PURPOSE: To determine the presence of dry eye and the changes in the conjunctival epithelium of patients infected with HIV-1 and with AIDS; to investigate the relation of the changes with the characteristics and with other ocular conditions of patients; to study the influence of HAART an eyes with keratoconjunctivitis sicca in patients with AIDS. METHODS: Patients with laboratory diagnosis of HIV infection, were examined and divided into two groups: I. HIV+ (without clinical diagnosis and with a CD4+ count of more than 200 cells/mm³); II. Patients with AIDS (CD4+ count less than 200 cells/mm³ and/or with clinical manifestations). The following were assessed: modes of transmission of HIV; ocular manifestations; laboratory findings, tear production and conjunctival impression cytology. RESULTS: 43 patients of group I e 77 patients of group II were studied. The internal ocular findings were decreased significantly after the use of HAART; however, this did not occur regarding external findings. 65,1% of the patients with dry eye were men. The changes of the Schirmer test and the tear film break up time were neither related to the severity of HIV disease nor to CD4+ count. All patients with changes in the conjunctival impression cytology showed KCS, and 88,8% of the patients were of the group II. Increase in frequency of these changes was found in patients with disease time of more than 4 years. CONCLUSION: The decrease in tear production has not been related to the severity of HIV infection and the use of HAART did not affect the frequency of dry eye syndrome in HIV- positive patients.
Keratoconjunctivitis sicca; HIV seropositivity; Acquired immunodeficiency syndrome; Antiviral agents; Combined modality therapy; HIV-1
