Annals of African Medicine, Vol. 4, No. 2, June, 2005, pp. 92

LETTER TO THE EDITOR

HUMAN IMMUNODEFICIENCY VIRUS (HIV) SEROPOSITIVITY IN PATIENTS PRESENTING TO AN EYE CLINIC

¹C. O.  Adeoti, ²A. A. Fagbami and ¹M. A. Isawumi

¹Departments of Ophthalmology, and ²Microbiology and Virology, LAUTECH Teaching Hospital, Osogbo Osun State, Nigeria
GP.O.Box 15222, Dugbe, Ibadan, Nigeria. E-mail: caroladeoti2001@yahoo.co.uk

Code Number: am05023

Dear Editor

An estimated 42 million people worldwide are now infected with the human immunodeficiency virus (HIV), ¹ compared with 30million people that were infected in 1997. Ninety per cent (90%) of these live in developing countries. Some people with HIV remain asymptomatic and these constitute an important source of transmission of the virus. HIV has been isolated from the tear fluid, conjunctiva of HIV positive but asymptomatic individuals. ² There have also been reports of health care workers who seroconverted following infected blood splash onto their mouths and non-intact skin. ³ The conjunctiva and cornea are also recognized as a potential route for transmission of infection. ⁴ In a study in Eastern Nigeria, 5.3% of eye patients were HIV positive. ⁵

This was a prospective study conducted at the eye clinic of LAUTECH Teaching Hospital, Osogbo, Nigeria from July 2002 - August 2003. Two hundred and forty-one patients coming for the first time were investigated using the enzyme linked immunosorbent assay (ELISA) technique after pretest counseling. They were tested for both HIV 1 and 2 using immunocomb. Those who tested positive had confirmatory test using immunocomb II HIV 1 and 2.

Eight (3.32%) were positive to HIV1.  No patient was positive for HIV 2. There were 6 males and 2 females. The clinical diagnosis in the HIV positive patients is shown in Table 1.

Table 1: HIV positive cases by diagnosis

This study shows that eye patients may have been infected with HIV. Eight (3.32%) out of 241 new patients seen were HIV positive. This is lower than what was obtained in Eastern Nigeria. ⁵ Male to female ratio in HIV positive patients   was 3: 1. This contrasts with other studies. Five (62%) patients were aged 20-40 years. The 2 patients with herpes zoster ophthalmicus were HIV positive and they were aged 22 and 37 years. This further confirms previous reports that Herpes zoster ophthalmicus in apparently healthy young adults is a marker of HIV infection in Africa.  Three patients (37%) were surgical patients. This is in contrast to other studies⁵where all the surgical patients were HIV negative. It is therefore necessary that ophthalmic workers must observe all the rules for preventing HIV transmission during surgical operations. The increasing number of HIV positive people who are asymptomatic also calls for high index of suspicion and so appropriate steps need be taken to avoid cross infection in clinical practice.

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