Middle East African Journal of Ophthalmology

LETTER TO THE EDITOR
Year
: 2017  |  Volume : 24  |  Issue : 4  |  Page : 222-

Demographic and clinical features of pediatric uveitis at a tertiary referral center in Iran


Mahmood Dhahir Al-Mendalawi 
 Department of Paediatrics, Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq

Correspondence Address:
Mahmood Dhahir Al-Mendalawi
Department of Paediatrics, Al-Kindy College of Medicine, University of Baghdad, P.O. Box. 55302, Baghdad Post Office, Baghdad
Iraq




How to cite this article:
Al-Mendalawi MD. Demographic and clinical features of pediatric uveitis at a tertiary referral center in Iran.Middle East Afr J Ophthalmol 2017;24:222-222


How to cite this URL:
Al-Mendalawi MD. Demographic and clinical features of pediatric uveitis at a tertiary referral center in Iran. Middle East Afr J Ophthalmol [serial online] 2017 [cited 2020 Aug 12 ];24:222-222
Available from: http://www.meajo.org/text.asp?2017/24/4/222/223110


Full Text



Sir,

I read with interest the study by Rahimi et al. on the demographic and clinical features of pediatric uveitis at a tertiary referral center in Iran.[1] The authors mentioned that noninfectious uveitis was detected in 81.5% of the studied patients compared to 18.5% for infectious uveitis. Among the infectious category, there were four patients with toxocariasis, four patients with toxoplasmosis, and one patient with herpes simplex virus infection.[1] Interestingly, no case of human immunodeficiency virus (HIV)-associated uveitis was reported. It is obvious that HIV infection is one of the twenty- first century's biggest global challenges to humankind with wide manifestations affecting all organs of our body, including eyes. It has been reported that there was a 52%–100% lifetime accumulative risk of HIV-positive patients developing various ocular problems. Seventy-seven percent of patients with ocular manifestations of HIV infection have been noticed to have CD4 counts <200 cells/μL.[2] In an interesting Thailand study, intraocular HIV-1 RNA was detected in 32% of HIV-positive patients with uveitis. Intraocular HIV-1 RNA loads were associated with high-HIV-1 RNA plasma loads (P < 0.001) and not being on highly active antiretroviral therapy (P = 0.005). In addition, detectable intraocular HIV-1 RNA levels were found to be higher in patients with the absence of retinal lesions (P = 0.008). In 7% of HIV-positive patients, the HIV load in the eye largely exceeded that of plasma.[3] Although no recent data on the exact prevalence of HIV infection in the pediatric population are yet present in Iran, the available data pointed out that the overall HIV rates in Iran have generally increased by 80% per year for the past decade.[4] It was not clearly evident in the methodology of Rahimi et al.'s study[1] that HIV infection was considered in the studied cohort through appropriate workp of CD4 count and viral overload measurements. Hence, I presume that the actual rate of pediatric HIV-associated uveitis might be underestimated.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Rahimi M, Oustad M, Ashrafi A. Demographic and clinical features of pediatric uveitis at a tertiary referral center in Iran. Middle East Afr J Ophthalmol 2016;23:237-40.
2Mowatt L. Ophthalmic manifestations of HIV in the highly active anti-retroviral therapy era. West Indian Med J 2013;62:305-12.
3Pathanapitoon K, Riemens A, Kongyai N, Sirirungsi W, Leechanachai P, Ausayakhun S, et al. Intraocular and plasma HIV-1 RNA loads and HIV uveitis. AIDS 2011;25:81-6.
4HIV in Iran. Lancet 2013;382:1958.