Ophthalmic Manifestations among HIV Patients at the Main Tertiary Hospital in Freetown, Sierra Leone: A Cross-Sectional Study

Ophthalmic diseases are common among people living with HIV (PLHIV) in developing countries. However, there are currently no published studies on ophthalmic complications among PLHIV in Sierra Leone. We conducted a cross-sectional study of PLHIV presenting at Connaught Hospital in Freetown, Sierra Leone from January through March 2020. Logistic regression was used to identify associations between ophthalmic manifestations and potential risk factors. A total of 103 PLHIV were studied (78.6% female, median age 41 years, 100% treatment-experienced). The median CD4 cell count was 374 cells/mm3 and 76.7% were virologically suppressed. Overall, 44.7% of study participants had at least one ophthalmic complication and 51.5% had poor visual acuity in at least one eye. The most common conditions were dry eye (21.4%), cataract (20.4%), blepharitis (10.7%), nucleosclerosis (6.8%), conjunctivitis (5.8%), penguecula (5.8%), toxoplasmic retinochoroiditis (3.9%), and posterior vitreous detachment (2.9%). In multivariate logistic regression analysis, poor visual acuity (adjusted odds (aOR) 2.75, 95% confidence interval (CI) [1.12–6.78]; p = 0.040) and CD4 cell count < 100 cells/mm3 (aOR 3.91, 95% CI [1.07–14.31]; p = 0.028) were independently associated with ophthalmic disease. A high proportion of PLHIV in this study had ophthalmic complications. This calls for greater integration of HIV and ophthalmologic care.