Description
Background Human Immunodeficiency Virus (HIV) is been a rising concern since it is spreading widely throughout the entire world. The census of U. S. in 2010 showed that there are more than one million people infected with HIV virus. HIV is a systemic disease that means it affects a number of organs and tissues, or affects the body as a whole. This paper focused on a specific part of eye, retina which is also affected by HIV. This research analyzed the relationship between HIV and retinal damage in both structural and functional aspect. Methods Data analyzed in this research came from the UCSD HIV Neurobehavioral Research Center and UCSD Jacobs Retina Center prospective longitudinal. This study compared mean value of structural and functional measures across three different groups (HIV+ with low CD4 count, HIV+ with high CD4 count and HIV- or control) and indentified which group is significantly different from others. For progression analysis Generalized Estimating Equations (GEE) was performed after controlling for age, gender and HIV duration. We identified the best predictor of HIV status among these structural and functional measurements by using multinomial logistic regression where control group is selected as reference group. The Akaike's Information Criterion (AIC) between the regression models were compared assuming the model with lowest AIC is best one predicting HIV status. Results For SLP the difference was significant for both parameters (p=0.0001, p=0.0014). For cSLT the difference was significant in Horizontal RNFL curvature (p=0.002) and glaucoma probability (p=0.0019). For CV and HVF the difference was significant (p=0.0005, p=0.0142, respectively) across the groups. There was a significant progression among horizontal RNFL curvature (p=0.003), vertical RNFL curvature (p=0.0001) and glaucoma probability (p=0.001).For SLP (TSNIT average RNFL thickness) the odds ratio for HIV (L) vs. control 0.902 (0.836 -- 0.924) and HIV (H) vs. control 0.879 (0.799-0.932). The AIC value (239.23) was lowest for SLP. HVF PSD measure the odds ratio for HIV (L) vs. control was 3.28 (1.26-8.6) and for high vs. normal it was 2.93 (1.21-7.78). AIC score for HVF (PSD) was lowest (187.22). Discussion These results indicated that RNFL structural damage and retinal functional deficit occurred mostly in HIV (L) group that consist HIV+ patients with low CD4 cell count. For clinical purpose it would be sufficient to use Scanning Laser Polarimetry (SLP) to evaluate the structural damage and Humphrey Visual Field (HVF) to evaluate the functional deficit in order to indentify HIV status in relation to the retinal damage
