AEGiS-15IAC: Clinical stage of disease in 100 newly diagnosed patients with HIV-1 in phnom penh, Cambodia.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

Clinical stage of disease in 100 newly diagnosed patients with HIV-1 in phnom penh, Cambodia.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. A10190)

Kong Bun N, Harwell JI, Prem Prey S, Pugatch D, Sovanna P, Ruffner KV
Danish Red Cross, Phnom Penh, Cambodia

BACKGROUND: The HIV-1 epidemic in Cambodia involves 2.6% of the adult population. Little data are published regarding the spectrum of HIV-1 complications in this setting.

METHODS: A prospective survey of signs, symptoms, and diagnoses of 100 patients with newly diagnosed HIV-1 in Phnom Penh. From November 2001 to September 2002, a total of 449 patients underwent HIV-1 testing. One hundred nineteen tested positive and 100 completed data collection.

RESULTS: Sixty-one subjects were men. Average age was 34 years (range 20-56). The average CD4 cell count was 36.4 cells/mm³ (range 1-274) or 3.7% (range 0.05-35.7%). Fever was present in 64. Eighty-eight subjects reported weight loss >10%. Sixty-four subjects had abdominal pain. Nineteen subjects had acute and 52 had chronic diarrhea. Ninety-five subjects returned for PPD reading and all were without induration. Fifty subjects had abnormal chest x-rays, 6 with cavitary disease. Forty-six (72%) of those with abdominal pain had abnormal abdominal ultrasounds. Ten subjects were WHO Stage 3, 90 were Stage 4. Fifty- four (63%) of those with Stage 4 disease had more than one Stage 4 condition. Thirty-seven subjects had zoster within the previous 5 years and 8 had an acute episode at the time of presentation. Illnesses identified included oral candidiasis (80), hairy leukoplakia (90), tuberculosis (53) (pulmonary 25, extrapulmonary 28), esophageal candidiasis (39), cryptosporidiosis (13), cryptococcal meningitis (12), severe bacterial infections (12), Pneumocystis carinii pneumonia (10), vulvovaginal candidiasis (4), salmonellosis (2), atypical mycobacteriosis (2), and histoplasmosis (2).

CONCLUSIONS: Newly diagnosed HIV-1 in Cambodia is associated with advanced disease and multiple concomitant illnesses. Interventions are needed to encourage patients to seek ambulatory health care. TB is common in this population. Increased screening and prevention of TB would reduce morbidity and mortality.

Keywords: AEGIS, HIV-1, CD4 Lymphocyte Count, Pneumonia, Pneumocystis, Tuberculosis, Leukoplakia, Hairy, Candidiasis, Oral, Meningitis, Cryptococcal, Disease Progression, Cambodia, Morbidity, Humans, Male, Adult, Animal, diagnosis

040711
A10190