Factors associated with development of opportunistic infections among patients on ART at a Ugandan Program-MJAP

Background

To establish the factors associated with development of opportunistic infections among patients on ART at an HIV/AIDS Program in Uganda.

Methods

Retrospective cohort analysis on adult patients initiated on ART between November 2005 and November 2007. The socio demographics, clinical and laboratory characteristics of patients that developed OIs were studied.

Results

Data of 4,878 patients on ART was analyzed. 3,247 (67.2%) were females. Median age 33 years (SD 8.5) and Median weight 53 kg (SD 10.0). Incidence of OIs 329 (6.7%); Oral candidiasis 106 (32%), Vaginal candidiasis 80 (24%), Kaposi's sarcoma 40 (12%), Herpes simplex 28 (9%), Oesophageal candidiasis 25 (8%), Tuberculosis 15 (5%), others 38 (10%). WHO stage 3&4 (OR 2.64, CI 2.04-3.43, P < 0.001), CD4 count <100 cells/mm³ (OR 1.92, CI 1.52-2.42, P < 0.001), not being married (OR 1.69, CI 1.33-2.14, P < 0.001) and having no formal education (OR 1.61 CI 1.09-2.36, P = .0015) were significantly associated with development of OIs among patients on ART.

Sex, age, body weight, ART regimen and Karnofsky score were not associated with development of OIs.

Discussion

The risk of OIs is higher among patients with a low CD4 count, high WHO clinical stage, no formal education and in those that are not married.

Early identification of HIV-infected individuals and linkage to HIV care and treatment is likely to minimize the incidence of Opportunistic Infections.