AEGiS-15IAC: Causes of admission and death as ARV use increases at joint clinical research center-comparision of four periods.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

Causes of admission and death as ARV use increases at joint clinical research center-comparision of four periods.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. B10222)

Mulindwa MN, Bateganya M, Kityo C, Ssali F, Mugyenyi P
Joint Clinical Research Center, Kampala, Uganda

BACKGROUND: The Joint clinical Research Center has pioneered the use of Antiretroviral drugs in Uganda as well as offering comprehensive care to patients with HIV/AIDS. To date, over 12,000 have received ARVs at the center. This is just one percent of all the patients in Uganda who need ARVs. As such management of opportunistic infections is still important even more than provision of ARVs alone. Opportunistic infections continue to be the major causes of admission at our 16-bed unit. We aimed to compare rates of the different infections over 4 periods as ARV use increased over the same period.

METHODS: Using our newly created database, we retrospectively examined records of admissions. We aimed to look at the different causes of admission as ARVs become more readily available. We looked at comparison of 4 different periods by retrospective review of all inpatient files.

RESULTS: The main infectious causes of admissions were, January 1999 - Dec 2000, 359 patients were admitted with, TB (29.5%), Cryptococcal meningitis (15.8%), Cerebral toxoplasmosis (10.8%) and PCP (12.5%) 31.5 deaths and subsequently in 2001 of 277 patients 24.2% had TB, 13% Cryptococcal meningitis, 11.2% had cerebral toxoplasmosis and 9.75% had PCP 20.2 deaths. In 2002, of 342 patients 23.2% had TB, 10.6% had cryptococcal meningitis, 10.03% toxoplasmosis and 8.31% PCP 22.9 deaths. We noted slight differences in 2003 where 333 patients have so far been admitted with TB accounting for 19.8% Cryptococcal meningitis 11.7%, 42 % being Cerebral toxoplasmosis and 10% PCP 20.4 deaths. All patients were admitted with severe immunosuppression with CD4 count< 200.

CONCLUSIONS: The causes of admission have not changed significantly over the four period compared. From this analysis it's too early to assess any reductions in opportunistic infection as ARVs are used increasingly. The role of immune reconstitution related opportunistic infections requires further evaluation.

Keywords: AEGIS, Acquired Immunodeficiency Syndrome, AIDS-Related Opportunistic Infections, HIV Infections, Anti-HIV Agents, Death, HIV, Toxoplasmosis, Cerebral, Meningitis, Cryptococcal, Toxoplasmosis, CD4 Lymphocyte Count, Biomedical Research, HIV Seropositivity, Cause of Death, Opportunistic Infections, Death Certificates, Uganda, Humans, etiology

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B10222