Magnitude of opportunistic infections and associated factors in HIV-infected adults on antiretroviral therapy in eastern Ethiopia

Abstract

PurposeThe aim of this study was to assess the prevalence of opportunistic infections (OIs) and associated factors among HIV-infected adults on anti-retroviral therapy (ART) in Hiwot Fana Specialized University Hospital, Eastern Ethiopia.Patients and methodsA hospital-based retrospective study was conducted in 358 HIV-infected adult patients on ART from April to June 2014. Data were collected through review of clinical records. The data was entered and analyzed by using SPSS version 16.0. Univariate and multivariate analyses were performed to determine the association of each independent variable with occurrence of OIs. A 95% confidence interval (CI) and P-value less than 0.05 were considered as significant association.ResultsA total of 358 patients were included in the study, in which majority (68.4%) were females. The mean age of patients was 34 (standard deviation [SD] ±9.8) years. The overall of prevalence of OIs among HIV/AIDS patients on ART was 48%. The highest prevalent rates of OIs observed were tuberculosis (TB) (21.23%), followed by Herpes zoster (11.2%) and oral candidiasis (9.5%). Baseline CD4 cell count <200 cells/mm3 (adjusted odds ratio [AOR] =1.645, 95% CI =2.187, 3.983), baseline World Health Organization (WHO) clinical stage III (AOR =2.801, 95% CI =1.958, 7.165) and IV (AOR =3.856; 95% CI =2.691, 10.390), and not using prophylaxis (AOR =1.912, 95% CI =1.444, 3.824) were found to have strong association with acquisition of OIs.ConclusionThere was a high prevalence of OIs observed in this study. Baselines CD4 count of <200 cells/mm3, advanced WHO clinical stages, and not using prophylaxis were found to be predictors of OIs. Interventions were aimed at promoting early HIV testing and enrollment of HIV-infected individuals into ART services needed before CD4 count decreased severely.

Frequency and distribution patterns of opportunistic infections associated with HIV/AIDS in Uganda

“…The most frequent OIs after HAART (late HAART) were diarrhoea <1 month and geohelminths. Similar OIs were also observation in other previous studies in African settings [17, 28, 31, 32]. …”

Opportunistic Infections and Associated Factors among HIV/AIDS Patients taking Ante-Retroviral Therapy Leku, Bona and Yirgalem Hospitals in Sidama Zone, Southern Ethiopia.

“…This study result was consistent with the study findings in Wolaita Zone, Southern Ethiopia 45.3% [11] and Uganda 43% [9]. This result higher when compared to eastern Ethiopia 20.2% had any form of tuberculosis, oral candidiasis, herpes zoster [15], 22.4% Nigeria [20], 19.7% Northern Ethiopia [21]. While, it was slightly lower when compared with 61.7% Nigeria [22], 47.6% Taiwan [23], and 48% eastern Ethiopia [15].…”

“…This result higher when compared to eastern Ethiopia 20.2% had any form of tuberculosis, oral candidiasis, herpes zoster [15], 22.4% Nigeria [20], 19.7% Northern Ethiopia [21]. While, it was slightly lower when compared with 61.7% Nigeria [22], 47.6% Taiwan [23], and 48% eastern Ethiopia [15]. The discrepancy might be due to differences in geographical areas of study participants, high exposure to infectious agents, social-economic status, drug resistance, immunity and nutrition, may affect the magnitude of OIs.…”

“…The developing countries more suffer from bacterial and protozoal infections due to lack of resources [11,12], HIV diagnosis, poor adherence to Anti-Retroviral Treatment (ART), drug resistance, poverty, poor nutrition, and high exposure to infectious agents [13]. The opportunistic infections may favor HIV replication and higher viral loads that lead to lower the quality of life of HIV infected persons, reduces patients' response to ART, increases stigma and limit one's ability to work, high medical care costs, and death [14,15].…”

“…More than 90% of HIV/AIDS deaths are attributable to opportunistic infections and malignancies [11]. Even though nationally representative and comprehensive data regarding the magnitude of opportunistic infections lack in Ethiopia, some regional studies have shown the prevalence ranging from 19.7% to 48% [15,17]. The prevalence of OIs among HIV patients on ART is still high namely; oral candidiasis 11.8%, followed by chronic diarrhea, 9.9% and tuberculosis 9.7% at Debre Markos referral hospital in Ethiopian [18].…”