Publication:

Clinical progression of opportunistic infections and their correlation with CD4 count in newly diagnosed HIV positive patients when attending tertiary care hospital

Background HIV is a great threat faced by humanity in India. Opportunistic infections (OIs) arise due to progressive decline in CD4 count. HIV related OIs are the major causes of morbidity and mortality. The most prevalent OI reported in India is tuberculosis followed by candidiasis and diarrhoeal diseases. The study aimed to evaluate spectrum OIs in newly diagnosed HIV positive patients and their relation with CD4 count.

Methods A prospective observational study was conducted over a period of 18 months from January 2021 to June 2022 at ART centre of a tertiary care hospital. All newly diagnosed HIV positive patients were clinically evaluated and monitored for absolute CD4 count by flow cytometer.

Results A total of 117 newly diagnosed HIV patients were enrolled, of whom 100 patients completed two follow -up. Among these, 65% were males and 35% females. The mean CD4 cell count was 289.04 cells/mm3.OIs were observed in 57% of patients. Of these, at ART initiation,71.93% patients had OIs, while 24.56% and 3.51% developed during 1st and 2nd follow up respectively. Tuberculosis was found to be most prevalent infection among HIV patients. Of total OIs, 24.56% patients of pulmonary tuberculosis and 17.54% extrapulmonary tuberculosis, followed by Oral candidiasis (26.31%).

Conclusions Tuberculosis was the most common OI in newly diagnosed HIV positive patients. OIs were more frequent in patients with lower CD4 counts. Early diagnosis, prompt initiation of treatment and periodic monitoring of CD4 count were key to manage HIV related OIs.