Ocular fi ndings in children with HIV/AIDS at Mbagathi District Hospital Nairobi, Kenya

Abstract

Objective: To establish ocular fi ndings in Kenyan children with HIV/AIDS. Design: Hospital-based cross sectional study Setting: Mbagathi District Hospital (Nairobi) MSF-Belgium HIV clinic support center and paediatric ward Subjects: A total of 208 HIV infected children were examined Results: The overall prevalence of ocular fi ndings was 67.3% (140 patients). 113 patients (54.3%) of the patients were on ARV therapy. The most common fi nding was adnexal lesions observed in 40.9% of the patients, followed by posterior segment fi ndings in 31.3%. Conjunctival microvasculopathy (30 patients, 14.4%), allergic conjunctivitis (27 patients, 13.0%) and molluscum contagiosum 12 patients, 5.8%) were the main adnexal fi ndings. Five cases (2.4%) of infectious conjunctivitis, 4 cases (1.9%) of herpes zoster ophthalmicus (HZO) and conjunctival growth were also recorded. Keratoconjunctivitis (6 patients, 2.9%), anterior uveitis (6 patients, 2.9%), and corneal ulcer (3 patients, 1.4%) were the main anterior segment fi ndings. Peripheral retinal perivasculitis (28 patients, 13.5%) was the commonest posterior segment fi nding, followed by CWS (18 patients, 8.7%) and presumed retinal pigment epitheliopathy (18 patients, 8.7%) . Two cases of white retinal infi ltrate associated with frosted branch vasculitis and 2 cases of focal retinal haemorrhages were also observed. Tuberculosis was the major systemic fi nding (93 patients, 44.7%). This study found that ocular fi ndings are directly related to the duration of exposure to HIV infection (age), to the severity of clinical state of the disease (WHO clinical staging) and to the severity of immune suppression (CD4 count). Conclusion: The results of this study suggest a high prevalence of ocular fi ndings in Kenyan children with HIV/AIDS. Retinal perivasculitis was the commonest retinal fi nding observed. Further studies are needed to investigate the unusual fi ndings of retinal pigment epitheliopathy observed in this study.