[Ocular manifestations of children living with HIV/AIDS in Kinshasa].

N L Nsiangani, D Kaimbo Wa Kaimbo, M K Kapepela
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Abstract

Objective: to determine the frequency of ocular manifestations in Congolese children aged 0 to 15 years infected with HIV/AIDS and to identify the predicted clinical and/or biological elements.

Methods: This was a prospective, descriptive and cross-sectional study performed from November 2010 to April 2011 in five sanitary structures who take care of children infected with HIV/AIDS. During the period of study, one hundred children infected with VIH/AIDS were examined. Seventy- six (76%) of children were under highly active anti-retrovial therapy (HAART). The age of children ranged from 0,5 month to 15 years. Children underwent a routine ophthalmic examination which included measurement of visual acuity, inspection of the adnexa and cornea, slit-lamp examination and dilated ophthalmoscopy. The CD4 lymphocyte count was determined in 88 of them.

Results: The frequency of ocular manifestations was 36%. The mean age of children was 8 years (SD: 4.01; range 0,5 month-15 years). The male female sex ratio was 0.8/1. Ocular complaints were present in 22 children (22%). Visual symptoms were most frequent in children with severe decrease of immunity. Of four children identified with a visual handicap, one (1.5%) had blindness and three (4.4%) had visual impairment. All of these four children had a CD4 lymphocyte count less than 15%. Among ocular manifestations, the adnexial manifestations were the most frequent with 18 cases (18%) followed by the posterior segment manifestations with 14 cases (14%) and the neuroophthalmic lesions with 5 cases (5%).

Conclusion: This study documented 36% of ocular manifestations; this frequency is comparable with the other African studies. Comparatively to studies conducted in other continents the frequency in African studies is high. This study also showed that the adnexial manifestations are the most frequent ocular findings and that the children with severe decrease of immunity are most exposed to visual troubles that can lead to blindness.

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[金沙萨感染艾滋病毒/艾滋病儿童的眼部表现]。
目的:确定0至15岁感染艾滋病毒/艾滋病的刚果儿童眼部表现的频率,并确定预测的临床和/或生物学因素。方法:这是一项前瞻性、描述性和横断面研究,于2010年11月至2011年4月在照顾感染艾滋病毒/艾滋病儿童的五个卫生机构中进行。在研究期间,对100名感染艾滋病毒/艾滋病的儿童进行了检查。76名(76%)儿童接受了高效抗逆转录病毒治疗(HAART)。儿童的年龄从0.5个月到15岁不等。儿童接受常规眼科检查,包括测量视力、检查附件和角膜、裂隙灯检查和扩张性眼科检查。其中88例检测CD4淋巴细胞计数。结果:眼部表现占36%。患儿平均年龄为8岁(SD: 4.01;范围:0、5个月-15年)。男女性别比为0.8/1。22名儿童(22%)出现眼部主诉。视觉症状最常见于免疫力严重下降的儿童。在四名被确定为视力障碍的儿童中,一名(1.5%)失明,三名(4.4%)视力受损。这4名儿童CD4淋巴细胞计数均低于15%。在眼部表现中,以附件表现最多,18例(18%),其次是后段表现14例(14%)和眼神经病变5例(5%)。结论:本研究记录了36%的眼部表现;这一频率与其他非洲研究相当。与在其他大陆进行的研究相比,非洲研究的频率很高。本研究还表明,附件表现是最常见的眼部表现,免疫力严重下降的儿童最容易出现视力问题,可能导致失明。
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