title: Assessment of clinico-immunological profile of newly diagnosed HIV patients presenting to a teaching hospital of eastern India.
abstract: OBJECTIVE
  Newly diagnosed HIV patients may be asymptomatic or present with a wide range of symptoms related to opportunistic infections, acute seroconversion illness or other medical illnesses. This study was designed to evaluate the socio-demographic parameters, spectrum of the presenting clinical conditions and concurrent immunological status of newly diagnosed HIV patients and document the WHO clinical stages at the time of HIV diagnosis.
  
  
  METHODS
  This cross-sectional, observational study was undertaken over a 12 month period at a tertiary referral hospital in eastern India. Three hundred sixty consecutive newly diagnosed HIV patients were selected for the study from the HIV clinic and medicine wards of this hospital. Demographic and clinical data and relevant laboratory investigations of the patients were recorded and analyzed.
  
  
  RESULTS
  Mean age of patients was 36.38±10.62 yr, while 63.89 per cent were males. The main mode of transmission of HIV for males and females were unprotected exposure to commercial sex (139, 60.44%) and intercourse with HIV seropositive spouses (89, 68.46%), respectively. Fever (104, 28.89%), weight loss (103, 28.61%) and generalized weakness (80, 22.22%) were the predominant symptoms. Overall mean CD4 count was 176.04±163.49 cells/μl (males 142.19±139.33 cells/μl; females 235.92±185.11 cells/μl). Overall, 224 opportunistic infections were documented in 160 patients, opportunistic diarrhoea (44, 12.22%) and pulmonary tuberculosis (39, 10.83%) being the commonest. There were 83 and 133 patients in WHO clinical stages 3 and 4, respectively; 291 (80.83%) patients were eligible for initiation of first-line antiretrovirals at presentation.
  
  
  CONCLUSIONS
  Advanced immunodeficiency and burden of opportunistic infections characterize newly diagnosed HIV patients in eastern India. The physicians should keep in mind that these patients may have more than one clinical condition at presentation.
authors.affiliation: Department of Medicine, Medical Collge, Kolkata, India.
authors.forename: Saptarshi
authors.initials: S
authors.lastname: Bishnu
authors.forename: Dipanjan
authors.initials: D
authors.lastname: Bandyopadhyay
authors.forename: Samiran
authors.initials: S
authors.lastname: Samui
authors.forename: Indrani
authors.initials: I
authors.lastname: Das
authors.forename: Pradip
authors.initials: P
authors.lastname: Mondal
authors.forename: Pramit
authors.initials: P
authors.lastname: Ghosh
authors.forename: Deeptarka
authors.initials: D
authors.lastname: Roy
authors.forename: Sukanta
authors.initials: S
authors.lastname: Manna
mesh_terms: D000328:Adult; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D002452:Cell Count; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000276:immunology / Q000473:pathology* / Q000635:transmission*; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D011247:Pregnancy; D012372:ROC Curve; D012680:Sensitivity and Specificity
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