Spectrum of clinical disease in a series of 135 hospitalised HIV-infected patients from north India.
BACKGROUND
Literature on the spectrum of opportunistic disease in human immunodeficiency virus (HIV)-infected patients from developing countries is sparse. The objective of this study was to document the spectrum and determine the frequency of various opportunistic infections (OIs) and non-infectious opportunistic diseases, in hospitalised HIV-infected patients from north India.


METHODS
One hundred and thirty five consecutive, HIV-infected patients (age 34 +/- 10 years, females 17%) admitted to a tertiary care hospital in north India, for the evaluation and management of an OI or HIV-related disorder between January 2000 and July 2003, were studied.


RESULTS
Fever (71%) and weight loss (65%) were the commonest presenting symptoms. Heterosexual transmission was the commonest mode of HIV-acquisition. Tuberculosis (TB) was the commonest OI (71%) followed by candidiasis (39.3%), Pneumocystis jiroveci pneumonia (PCP) (7.4%), cryptococcal meningitis and cerebral toxoplasmosis (3.7% each). Most of the cases of TB were disseminated (64%). Apart from other well-recognised OIs, two patients had visceral leishmaniasis. Two cases of HIV-associated lymphoma were encountered. CD4+ cell counts were done in 109 patients. Majority of the patients (82.6%) had CD4+ counts <200 cells/microL. Fifty patients (46%) had CD4+ counts <50 cells/microL. Only 50 patients (37%) received antiretroviral therapy. Twenty one patients (16%) died during hospital stay. All but one deaths were due to TB (16 patients; 76%) and PCP (4 patients; 19%).


CONCLUSIONS
A wide spectrum of disease, including both OIs and non-infectious opportunistic diseases, is seen in hospitalised HIV-infected patients from north India. Tuberculosis remains the most common OI and is the commonest cause of death in these patients.
Sharma
S K
SK
Department of Medicine, All India Institute of Medical Sciences, New Delhi, India. sksharma@aiims.ac.in
Kadhiravan
Tamilarasu
T
Banga
Amit
A
Goyal
Tarun
T
Bhatia
Indrish
I
Saha
P K
PK
D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology* / Q000401:mortality; D000293:Adolescent; D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000008:administration & dosage; D018791:CD4 Lymphocyte Count; D002177:Candidiasis / Q000453:epidemiology; D005260:Female; D005334:Fever; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology* / Q000401:mortality; D006760:Hospitalization; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011020:Pneumonia, Pneumocystis / Q000453:epidemiology / Q000401:mortality; D014376:Tuberculosis / Q000453:epidemiology / Q000401:mortality; D015431:Weight Loss
D019380:Anti-HIV Agents