Ocular lesions associated with HIV infection in India: A series of 100 consecutive patients evaluated at a referral center

PURPOSE: To document the ocular disorders seen in patients known to be infe cted with human immunodeficiency (HIV) virus at a referral eye clinic in In dia. METHODS: The first 100 individuals known to be HIV-positive at a referral e ye clinic between 1993 and 1998 were enrolled in a prospective study. They underwent complete ocular and systemic evaluation. RESULTS: Most of the patients (76%) were in the 20- to 40-year age group. H eterosexual exposure to commercial sex workers was the most common risk fac tor (70%) for HIV infection. Cytomegalovirus (CMV) retinitis (17%) and HIV retinopathy (15%) were the most common HIV-associated ophthalmic lesions. P ulmonary tuberculosis (67%) and oropharyngeal candidiasis (66%) were the mo st commonly associated systemic infections. Ocular involvement was most com mon in children who contracted the disease through perinatal transmission ( 66.7%) and in homosexual patients (60%). Ocular involvement was comparative ly less common in patients who contracted the disease through blood transfu sions (33%) or exposure to commercial sex workers (21.3%). CONCLUSIONS: This study shows that the spectrum of ocular lesions associate d with HIV infection in India is different from that seen elsewhere in the world. The prevalence of CMV retinitis and HIV retinopathy is lower in Indi a, and there have been no cases of ocular Kaposi sarcoma. Adnexal infection s, albeit rare, were seen in our series. The nonavailability and cost of th erapy influenced the visual prognosis in these patients. (Am J Ophthalmol 2 000;129:9-15. (C) 2000 by Elsevier Science Inc. All rights reserved.)