Prevalence of HIV and HIV-related diseases in the adult medical wards of a tertiary hospital in Durban, South Africa

Abstract

Our objective was to determine the prevalence of HIV and the distribution of HIV-related diseases among adult, medical inpatients. Consecutive admissions were recruited and a single ELISA assay was used to determine HIV infection. Demographic and clinical details were extracted from clinical records. Of 507 patients, 54% were infected with HIV of which 84% had AIDS. HIV-infected patients were significantly younger (34.9 years) than uninfected patients (47.1 years) and had significantly higher risks for oral/oesophageal candidiasis (risk ratio [RR] 18.6), generalized lymphadenopathy (RR 7.1), unexplained fever (RR 7.0), chronic diarrhoea (RR 6.2) and pulmonary tuberculosis (RR 3.1). Pulmonary tuberculosis was present in 56% of HIV cases. Mortality was 22% for HIV cases and 9% (P=0.016) for others. The mean length of hospital stay was the same for HIV-infected and uninfected patients. AIDS is the most common reason for admission to adult medical wards and will increasingly limit the number of beds available for non-AIDS patients.

Clinical characteristics and predictors of mortality in hospitalized HIV-infected Nigerians

“…Opportunistic infections are a major cause of morbidity and mortality in patients with HIV infection. In resource-limited settings, knowledge regarding the prevalence of the various IOs might aid [2,[7][8][9]. This mortality rate is much higher than that reported in the United States in the pre-HAART era [10,11].…”

The epidemiology, pathogenesis, transmission, diagnosis, and management of multidrug-resistant, extensively drug-resistant, and incurable tuberculosis

“…506 Initiating antiretroviral therapy during tuberculosis treatment improves survival; 315,317 integrating tuberculosis and HIV care is costeffective; 507 early initiation of antiretroviral therapy in people with MDR tuberculosis and HIV substantially reduces mortality; 508 and, in patients with XDR tuberculosis and HIV, more deaths occur among those not receiving antiretroviral therapy. 509 Despite this overwhelming supportive evidence and guidelines for integration, implementation is scarce.…”

Review of Human Immunodeficiency Virus Type 1–Related Opportunistic Infections in Sub‐Saharan Africa

“…tuberculosis. Tuberculosis was diagnosed in 27%-34% of consecutive HIV-1-infected patients admitted to hospitals in Kenya [21] and South Africa [22], 39% of rural Tanzanians presenting with respiratory symptoms [23], and 61% of Burundian patients with AIDS [24]. Tuberculosis was diagnosed by smear or culture of a sputum sample and/or bronchoalveolar lavage or transbronchial biopsy in 23% of smear-negative Rwandan patients [25], 27% of inpatients in Burundi [26], 51% of patients in a respiratory ward in Abidjan [27], and 69% of highly selected patients in Tanzania [28].…”