Evaluation of the incidence of ocular manifestations in HIV-infected pediatric patients: a cross-sectional study

Introduction: Acquired immunodeficiency syndrome (AIDS) is a pandemic affecting about 1.8 million children aged 0-14 years globally (2019). Exposure to human immunodeficiency virus (HIV) occurs in utero, during delivery, and lactation. There is lack of knowledge and information regarding ocular manifestations in HIV-positive children. Aim of the paper was to determine the incidence of ocular manifestations and their correlation with CD4+ count level in HIV-positive children. Material and methods: A cross-sectional study evaluating ophthalmic manifestations, and correlation of various parameters and severity with ophthalmological findings in HIV-positive children. Results: For 2 years, 100 HIV-positive children, including 61 boys and 39 girls, were evaluated for ocular manifestations, with most of them aged above 6 years. About 97% of the study's population had CD4+ count above 500 cells/mm3. The total prevalence of ocular manifestations was 19%, ocular manifestations occurring in the anterior segment was 16%, and 4% had posterior segment ocular manifestations with good visual acuity. Ten (52.6%) patients had molluscum contagiosum, 4 (21%) conjunctival vasculopathy, and 1 (5.2%) each cytomegalovirus retinitis and herpes zoster ophthalmicus. Conclusions: This comprehensive ocular evaluation, irrespective of the level of visual acuity, showed that there is a possibility for improvement in the guidelines for early detection of HIV, decreasing the transmission of HIV from mother-to-child, early initiation of highly active antiretroviral therapy (HAART) in mothers and children as well as children's adherence to HAART, eye care, screening, and follow-up of HIV-positive children.