indinavir-sulfate and Uveitis

Uveitis is an ocular manifestation rarely observed in HIV-infected patients. We observed three cases of anterior uveitis without progressive retinitis in HIV patients receiving antiprotease treatment.. The first patient developed a first episode of uveitis during ritonavir therapy. Two other episodes occurred with indinavir. The second patient developed uveitis when treated with indinavir. In the third patient, the first episode developed with indinavir and a second with a ritonavir-saquinavir combination. Uveitis was unilateral in 4 episodes. Clinical manifestations were red irritable eyes and, in 2 episodes, reduced visual acuity. The antiprotease was interrupted in 4 of the 6 episodes and clinical course was rapidly favorable.. Pure anterior uveitis should suggest drug induction in HIV infected patients; rifabutin is often the cause. Infectious causes predominate in case of total uveitis associating choroid and retinal involvement. Cytomegalovirus, herpes zoster, syphilis, and toxoplasmosis have been incriminated. Antiproteases would appear to be a new cause of anterior uveitis in HIV-infected patients.

Topics: Adult; AIDS-Related Opportunistic Infections; Anti-HIV Agents; Drug Combinations; HIV Infections; HIV Protease Inhibitors; Humans; Indinavir; Male; Middle Aged; Rifabutin; Ritonavir; Saquinavir; Uveitis; Uveitis, Anterior; Visual Acuity

To quantify the inflammatory reaction that can be seen in HIV-infected patients with cytomegalovirus (CMV) retinitis after the introduction of an HIV protease inhibitor and correlate it with ocular findings and systemic HIV parameters.. Report of a patient with CMV retinitis systematically followed by slit-lamp examination, funduscopy, fundus photographs and laser flare photometry before and after introduction of an HIV protease inhibitor.. Manifest granulomatous panuveitis developed 2 months after the introduction of the protease inhibitor indinavir (CD4 rise from 2 to 64 CD4/mm3) and coincided with cicatrization of the CMV retinitis in the absence of efficient anti-CMV therapy.. Occurrence of uveitis in patients with CMV retinitis following the introduction of HIV protease inhibitors may be a factor indicating a good ocular prognosis, possibly pointing to the presence of the anti-CMV repertoire in the reconstituting CD4 cell population.

Topics: Adult; CD4 Lymphocyte Count; Cicatrix; Cytomegalovirus Infections; HIV Protease Inhibitors; Humans; Indinavir; Male; Prognosis; Retinitis; Treatment Outcome; Uveitis