Curation ); précédent : 000460; suivant : 000462Retinal Microvasculopathy Is Common in HIV/AIDS Patients: A Cross-Sectional Study at the Cape Coast Teaching Hospital, Ghana
Auteurs : Emmanuel Kwasi Abu [Ghana] ; Samuel Abokyi [Ghana] ; Dorcas Obiri-Yeboah [Ghana] ; Richard Kobina Dadzie Ephraim [Ghana] ; Daniel Afedo [Ghana] ; Lawrence Duah Agyeman [Ghana] ; Samuel Bert Boadi-Kusi [Ghana]Source :
- Journal of Ophthalmology [ 2090-004X ] ; 2016.
Abstract
Url:
DOI: 10.1155/2016/8614095
PubMed: 28127467
PubMed Central: 5227161
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<author><name sortKey="Abu, Emmanuel Kwasi" sort="Abu, Emmanuel Kwasi" uniqKey="Abu E" first="Emmanuel Kwasi" last="Abu">Emmanuel Kwasi Abu</name>
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<author><name sortKey="Agyeman, Lawrence Duah" sort="Agyeman, Lawrence Duah" uniqKey="Agyeman L" first="Lawrence Duah" last="Agyeman">Lawrence Duah Agyeman</name>
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<author><name sortKey="Boadi Kusi, Samuel Bert" sort="Boadi Kusi, Samuel Bert" uniqKey="Boadi Kusi S" first="Samuel Bert" last="Boadi-Kusi">Samuel Bert Boadi-Kusi</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Retinal Microvasculopathy Is Common in HIV/AIDS Patients: A Cross-Sectional Study at the Cape Coast Teaching Hospital, Ghana</title>
<author><name sortKey="Abu, Emmanuel Kwasi" sort="Abu, Emmanuel Kwasi" uniqKey="Abu E" first="Emmanuel Kwasi" last="Abu">Emmanuel Kwasi Abu</name>
<affiliation wicri:level="1"><nlm:aff id="I1">Department of Optometry, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana</nlm:aff>
<country xml:lang="fr">Ghana</country>
<wicri:regionArea>Department of Optometry, School of Allied Health Sciences, University of Cape Coast, Cape Coast</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Abokyi, Samuel" sort="Abokyi, Samuel" uniqKey="Abokyi S" first="Samuel" last="Abokyi">Samuel Abokyi</name>
<affiliation wicri:level="1"><nlm:aff id="I1">Department of Optometry, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana</nlm:aff>
<country xml:lang="fr">Ghana</country>
<wicri:regionArea>Department of Optometry, School of Allied Health Sciences, University of Cape Coast, Cape Coast</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Obiri Yeboah, Dorcas" sort="Obiri Yeboah, Dorcas" uniqKey="Obiri Yeboah D" first="Dorcas" last="Obiri-Yeboah">Dorcas Obiri-Yeboah</name>
<affiliation wicri:level="1"><nlm:aff id="I2">Department of Microbiology and Immunology, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana</nlm:aff>
<country xml:lang="fr">Ghana</country>
<wicri:regionArea>Department of Microbiology and Immunology, School of Medical Sciences, University of Cape Coast, Cape Coast</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Ephraim, Richard Kobina Dadzie" sort="Ephraim, Richard Kobina Dadzie" uniqKey="Ephraim R" first="Richard Kobina Dadzie" last="Ephraim">Richard Kobina Dadzie Ephraim</name>
<affiliation wicri:level="1"><nlm:aff id="I3">Department of Medical Laboratory Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana</nlm:aff>
<country xml:lang="fr">Ghana</country>
<wicri:regionArea>Department of Medical Laboratory Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Afedo, Daniel" sort="Afedo, Daniel" uniqKey="Afedo D" first="Daniel" last="Afedo">Daniel Afedo</name>
<affiliation wicri:level="1"><nlm:aff id="I1">Department of Optometry, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana</nlm:aff>
<country xml:lang="fr">Ghana</country>
<wicri:regionArea>Department of Optometry, School of Allied Health Sciences, University of Cape Coast, Cape Coast</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Agyeman, Lawrence Duah" sort="Agyeman, Lawrence Duah" uniqKey="Agyeman L" first="Lawrence Duah" last="Agyeman">Lawrence Duah Agyeman</name>
<affiliation wicri:level="1"><nlm:aff id="I3">Department of Medical Laboratory Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana</nlm:aff>
<country xml:lang="fr">Ghana</country>
<wicri:regionArea>Department of Medical Laboratory Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast</wicri:regionArea>
</affiliation>
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<author><name sortKey="Boadi Kusi, Samuel Bert" sort="Boadi Kusi, Samuel Bert" uniqKey="Boadi Kusi S" first="Samuel Bert" last="Boadi-Kusi">Samuel Bert Boadi-Kusi</name>
