Sympathetic ophthalmia in HIVinfection. A clinicopathological case report

Background The purpose of this study is to report a case of sympathetic ophthalmia (SO) in an HIV-infected patient on treatment with highly active antiretroviral therapy (HAART) 9 years after a penetrating eye injury. Methods The study utilized clinical course and histopatho- logical findings. Results Histopathology of the enucleated right eye showed a predominantly lymphocytic inflammatory infiltration with some plasma cells and epithelioid granulomata in the choroid, suggesting the diagnosis of SO. Conclusions SO seems to be driven by T lymphocytes, spe- cificallybytheCD4subsetofTcells.HIV-infectedindividuals suffer a decline in CD4 Tcell numbers, leading to an acquired immunodeficiency that could halt the development of the inflammatory reaction responsible for SO. The restoration of the CD4 counts by HAART therapy makes HIV-infected individuals as susceptible to SO as non-infected ones. To the best of our knowledge, there are no cases of SO in HIV- infected patients reported in the literature.