Risk of uveitis in patients with human immunodeficiency virus

Background: This multi-institutional, retrospective cohort study using TriNetX database aims to explore the relationship between HIV infection and uveitis. Methods: HIV patients were propensity-matched to individuals from our non-HIV cohort (1:1 ratio) based on variables such as age (every 5 year), sex, ethnicity, race, and relevant comorbidities. The Cox proportional hazards regression model was utilized to assess the impact of variables on uveitis risk, reporting hazard ratios (HRs) with 95% confidence intervals (CIs). Kaplan-Meier survival analysis and log-rank tests were applied to estimate the cumulative incidence of uveitis. Statistical significance was set at a two-sided p-value < 0.05. Results: We found that adult patients with HIV infection had a significantly increased risk of developing uveitis compared to non-HIV counterparts, with an overall HR of 3.02 (95% CI: 2.70 − 3.39). The risk remained elevated across designated follow-up intervals of 1 year (HR = 4.68 [3.69 − 5.92]), 2 years (HR = 4.44 [3.65 − 5.41]), and 3 years (HR = 4.06 [3.42 − 4.81]), with consistent increases noted when dividing into different uveitis types except for anterior uveitis. The risk was higher among patients with acquired immunodeficiency syndrome (AIDS) compared to asymptomatic HIV (HR = 2.64 [1.30 − 5.35]). Furthermore, HIV patients receiving treatment within three months exhibited a notably increased risk (HR = 2.87 [2.33 − 3.54]). Conclusions: This study reveals that individuals with HIV face a significantly heightened risk of developing uveitis. Our findings indicate that this risk is most substantial for intermediate and posterior uveitis, challenging the long-held belief that anterior uveitis is the predominant form in this population.