HIV-Care Outcome in Saudi Arabia; a Longitudinal Cohort.
BACKGROUND
Clinical characteristics of HIV-1 infection in people inhabiting Western, Sub-Saharan African, and South-East Asian countries are well recognized. However, very little information is available with regard to HIV-1 infection and treatment outcome in MENA countries including the Gulf Cooperation Council (GCC) states.


METHODS
Clinical, demographic and epidemiologic characteristics of 602 HIV-1 infected patients followed in the adult Infectious Diseases Clinic of King Faisal Specialist Hospital and Research Centre, in Riyadh, Kingdom of Saudi Arabia a tertiary referral center were longitudinally collected from 1989 to 2010.


RESULTS
Of the 602 HIV-1 infected patients in this observation period, 70% were male. The major mode of HIV-1 transmission was heterosexual contact (55%). At diagnosis, opportunistic infections were found in 49% of patients, most commonly being pneumocysitis. AIDS associated neoplasia was also noted in 6% of patients. A hundred and forty-seven patients (24%) died from the cohort by the end of the observation period. The mortality rate peaked in 1992 at 90 deaths per 1000 person-year, whereas the mortality rate gradually decreased to <1% from 1993-2010. In 2010, 71% of the patients were receiving highly active retroviral therapy.


CONCLUSIONS
These data describe the clinical characteristic of HIV-1-infected patients at a major tertiary referral hospital in KSA over a 20-year period. Initiation of antiretroviral therapy resulted in a significant reduction in both morbidity and mortality. Future studies are needed in the design and implementation of targeted treatment and prevention strategies for HIV-1 infection in KSA.
Immunocompromised Host Research, Department of Infection and Immunity, King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia.
Maha A
MA
Al-Mozaini
Immunocompromised Host Research, Department of Infection and Immunity, King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia ; Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.
Michael K
MK
Mansour
Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia.
Abdullah A
AA
Al-Hokail
Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia.
Magid A
MA
Mohmed
Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia.
Munirah A Bin
MA
Daham
Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia.
Hail M
HM
Al-Abdely
Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia.
Husn H
HH
Frayha
Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia.
Fahad A
FA
Al-Rabiah
Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia.
Sami H
SH
Alhajjar
Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA.
Salmaan
S
Keshavjee
Immunocompromised Host Research, Department of Infection and Immunity, King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia.
Chaker N
CN
Adra
Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia.
Abdulrahman A
AA
Alrajhi
AIDS; Acquired immunodeficiency syndrome; Antiviral therapy; CD4+T cells; HIV; Human immunodeficiency Virus-1; Opportunistic infections; Viral load