Relapsing Uveitis due to Human T-lymphotropic Virus Type 1 in a Patient Living With HIV Diagnosed by Metagenomic Deep Sequencing

• Type of Material: Article
• Authors: Varun Phadke, Emory University; Jessica Shantha, Emory University; Ghazala O'Keefe, Emory University
• Language: English
• Date: 2020-03-01
• Publisher: Oxford University Press Inc.
• Publication Version: Final Published Version
• Copyright Statement: © The Author(s) 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1093/ofid/ofaa078
• Title of Journal or Parent Work: Open Forum Infectious Diseases
• Volume: 7
• Issue: 3
• Start Page: 1
• End Page: 3
• Grant/Funding Information: Dr. Shantha’s work is supported by the National Eye Institute of the National Institutes of Health (K23EY030159).
• Keywords: HTLV-1; Life Sciences & Biomedicine; Microbiology; Infectious Diseases; Science & Technology; Immunology; uveitis; metagenomic deep sequencing; HIV
• Research Categories: Health Sciences, Opthamology; Biology, Microbiology; Health Sciences, Epidemiology

Abstract

HIV infection can result in vision loss from different causes, including HIV retinopathy and uveitis secondary to other infections, such as toxoplasmosis and viral retinitis. It is imperative to identify any infectious causes of uveitis to successfully treat the condition and prevent further vision loss. Metagenomic deep sequencing (MDS) is an emerging technology that presents an unbiased approach to the evaluation of clinical syndromes, including uveitis, that have not been diagnosed by pathogen-specific testing. Herein we present a case of a woman living with HIV with 11 years of relapsing bilateral uveitis refractory to systemic corticosteroid therapy who was diagnosed with human T-lymphotropic virus type 1 (HTLV-1)–associated uveitis by this technology. We also briefly review the literature of MDS as a diagnostic tool and the epidemiology, pathogenesis, and diagnosis of HTLV-1-associated uveitis.