Retinal nerve fibre layer thickness and contrast sensitivity in HIV-infected individuals in South Africa: a case-control study

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dc.contributor.authorPathai, Sophiaen_ZA
dc.contributor.authorLawn, Stephen Den_ZA
dc.contributor.authorWeiss, Helen Aen_ZA
dc.contributor.authorCook, Colinen_ZA
dc.contributor.authorBekker, Linda-Gailen_ZA
dc.contributor.authorGilbert, Clare Een_ZA
dc.date.accessioned2015-11-23T12:25:40Z
dc.date.available2015-11-23T12:25:40Z
dc.date.issued2013en_ZA
dc.description.abstractBACKGROUND: Antiretroviral treatment (ART) has altered the spectrum of HIV-related eye disease, resulting in a lower prevalence of retinal opportunistic infections (OIs). However, abnormalities in visual function have been reported in HIV-infected individuals despite effective viral suppression and the absence of retinal OIs. These changes may be mediated by an HIV-associated 'neuroretinal disorder', characterized by changes in the retinal nerve fibre layer (RNFL). HIV infection may also be associated with accelerated biological aging. The aim of this study was to investigate the relationships between contrast sensitivity, RNFL thickness, HIV infection and frailty in South African adults. METHODS: Case-control study of 225 HIV-infected individuals without retinal OIs and 203 gender/age-matched HIV-seronegative individuals. Peri-papillary RNFL thickness was determined with spectral domain optical coherence tomography in four quadrants. CS was measured using a Pelli-Robson chart. Frailty was assessed using standard criteria. Multivariable linear and logistic regression were used to assess associations between HIV status and RNFL/CS and frailty. RESULTS: The median age of both groups was similar (41.2 vs. 41.9 years, p = 0.37). 88% of HIV-infected individuals were receiving ART and their median CD4 count was 468 cells/μl. Adjusted CS score was lower in HIV-infected participants compared to HIV-seronegative individuals (1.76 vs. 1.82, p = 0.002). Independent predictors of poor CS in the HIV-infected group were positive frailty status and current HIV viral load >2 log copies/ml. Lower CS score was also associated with thin temporal RNFL in HIV-infected individuals (p = 0.04). Superior quadrant RNFL thickness was greatest in ART-naïve participants relative to the HIV-uninfected group (p-trend = 0.04). Longer ART duration was associated with thinning of inferior and nasal RNFL quadrants (p-trend = 0.03 and 0.04, respectively). CONCLUSIONS: Contrast sensitivity is reduced in HIV-infected individuals and functionally associated with frailty and unsuppressed viraemia. This may reflect structural changes in the RNFL that are evident despite the absence of OIs.en_ZA
dc.identifier.apacitationPathai, S., Lawn, S. D., Weiss, H. A., Cook, C., Bekker, L., & Gilbert, C. E. (2013). Retinal nerve fibre layer thickness and contrast sensitivity in HIV-infected individuals in South Africa: a case-control study. <i>PLoS One</i>, http://hdl.handle.net/11427/15276en_ZA
dc.identifier.chicagocitationPathai, Sophia, Stephen D Lawn, Helen A Weiss, Colin Cook, Linda-Gail Bekker, and Clare E Gilbert "Retinal nerve fibre layer thickness and contrast sensitivity in HIV-infected individuals in South Africa: a case-control study." <i>PLoS One</i> (2013) http://hdl.handle.net/11427/15276en_ZA
dc.identifier.citationPathai, S., Lawn, S. D., Weiss, H. A., Cook, C., Bekker, L. G., & Gilbert, C. E. (2013). Retinal nerve fibre layer thickness and contrast sensitivity in HIV-infected individuals in South Africa: a case-control study. PloS one, 8(9), 73694. doi:10.1371/journal.pone.0073694en_ZA
