Epidemiological features of human immunodeficiency virus infection in rural area of western India

Abstract

Objectives: To investigate epidemiological features of human immunodeficiency virus (HIV) infection first time in rural areas of Western India, Maharashtra.

Methods: Cross-sectional prospective study with relevant investigations of 290 patients, 181 males and 109 females of age group up to 60 years, screened by two methods, Tridot or Combiads and Eliza test. Criteria were repeated respiratory infections, pulmonary tuberculosis with recurrence or relapse in spite of adequate multidrug therapy (MDT), chronic skin infections, venereal diseases, pyrexia of unknown origin, weight loss, generalised lymphadenopathy and wives of all HIV positive persons.

Results: 51 persons were found HIV +ve (17.5% prevalence rate), 57% of the wives of HIV +ve were infected. 42% of the patients of tuberculosis with recurrence or repeated respiratory infection and 50% of patients presenting only with weight loss more than 10% of body weight were positive. Heterosexual transmission was predominant, middle income group, male dominance and age group between 21 to 40 was infected most. The most common superinfection in 28 acquired immunodeficiency syndromes (AIDS) cases was Mycobacterium tuberculosis (100%) responded to MDT but after recurrence there was progressive failure of response to therapy. Five patients of AIDS had scabies which failed to respond. Out of 9 AIDS patients, 5 had chronic amoebic dysentry which also did not respond. Retinal examination showed cotton wool feather shaped spots in four AIDS cases and in one asymptomatic HIV +ve person. These spots went on increasing as diseases progressed. Time interval between detection of AIDS patients and death was short (12 to 18 months).

Conclusions: HIV infection is spreading in rural area of Western India so rapidly that it will seriously jeopardize primary health care. Non-responding infections like scabies and amoebic dysentry may be presenting symptoms in AIDS in additions to resistant tuberculosis.