Functional and structural neuroretinal disorders in HIV Controllers. Prospective cohort study

• Published in: HIV medicine 2024-11, Vol.25 (11), p.1192-1202
• Main Authors: Ruiz‐Bilbao, Susana, Videla, Sebastian, Pascual, Ester, Soler, Montse, Jordi, Puig, Grizolli, Stefano, Negredo, Eugènia, Castellvi‐Manent, Jordi
• Format: Article
• Language: English
• Subjects: Acuity; Adult; Antiretroviral agents; Antiretroviral therapy; Biomarkers; Cohort analysis; Controllers; Disorders; Female; Ganglion cells; Health services; HIV; HIV controllers; HIV Infections - complications; HIV Infections - drug therapy; Human immunodeficiency virus; Humans; Incidence; Male; Middle Aged; Nerves; neuro‐retinal disorders; ocular aging in HIV; Parameter sensitivity; Prevalence; Prospective Studies; Quality of Life; retina in HIV; Retinal Diseases - epidemiology; retinal OCT in HIV; Structure-function relationships; Visual Acuity; Visual field; Visual Fields
• ISSN: 1464-2662; 1468-1293; 1468-1293
• DOI: 10.1111/hiv.13685

Objective To estimate the prevalence and cumulative incidence of neuro‐retinal‐disorders (NRD) in HIV‐controllers. Design Prospective, single‐centre, cohort study of people living with HIV (PLWH): elite‐controllers, long‐term‐non‐progressors and early diagnosed. Methods The study compared “HIV‐controllers” (including elite‐controllers and long‐term‐non‐progressors), who were not on antiretroviral therapy (ART), and “HIV‐treatment” (HIV‐infected subjects with a recent diagnosis and on ART). A matched cohort of “non‐HIV subjects” was created. NRD was defined as at least one altered (not normal) ophthalmological parameter (functional or structural). Functional (visual acuity, contrast sensitivity, chromatic vision, visual field) and structural parameters (ganglion cells, macular nerve fibre layer, peripapillary nerve fibre layers, vascular calibre) as well as quality of life (Medical Outcomes Study‐HIV Short Form‐30) were assessed. Results Between March 2012 and November 2015, the study included all HIV‐controllers (16 elite‐controllers, 1 long‐term‐non‐progressor), 11 HIV‐treatment and 16 non‐HIV. Prevalence of NRD at baseline was 88.2% (15/17, 95% CI: 65.7%–96.7%), 90.9% (10/11, 95% CI: 62.3%–98.4%) and 56.3% (9/16, 95% CI: 33.2%–76.9%), respectively. Cumulative incidence at 3 years was 50% (1/2), 100% (1/1) and 33.3% (2/6), respectively. None of the participants manifested ocular clinical symptoms. Three years later, prevalence of NRD was 92.3% (12/13, 95% CI: 66.7%–98.6%), 75% (6/8, 95% CI: 40.9%–92.9%) and 50.0% (7/14, 95% CI: 26.8%–73.2%), respectively. Contrast sensitivity and structural parameters were globally the most affected among PLWH. Quality of life (total score) [median (interquartile range)] at baseline and 3 years was 82 (71–89) and 74 (63.5–79.25) in HIV‐controllers and 80 (73–88) and 88 (83–92) in HIV‐treatment. Conclusions HIV‐controllers and those individuals on ART presented a higher percentage of NRD than non‐HIV. Our results suggest that NRD could be a biomarker of ocular aging among PLWH.