Opportunistic infections in patients with AIDS admitted to an university hospital of the Southeast of Brazil.
Opportunistic diseases in HIV-infected patients have changed since the introduction of highly active anti-retroviral therapy (HAART). This study aims at evaluating the frequency of associated diseases in patients with AIDS admitted to an university hospital of Brazil, before and after HAART. The medical records of 342 HIV-infected patients were reviewed and divided into two groups: group 1 comprised 247 patients before HAART and, group 2, 95 patients after HAART. The male-to-female rate dropped from 5:1 to 2:1for HIV infection. There was an increase in the prevalence of tuberculosis and toxoplasmosis, with a decrease in Kaposi's sarcoma, histoplasmosis and cryptococcosis. A reduction of in-hospital mortality (42.0% vs. 16.9%; p = 0.00002) has also occurred. An agreement between the main clinical diagnoses and autopsy findings was observed in 10 out of 20 cases (50%). Two patients with disseminated schistosomiasis and 2 with paracoccidioidomycosis are reported. Overall, except for cerebral toxoplasmosis, it has been noticed a smaller proportion of opportunistic conditions related to severe immunosuppression in the post HAART group. There was also a significant reduction in the in-hospital mortality, possibly reflecting improvement in the treatment of the HIV infection.
Nobre
Vandack
V
Department of Internal Medicine, Infectious Disease Branch, School of Medicine, Federal University of Minas Gerais MG, Brazil.
Braga
Emanuella
E
Rayes
Abdunnabi
A
Serufo
José Carlos
JC
Godoy
Pérsio
P
Nunes
Nívea
N
Antunes
Carlos Maurício
CM
Lambertucci
José Roberto
JR
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy / Q000401:mortality*; D000293:Adolescent; D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000401:mortality*; D001938:Brazil / Q000453:epidemiology; D018791:CD4 Lymphocyte Count; D016009:Chi-Square Distribution; D005260:Female; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies
D019380:Anti-HIV Agents