Non-infectious Uveitis as a Manifestation of the Immune Reconstitution Inflammatory Syndrome in Patients Infected by HIV

Objective: To describe a retrospective review of HIV patients with noninfectious uveitis. Data collected included: demographics, anatomic classification and phenotypic diagnosis of the uveitis, systemic immune-mediated disorders (IMD), time from HIV diagnosis to uveitis, CD4 count, viral load, treatment and complications of treatment and time of follow-up. Results: Twenty patients (18 males) were included. The time lag between HIV diagnosis and the onset of uveitis was 9 +/- 8.5 years. Mean CD4 count was 670 +/- 294 cells/ml. Viral load was undetectable in 14 out of 18 cases. In 6 patients IMD was diagnosed prior to or concurring with the uveitis diagnosis. The use of immunosuppressive therapies was necessary in 6 patients (including biologics in 4 cases). The mean follow-up was 42.2 months. Conclusions: noninfectious uveitis could be the first manifestation of IMD in patients with well-controlled HIV infection. Immunosuppression appeared to be a safe therapeutic option in our cohort of patients.

Automated summary

A retrospective review of HIV patients with noninfectious uveitis found that uveitis could be the initial manifestation of immune-mediated disorders in patients with well-controlled HIV infection, and immunosuppression appeared to be a safe therapeutic option.