Clinical profile of opportunistic infections in HIV seropositive patients attending tertiary centre, Raichur, India
Keywords:HIV, Opportunistic infection, TB
Background: According to Karnataka state HIV statistics, HIV positivity among general clients tested at ICTCs, Raichur (4.9%) had third highest proportion of HIV positive cases. Authors decided to focus on opportunistic infections (OIs) in HIV patients of Raichur district since they contribute to the mortality and morbidity.
Methods: It’s a cross sectional, hospital-based study with 100 patients with HIV infections as per NACO guidelines with features of OIs were included in study.
Results: In this study, 77 males (77%), 23 female (23%) patients with 58% (n=58) of them in 30-39yrs age group and 21% (n=21) in 20-29yrs were seen. Majority of cases were laborers (47%) and less educated (n=55). Symptoms included loss of appetite (76%) n=76, fever (72%) n=72, cough (55%) n=55 and diarrhoea15% (n=15). The respiratory system was most frequently involved by opportunistic infections and accounted for 56% (n=56) of the total cases and clinically consolidation/crepitation was most frequent presentation accounting for 75% (n=42). Tuberculosis was most common OI (55%) with combined pulmonary and extra pulmonary in 56.37% (n=31), tubercular meningitis and tubercular lymphadenopathy each accounting for 30.77% (n=12) amounted majority, with pleural effusion 20.52% (n=8). Median CD4+T cell count was 217.72 in TB. Candidiasis is second most common OI with 49% (n=49), median CD4 count being 190.07. Other OIs observed were pneumocystosis 16% (n=16), cryptococcosis 2% (n=2).
Conclusions: Most common OI in the study was tuberculosis (in extra pulmonary TB meningitis and TB lymphadenitis) followed by Candidiasis, Pneumocystosis and Cryptococcosis.
Global HIV and AIDS Statistics. 2018. fact sheet/UNAIDS. Available at: http// www.unaids.org/resources/fact-sheet.
National AIDS Control Organization (NACO). HIV Sentinel Surveillance and HIV Estimation: A Technical Brief; 2017, Available at: http://naco.gov.in/sites/default/files/HIV%20SENTINEL%20SURVEILLANCE_06_12_2017_0.pdf.
HIV Estimations 2017 Report. NACO. Available at: http://naco.gov.in/sites/default/files/HIV%20Estimations%202017%20Report_1.pdf.
Fauci AS, Lane HC. ‘Human Immunodeficiency Virus Disease: AIDS and Related Disorder’, In Longo DL, Kasper DL, Jameson JL, Fauci AS, Hauser SL, Loscalzo J, eds. Harrison's Principle of Internal Medicine, 18th ed. Mc Graw Hill Medical companies, 2012:1542-1564.
WHO Case definitions of HIV for Surveillance and Revised Clinical Staging and Immunological Aged 15 years or older. WHO Regional Office for South-East Asia; 2007. Available at: http://www.searo.who.int/LinkFiles/Publications_7.hiv.pdf.
Guidelines for the prevention and management of common opportunistic infection/malignancies among HIV infected adults and adolescents. NACO. Ministry of Health and Family Welfare, May 2007. Available at: http://www.naco.gov.in/guidelines for prevention and management of common opportunistic infections.
Luft BJ, Remington JS. Toxoplasmic encephalitis in AIDS. Clin Infectious Dis. 1992 Aug 1;15(2):211-22.
Chua RH, Villareal DT, Baisac J. Diagnostic and Therapeutic Problems in Cryptococcus Meningitis. Infect Dis. 1987;16(1):10-7.
Kulkarni SV, Kairon R, Sane SS, Padmawar PS, Kale VA, Thakar MR, et al. Opportunistic parasitic infections in HIV/AIDS patients presenting with diarrhoea by the level of immunesuppression. Indian J Med Res. 2009 Jul 1;130(1):63-6.
Chakravarty J, Mehta H, Parekh A, Attili SVS, Agarwal NR, Singh SP, et al. Study on Clinico-epidemiological profile of HIV patients in Eastern India. Journal Asso Physician India. 2006:54.
Kumarasamy N, Solomon S, Paul SJ, Venilla R, Amalraj RE. Spectrum of opportunistic infections among AIDS patients in Tamil Nadu, India. Int J STD AIDS. 1995 Nov;6(6):447-9.
Chakraborty N, Mukherjee A, Santra S, Sarkar RN, Banerjee D, Guha SK, et al. Current trends of opportunistic infections among HIV-seropositive patients from Eastern India. Japanese journal of infectious diseases. 2008 Jan 1;61(1):49-53.
Singh A, Bairy I, Shivananda PG. Spectrum of opportunistic infections in AIDS cases. NEJM. 2003;57(1):16-21.
Sharma SK, Kadhiravan T, Banga A, Goyal T, Bhatia I, Saha PK. Spectrum of clinical disease in a series of 135 hospitalised HIV-infected patients from north India. BMC Infectious Dis. 2004 Dec;4(1):52.
Vajpayee M, Kanswal S, Seth P, Wig N. Spectrum of opportunistic infections and profile of CD4+ counts among AIDS patients in North India. Infection. 2003 Oct 1;31(5):336-40.