dc.identifier.ris TY - Journal Article AU - Pathai, Sophia AU - Lawn, Stephen D AU - Weiss, Helen A AU - Cook, Colin AU - Bekker, Linda-Gail AU - Gilbert, Clare E AB - BACKGROUND: Antiretroviral treatment (ART) has altered the spectrum of HIV-related eye disease, resulting in a lower prevalence of retinal opportunistic infections (OIs). However, abnormalities in visual function have been reported in HIV-infected individuals despite effective viral suppression and the absence of retinal OIs. These changes may be mediated by an HIV-associated 'neuroretinal disorder', characterized by changes in the retinal nerve fibre layer (RNFL). HIV infection may also be associated with accelerated biological aging. The aim of this study was to investigate the relationships between contrast sensitivity, RNFL thickness, HIV infection and frailty in South African adults. METHODS: Case-control study of 225 HIV-infected individuals without retinal OIs and 203 gender/age-matched HIV-seronegative individuals. Peri-papillary RNFL thickness was determined with spectral domain optical coherence tomography in four quadrants. CS was measured using a Pelli-Robson chart. Frailty was assessed using standard criteria. Multivariable linear and logistic regression were used to assess associations between HIV status and RNFL/CS and frailty. RESULTS: The median age of both groups was similar (41.2 vs. 41.9 years, p = 0.37). 88% of HIV-infected individuals were receiving ART and their median CD4 count was 468 cells/μl. Adjusted CS score was lower in HIV-infected participants compared to HIV-seronegative individuals (1.76 vs. 1.82, p = 0.002). Independent predictors of poor CS in the HIV-infected group were positive frailty status and current HIV viral load >2 log copies/ml. Lower CS score was also associated with thin temporal RNFL in HIV-infected individuals (p = 0.04). Superior quadrant RNFL thickness was greatest in ART-naïve participants relative to the HIV-uninfected group (p-trend = 0.04). Longer ART duration was associated with thinning of inferior and nasal RNFL quadrants (p-trend = 0.03 and 0.04, respectively). CONCLUSIONS: Contrast sensitivity is reduced in HIV-infected individuals and functionally associated with frailty and unsuppressed viraemia. This may reflect structural changes in the RNFL that are evident despite the absence of OIs. DA - 2013 DB - OpenUCT DO - 10.1371/journal.pone.0073694 DP - University of Cape Town J1 - PLoS One LK - https://open.uct.ac.za PB - University of Cape Town PY - 2013 T1 - Retinal nerve fibre layer thickness and contrast sensitivity in HIV-infected individuals in South Africa: a case-control study TI - Retinal nerve fibre layer thickness and contrast sensitivity in HIV-infected individuals in South Africa: a case-control study UR - http://hdl.handle.net/11427/15276 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/15276
dc.identifier.urihttp://dx.doi.org/10.1371/journal.pone.0073694
dc.identifier.vancouvercitationPathai S, Lawn SD, Weiss HA, Cook C, Bekker L, Gilbert CE. Retinal nerve fibre layer thickness and contrast sensitivity in HIV-infected individuals in South Africa: a case-control study. PLoS One. 2013; http://hdl.handle.net/11427/15276.en_ZA
dc.language.isoengen_ZA
dc.publisherPublic Library of Scienceen_ZA
dc.publisher.departmentDesmond Tutu HIV Centreen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.en_ZA
dc.rights.holder© 2013 Pathai et alen_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/4.0en_ZA
dc.sourcePLoS Oneen_ZA
dc.source.urihttp://journals.plos.org/plosoneen_ZA
dc.subject.otherFrailtyen_ZA
dc.subject.otherHIVen_ZA
dc.subject.otherHIV infectionsen_ZA
dc.subject.otherAntiretroviral therapyen_ZA
dc.subject.otherVisual acuityen_ZA
dc.subject.otherTomographyen_ZA
dc.subject.otherViral loaden_ZA
dc.subject.otherNerve fibersen_ZA
dc.titleRetinal nerve fibre layer thickness and contrast sensitivity in HIV-infected individuals in South Africa: a case-control studyen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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