Abstract
BackgroundHuman immunodeficiency virus (HIV) pandemic is among the greatest health crises ever faced by humanity. Morbidity and mortality in HIV disease is due to immunosuppression leading to life-threatening opportunistic infections (OIs) during the natural course of the disease. This study was aimed to assess the prevalence and CD4 correlates of OIs among adult HIV-infected patients attending at Gondar University Hospital.MethodsCross sectional study was conducted on 360 adult HIV-infected patients attending antiretroviral therapy clinic from February 2012-April 2012. Patients’ OI status was determined through clinical diagnosis and laboratory investigations. CD4 count was determined using flow cytometry technique. Sociodemographic and clinical data were obtained from interview and patients’ medical records. Bivariate and multivariate logistic regression analysis was done using SPSS version 16 statistical soft ware and odds ratio was used as the measure of association. P-value less than 0.05 was considered statistically significant for all tests.ResultsIn this study, 360 HIV-infected patients were included; of whom (n = 216/360, 60%) were females. The majority of patients (n = 153/360, 42.5%) were 25-34 years old with mean age of 35.5+ 8.8 standard deviation. The overall prevalence of OIs was (n = 71/360, 19.7%). Tuberculosis (n = 35/360, 9.72%) followed by oral candidiasis (n = 18/360, 5%) and diarrhea (n = 12/360, 3.3%) were the most frequently observed OIs. CD4 count less than 200/mm3 (OR = 4.933, P < 0.001), World Health Organization (WHO) clinical stage III (OR = 9.418, P < 0.001) and IV (OR = 22.665, P < 0.001) were found to have strong association with acquisition of OIs.ConclusionsTuberculosis, oral candidiasis and diarrhea were the leading OIs encountered by HIV-infected patients. CD4 count less than 200/mm3 and advanced WHO clinical stages of the disease were found to be predictors of OIs. Interventions aimed at preventing and treating HIV associated OIs are crucial. Initiation of ART before the CD4 count drops below 350 should be encouraged.
Highlights
Human immunodeficiency virus (HIV) pandemic is among the greatest health crises ever faced by humanity
Morbidity and mortality in HIV disease result due to underlying immunosuppression which leads to lifethreatening opportunistic infections (OIs) during the natural course of the disease [3]. the widespread use of Antiretroviral treatment (ART) starting in the mid-1990s has had the most profound influence on reducing OI-related mortality in HIVinfected persons in those countries in which these therapies are accessible and affordable [4,5]
The present study revealed that tuberculosis infection followed by oral candidiasis and diarrheal diseases emerged as the predominant OIs identified with prevalence of (n = 35/360, 9.72%), (n = 18/360, 5%) and (n = 12/360, 3.3%) respectively
Summary
Human immunodeficiency virus (HIV) pandemic is among the greatest health crises ever faced by humanity. Morbidity and mortality in HIV disease is due to immunosuppression leading to life-threatening opportunistic infections (OIs) during the natural course of the disease. In Ethiopia, approximately one million people are living with HIV which has become the leading cause of mortality among 15-49 years of age, that accounts for about 43% of all population in 2008 [2]. Morbidity and mortality in HIV disease result due to underlying immunosuppression which leads to lifethreatening opportunistic infections (OIs) during the natural course of the disease [3]. OIs continue to cause morbidity and mortality in HIV/ AIDS patients even after ART. OIs continue to cause substantial morbidity and mortality in patients with HIV-1 infection despite use of ART [6]
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