Human immunodeficiency virus-induced uveitis: intraocular and plasma human immunodeficiency virus-1 RNA loads.

OBJECTIVE: To report on a human immunodeficiency virus (HIV)-infected patient with uveitis and an intraocular HIV1 RNA load largely exceeding that of plasma and no evidence of other intraocular infectious agents causing uveitis than HIV itself.

DESIGN: Interventional case report.

PARTICIPANT: A 37-year-old male HIV-infected patient with uveitis and no retinal manifestations.

METHODS: Clinical and laboratory examinations including extensive intraocular fluid analyses for various pathogens and HIV-1 RNA loads in the aqueous and plasma.

MAIN OUTCOME MEASURES: Results of aqueous analysis and ophthalmologic features. Correlations between the results of aqueous testing and clinical characteristics.

RESULTS: A 37-year-old patient presented with progressive uveitis. He was positive for HIV-1, and his HIV-1 RNA plasma load was 44,600 copies/mL. His intraocular HIV-1 RNA load was >1,900,000 copies/mL, which largely exceeded his concurrent plasma load. No evidence of infectious agents other than HIV itself was found, and the uveitis reacted promptly to solely the antiretroviral treatment.

CONCLUSIONS: Our findings suggest that HIV can locally replicate within the eye and cause an intraocular inflammatory reaction.