Spectrum and prognostic significance of opportunistic diseases in HIV/AIDS patients in Ilorin, Nigeria

Abstract

Background: Opportunistic diseases (ODs) of varying types and severities have been reported amongst HIV infected patients around the world, this made us to define the incidence, spectrum and effects of ODs on HIV infected Nigerians' CD4+cells count and survival rate.

Design: Retrospective analyses of HIV register from February 2002 to July 2004.

Results: ODs developed in 201 (68.6%) patients, 107 (53.2%) were AIDS-defining viz; TB, HIV-encephalopathy, scopulariopsis meningitis, cutaneous kaposis sarcoma and pulmonary candidiasis. Mean CD4+ count was lower with ODs compared to the controls, 138/ul vs 211/ul, p < -0.0006. It was low with non-AIDS-defining infection, 221.6/ul, lower with non-infectious AIDS-defining diseases, 192.4/ul and lowest with AIDS-defining infections, 117.7/ul. Mortality rate was 29.4%; 51 infectious and 8 non-infectious ODs against 19 (18.4%) from the controls. Risk of death was four folds higher with ODs over the controls, 59 vs 19, OR=3.98, 95%CI= 2.20- 7.27, X=24.2, p-<0.0001. This risk was also higher with infectious AIDS-defining illnesses compared to non-infectious ones, 48 vs 8, RR=4.83, 95 %CI=2.80- 8.34, X= 51.7, p-<0.0001. Death from TB was over 2(1/2) times higher than deaths from other AIDS-defining diseases, 45 vs 14, RR=2.7,95%CI=2.01-3.73,x=37.3, p-<0.0001. Average survival was shorter with ODs; 12.3weeks compared to controls, 37.8weeks, p-< -0.039. Mean survival was longest with EPTB, 29.8weeks and shortest with fungal meningitis, 1.9weeks.

Conclusion: incidence of ODs was high, 68.6%; it was associated with lower CD4+ count and shorter patient's survival especially when it was infectious and AIDS defining.