title: Mortality and morbidity patterns among HIV patients with prognostic markers in a tertiary care hospital in southern India.
abstract: BACKGROUND
  Opportunistic infections are an important cause of morbidity and mortality in persons infected with HIV. In recent years, antiretroviral treatment (ART) and prophylaxis against various other opportunistic infections have contributed to a decrease in AIDS-related mortality. We conducted a study of HIV infected inpatients in our centre to study the various factors contributing to mortality in HIV/AIDS patients and to study the role of antiretroviral drugs in increasing longevity.
  
  
  METHODS
  We retrospectively reviewed the medical records of HIV/AIDS patients who were admitted to a tertiary care hospital from 1 January 2005 to 28 February 2006. Socio demographic information, CD4 lymphocyte counts (wherever available); diagnoses at discharge, incidence of opportunistic infections in patients and final outcome of the patients were collected.
  
  
  RESULTS
  There was no difference in mean age between the patients who died and those who are surviving. Body weight was comparatively lower for the patients who died than the survivors. Albumin levels were significantly lower among those who died (0.56 ± 1.29 versus 2.73 ± 1.13). CD4 counts did not predict a worse prognosis. History of fever (76.7% versus 53.17%) and weight loss (56.7% versus 33.33%) predictably pointed to a bad prognosis. On the brighter side, administration of specific therapy which included Lamivudine was associated with a better outcome (OR - 0.07, p = 0.004) than any other combination of ART.
  
  
  CONCLUSIONS
  The above findings could be a rough guide for evaluating the status of HIV/AIDS patients who cannot afford frequent medical investigations in developing countries. Moreover as in our study, it was found that CD4 count was not a very reliable marker for the prognosis in such patients. A broader study could be a clue to a more cost-effective and cheaper alternative mode of assessment for HIV/AIDS patients in developing countries where medical facilities are not just unaffordable but also scanty.
authors: Pushpagiri Medical College Hospital, Tiruvalla.
authors: A
authors: A
authors: Rajeev
authors: A
authors: A
authors: Sharma
keywords: AIDS; Antiretroviral therapy; HIV; Prognostic markers; Survival
references: AIDS. 2002 May 3;16(7):1031-8
references: 11953469
references: J Med Assoc Thai. 2004 Feb;87(2):173-9
references: 15061301
references: Ann Intern Med. 2001 Jul 3;135(1):17-26
references: 11434728
references: J Acquir Immune Defic Syndr. 2011 Apr;56(4):365-71
references: 21160429
references: J Acquir Immune Defic Syndr. 2006 Feb 1;41(2):194-200
references: 16394852
references: Pediatr Infect Dis J. 2001 Jan;20(1):40-8
references: 11176565