Magnitude of opportunistic infections and associated factors in HIV-infected adults on antiretroviral therapy in eastern Ethiopia

Abstract

Habtamu Mitiku, Fitsum Weldegebreal, Zelalem Teklemariam Haramaya University, College of Health and Medical Sciences, Department of Medical Laboratory Sciences, Harar, Ethiopia Purpose: The aim of this study was to assess the prevalence of opportunistic infections (OIs) and associated factors among HIV-infected adults on anti-retroviral therapy (ART) in Hiwot Fana Specialized University Hospital, Eastern Ethiopia. Patients and methods: A hospital-based retrospective study was conducted in 358 HIV-infected adult patients on ART from April to June 2014. Data were collected through review of clinical records. The data was entered and analyzed by using SPSS version 16.0. Univariate and multivariate analyses were performed to determine the association of each independent variable with occurrence of OIs. A 95% confidence interval (CI) and P-value less than 0.05 were considered as significant association. Results: A total of 358 patients were included in the study, in which majority (68.4%) were females. The mean age of patients was 34 (standard deviation [SD] ±9.8) years. The overall of prevalence of OIs among HIV/AIDS patients on ART was 48%. The highest prevalent rates of OIs observed were tuberculosis (TB) (21.23%), followed by Herpes zoster (11.2%) and oral candidiasis (9.5%). Baseline CD4 cell count <200 cells/mm3 (adjusted odds ratio [AOR] =1.645, 95% CI =2.187, 3.983), baseline World Health Organization (WHO) clinical stage III (AOR =2.801, 95% CI =1.958, 7.165) and IV (AOR =3.856; 95% CI =2.691, 10.390), and not using prophylaxis (AOR =1.912, 95% CI =1.444, 3.824) were found to have strong association with acquisition of OIs. Conclusion: There was a high prevalence of OIs observed in this study. Baselines CD4 count of <200 cells/mm3, advanced WHO clinical stages, and not using prophylaxis were found to be predictors of OIs. Interventions were aimed at promoting early HIV testing and enrollment of HIV-infected individuals into ART services needed before CD4 count decreased severely. Keywords: AIDS, CD4, prophylaxis, WHO clinical stage