Relação entre as alterações carotídeas e retinianas em pacientes infectados pelo vírus HIV sem infecção oportunista em atividade

Abstract

The Human Immunodeficiency Virus (HIV) has as a biological target the immune system, responsible for defending the body from diseases. The most affected cells in this system are lymphocytes, more specifically T CD4+, defense cells of the human body. This pathogen was identified in the 1980s, and today it is present all over the world, generating many hospitalizations, a lot of drug spending, causing significant impacts on the health and economy of several countries. The number of HIV-infected individuals with access to antiretroviral therapy is increasing. Studies have shown that, compared to Europe and North America, infected individuals in developing countries face a 10-fold increased risk of blindness from eye complications due to limited access to appropriate treatment. Ocular manifestations are seen in up to 50% of patients with the virus, with retinal damage being the most common presentation. These eye changes can be mild or even lead to blindness due to acute retinal necrosis (NRA) or progressive external retinal necrosis (PORN). Studies suggest that cardiovascular disease is approximately 1.5 to 2 times higher in people living with the virus than in uninfected people. This carotid damage is related to the prothrombotic effect of the virus, and this is related to greater cardiovascular diseases. Histopathologically, retinal vascular changes are similar to diabetic retinopathy, including loss of pericytes, edematous endothelial cells, as well as thickening of basement membranes. Capillaries become narrow or blocked. Up to 70% of patients may have lesions that are clinically diagnosed on a routine eye exam. In view of these aspects, this study aims to compare three groups of patients (a group with HIV without infectious ocular changes, a positive control group of diabetic patients and a negative control group with healthy patients) who attended consultations at the Ophthalmology Outpatient Clinic. from the University Hospital of UFGD, by means of an assessment of ocular alterations, changes in the carotid pattern and blood parameters, verifying if there was a higher prevalence of ocular and visual alterations in HIV positive patients, with or without atherosclerotic plaques, than in previously healthy or diabetic patients.