Spectrums of opportunistic infections and malignancies in HIV-infected patients in tertiary care hospital, China

PLoS One. 2013 Oct 25;8(10):e75915. doi: 10.1371/journal.pone.0075915. eCollection 2013.

Abstract

Background: HIV-related opportunistic infections (OIs) and malignancies continued to cause morbidity and mortality in Chinese HIV-infected individuals. The objective for this study is to elucidate the prevalence and spectrums of OIs and malignancies in HIV-infected patients in the Beijing Ditan Hospital.

Methods: The evaluation of the prevalence and spectrums of OIs and malignancies was conducted by using the clinical data of 834 HIV-infected patients admitted in the Beijing Ditan hospital from January 1, 2009, to November 30, 2012.

Results: The prevalence and spectrums of OIs and malignancies varied contingent on geographic region, transmission routes, and CD4 levels. We found that tuberculosis was most common OI and prevalence was 32.5%, followed by candidiasis(29.3%), Pneumocystis pneumonia(PCP)(22.4%), cytomegalovirus(CMV) infection(21.7%), other fungal infections(16.2%), mycobacterium avium complex(MAC)(11.3%), cryptococcosis(8.0%), progressive multifocal leukoencephalopathy(PML)(4.4%), Cerebral Toxoplasmosis(3.5%) and Penicillium marneffei infection(1.4%); while Lymphoma(2.9%), Kaposi's sarcoma(0.8%) and cervix carcinoma(0.3%) were emerged as common AIDS-defining malignancies. Pulmonary OI infections were the most prevalent morbidity and mortality in patients in the AIDS stage including pulmonary tuberculosis (26.6%) and PCP (22.4%). CMV infection(21.7%) was most common viral infection; Fungal OIs were one of most prevalent morbidity in patients in the AIDS stage, including oral candidiasis (29.3%), other fungal infection (16.2%), Cryptococcosis (8.0%) and Penicillium marneffei infection (1.4%). We found the low prevalence of AIDS-defining illnesses in central neural system in this study, including progressive multifocal leukoencephalopathy (4.4%), cerebral toxoplasmosis (3.5%), tuberculosis meningitis (3.2%), cryptococcal meningitis (2.4%) and CMV encephalitis (1.1%). In-hospital mortality rate was 4.3 per 100 person-years due to severe OIs, malignancies, and medical cost constraints.

Conclusions: The prevalence and spectrums of OIs, malignancies and co-infections were discussed in this study. It would help increase the awareness for physicians to make a diagnosis and empirical treatment sooner and plan good management strategies, especially in resource limited regions.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • AIDS-Related Opportunistic Infections / epidemiology*
  • AIDS-Related Opportunistic Infections / transmission
  • Adult
  • CD4 Lymphocyte Count
  • China
  • Coinfection
  • Female
  • HIV Infections / complications*
  • Hospital Mortality
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / epidemiology*
  • Neoplasms / etiology*
  • Prevalence
  • Retrospective Studies
  • Tertiary Care Centers*

Grants and funding

Support for this work was provided by: (1) The Twelve-fifth Key Project The Study of Construction of Representative areas for Prevention and Therapy of Fatal Infectious Diseases such AIDS & Viral Hepatitis in Chaoyang District, Beijing (2012ZX10004-904); (2)Beijing Natural Science Fund The evaluation of association between polymorphism of leptin or adiponectin and NAFLD complicated with AIDS(7112065). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.