Proportion of opportunistic infections and risk factors associated with its appearance in patients with HIV

Abstract

Opportunistic infections are the main cause of morbidity, disability and mortality in patients with HIV, increasing the number of hospitalizations and costs of care. Objective: To estimate the proportion of opportunistic infections and to identify the factors associated with their appearance in patients with HIV treated at the Comprehensive Care Service of the Dr. Mario Catarino Rivas National Hospital, San Pedro Sula, 2019-2020. Methods: Analytical observational study of cases (opportunistic infection present) and controls. Forty cases and 120 controls were evaluated, with a confidence level of 95%, statistical power of 80%, with simple random sampling. The distribution of variables between cases and controls was used to obtain the Odds Ratio. Results: Opportunistic infections included: 52.5% (21) tuberculosis, 15.0% (6) histoplasmosis, 12.5% (5) cytomegalovirus, 10.0% (4) toxoplasmosis, 10.0% (4) candidiasis, 7.5% (3) cryptococcosis. The CD4 T lymphocyte count was <200 cells/mm3 in 60.0% (24) of the case group and 10.8% (13) of the control group. Viral load ˃1000 copies/ml (OR 14,500 CI 95% 6,109-34,415), the history of abandonment (OR 4,363 CI 95% 1,928-9,872) and not taking antiretroviral treatment (OR 64,076 CI 95% 8,063-509,165) were associated with infections opportunists. Viral load greater than 1,000 copies/mL prevailed in the group of cases, and an association was found with the presence of opportunistic infections with OR 14,500 (95% CI 6.109-34.415, p=.0001). Conclusion: Non-taking ARVs increases the risk of developing opportunistic infections 64-fold, and having stopped antiretroviral treatment increases the likelihood of developing an opportunistic infection 4-fold. Highly active antiretroviral therapy and adherence to treatment is the best strategy to prevent opportunistic infections in HIV-infected patients.