Vol. 4, Issue 8, Part A (2018)

Abstract
Background: Opportunistic Infections (OIs) are important determinants of morbidity and mortality in HIV infected persons. The spectrum of OIs varies in different regions and appear at different thresholds of CD4+T cell count. Method: Eighty six hospitalized patients with HIV infections confirmed as per National AIDS Control Organization (NACO) guidelines were studied prospectively for evaluation of opportunistic infections and their co-relation with CD4+T cell count between July 2010 to September 2012. Results: Of the cases under study 62 patients (72%) were male and 24 patients (28%) were female. Forty five cases (52.3%) were in age group of 31 to 45 years followed by 28% between 15 to 30 years and 19.7% between 46 to 65 year. Heterosexual transmission was the commonest mode in 63 cases (73.3%). In nineteen cases (22%) mode of transmission could not be known. Among the patient studied, 36 cases (42%) had a CD4+T cell count between 101 – 200/ml followed by 29 cases (33%) with 200-400/ml,15 cases (18%) with 51 – 100/ml and 6 cases (7%) with ≤ 50/ml. Fifty seven cases (66%) had single OI while rest had multiple OIs. Tuberculosis was the most common OI (51%) with pleural effusion in 23 cases, pulmonary tuberculosis in 18 cases, lymphadenitis in 7 cases, meningitis in 4 cases tuberculous peritonitis and disseminated tuberculosis in 2 cases each and spinal tuberculosis in one case. Median CD4+T cell count was 218/ml in those with tuberculosis. Candidiasis was the second most common OI (43%) with oral candidiasis in 36%, oral and oesophageal candidiasis in 5% and vulvo-vaginal candidiasis in 2% cases. Median CD4+ T cell count was 272/ml. Among other OIs it is observed that Cryptosporidiosis seen in 9.3% cases with median CD4 count of 142/ml, CNS Toxoplasmosis seen in 7% cases with median CD4 count 76/ml, Pneumocystis jiroveci pneumonia were seen in 5.8% cases with median CD4 count of 123/ml, Herpes simplex infection was found in 4.6% cases with median CD4 count of 109/ml, Cryptococcal meningitis seen in 2 cases with median CD4 count 92/µl, Molluscum contagiosum and Progressive Multifocal Leucoencephalopathy seen in one case each with median CD4 count of 35/ml and 28/ml respectively. Conclusion: Most common OI in the study was tuberculosis, of which pleural effusion is commonest manifestation. Other OIs are candidiasis second most common followed by cryptosporidium, toxoplasma, pneumocystis jiroveci, herpes simplex, cryptococcus, molluscum contagiosum and JC virus infection.