A Single Center Experience: Short Term CD4 Count Monitoring and Rate of Opportunistic Infections in Human Immunodeficiency Virus (HIV) Infected Patients

Background /Objectives : CD4 cell count is a key measure of Human immunodeficiency virus (HIV) disease progression and for the risk of developing a life-threatening opportunistic infections (OIs). We designed this study to assess and monitor CD4 count at baseline and response to antiretroviral therapy (ART) at 6 and 12 months and to know the prevalence of OIs among all adult with HIV-infection in a tertiary care hospital in Saudi Arabia (SA). Material/methods: Retrospective study was conducted with a total of 61 HIV seropositive patients attended at King Abdulaziz Medical City-Riyadh from January 2005 to November 2015, data was collected and recorded form patients’ charts, electronic health record system and HIV database for age, gender, nationality, CD4 count at baseline for all patients and at 6 months and 12 months for patients receiving ART and OIs. Flow cytometry was used for absolute CD4 count measurement. Identification of all causative microorganisms of OIs was performed by the standard microbiologic methods with clinical correlation. Results: Majority, 46/61(75.4%) of study participants were male patients. The mean age of participants was 44.39 with std of +/- 13.375 years. Mean baseline CD4 count for all study participants was 285.28 with std of +/- 306.333 cells/μL. Distribution of baseline CD4 count for all patients was, DC4 count less than 200 cells/μL were 34/61(55.7%), CD4 count from 200-500 cells/μL were 13/61(21.3%) and CD4 count more than 500 cells/μL were 14/61(23.0%). A total of 30/61 patients (49.2%) were not receiving ART and 31/61 patients (51.8%) were receiving ART. A total of 22/61 (36.1%) OIs were observed from the study participants. Commonly observed OIs were Cytomegalovirus (CMV) 14/61 (23.0%) (Positive IgG and IgM antibodies, pp65 antigen and PCR without clinical correlation), Tuberculosis 4/61(6.6%), pneumocystis pneumonia 2/61(3.3%) Toxoplasmosis 2/61(3.3%), Syphilis 2/61(3.3), varicella zoster virus (VZV) 1/61(1.6%), herpes simplex virus (HSV) 1/61 (1.6%). Conclusions: Half of HIV-infected patients 55.7% in this study were severely immunocompromised at the time of HIV diagnosis. Half of patients receiving ART were nonadherence to medications and 21% of patients had a poor immunologic response after one year of adherence to ART. One-third of our HIV-positive patients were infected with one or more OIs.