Risk factors and patterns of Opportunistic infections in HIV patients on active care in GHTM – CoE ART Centre
Journal Title: Stanley Medical Journal - Year 2017, Vol 4, Issue 2
Abstract
Background Government Hospital of Thoracic Medicine- ART centre is a centre of excellence(COE) for HIV with >4700 PLHA (people living with HIV AIDS) on active care. Though the introduction of Highly Active Antiretroviral Therapy (HAART) has led to decline in HIV related opportunistic infections (OIs), many patients are still lost due to Opportunistic infections. This study was undertaken to study the pattern and risk factors of opportunistic infections among PLHA on active care. Methodology A retrospective analysis of PLHA on active care during the period July 2015 to June 2016 was conducted using Data collected from the patient’s registration card, Master line list, OI registers and case records maintained at the ART centre. The patients with opportunistic infections diagnosed during the study period were included for the study. The data of these patients including demographic profile, opportunistic infections and risk factors for the development of opportunistic infections were studied and the results presented herewith. Results 628/4736 patients had opportunistic infections during this period, 79 being on Pre ART and 549 on ART. Majority of OIs were among males (64.8%) of productive age group 20 – 60 years(94.4%). OI identified included PTB (45.7%), EPTB (13.4%), Recurrent respiratory tract infections (27.4%), Candidiasis (11.5%), Acute Gastroenteritis (2.1%), Herpes Zoster (1.1%), Papular Pruritic Eruptions (2.1%), Cryptococcal meningitis (0.5%), PCP (0.3%). Risk factors identified for OIs were lower socioeconomic group (29.8%), Clinical stage III and IV (72.8%), Baseline CD4 <200 (60.8%), CD4 <200 at time of OI diagnosis (42.7%) and HAART non adherence (23.7%). Mortality due to OIs was 14.8% most common cause being Tuberculosis (80%). Most of the OIs were in first year of ART (62.5%). Conclusion Opportunistic infections remain a challenge in PLHA. Early initiation and adherance to ART and preventive strategies, early identification and treatment of OIs are the need of the hour.
Authors and Affiliations
Sridhar R, Vinod Kumar V, Vijila Christian, Barakathul Reshma
Keywords
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