Opportunistic Infections among People Living with HIV (PLHIV) with Diabetes Mellitus (DM) Attending a Tertiary Care Hospital in Coastal City of South India.
BACKGROUND
HIV/AIDS and Diabetes Mellitus are the diseases' known to supress cell mediated immunity and predispose patients for opportunistic infections. Hence, we conducted a study to compare the common opportunistic infections (OIs) between People Living with HIV with DM (PLHIV-DM) and PLHIV without DM (PLHIV).


METHODS
PLHIV with DM and without DM (1:1) were prospectively included in the study from January 2011 to January 2012 at a tertiary care hospital in Mangalore city. Patients were classified as Diabetic if their fasting plasma glucose was ≥ 7.0 mmol/l (126 mg/dl) or 2-h plasma glucose was ≥11.1 mmol/l (200 mg/dl). Standard procedures and techniques were followed for diagnosis of OIs as per WHO guidelines. The data was entered and analyzed using Statistical Package for Social Sciences (SPSS) version 11.5.


RESULTS
The study included 37 PLHIV with DM and 37 PLHIV without DM and both groups were treated with Anti-Retroviral Therapy (ART). The median age was 47 years (IQR: 41-55 years) for PLHIV-DM as compared to 40 years (IQR: 35-45.5 years) for PLHIV (p<0.0001). PLHIV-DM had median CD4 counts of 245 (IQR: 148-348) cells/μl compared to 150(IQR: 70-278) cells/μl for PLHIV (p = 0.02). Common OIs included oral candidiasis (49% of PLHIV-DM and 35% of PLHIV); Cryptococcal meningitis (19% of PLHIV-DM and 16% of PLHIV); Pneumocystis jiroveci pneumonia (5% of PLHIV-DM and 18% of PLHIV); extra pulmonary tuberculosis (22% of PLHIV-DM and 34.5% of PLHIV); and Cerebral toxoplasmosis (11% of PLHIV-DM and 13.5% of PLHIV). Microbiological testing of samples from PLHIV-DM, C krusei was the most common Candida species isolated from 9 out of 18 samples. Out of six pulmonary TB samples cultured, four grew Non-tuberculosis mycobacteria (NTM) and two Mycobacterium tuberculosis complexes.


CONCLUSIONS
Study did not identify any significant difference in profile of opportunistic infections (OIs) between PLHIV with and without Diabetes.
Department of Microbiology, Apollo Hospitals, Chennai, Tamil Nadu, India.
Poojary
P
Indira
Department of Community Medicine, Kasturba Medical College (Manipal University), Mangalore, Karnataka, India.
Papanna Mohan
PM
Kumar
Department of Microbiology, Kasturba Medical College (Manipal University), Mangalore, Karnataka, India.
Shenoy
S
Shalini
Department of Community Medicine, Kasturba Medical College (Manipal University), Mangalore, Karnataka, India.
Kulkarni
K
Vaman
D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology* / Q000276:immunology; D000328:Adult; D018791:CD4 Lymphocyte Count; D048909:Diabetes Complications / Q000453:epidemiology* / Q000276:immunology; D005260:Female; D006801:Humans; D007108:Immune Tolerance; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D062606:Tertiary Care Centers