Disease-specific HIV prevalence and level of immune-suppression among hospitalized patients in North Uganda.
Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. C10438)
Fabiani M, Nattabi B, Nigro L, Rizzardini G, Okwey R, Cocca G, Ouma J, Ranghiasci A, Di Vincenzo A, Ogwang M, Declich S St. Mary's Hospital Lacor, Gulu, Uganda
Background : Evaluating the pattern of HIV-related diseases and their level of immune-suppression is useful to manage hospitalized cases and to plan anti-retroviral and opportunistic infections therapies. This study is aimed at estimating the disease specific HIV prevalence and the level of immune-suppression in a referral hospital in North Uganda. Methods : In November 2002, a HIV sero-survey was conducted among 354 patients admitted to the Medical ward of the St. Mary's Hospital Lacor. HIV testing and CD4 cells count were performed using an algorithm based on rapid tests and flowcytometry, respectively. Results : Overall, the HIV prevalence among the patients included in the survey was 46.9% (166/354). A high prevalence was observed among patients admitted for TB (67.4%, 31/46), enteritis (68.3%, 28/41) and pneumonia (51.6%, 16/31). All the 24 patients clinically diagnosed with AIDS (including Kaposi's sarcoma and cryptococcal meningitis) had the diagnosis confirmed by the HIV serological test. Among the other diseases resulting in at least ten admissions, only malaria showed a relatively high HIV prevalence (50.0%, 7/14), whereas all the remaining diagnoses combined showed a lower prevalence (30.3%, 60/198). The analysis of the level of immune-suppression showed a median number of CD4 cells less than 100 among HIV-positive patients (ranging from 45 CD4 cells among patients admitted for enteritis to 76 CD4 cells among TB patients), with the exception of HIV-positive patients admitted for malaria (median CD4=299 cells) or those admitted for the remaining diseases combined (median CD4=156 cells). Conclusions : As expected, a high HIV prevalence and level of immune-suppression was observed among patients admitted for well-known HIV-related disease. Among the other diseases, a high prevalence was observed among malaria patients, thus supporting findings from other studies on a possible interaction between HIV and malaria infections.
Keywords: AEGIS, Prevalence, Acquired Immunodeficiency Syndrome, HIV Seropositivity, HIV Infections, CD4 Lymphocyte Count, Immunosuppression, Uganda, Humans, epidemiology, diagnosis
