TY - JOUR
T1 - Incidence of common opportunistic infections in HIV-infected individuals in Pune, India
T2 - analysis by stages of immunosuppression represented by CD4 counts
AU - Ghate, Manisha
AU - Deshpande, Swapna
AU - Tripathy, Srikanth
AU - Nene, Madhura
AU - Gedam, Preeti
AU - Godbole, Sheela
AU - Thakar, Madhuri
AU - Risbud, Arun
AU - Bollinger, Robert
AU - Mehendale, Sanjay
N1 - Funding Information:
In collaboration with the Johns Hopkins University, Baltimore, USA, the National AIDS Research Institute, Pune conducted a prospective cohort study entitled “HIV incidence and participant retention” as part of the HIV Prevention Trial Network (HPTN) funded by the National Institutes of Health (NIH), USA. The study was carried out in Pune, a city located in the high HIV prevalence state of Maharashtra in India. The study was initiated in September 2002, enrolling HIV serodiscordant couples, with the objectives of determining the incidence of HIV infection in the uninfected spouses of HIV-infected persons and the retention of the enrolled couples in the cohort at the end of one year. Enrollment into the study was continued until November 2004. Although originally designed as a one-year follow-up study, the follow-up was extended until August 2005 to accumulate more person-years of follow-up for the determination of HIV incidence. In this paper, we present the findings from the HIV-infected partners who were enrolled and followed as a part of the HIV discordant couples cohort.
Funding Information:
The National AIDS Research Institute, Indian Council of Medical Research (ICMR) provided the infrastructural, operational, and logistical support for this study. The ICMR and the Health Ministry Screening Committee, Government of India approved the study. Funding support was provided by the Fogarty International Center, U.S. National Institutes of Health, Program of International Training Grants in Epidemiology Related to AIDS, D43 TW00010-AITRP, as well as a contract from the National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH) through Family Health International (FHI) (AI 47968) under the HIV Prevention Trials Network (HPTN) project. The manuscript review committee (MRC) of the HPTN approved the manuscript being submitted. The views expressed do not necessarily reflect the views of the ICMR, the Johns Hopkins University, FHI, or the NIH.
PY - 2009/1
Y1 - 2009/1
N2 - Background: Opportunistic infections (OIs) influence the morbidity and mortality due to HIV infections. Data from India on the incidence of OIs among HIV-infected individuals by stages of immunodeficiency are scarce. Methods: Between September 2002 and November 2004, HIV-infected individuals were enrolled in a prospective study in Pune. They were clinically and immunologically evaluated quarterly. Incidence rates of specific OIs were calculated. Results: Median CD4 counts in HIV-infected male and female patients at baseline were 197/mm3 and 413/mm3, respectively. Tuberculosis was the most common OI with an incidence of 15.4 (95% CI 12.2-19.2) per 100 person-years, followed by oral candidiasis 11.3 (95% CI 8.6-14.5), herpes zoster 10.1 (95% CI 7.6-13.1), and cryptococcal meningitis 1.7 (95% CI 0.8-3.1) per 100 person-years. Patients with baseline CD4 counts of <200/mm3 were six times more likely to develop OIs compared to those with CD4 counts of >350/mm3 (p < 0.001). Conclusions: The high incidence of commonly reported OIs in Indian HIV-infected individuals highlights the need for early screening and also the need to increase awareness in healthcare providers, in order to improve decisions regarding prophylaxis for prevention and appropriate therapeutic intervention. Emphasis needs to be given to the early diagnosis and management of tuberculosis in HIV-infected individuals.
AB - Background: Opportunistic infections (OIs) influence the morbidity and mortality due to HIV infections. Data from India on the incidence of OIs among HIV-infected individuals by stages of immunodeficiency are scarce. Methods: Between September 2002 and November 2004, HIV-infected individuals were enrolled in a prospective study in Pune. They were clinically and immunologically evaluated quarterly. Incidence rates of specific OIs were calculated. Results: Median CD4 counts in HIV-infected male and female patients at baseline were 197/mm3 and 413/mm3, respectively. Tuberculosis was the most common OI with an incidence of 15.4 (95% CI 12.2-19.2) per 100 person-years, followed by oral candidiasis 11.3 (95% CI 8.6-14.5), herpes zoster 10.1 (95% CI 7.6-13.1), and cryptococcal meningitis 1.7 (95% CI 0.8-3.1) per 100 person-years. Patients with baseline CD4 counts of <200/mm3 were six times more likely to develop OIs compared to those with CD4 counts of >350/mm3 (p < 0.001). Conclusions: The high incidence of commonly reported OIs in Indian HIV-infected individuals highlights the need for early screening and also the need to increase awareness in healthcare providers, in order to improve decisions regarding prophylaxis for prevention and appropriate therapeutic intervention. Emphasis needs to be given to the early diagnosis and management of tuberculosis in HIV-infected individuals.
KW - CD4 count
KW - HIV
KW - Incidence
KW - India
KW - Opportunistic infections
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U2 - 10.1016/j.ijid.2008.03.029
DO - 10.1016/j.ijid.2008.03.029
M3 - Article
C2 - 18602329
AN - SCOPUS:58049214875
SN - 1201-9712
VL - 13
SP - e1-e8
JO - International Journal of Infectious Diseases
JF - International Journal of Infectious Diseases
IS - 1
ER -