Prevalence and risk factors for opportunistic infections in HIV patients who developed adverse drug reactions (ADRs) to antiretroviral therapy (ART) in a tertiary-care teaching hospital

Abstract

Background: The introduction of highly active antiretroviral therapy (HAART) has led to decline in HIV-related opportunistic infections (OIs). Knowledge of the most common OI of that geographical area will help in implementing the preventive measures against that pathogen. We determined the prevalence and risk factors for OIs among patients who developed adverse drug reaction (ADR) to antiretroviral therapy (ART) in a tertiary-care teaching hospital. Aims and Objective: To collect demographic details of HIV-positive patients who were on ART and developed ADR to ART with OI and without OI; to determine the prevalence of OIs in HIV-positive patients who developed ADR to ART; and to investigate the sociodemographic and clinical risk factors associated with their occurrence. Materials and Methods: A cross-sectional study carried out between January and June 2012. The study population comprised HIV-infected patients, who were receiving ART at ART Center, KR Hospital of Mysore Medical College and Research Institute, Mysore, Karnataka, India, who developed ADRs to ART with or without OI. Results: The prevalence of OI was 50.63%. The sociodemographic variables that had significant positive association with the presence of OIs on univariate analysis includes employment [odds ratio (OR) = 4.96, 95% confidence interval (CI) = 2.52–9.75; p = 0.00). The risk of OIs did not significantly differ according to gender (OR = 0.77, 95% CI = 0.41–1.45; p = 0.21), age (OR = 1.658, 95% CI = 0.82–3.32; p = 0.079), residence (OR = 0.812, 95% CI = 0.43–1.52; p = 0.26), literacy (OR = 0.90, 95% CI = 0.48–1.70; p = 0.38), marital status (OR = 1.8, 95% CI = 0.70–4.61; p = 0.11), or weight (OR = 1.69, 95% CI = 0.84–3.42; p = 0.07). The univariate analysis of clinical risk factors for OIs had a significant positive association with WHO staging (OR = 24.04, 95% CI = 5.5–105.01; p = 0.00) and CD4 count (OR = 2.61, 95% CI = 1.32–5.16; p = 0.00). The risk of OIs did not significantly differ with adherence (OR = 0.37, 95% CI = 0.07–1.99; p = 0.13). Conclusion: OIs remain a challenge in patients receiving ART in resource-limited settings. There is a need to intensify the management of OIs despite ART use.