Opportunistic infections in relation to CD4 counts in human immunodeficiency virus seropositive patients in a tertiary care hospital in North India

Abstract

Context: The human immunodeficiency virus (HIV) seropositive patients have decreased immunity predisposing them to various opportunistic infections (OI). The CD4 counts in the patient can be taken as a marker to evaluate the immune status. Aim: The aim of the study is to screen the HIV seropositive patients for OI in relation to their CD4 counts in a tertiary care hospital. Settings and Design: The present study was prospective in design conducted in the Department of Microbiology in a tertiary care hospital. Materials and Methods: A total of 80 HIV-seropositive patients, admitted from a period of 1΍ years were screened for OI. CD4 counts were done in all patients and measured by flow cytometry. Sputum and bronchoalveolar lavage samples were tested for tuberculosis and pneumocystis carinii pneumonia (PCP); oral candidiasis was detected by potassium hydroxide preparation; stool samples were subjected to direct and ether concentration method and stained for opportunistic stool infections; serum samples were tested for toxoplasmosis and cytomegalovirus (CMV) infection by enzyme-linked immunosorbent assay. Cerebrospinal fluid samples were tested for cryptococcosis. Results: A total of 38 (47.5%) patients were positive for OI. There were 13.6% patients presenting with infections having a CD4 count of below 200 cells/μL of whom, oral candidiasis (40.8%), cryptosporidiosis (23.68%), tuberculosis (5.92%), and CMV immunoglobulin M (IgM), PCP, isosporiasis and cryptococcosis were (2.96%). Conclusions: Majority of OI are present in patients with HIV with a low CD4 count, which emphasizes the need for monitoring such patients.