Incidence and predictors of HIV related opportunistic infections after initiation of highly active antiretroviral therapy at Ayder Referral Hospital, Mekelle, Ethiopia: A retrospective single centered cohort study

Abstract

Introduction Even though use of antiretroviral therapy (HAART) decreases the incidence of opportunistic infections (OIs) they are continuing to be a major cause of morbidity and mortality. Studies concerning this problem are scarce in Eastern Africa. The aim of this study was to determine the incidence and predictors of OIs after initiation of HAART in Ethiopia. Methods A health facility based single centered cohort study using structured data extraction sheet was conducted. The study population was all HIV positive ART naive adolescents and adults who started HAART between January 2009 and May 2012. Simple random sampling technique was used to select 317 patients from the record. Multivariate binary logistic regression model was used to determine factors for the occurrence of OIs after initiation of HAART. Results The incidence of OIs after HAART was 7.5 cases/100person years. Tuberculosis, oral candidiasis, pneumonia and toxoplasmosis were the leading OIs after HAART. A bed ridden functional status at initiation of HAART, presence of OIs before HAART, non-adherence and low hemoglobin level were predictors for the occurrence of OIs after HAART.

Incidence and Predictors of Opportunistic Infections Among Adult HIV Infected Patients on Anti-Retroviral Therapy at Dessie Comprehensive Specialized Hospital, Ethiopia: A Retrospective Follow-Up Study

“…This result is in line with a study conducted in Mekelle Ayder referral hospital, which reported tuberculosis (32.3%) as the highest proportion among the other OIs. 13 The reason for higher number of tuberculosis in our study could be due to only 45.8% of PLWHIV took IPT. Lower IPT intake is associated with increased incidence of tuberculosis.…”

“…This finding is higher than the previous Ethiopian study conducted in Ayder Referral Hospital (7.5 cases/100 person-years). 13 This higher figure might be attributed to significant number of patients followed in this study had poor ART drug adherence and were at advanced stages of HIV/AIDS which could probably elevate the incidence. In addition, sample size variations between the two studies could contribute for this difference.…”

“…Studies from northern and northwestern part of Ethiopia indicate the most common OIs among PLWHIV are oropharyngeal candidiasis and tuberculosis (Tb), respectively. 13 , 14 PLWHIV are more at risk of contracting OIs depending on exposure to potential pathogens, the virulence of the pathogens, the degree of host immunity, and the use of different antimicrobial prophylaxis to prevent OI. 15…”

“…The incidence of OI in Ethiopia is also rising at a high rate, shown by a study conducted in Mekelle, Ayder Hospital, which reported 7.5 cases per 100 person-year of observations. 13 In recent years, efforts have been made to integrate OI diagnosis and treatment with HIV care to prevent, diagnose and treat OI among PLWHIV. However, this also needs a good understanding of the situation through research especially in the study area where OI incidence rate and related factors are not fully studied yet.…”

Spectrum of Opportunistic Disease and Associated Factors Among Patients Attending ART Clinic, Nekemte Specialized Hospital, Western Ethiopia

“…Opportunistic infections (OIs) associated with HIV remain the single main cause of ill-health and death among HIV/AIDS patients in resource poor settings , therefore HIV positive patients in resource poor settings continue to suffer from (8). Evidence of studies conducted in different parts of Ethiopia had documented that, the incidence of OIs after HAART was increased in especially among hospitalized HIVpatients (9,10) and, reported the prevalence of OIs among HIV infected patients in the range of 33.3% in Addisa Abeba to 88% in Dawro Zone . Tuberculosis (TB), oral candidacies, Pneumocystis Carini Pneumonia (PCP), bacterial pneumonia, Herpes Zoster, Cryptococcus meningitides, Persistent diarrhea, kaposi´s sarcoma and lymphoma are the most reported common opportunistic infections in HIV patients in Ethiopia (15,17,18), but major differences in spectrum of OIs observed across the country.…”