Types and prevalence of HIV-related opportunistic infections/conditions among HIV-positive patients attending Kenyatta National Hospital in Nairobi, Kenya

Abstract

Background: Although antiretroviral therapy (ART) has resulted in significant decrease in opportunistic infections (OIs), OIs continue to cause significant morbidity and mortality among HIV patients.
 Objective: To determine the prevalence and types of HIV/AIDS-related OIs among patients attending Kenyatta National Hospital (KNH) in Nairobi, Kenya.
 Methods: A cross-sectional study was conducted from May to August 2010 among patients ≥19 years. An interviewer-ad- ministered questionnaire was used to collect data on socio-demographic factors, HIV and OIs. CD4 data were extracted from clinical records.
 Results: Most patients (72%) had lived with HIV for ≤ 5 years and 78.8% had an OI. The 3 most common OIs were TB (35%), Herpes Zoster (HZ; 15.4%) and oral thrush (OT; 8%). Years of HIV infection significantly predicted TB (p=0.01). Patients with CD4 ≤ 349 were almost twice as likely to have TB, than those with CD4 ≥500. Type of occupation predicted OT (p=0.04) with skilled workers less likely to have OT. Patients with primary/vocational/technical education were >3 times more likely to have HZ than those with tertiary education.
 Conclusion: Due to the complex management of HIV and its associated OIs, appropriate implementation of the recom- mended guidelines for care and prevention among patients at KNH is important.
 Keywords: HIV-related opportunistic infections; Kenyatta National Hospital; Kenya.

Opportunistic Infections and Associated Factors among HIV-Infected Adult Persons on Antiretroviral Therapy at Ruhengeri Referral Hospital, Rwanda: A cross-sectional study

“…The commonest OIs were tuberculosis accounting for 20% (n = 39), oral candidiasis, pneumonia and STI accounting for 15.6% each. These common OIs PLWHIV are similar to those documented among PLWHIV receiving ART in other settings, namely in Kenyatta National Hospital in Nairobi, Kenya, [12] in Port Harcourt, Nigeria, [14] and in urban Ugandan cohort. [15] Tuberculosis remains one of the top OIs in many health care settings, with devastating effect on CD4+T cell counts, such as in Sichuan, China.…”

“…[10] The OIs prevalence remains higher in many other countries, such as in South-West Nigeria (Ibadan) with 46.6% among newly enrolled PLWHIV aged 50 years or above, [11] and 78.8% among older adults in Kenya. [12] This lower prevalence in Rwanda when compared with similar countries results from efforts made by the Rwanda Biomedical Center and other agencies in the management of PLWHIV in different angles of their life including medical, psychosocial and nutritional care as per the national guidelines; with rigorous mentorship from the national level, the HIV/ AIDS and STIs.…”

<p>Magnitude and Associated Factors of Pulmonary Tuberculosis Among HIV/AIDS Patients Attending Antiretroviral Therapy Clinic at Debre Tabor Specialized Hospital, Northwest Ethiopia, 2019</p>

“… 44 The discrepancy in the magnitude of TB among HIV-positive participants may be explained by the difference in the health-care system among ART centres, variation in study design, 45 the diagnostic methods 46 employed (smear microscopy, culture, GeneXpert), ART regimens and its adherence 47 and adverse drug-related problems that trigger MTB-MDR. Besides, the variation may be attributed due to the course of infection 8 and the presence of concomitant opportunistic infections 48 that alters the host immunity, the socio-economic condition 49 of study subjects, and awareness of the community to seek health care for both TB and HIV. 4 , 5 , 16 , 24 , 25 , 31 , 50 For example, the GeneXpert assay is essential due to its rapid diagnosis for MTB disease and its drug resistance (MTB/RIF) simultaneously in less than 2 hours.…”

Opportunistic Infections Among Human Immunodeficiency Virus (HIV) Infected Patients in Turkey: A Systematic Review

“…Additionally, they found the most common opportunistic infection as tuberculosis with 35%, and patients with lower CD4 + T lymphocyte counts of 0-199 and 200-349 had two times greater odds of having tuberculosis than those with CD4 + T lymphocyte count of ≥ 500 ( 68 ). Among the 18 countries, including Turkey, under the program of stopping tuberculosis in the WHO European Region, the incidence of tuberculosis was estimated as 52.5 per 100,000 people ( 69 ).…”