Prevalence of Opportunistic Infections and Associated Factors among HIV Positive Patients taking Anti-Retroviral Therapy in DebreMarkos Referral Hospital, Northwest Ethiopia

Abstract

Introduction: Opportunistic infections (OIs) are infections that are more frequent or more severe because of immune-suppression in HIV-infected persons, and they are the major clinical manifestation of HIV patients. They indirectly affect the natural history of HIV disease. Many studies concentrated on drug adherence, survival and other aspects of the diseases but limited studies are evident on OIs after Anti-Retroviral Therapy (ART) initiated. So this study was conducted to assess the prevalence of opportunistic infections and associated factors among HIV positive patients taking (ART) in DebreMarkos referral hospital, Northwest Ethiopia. Methods:A cross sectional study design was conducted among HIV patients taking ART from 5 to 7years. The study was conducted in DebreMarkos referral hospital among 423 patients. The data was entered in EPI data version 3.1 and analysis with done by using Statistical Package for Social Sciences (SPSS) version 16.0. Bivariate and multivariate analysis was performed to determine the association of each independent variable with occurrence of OIs. 95% CI and p-value less than 0.05 were considered as significant association. Result: Majority, 241(57%) of the study participants were female patients. The mean age of the study participants was 35.17, with standard deviation of +/- 9.481 years. A total of 181 OIs were observed from the study participants during the study period. The commonest type of OIs were oral candidiasis 50(11.8%), followed by chronic diarrhea for greater than 1 month, 42(9.9%) and tuberculosis, 41(9.7%). The factors associated with OIs were; Age less than 40 years old was protective (AOR=0.47, 95%CI=0.25, 0.90); baseline WHO stages of IIII those who used to chew khat was at risk of developing OI almost five times more likely than those who did not chew (AOR=4.733, 95%CI=1.185, 18.915); patients with good ART adherence were less likely to develop OI compare to their counter parts (AOR=0.163, 95%CI=0.051, 0.522); current hemoglobin level of ≥ 10 g/dl was protective (AOR=0.313, 95%CI=0.162, 0.605); and recent weight of <60 kg (AOR=3.658, 95%CI=1.656, 8.078). Conclusion and recommendation: The prevalence of OIs among HIV patients on ART is still high namely oral candidiasis, pathogens that cause chronic diarrhea and tuberculosis. Education on adherence of medications, and use of prophylactic medications for OIs should be given for HIV patients taking ART. Similar studies should be conducted to identify the relation between substance abuse and OIs in HIV patients taking ART