Absolute CD4 Vs. CD4 Percentage for Predicting the Risk of Opportunistic Illness in HIV Infection

Abstract Background Human immune deficiency virus (HIV) infection remains a major health problem since discovery of the virus in 1981. Globally, since introduction of antiretroviral therapy, AIDS related death felt by more than 25% between 2005 &2011. Also, HIV related opportunistic infections (OIs) are less common, especially with use of prophylaxis to prevent such infections (3). We aim in this study to assess the incidence of HIV infection and related OIs in Qatar for 17-year period, and assess the spectrum of these infections, risk factors and treatment outcome. Methods retrospective cohort study for all HIV infected patients registered in Qatar from 2000-2016. Incidence of HIV infection and related opportunistic illness was calculated per 100000 population. Demographic and Clinical characteristic were compared between two groups of patients with and without opportunistic illness. Results of 167 cases with HIV infection 54 (32.3%) of them had opportunistic illness. The average incidence rate of HIV infection over 17 years is 0.69 per 100000 population, and the incidence rate for opportunistic illness is 0.27 per 100000 population, figure1. The most common opportunistic illness is pneumocystis jirovecii pneumonia (PCP) 25% of cases, followed by CMV retinitis 7.2%, Tuberculosis 5.4%, Toxoplasmosis 4.2% and less than 2% for Kaposi sarcoma, lymphoma and cryptococcal infection.

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AIDS-defining opportunistic illnesses in Qatar, 2000–2016: a cohort study

Journal of Emergency Medicine Trauma and Acute Care ◽

10.5339/jemtac.2021.qhc.29 ◽

2021 ◽

Vol 2021 (2) ◽

Author(s):

Maisa Ali ◽

Mahmoud Qasim ◽

Hussam AlSoub

Keyword(s):

Cohort Study ◽

Antiretroviral Therapy ◽

Hiv Infection ◽

Incidence Rate ◽

Significant Risk ◽

Kaposi Sarcoma ◽

Pneumocystis Jirovecii Pneumonia ◽

Major Health Problem ◽

Opportunistic Illness ◽

Population Demographic

Background: Human immunodeficiency virus (HIV) infection remains a major health problem since discovery of the virus in 1981 Globally, since the introduction of antiretroviral therapy in 1996, acquired immunodeficiency syndrome (AIDS) related deaths fell by more than 25% between 2005 and 2011. HIV related opportunistic illnesses (OIs) are less common, especially with the use of prophylaxis. This study aims to assess the incidence of HIV infection and related OIs in Qatar over a 17-year period. Methods: This is a retrospective cohort study of all HIV infected patients registered in Qatar from 2000-2016. Incidence of HIV infection and related OIs were calculated per 100,000 population. Demographic and clinical characteristics were compared between two groups of patients with and without OIs. Results: In 167 cases with HIV infection, 54 (32.3%) had OIs. The average incidence rate of HIV infection over 16 years is 0.69 per 100,000 population, and the incidence rate for OIs is 0.27 per 100,000 population (Figure 1). The most common OIs is pneumocystis jirovecii pneumonia (PCP), seen in 25% of cases, followed by cytomegalovirus (CMV) retinitis with 7.2%, tuberculosis 5.4%, toxoplasmosis 4.2%, and less than 2% for Kaposi sarcoma and cryptococcal infection. The treatment outcome of cases with OIs was: cure in 59.3%, failure in 3.7%. Mortality within 3 months of OIs was 3.7%, whereas 33.4% accounted for loss to follow up after starting the treatment due to patients leaving the country. Most patients in both groups were young males. The CD4 lymphocyte count and percentage (CD4%), CD4/CD8 ratio and viral load were statistically significant risk factors in cases with OIs (p < 0.05). Presence of comorbidities was lower in patients with OIs (p = 0.032). Conclusion: Qatar has a low prevalence rate for HIV infection and related opportunistic illness. Early diagnosis and use of antiretroviral therapy are important measures to decrease the rate of opportunistic illness.

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Spectrum of opportunistic infections in hospitalized HIV-infected patients in Phnom Penh, Cambodia

International Journal of STD & AIDS ◽

10.1258/095646203765371312 ◽

2003 ◽

Vol 14 (6) ◽

pp. 411-416 ◽

Cited By ~ 18

Author(s):

Chhin Senya ◽

Akanksha Mehta ◽

Joseph I Harwell ◽

David Pugatch ◽

Timothy Flanigan ◽

...

Keyword(s):

Hiv Infection ◽

Opportunistic Infections ◽

Pneumocystis Carinii ◽

Chronic Diarrhoea ◽

Phnom Penh ◽

Cell Counts ◽

Cd4 Cell Counts ◽

Effective Prophylaxis ◽

Opportunistic Illness ◽

Advanced Hiv Disease

The aim of the study was to provide more comprehensive data on the clinical characteristics of hospitalized AIDS patients in Cambodia. Chart review of 381 HIV-infected patients admitted to a public hospital in Phnom Penh, Cambodia between December 1999 and May 2000 was performed. The in-hospital mortality rate was 43.6%. Approximately 50% of patients had two or more concurrent illnesses. Very advanced HIV disease was common, with CD4 cell counts below 10 cells/mm3 in 43.2%. Only 28.3% of the patients had documentation of their HIV infection prior to hospitalization. Chronic diarrhoea was the most frequent opportunistic illness (41.2%), followed by tuberculosis (26%), cryptococcal meningitis (12.6%), Pneumocystis carinii pneumonia (8.4%), and encephalitis (4.7%). Chronic diarrhoea and tuberculosis were the most important opportunistic infections observed in HIV-infected hospitalized patients in Cambodia. These findings illustrate the need for early diagnosis of HIV-infection, effective prophylaxis for opportunistic infections and improved access to antiretroviral therapy in Cambodia.

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