Purpose: To describe the clinical presentation, ocular complications and clinical
implications of acute HZO in HIV positive patients.
Method: Prospective descriptive clinical case series of 54 individuals aged 18 – 50 years
with confirmed HIV infection and acute presentation of HZO.
Results: A female preponderance (1.7:1) and mean age of 36.6 years (range 18 – 49
years) was recorded. The majority of patients were referred from CHC and only 28% of
referred patients received appropriate antiviral treatment at the referral site. Mean
duration of rash at presentation was 4.7 days (range 1 – 12 days) with 31% of patients
presenting within 3 days of rash eruption. Patients attended a mean of 2.7 clinical visits.
Equal proportions had known and unknown HIV serostatus at presentation. Mean CD4+
was 276 cells/mm3 (range 44 - 859 cells/mm3). 67% of patients had a CD4+ count < 350
cells/mm3. Periocular discomfort was the most common presenting symptom (70%);
decreased VA (2%) was an uncommon presenting symptom. Multidermatomal
involvement was uncommon (7%). At presentation normal VA was seen in 69% of
patients and 94% had no global visual impairment. Corneal complications (89%) and
intraocular inflammation (46%) were the most common ocular complications. Ocular
complications at presentation and multiple complications were the rule (70% and 61%).
Hutchinson sign was found to be of little clinical value. Visual outcome was fair, 22% of
patients having residual visual impairment. Post-herpetic neuralgia was common (74%).
Conclusion: HZO is a common HIV marker condition with ocular complications. It may
have an application as an indication for the initiation of ARV treatment.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/14421 |
| Date | 31 March 2014 |
| Creators | Botha, Andre F |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | application/pdf |
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