<affiliation wicri:level="1"><nlm:aff id="I1">Department of Optometry, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana</nlm:aff>
<country xml:lang="fr">Ghana</country>
<wicri:regionArea>Department of Optometry, School of Allied Health Sciences, University of Cape Coast, Cape Coast</wicri:regionArea>
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<series><title level="j">Journal of Ophthalmology</title>
<idno type="ISSN">2090-004X</idno>
<idno type="eISSN">2090-0058</idno>
<imprint><date when="2016">2016</date>
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<front><div type="abstract" xml:lang="en"><p><italic>Purpose</italic>
. The purpose of this study was to evaluate the ocular disorders in HIV positive patients attending the Cape Coast Teaching Hospital, Ghana.<italic> Methods</italic>
. A cross-sectional study using systematic random sampling was conducted on 295 HIV positive patients. Data collection consisted of semistructured questionnaires, laboratory investigation, medical profile, and ophthalmic examination. Statistical association tests including <italic>χ</italic>
<sup>2</sup>
, independent <italic>t</italic>
-test, and ANOVA were done. A <italic>p</italic>
value ≤ 0.05 was considered statistically significant.<italic> Results</italic>
. Of the 295 participants, 205 (69.5%) were on antiretroviral therapy while 90 (30.3%) were not on therapy. Majority of the participants (162, 54.9%) were in clinical stage two, followed by stages three (68, 23.1%), one (62, 21%), and four (3, 1%), respectively. The overall prevalence of ocular disorders was 5.8%. The most common HIV related ocular disorder was HIV retinal microvasculopathy (58.8%), followed by herpes zoster ophthalmicus and<italic> Toxoplasma</italic>
retinochoroiditis, both representing 11.8% of ocular disorders seen. Cytomegalovirus retinitis, Bell's palsy, and optic neuritis were the least common (5.9%). CMV retinitis recorded the highest viral load of 1,474,676 copies/mL and mean CD4 count of 136 cells/mm<sup>3</sup>
. The mean CD4 count for participants with HIV related ocular disorders was significantly lower compared to participants without disorders (<italic>t</italic>
= 2.5, <italic>p</italic>
= 0.012). Participants with ocular disorders also recorded significantly higher mean viral loads than those who did not have ocular disorders (<italic>t</italic>
= 2.8, <italic>p</italic>
= 0.006).<italic> Conclusion</italic>
. Lower CD4 counts and high viral load copies were associated with the manifestation of HIV related ocular disorders.</p>
</div>
</front>
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<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Ophthalmol</journal-id>
<journal-id journal-id-type="iso-abbrev">J Ophthalmol</journal-id>
<journal-id journal-id-type="publisher-id">JOPH</journal-id>
<journal-title-group><journal-title>Journal of Ophthalmology</journal-title>
</journal-title-group>
<issn pub-type="ppub">2090-004X</issn>
<issn pub-type="epub">2090-0058</issn>
<publisher><publisher-name>Hindawi Publishing Corporation</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">28127467</article-id>
<article-id pub-id-type="pmc">5227161</article-id>
<article-id pub-id-type="doi">10.1155/2016/8614095</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Retinal Microvasculopathy Is Common in HIV/AIDS Patients: A Cross-Sectional Study at the Cape Coast Teaching Hospital, Ghana</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid" authenticated="false">http://orcid.org/0000-0003-2354-9170</contrib-id>
<name><surname>Abu</surname>
<given-names>Emmanuel Kwasi</given-names>
</name>
<xref ref-type="aff" rid="I1"><sup>1</sup>
</xref>
<xref ref-type="corresp" rid="cor1"><sup>*</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Abokyi</surname>
<given-names>Samuel</given-names>
</name>
<xref ref-type="aff" rid="I1"><sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Obiri-Yeboah</surname>
<given-names>Dorcas</given-names>
</name>
<xref ref-type="aff" rid="I2"><sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author"><contrib-id contrib-id-type="orcid" authenticated="false">http://orcid.org/0000-0001-5572-9059</contrib-id>
<name><surname>Ephraim</surname>
<given-names>Richard Kobina Dadzie</given-names>
</name>
<xref ref-type="aff" rid="I3"><sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Afedo</surname>
<given-names>Daniel</given-names>
</name>
