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Visual Changes in Early HIV Infection
Mar 11, 2001

Dr. Feinberg, I've recognized, through HIV-related discussions and internet readings, that many HIV+ patients develop floaters (vitreous fiber condensation 'cobweb type') in early HIV infection.

I believe this is because of the immune system's recovery after ARS and the associated inflammatory response. This condition seems to be similar to documented HIV uveitis experienced by HIV patients after initiating HAART.

My hypothesis is that the occurence of multi-focal cobweb-like floaters after ARS, in treatment naive HIV+ patients, is caused by the inflammatory response associated with immune system reconstitution after ARS.

Your thoughts please.

DISCLAIMER: I understand that floaters are, nonspecific develops and a common part of the aging process and that HIV- as well as HIV+ develop them.

Response from Dr. Feinberg

The mechanism you propose might be responsible if HIV directly infected retinal cells, and the subsequent immune response were directed at those cells. I know of no data that indicate that retinal cells are infected by HIV, but some brain cells are permissive for HIV infection and the eye is, in a manner of speaking, an anatomic extension of the brain.


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