Advancement of HIV and Co-infections: A Prospective Observational Study

Abstract

Aim: To assess the incidence of comorbidities and opportunistic infections (OIs) in advanced HIV. Design: This is a prospective observational study conducted on people living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) (PLHA) with a laboratory-confirmed cluster of differentiation-4 (CD4) counts <100/mm 3 . Recruitment of 102 PLHA patients was performed with no filtering criteria based on the duration of diagnosis, antiretroviral therapy (ART) naive, or ART failure. Data collection was initiated post-clearance by the Institutional Ethics Committee. Methods: The study was conducted at the tertiary care center. The prevalence of underlying comorbidities and the incidence of multiple OIs were assessed in 102 HIV patients with CD4 <100/mm 3 . A detailed clinical examination was carried out, and all relevant investigations were digitally recorded. Results: The mean age of the participants among the 102 PLHA with a CD4 count of 100/mm 3 was 41.4 + 11.2 years, and their mean CD4 count was 62.3 + 20.5/mm 3 at the time of recruitment. A total of 62 (60.8%) patients were ART-naive. The two most prevalent comorbidities in the research population were anemia and renal failure. Fungal infections (66.6%) in the study cohort varied from the most frequent oral thrush (42.1%) to disseminated histoplasmosis (7.8%). Tuberculosis was the second most prevalent opportunistic illness (36.2%). Syphilis cases were prevalent (8.8%) among sexually transmitted illnesses linked to HIV, with most of the cases being latent syphilis; 3.9% of the patients were coinfected with chronic hepatitis B and HIV, and only one possessed chronic hepatitis C. Conclusion: Comorbidities and OIs are major public health concerns in Indian healthcare settings. Our findings show that the prevalence of comorbidities and OIs is high. Furthermore, late diagnosis with HIV, a CD4 count <100/mm 3 , and poor adherence indicate an increased incidence and decreased survival time among PLHA with underlying comorbidities and OIs . Early care-seeking and the beginning of ART, as well as ongoing monitoring of patients to ensure they take their medication on schedule, are critical to reducing OIs and improving general health. Further research is highly recommended to gain deeper insights.