Differing spectrum of HIV-associated ophthalmic disease among patients starting antiretroviral therapy in India and South Africa.

Differences in the prevalence and spectrum of HIV-associated ophthalmic disease in Africa and Asia are not well documented. We studied two comparable cohorts of patients initiating antiretroviral therapy in Mumbai, India, and Cape Town, South Africa. The prevalence of HIV-associated ophthalmic disease was higher in the Indian population (17.5%) than in the South African population (12.1%). This was largely because of vitreo-retinal opportunistic infections (11.4%vs. 2.6%, respectively), notably cytomegalovirus retinitis. This difference persisted after adjusting for confounding factors (adjusted odds ratio=11.32, 95% confidence interval: 2.67-48.13), confirming a marked geographical difference in the prevalence of HIV-associated retinal disease.