Abstract

STUDY OF OPPORTUNISTIC PULMONARY COMPLICATIONS IN SERO-POSITIVE HIV PATIENTS AND THEIR CORRELATION WITH CD4 COUNT IN A TERTIARY CARE CENTER OF GOA STATE

Raghu B. P.* and A. M. Mesquita

ABSTRACT

Background: Pulmonary symptoms are common complaints among HIV-infected individuals and are increasingly frequent as CD4 counts decline to <200 cells/μL. As the CD4 count declines episodes of bacterial pneumonia often accompanied by bacteremia and sepsis and M tuberculosis infection often extra pulmonary or disseminated is frequent. At CD4 count of <100 cells/μL, bacterial pathogens such as Staphylococcus aureus and Pseudomonas aeruginosa and pulmonary involvement from Kaposi sarcoma or Toxoplasma gondii, respiratory diseases caused by endemic fungi and certain viruses are increasingly diagnosed. Identification of these opportunistic organisms in sputum or broncho-alveolar lavage fluid is crucial before initiating treatment. Objectives: To study the opportunistic pulmonary complications in sero-positive patients with CD4 count less than 200 cells/μl. Method: Subjects reactive for HIV by ELISA with CD4 count less than 200 cells/μl were selected and clinical spectrum analysis with relevant investigations were done. Results: Of 150 HIV positive adults 130 patients CD4 count was less than 200 cells/μl. Average age of presentation was 33.1 years. Heterosexual (polygamous) contact was the common risk factor in almost all. Pulmonary tuberculosis, pneumonia and bronchitis were the commonest pulmonary opportunistic infections. Conclusion: Our data suggests that most common mode of transmission of HIV is heterosexual. Patients with CD4 count less than 200 cells/μl present with symptoms more frequently. Atypical presentations are more common with very low CD4 count (< 50).

Keywords: HIV, Opportunistic, Complications, CD4 count.