Corneal endothelial deposits in patients with HIV infection or AIDS: epidemiologic evidence of the contribution of rifabutin

Background: We noted a number of patients with unusual fine, stellate corne al endothelial deposits. The distribution of the deposits appeared to be co ncentric, involving mostly the periphery, We postulated that the changes mi ght be related to the use of rifabutin rather than to cytomegalovirus (CMV) retinitis, We conducted a study among patients infected with HIV to assess the factors associated with these corneal changes. Methods: All patients with HIV infection or AIDS who presented to an ocular AIDS clinic in Vancouver between May Ib and July 4, 1996, were examined fo r the presence of corneal endothelial deposits. The clinical history was no ted in a masked fashion. Results: Of the 162 patients examined, 25 showed fine, diffuse, white, stel late corneal endothelial deposits occurring predominantly in the periphery. The presence of the deposits was associated with rifabutin use (odds ratio 5.6, 95% confidence interval 2.5 to 12.9) independent of the presence of C MV retinitis, the CD4 count, the presence of uveitis and use of other medic ations. Interpretation: Corneal endothelial deposits found in patients with HIV inf ection are associated with rifabutin use independent of the presence of CMV retinitis. The deposits should be monitored to determine their clinical si gnificance.