Brief Report: Retinal Microvasculature and Immune Restoration Among South Eastern Asian Patients With HIV/AIDS Over a 9-Month Antiretroviral Therapy

Background: Longitudinal evidence on retinal microvasculature and subsequent systemic inflammatory alteration is lacking. We investigated the association between retinal microvasculature and immune response among patients with HIV/AIDS over a 9-month antiretroviral therapy. Methods: We conducted a prospective cohort study on patients with HIV/AIDS at Singapore Communicable Disease Centre since June 2011. We recruited all eligible patients and then reviewed them every 3 months over a 9-month follow-up, including performing blood tests (CD4(+)/CD8(+) T-cell counts and HIV viral load), blood pressure, anthropometry measurements, and retinal photography at each visit. We assessed retinal vascular indexes using a semiautomated computer-based program. Finally, we applied a linear mixed model to analyze associations between baseline retinal vascular indexes and 9-month changes of CD4(+)/CD8(+) T-cell counts and HIV viral load throughout study observation, after adjusting for major confounders. Results: We found that narrower arteriolar caliber (per 10 mu m decrease), wider venular caliber (per 10 mu m increase), and larger arteriolar branching angle (per 10 degrees increase) in the retina assessed at baseline were significantly associated with 9-month reductions in CD4(+) T-cell count by 52.97 cells/mu L (P = 0.006), 33.55 cells/mu L (P = 0.01), and 39.09 cells/mu L (P = 0.008), accordingly. Conclusion: Patients with HIV/AIDS with a suboptimal retinal microvascular morphology tended to fail immune restoration undertaking a 9-month antiretroviral therapy.