Epidemiology of Herpes Simplex Eye Disease in an Urban Population

Date of publication : 2017/02/04

Publisher : الموقع

Epidemiology of Herpes Simplex Eye Disease in an Urban Population

David C. Gritz 

Purpose: To determine whether HIV/AIDS, diabetes mellitus, and atopic disease are associated with herpes simplex virus (HSV) eye disease, and to examine the characteristics of HIV-positive patients with HSV eye disease. 
Methods: This retrospective case-control study compared cases (inclusion criteria: a diagnosis of HSV eye disease by an ophthalmologist and residency in the Bronx) with a medical center outpatient-based control group (attending an outpatient clinic and residency in the Bronx). The study period was June 1, 2010 through May 31, 2014 and included all outpatient visits within the Montefiore Medical Center healthcare system (Bronx, NY, USA). Ratio of cases to controls was 1:4. Associations evaluated included age, gender, HIV/AIDS, diabetes mellitus, and atopic disease. 
Results: HSV eye disease was confirmed in 70 patients, who were compared to 280 controls. Patients with ocular HSV had a greater prevalence of HIV/AIDS compared to controls (8.6% and 2.9%, respectively). Using multivariate analysis to control for age and gender, atopic dermatitis (OR 3.08, 95% CI: 0.84 to 11.20) and diabetes with chronic complications (OR 2.25, 95% CI: 0.91 to 5.61) approached significance, while HIV/AIDS (OR 3.37, 95% CI: 1.09 to 10.40), an age less than 45 years (OR 2.89, 95% CI: 1.54-5.41), and male gender (OR 1.85, 95% CI: 1.07 to 3.18) were significant. Among the HIV-positive group of HSV eye disease patients, 5 of 6 (83.3%) were on HAART therapy and all 6 (100%) presented with a form of keratitis or retinitis. 
Conclusions: HIV-positive status results in more than a three-fold increased risk of developing ocular HSV. To our knowledge, this study represents the first time strength of association has been calculated between HIV and HSV eye disease.