Spectrum of opportunistic infections in relation to CD4 counts in HIV/AIDS patients admitted in the department of general medicine of a tertiary care hospital


  • Deepak Pandharpurkar Department of General Medicine, Centre of Excellence, Gandhi Hospital, Secundrabad, Telangana, India
  • Nagender Devulapally Department of General Medicine, AIMSR, Hyderabad, Telangana, India
  • B. Gouthami Department of General Medicine, Greater Eastern Medical school and Hospital, Srikakulam, Andhra Pradesh, India
  • Gudikandula Krishna Department of General Medicine, Centre of Excellence, Gandhi Hospital, Secundrabad, Telangana, India




CD4 Count, HIV/AIDS, Opportunistic infections


Background: HIV/AIDS was first recognized in USA in 1981 when centre for disease control (CDC) reported unexplained occurrence of Pneumocystis carinii pneumonia in 5 healthy homosexuals. Soon it was recognized in drug abusers and blood transfusion recipients. The present study has been taken up with an aim to know the incidence of various opportunistic infections in HIV positive patients and to correlate different opportunistic infections (OIs) with the CD4+cellcount.

Methods: Sample of 132 cases admitted in Gandhi hospital during the study period were taken. CD4+ counting of blood samples was done by Flow cytometry as per manufacturer’s instructions (FACS Calibur, Becton- Dickinson, Immunocytometry system). Correlation of CD4 cell counts was done with the respective opportunistic infections.

Results: TB (50%) is the most frequent OI followed by candidiasis (49%), pneumocystis (16%) and others. The mean CD4 cell count in TB was 110.80/mL and in candidiasis 97.84/mL. Low values were observed in CMV (27/mL) and in toxoplasmosis (61.66/mL).

Conclusions: In most of the patient’s respiratory system was the most common system involved by OIs and had CD4 T cell count below 200/mL. Early diagnosis and prompt treatment of opportunistic infections is important. This study helps the clinicians in proper guidance to come up before development of severe immunodeficiency to prevent serious and fatal outcome.


Sarvepalli AK, Dharana PK. Spectrum of opportunistic infections with correlation to CD4 counts in newly diagnosed HIV seropositive cases. Int J Adv Med. 2017;4:252-8.

Palella FJ Jr, Baker RK, Moorman AC, Chmiel JS, Wood KC, Brooks JT, et al. Mortality in the highly active antiretroviral therapy era: changing causes of death and disease in the HIV outpatient study. J Acquir Immune Defic Syndr. 2006 Sep;43(1):27-34.

Noor R, Morsalin M, Chakraborthy B. Reduction of CD4 count induces opportunistic infections in people living with HIV (PLHIV). Bangladesh J Med Sci. 2014;13:285 91.

Mala E, Oberoi A. Opportunistic infections in relation to CD4 counts in human immunodeficiency virus seropositive patients in a tertiary care hospital in North India. CHRISMED J Health Res. 2015;2(3):199-202.

Ayyagari A, Sharma AK, Prasad KN, Dhole TN, Kishore J, Chaudhary G. Spectrum of opportunistic infections in HIV infected cases in a Tertiary Care Hospital. Indian J Med Micro. 1999;17(2):78-80.

Sunderam G, McDonald RJ, Maniatis T, Oleske J, Kapila R, Reichman LB. Tuberculosis as amanifestation of acquired immunodeficiency syndrome (AIDS). JAMA. 1986;256(3):362-66.

Kumarasamy N, Solomon S, Madhivanan P, Ravikumar B, Thyagarajan SP, Yesudian P. Dermatologic manifestations among human immunodeficiency virus patients in south India. Int J Dermatol. 2000 Mar;39(3):192-5.

Misra SN, Sengupta D, Satpathy SK. AIDS in India: recent trends in opportunistic infections. Southeast Asian J Trop Med Public Health. 1998;29(2):373-6.

Nissapatorn V, Lee C, Fatt QK, Abdullah KA. AIDS-related opportunistic infections in Hospital Kuala Lumpur. Jpn J Infect Dis. 2003 Oct-Dec;56(5-6):187-92.

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 1;31(5):336-40.

Sinha S, Guleria R. Spectrum of Pulmonary infections in HIV positive patients: Indian scenario. Chest. 2004;126(4):917S.

Crowe SM, Carlin JB, Stewart KI, Lucas CR, Hoy JF. Predictive value of CD4 lymphocyte numbers for the development of opportunistic infections and malignancies in HIV-infected persons. J Acquir Immune Defic Syndr. 1991;4(8):770-6.

Giri TK, Pande I, Mishra NM, Kailash S, Uppal SS, Kumar A. Spectrum of clinical and laboratory characteristics of HIV infection in northern India. J

Commun Dis. 1995 Sep;27(3):131-41.

Sande M, Paul A. Tuberculosis in the HIV infected patient. The Medical Management of AIDS. 6th Ed. WB Saunders company; 1999:353-359.

Sande M, Paul A. Tuberculosis in the HIV infected patient. The Medical Management of AIDS. 6th Ed. WB Saunders company; 1999:185-194.

Hung CC, Yang YL, Lauderdale TL, McDonald LC, Hsiao CF, Cheng HH et al. Colonization of human immunodeficiency virus-infected outpatients in Taiwan with Candida species. J Clin Microbiol. 2005;43(4):1600-3.

National AIDS Control Organisation. Natural history and clinical manifestations of HIV/AIDS. In: Specialist s training and reference module. New Delhi; 2000:23-29.






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