Hubungan Antara Kadar Cluster of Differentiation 4 dengan Manifestasi Neurooftalmik pada Penderita HIV Positif di Rumah Sakit Umum Pusat Haji Adam Malik Medan

Abstract

Background: Human Immunodeficiency Virus (HIV) is a disease that attacks the immune system with the main target are CD4 T lymphocytes with various clinical manifestations. The neuroophthalmic manifestations of HIV infection involve afferent and efferent visual pathways both in asymptomatic patients and in patients with neurological symptoms without visual impairment. Neuroophthalmic involvement is caused by direct infection, opportunistic infections and malignancy. Screening for neuroophthalmic disorders should be done even without vision complaints to identify neuroophthalmic signs and symptoms and refer to a neuroophthalmologist soon. Objective: To determine the relationship between CD4 levels and neuroophthalmic manifestations in HIV positive patients. Methods: It was a crosssectional study with primary data sources taken consecutively from HIV positive patients at Haji Adam Malik General Hospital in Medan. Subjects were examined for CD4 levels and also performed the neuroophthalmic and neurological physical examination such as visual acuity examination, visual field, pupil examination and fundoscopy. Results: There were 45 subjects with demographic characteristics the most of subjects were male (71.1%), age group 31-40 years (55.6%) with an average age of 35.98 + 9.23 years, self-employed (46.7 %), married (60%) and Bataknese (62.8%). CD4 levels < 200 cells/μL were found in 55.6% with a median value of 162 cells/μL (30-878). The most of neuroophthalmic clinical manifestations were found in 52% of subjects with CD4 levels <200 cells/μL with symptoms of blurred vision (22.2%) and clinical signs of abnormalities on fundoscopy (20%). There was a significant relationship between CD4 levels and neuroophthalmic manifestations in HIV patients (p<0.005). Conclusion: There was a significant relationship between CD4 levels and neuroophthalmic manifestations in HIV patients (p<0.005).