A Rajeev1, A Sharma. 1. Pushpagiri Medical College Hospital, Tiruvalla.
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. METHOD: 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. CONCLUSION: 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.
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/AIDSpatients and to study the role of antiretroviral drugs in increasing longevity. METHOD: We retrospectively reviewed the medical records of HIV/AIDSpatients 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. CONCLUSION: The above findings could be a rough guide for evaluating the status of HIV/AIDSpatients 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/AIDSpatients in developing countries where medical facilities are not just unaffordable but also scanty.
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