Ocular Syphilis in HIV-Positive Patients Receiving Highly Active Antiretroviral Therapy
| Autor: | Gayle P. Balba, Allan G. Palestine, Anurag Malani, Princy Kumar, Andrea N. James, Joseph Timpone, James N. Welch |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
medicine.medical_specialty
Pediatrics Eye Diseases genetic structures HIV Infections Fluorescent treponemal antibody absorption test Rapid plasma reagin Uveitis Blurred vision Antiretroviral Therapy Highly Active medicine Humans Syphilis Retrospective Studies medicine.diagnostic_test business.industry Incidence Incidence (epidemiology) Retinal detachment Retrospective cohort study General Medicine medicine.disease eye diseases Surgery medicine.symptom business |
| Zdroj: | The American Journal of Medicine. 119:448.e21-448.e25 |
| ISSN: | 0002-9343 |
| DOI: | 10.1016/j.amjmed.2005.11.016 |
| Popis: | Background From October 2001 to October 2002, we have observed a surprisingly high incidence of ocular syphilis in human immunodeficiency virus-positive (HIV+) patients receiving highly active antiretroviral therapy at our clinic. Methods We conducted a retrospective chart and patient database review. Results From 1997 to 2002, 455 patients in our clinic were screened for syphilis; 320 were screened from 2001 to 2002; 7.3% of patients (33/455) were diagnosed with syphilis. During the past year, syphilis was diagnosed in 7.5% of patients (24/320), of whom 13% (3/24) had ocular syphilis. We estimate the prevalence of ocular syphilis in HIV+ patients on highly active antiretroviral therapy screened for syphilis to be 9% (3/33). Presenting symptoms included blurred vision, loss of vision, central scotomas, and bilateral ocular involvement. The most common ocular manifestation of syphilis was posterior chamber uveitis; one patient also had a retinal detachment. All patients demonstrated reactive rapid plasma reagin and fluorescent treponemal antibody absorption test results, cerebrospinal fluid pleocytosis, and elevated total protein. Each patient received a 21-day course of intravenous penicillin G (24 million units daily) with improvement of visual symptoms. Conclusion Our data demonstrate an unexpectedly high incidence of ocular syphilis in our HIV+ patients receiving highly active antiretroviral therapy during the past year. A diagnosis of ocular syphilis should be considered in any HIV+ patient who presents with visual symptoms, irrespective of the patient's CD 4 count. |
| Databáze: | OpenAIRE |
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