Clinical features of HIV/AIDS patients presenting to an inner city clinic in Ho Chi Minh City, Vietnam.
An outpatient HIV clinic was opened in March 2005 in Binh Thanh District, a poor section of Ho Chi Minh City, Vietnam. Over 1500 patients were seen in the first year. The average age of patients was 27 years. Men represented 77% of the clinic population, women, 23% and children under the age of 16 years of age, 5% of the population. The most common risk factor among men was being an injecting drug user (IDU), 76%, and among women, being married to an IDU HIV-positive man, 35%. Physical signs of disease were uncommon: lymphadenopathy in 24% and hepatomegaly and splenomegaly in 4% and 3%, respectively. Men and women were anaemic at presentation, with a mean haemoglobin of 11.9 g/dL and 11.1 g/dL, respectively. An overwhelming majority of patients had profound immunodeficiency. The mean CD4+ cell count was 164 cells/mL and the median was 69 cells/mL. No correlation was found between the World Health Organization's stage of disease and the CD4+ cell count. Thus, the former is a poor predictor of immunity in this population. Data regarding opportunistic infections diagnosed at the first visit were studied. Candidiasis of the oral pharynx, oesophagus or vagina was found in 34.5% of the patients, and pulmonary and extrapulmonary tuberculosis was found in 32% of the patients. Pneumocystis carinii pneumonia (PCP) was diagnosed in only 3% of the patients. Cotrimoxazole prophylaxis is advocated for HIV-infected Vietnamese, but the incidence of PCP is negligible and resources could be spent elsewhere. The various opportunistic infections seen in this resource-poor clinic setting is likely to be a pattern of presentation of HIV-infected Vietnamese for some time to come.
Klotz
Stephen A
SA
Section of Infectious Diseases, University of Arizona, Tucson, AZ 85724, USA. sklotz@u.arizona.edu
Nguyen
Hao Cong
HC
Van Pham
Tam
T
Nguyen
Liem Thanh
LT
Ngo
Dong Thi Anh
DT
Vu
Son Nhoc
SN
D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology / Q000382:microbiology*; D000293:Adolescent; D000328:Adult; D018791:CD4 Lymphocyte Count; D002177:Candidiasis / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000097:blood* / Q000150:complications* / Q000453:epidemiology / Q000208:ethnology; D006801:Humans; D008297:Male; D014376:Tuberculosis / Q000453:epidemiology; D014744:Vietnam / Q000453:epidemiology