<xref ref-type="aff" rid="I1"><sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Agyeman</surname>
<given-names>Lawrence Duah</given-names>
</name>
<xref ref-type="aff" rid="I3"><sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Boadi-Kusi</surname>
<given-names>Samuel Bert</given-names>
</name>
<xref ref-type="aff" rid="I1"><sup>1</sup>
</xref>
</contrib>
</contrib-group>
<aff id="I1"><sup>1</sup>
Department of Optometry, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana</aff>
<aff id="I2"><sup>2</sup>
Department of Microbiology and Immunology, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana</aff>
<aff id="I3"><sup>3</sup>
Department of Medical Laboratory Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana</aff>
<author-notes><corresp id="cor1">*Emmanuel Kwasi Abu: <email>eabu@ucc.edu.gh</email>
</corresp>
<fn fn-type="other"><p>Academic Editor: Jesús Pintor</p>
</fn>
</author-notes>
<pub-date pub-type="ppub"><year>2016</year>
</pub-date>
<pub-date pub-type="epub"><day>29</day>
<month>12</month>
<year>2016</year>
</pub-date>
<volume>2016</volume>
<elocation-id>8614095</elocation-id>
<history><date date-type="received"><day>27</day>
<month>9</month>
<year>2016</year>
</date>
<date date-type="accepted"><day>6</day>
<month>12</month>
<year>2016</year>
</date>
</history>
<permissions><copyright-statement>Copyright © 2016 Emmanuel Kwasi Abu et al.</copyright-statement>
<copyright-year>2016</copyright-year>
<license xlink:href="https://creativecommons.org/licenses/by/4.0/"><license-p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
<abstract><p><italic>Purpose</italic>
. The purpose of this study was to evaluate the ocular disorders in HIV positive patients attending the Cape Coast Teaching Hospital, Ghana.<italic> Methods</italic>
. A cross-sectional study using systematic random sampling was conducted on 295 HIV positive patients. Data collection consisted of semistructured questionnaires, laboratory investigation, medical profile, and ophthalmic examination. Statistical association tests including <italic>χ</italic>
<sup>2</sup>
, independent <italic>t</italic>
-test, and ANOVA were done. A <italic>p</italic>
value ≤ 0.05 was considered statistically significant.<italic> Results</italic>
. Of the 295 participants, 205 (69.5%) were on antiretroviral therapy while 90 (30.3%) were not on therapy. Majority of the participants (162, 54.9%) were in clinical stage two, followed by stages three (68, 23.1%), one (62, 21%), and four (3, 1%), respectively. The overall prevalence of ocular disorders was 5.8%. The most common HIV related ocular disorder was HIV retinal microvasculopathy (58.8%), followed by herpes zoster ophthalmicus and<italic> Toxoplasma</italic>
retinochoroiditis, both representing 11.8% of ocular disorders seen. Cytomegalovirus retinitis, Bell's palsy, and optic neuritis were the least common (5.9%). CMV retinitis recorded the highest viral load of 1,474,676 copies/mL and mean CD4 count of 136 cells/mm<sup>3</sup>
. The mean CD4 count for participants with HIV related ocular disorders was significantly lower compared to participants without disorders (<italic>t</italic>
= 2.5, <italic>p</italic>
= 0.012). Participants with ocular disorders also recorded significantly higher mean viral loads than those who did not have ocular disorders (<italic>t</italic>
= 2.8, <italic>p</italic>
= 0.006).<italic> Conclusion</italic>
. Lower CD4 counts and high viral load copies were associated with the manifestation of HIV related ocular disorders.</p>
</abstract>
</article-meta>
</front>
<floats-group><table-wrap id="tab1" orientation="portrait" position="float"><label>Table 1</label>
<caption><p>Ocular disorders among participants.</p>
</caption>
<table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">Ocular disorder</th>
<th align="center" rowspan="1" colspan="1"><italic>n</italic>
(%)</th>
</tr>
</thead>
<tbody><tr><td align="left" rowspan="1" colspan="1">Cytomegalovirus retinitis</td>
<td align="center" rowspan="1" colspan="1">1 (5.9)</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Herpes zoster ophthalmicus</td>
<td align="center" rowspan="1" colspan="1">2 (11.8)</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">HIV retinal microvasculopathy</td>
<td align="center" rowspan="1" colspan="1">10 (58.8)</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"><italic>Toxoplasma</italic>
retinochoroiditis</td>
