OCULAR DISORDERS AMONG PERSONS LIVING WITH HIV/AIDS IN OSUN STATE, NIGERIA

Abstract

HIV/AIDS affects all the structures of the eye and the orbit with grave implications on vision and quality of life of the sufferers. More than half of persons living with HIV/ AIDS (PLWHA) were expected to develop at least one HIV related ocular disorder in a life time. The prevalence and spectrum of ocular disorders among PLWHA in Osun State are unknown. Data on nurses of visual impairment among PLWHA in Osun State are also sparse. Therefore, this study determined the prevalence and types of ocular disorders among PLWHA in Osun State. A hospital based multicentre cross-sectional study was conducted among randomly selected sample of 505 PLWHA in Osun State. Data were collected using semi-structured questionnaires and ophthalmologic clinical examinations. The outcome variables were presence or absence of ocular disorders and visual impairment. The independent variables were socio-demographic and clinical characteristics of respondents. Descriptive statistics, Chi square test and binary logistic regression were used to analyse data using SPSS version 20. Level of significance was set at 0.05. Male: Female ratio of respondents was 1:4. and median age was 40.0 years (range: 3.5-80.0). The median period between diagnosis of HIV/AIDS and interview of respondents was 3.0 years (range: 0-12.8). More than 90% of respondents were on highly active anti-retro-viral 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%). Cytomegalovirus (CMV) retinitis was found in only 2 (0.4%) respondents. Visual impairment occurred among 22 (4.4%) respondents. Refractive errors (50.0%), cataract (13.6%), age-related macular degeneration (9.1 %) and uveitis (9.0%) were the common causes of visual impairment. Respondents with CD4+ count of at least 500 cells/μI (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.l.=0.15-0.83; p= 0.02) were less likely to have HIV related ocular disorders. On the other hand, respondents without HIV related ocular disorders (OR=0.05: 95% C.I.=0.01-0.28; p=0.001); those who did not have non-HIV related disorders (OR=0.13; 95% C.I.=0.03-0.63; p=0.01) and those with WHO clinical stages 1 & 2 of HIV infection (OR=0.35: 95% C.I.=0.13-0.95; p=0.04) were less likely to have visual impairment. 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. Some of the ocular disorders resulted in visual impairment among the respondents. Policy makers and care givers need to collaborate with Ophthalmologists to eliminate causes of visual impairment among persons living with HIV/AIDS in Osun State.