Clinical and Immunological Profile in Newly Diagnosed HIV Patients

Rajasekar, N (2013) Clinical and Immunological Profile in Newly Diagnosed HIV Patients. Masters thesis, Madurai Medical College, Madurai.


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INTRODUCTION: Simian immunodeficiency virus (SIV) was prevalent among chimpanzees for several thousands of years. For unknown reasons it had remained silent without harming humans. During the middle of twentieth century, it had transformed into Human Immunodeficiency virus. Numerous hypotheses have been forwarded for explaining this phenomenon. In most of the theories, colonisation of African nations, rapid urbanisation, unprotected sex and travel were being attributed for the sudden transformation and spread. After transformation it had taken only few years for the pandemic to get established. Today the virus has spread worldwide and has become a biggest public health challenge for low income countries. As it primarily affects working population of a nation, it has resulted in a great economic burden. Infections which were previously uncommon and sporadic, are being frequently reported. Several countries are witnessing resurgence of tuberculosis. HIV is one of the most extensively studied virus. Thousands of articles are being published each year about HIV/AIDS. This has led to immense knowledge about the virus as well as the disease. Epidemiological data, statistics and guidelines are regularly updated by international bodies. Mandatory screening with effective testing methods have effectively brought down blood products related transmission to a negligible rate. Active campaigns about HIV have resulted in increased awareness among public. Global annual new HIV infection rate have started to decline. Treatment regimens have been changed to improve the drug compliance as well to minimise adverse effects. Now patients are able to lead a normal life like any other person with the help of effective therapeutic regimens. In developed nations like United States, many patients who are under treatment remain asymptomatic for more than two decades. AIM: 1. To study about the clinical profile of HIV at the time of diagnosis. 2. To study about the mean CD4 count among newly diagnosed HIV patients. 3. To study about the correlation between CD4 count and the various clinical parameters. MATERIALS AND METHODS: Design of study : Cross sectional study. Period of study : July 2011 – September 2012. Study population : 151 cases. Settings : Study was conducted in ART Centre, Government Rajaji Hospital, Madurai. Selection of study subjects: Inclusion criteria: Patients who were diagnosed as HIV for the first time. Exclusion criteria: • Patients who were already diagnosed as HIV positive. • Patients who were previously on ART and discontinued. • Children < 13 years. SUMMARY: 1. Mean age of the study group was 36.73. 2. Males are predominantly involved. 3. Most of the females were married and have HIV positive partners. 4. Most of the males present in either stage 3 or stage 4 5. Heterosexual route was the predominant mode of transmission. 6. Oral candidiasis and tuberculosis were the commonest opportunistic infections. 7. Weight loss, chronic diarrhea and fever of unknown origin were commonest non specific symptoms. 8. Tuberculous meningitis was the commonest extrapulmonary tuberculosis. 9. Mean age of Stage 1 was low when compared to other stages. 10. Mean CD4 count in our study was 278.5. For males: 259.1. For females: 312.4. 11. CD4 count of stage 4 was statistically lower than other stages. 12. Oral candidiasis, tuberculosis and PCP pneumonia correlate significantly with CD4 count less than 200. CONCLUSION: Proportion of late presenters are very high worldwide. Early diagnosis in these patients would have helped them to survive for longer periods. Recommendations must be made to integrate HIV testing along with basic investigations during routine health visits in high risk individuals. Awareness must be created among serodiscordant couples and HIV infected partner may be advised to start on ART to reduce the transmission to HIV negative partner. Awareness about the availability of voluntary testing must be created among high risk individuals as well as general population. The immense knowledge and scientific advances in the field of HIV/AIDS would become meaningless if the available valuable resources underutilized by the community. So the special focus should be made to diagnose the HIV patients at early stages to achieve WHOs ambitious target of zero “AIDS related death”.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Clinical ; Immunological Profile ; Newly Diagnosed HIV Patients.
Subjects: MEDICAL > General Medicine
Depositing User: Subramani R
Date Deposited: 20 Mar 2018 03:25
Last Modified: 20 Mar 2018 16:06

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