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- ISSN: 1570-162X
- E-ISSN: 1873-4251
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Discordance of Aqueous/Plasma HIV Replication on ART
- Source: Current HIV Research, Volume 22, Issue 1, Jan 2024, p. 27 - 30
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- 04 Jul 2023
- 26 Oct 2023
- 27 Dec 2023
Abstract
Background
The study was conducted to analyze HIV dynamics across blood–retinal barrier (BRB) and the relevant risk factors for HIV-associated ocular complications.
Methods
This study included a case series of 40 HIV-positive patients with ocular lesions, which were studied retrospectively. Clinical and laboratory examinations included plasma and intraocular viral load (VL).
Results
HIV VL on paired aqueous/plasma samples was available for 40 patients. Aqueous VL was negatively associated with antiretroviral treatment (ART) duration (p = 0.02 and p < 0.05), and plasma VL was independent of ART duration (p = 0.53). An aqueous/plasma discordance was found in 19/40 (47.5%) patients, eight of whom (20%) had detectable aqueous VL despite a suppressed plasma VL (escape). There were significant differences in CD4+ T-lymphocyte levels (p = 0.011 and p < 0.05) and ART duration (p = 0.007 and p < 0.05) between the patients with HIV-associated ocular complications and the patients without.
Conclusion
This study provides a rationale for initiating ART early in the course of infection to reduce HIV VL in the aqueous humor, and raises the possibility of the ocular sanctuary where HIV replicates. Meanwhile, early and standard ART would be an optimal option to protect against ocular opportunistic infection.
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