Assessing the Trends Describing the ImpAn Assessment of the Impact of Highly Active Antiretroviral Therapy (HAART) on HIV-Related Eye Diseases

People with HIV/AIDS have dealt with ocular complications of their disease since the beginning of the epidemic as recognized in 1981. Many studies were done describing incidence, prevalence, treatment and management of eye diseases caused by HIV in years before and after the introduction of the use of highly active antiretroviral therapy (HAART). This paper identifies studies directed at HIV related eye disease in the era after the introduction of HAART and finds evidence of the positive effects of HAART for some eye diseases. Examples of eye diseases with evidence of positive effects of HAART include cytomegalovirus retinitis and HIV retinopathy. Many populations have experienced a reduction in the incidence and prevalence of these and other HIV eye diseases in the era of HAART. While these trends are highly suggestive of the benefits of HAART for treating some HIV related eye diseases, further research is needed to strengthen the causal link for those conditions where improvements have been seen and to more clearly identify other ocular conditions that may benefit from HAART. Such evidence is critical when looking at the global picture of HIV eye disease because HIV eye disease is still a significant burden globally Many of the 34 million people in the world affected with HIV do not have access to treatment of HIV with HAART, and so it is important to look at the characteristics of individual HIV-related eye diseases and ascertain the impact of HAART use on these diseases, to build the evidence base for documenting the benefits of HAART in treating HIV ocular conditions, worldwide. An important step in identifying the benefits of HAART on specific HIV related eye diseases includes presenting a trend analysis comparing situations when HAART is used and when it is not used This information can then be used to inform practice and develop plans for further research. This paper presents the first steps in this research process by carefully reviewing these trends for a wide range of eye diseases that are related to HIV. The findings described in this paper not only provide support for further studies, but also can serve as hypothesis generating results to help design such studies. The importance of undertaking such studies is directly related to practice based evidence that using widespread HAART could lessen the burden of HIV eye diseases in populations that have not currently adopted widespread HAART use.Master of Public Healt