Intraocular and Plasma HIV-1 RNA in HIV-infected Patients with CMV Retinitis and HIV-infected Controls

HIV-1 RNA was quantified in intraocular specimens and plasma from AIDS patients with CMV retinitis undergoing therapeutic vitrectomy and in 8 control subjects undergoing cataract surgery using the Amplicor RT-PCR-based assay. The HIV-1 RNA concentration in the intraocular specimens was significantly lower than in plasma. Patients with CMV retinitis and plasma HIV-1 RNA concentrations > 100,000 copies/ml generally had detectable HIV-1 RNA in their intraocular specimens. These findings point to the risk of percutaneous injury from a sharp instrument used in HIV-infected patients during ophthalmic surgery and possible transmission of HIV during such surgery. Prevention of percutaneous contact will require the use of surgical instruments that reduce the likelihood of injury, as well as the wearing of double gloves during surgery.