Conjunctival flora in patients with human immunodeficiency virus infection.
PURPOSE: To compare the conjunctival flora of human immunodeficiency virus (HIV)-positive and HIV-negative patients. Also, to assess the prophylactic effect of oral clarithromycin against Mycobacterium avium complex on the conjunctival flora of HIV-positive patients. METHODS: Ninety-four eyes of 47 HIV-positive patients and 122 eyes of 61 control patients were examined. All participants had a detailed anterior segment examination, including conjunctival cultures and laboratory blood tests. Culture results for different organisms were evaluated by chi-square analysis between the groups. The effect of systemic antibiotic treatment on the conjunctival flora of patients with HIV infection was evaluated by chi-square analysis. RESULTS: Bacterial organisms in the conjunctival sac were detected in four out of 28 (14.3%) eyes of HIV-positive patients treated with systemic clarithromycin and in 32 out of 66 (48.5%) eyes of HIV-positive patients without systemic clarithromycin treatment (p < 0.01). The CD4-positive T-cell counts in these groups were 158/microl and 416/microl, respectively (p < 0.01). Bacterial organisms were also detected in 46 of 122 (37.7%) control eyes. No difference was observed in the types and proportions of organisms isolated from the conjunctiva between HIV-positive patients without systemic clarithromycin treatment and controls. CONCLUSION: There was no difference between the conjunctival flora of HIV-negative and HIV-positive patients. Systemic clarithromycin treatment decreased the conjunctival flora of HIV patients, including those who had a CD4 count that was less than 50/microl.