Inflammatory mechanisms contributing to retinal alterations in HIV infection and long-term ART

Southern African Journal of HIV Medicine

Field Value
Title Inflammatory mechanisms contributing to retinal alterations in HIV infection and long-term ART
Creator Buthelezi, Lungile M. Munsamy, Alvin J. Mashige, Khathutshelo P.
Subject Optometry; Primary health care retina; blood-retina barrier; HIV; antiretroviral therapy; inflammation; optical coherence tomography
Description People living with HIV (PLWH) may face an increased risk of eye complications associated with ageing, chronic inflammation, and the toxicity arising from long-term antiretroviral therapy (ART). This review aims to understand how inflammatory pathways contribute to retinal alterations observed in PLWH on long-term ART. This review was conducted using four electronic database searches, namely Scopus, Hinari, Google Scholar, and PubMed; from 1996 (when ART became available) until January 2022, without language restriction. Sources from clinical trials, meta-analyses, randomised controlled trials, and systematic reviews were used. Dysregulated para-inflammation (chronic inflammation) damages the blood-retina barrier, resulting in the altered retinal immune privilege and leading to the development of retinal and blood vessel changes. There is an interplay between the effects of the disease versus ART. ART causes mitochondrial toxicity, which affects the retinal ganglion cells and retinal pigment epithelium (RPE) due to oxidative stress. Infection by HIV also affects retinal microglia, which contributes to RPE damage. Both of these mechanisms affect the blood vessels. Assessing the integrity of the inner and outer blood-retina barrier is a pivotal point in pinpointing the pathogenesis of inner retinal alterations. Optical coherence tomography is a valuable tool to assess these changes. There is a paucity of research to understand how these structural changes may affect visual function, such as contrast sensitivity and colour vision.
Publisher AOSIS
Date 2024-03-26
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — Narrative review
Format text/html application/epub+zip text/xml application/pdf
Identifier 10.4102/sajhivmed.v25i1.1548
Source Southern African Journal of HIV Medicine; Vol 25, No 1 (2024); 10 pages 2078-6751 1608-9693
Language eng
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Coverage Southern Africa — HIV
Rights Copyright (c) 2024 Lungile M. Buthelezi, Alvin J. Munsamy, Khathutshelo P. Mashige