<td align="center" rowspan="1" colspan="1">2 (11.8)</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Bell's (hemifacial) palsy</td>
<td align="center" rowspan="1" colspan="1">1 (5.9)</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Optic neuritis</td>
<td align="center" rowspan="1" colspan="1">1 (5.9)</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"><italic>Total</italic>
</td>
<td align="center" rowspan="1" colspan="1"><italic>17 (100)</italic>
</td>
</tr>
</tbody>
</table>
</table-wrap>
<table-wrap id="tab2" orientation="portrait" position="float"><label>Table 2</label>
<caption><p>Comparing mean CD4 counts/viral loads between various ocular disorders manifested.</p>
</caption>
<table frame="hsides" rules="groups"><thead><tr><th rowspan="2" align="left" colspan="1">HIV biomarker</th>
<th colspan="6" align="center" rowspan="1">Mean count</th>
<th rowspan="2" align="center" colspan="1"><italic>F</italic>
</th>
<th rowspan="2" align="center" colspan="1"><italic>p</italic>
value</th>
</tr>
<tr><th align="center" rowspan="1" colspan="1">CMV R</th>
<th align="center" rowspan="1" colspan="1">HZO</th>
<th align="center" rowspan="1" colspan="1">HIV RM</th>
<th align="center" rowspan="1" colspan="1">TR</th>
<th align="center" rowspan="1" colspan="1">ON</th>
<th align="center" rowspan="1" colspan="1">BP</th>
</tr>
</thead>
<tbody><tr><td align="left" rowspan="1" colspan="1">Nadir CD4 (cells/mm<sup>3</sup>
)</td>
<td align="center" rowspan="1" colspan="1">136</td>
<td align="center" rowspan="1" colspan="1">269</td>
<td align="center" rowspan="1" colspan="1">142</td>
<td align="center" rowspan="1" colspan="1">342</td>
<td align="center" rowspan="1" colspan="1">278</td>
<td align="center" rowspan="1" colspan="1">148</td>
<td align="center" rowspan="1" colspan="1">2.5</td>
<td align="center" rowspan="1" colspan="1">0.20</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Viral load (copies/mL)</td>
<td align="center" rowspan="1" colspan="1">1,474,676</td>
<td align="center" rowspan="1" colspan="1">38,090</td>
<td align="center" rowspan="1" colspan="1">20,308</td>
<td align="center" rowspan="1" colspan="1">146</td>
<td align="center" rowspan="1" colspan="1">18,060</td>
<td align="center" rowspan="1" colspan="1">41,120</td>
<td align="center" rowspan="1" colspan="1">362.7</td>
<td align="center" rowspan="1" colspan="1"><0.001</td>
</tr>
</tbody>
</table>
<table-wrap-foot><fn><p>CMV R: cytomegalovirus retinitis; HZO: herpes zoster ophthalmicus; HIV RM: HIV retinal microvasculopathy; TR: <italic>Toxoplasma</italic>
retinochoroiditis; ON: optic neuritis; BP: Bell's palsy.</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="tab3" orientation="portrait" position="float"><label>Table 3</label>
<caption><p>Comparing mean CD4 counts/viral loads between patients who manifested ocular disorders and those who did not.</p>
</caption>
<table frame="hsides" rules="groups"><thead><tr><th rowspan="2" align="left" colspan="1">HIV biomarker</th>
<th colspan="2" align="center" rowspan="1">Mean count (CI)</th>
<th rowspan="2" align="center" colspan="1"><italic>t</italic>
</th>
<th rowspan="2" align="center" colspan="1"><italic>p</italic>
value</th>
</tr>
<tr><th align="center" rowspan="1" colspan="1">Participants with ocular disorders</th>
<th align="center" rowspan="1" colspan="1">Participants without ocular disorders</th>
</tr>
</thead>
<tbody><tr><td align="left" rowspan="1" colspan="1">Nadir CD4 count (cells/mm<sup>3</sup>
)</td>
<td align="center" rowspan="1" colspan="1">172 (92.2–251.6)</td>
<td align="center" rowspan="1" colspan="1">309 (279.9–339.1)</td>
<td align="center" rowspan="1" colspan="1">2.5</td>
<td align="center" rowspan="1" colspan="1">0.012</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Current CD4 count (cells/mm<sup>3</sup>
)</td>
<td align="center" rowspan="1" colspan="1">660 (438.8–880.2)</td>
<td align="center" rowspan="1" colspan="1">807 (764.1–849.6)</td>
<td align="center" rowspan="1" colspan="1">1.7</td>
<td align="center" rowspan="1" colspan="1">0.10</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Viral load (copies/mL)</td>
<td align="center" rowspan="1" colspan="1">165,270 (164883.1–495420.3)</td>
<td align="center" rowspan="1" colspan="1">31,992 (15919.2–48065.2)</td>
<td align="center" rowspan="1" colspan="1">2.8</td>
<td align="center" rowspan="1" colspan="1">0.006</td>
</tr>
</tbody>
</table>
</table-wrap>
</floats-group>
</pmc>
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