Pattern of comorbidities among highly active anti‑retroviral therapy‑naive HIV‑infected adult Nigerian patients at initial diagnosis
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Abstract
Background: Comorbidities associated with HIV infection may have profound impact on the future clinical outcomes of infected patients. This study was carried out to assess the prevalence and types of comorbidities in newly diagnosed, highly active anti-retroviral therapy (HAART)-naïve adult HIV patients.
Methods: A retrospective study of 501 consecutive newly diagnosed, HAART-naïve HIV-infected patients was carried out between April 2014 and September 2015 at the University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria. Demographic characteristics, clinical data and comorbid disease condition at initial presentation were retrieved from the hospital records of study patients. Summary statistics was used to present discrete variables. Medians were calculated for continuous variables (age and CD4 counts). Kruskal–Wallis test was used to compare the medians across the different groups, and the Dunn’s post’s test was used to compare medians between two groups.
Results: One hundred and sixty-one (32.1%) of 501 study patients were identified with comorbid conditions, of which 6 patients had more than one comorbid condition, indicating polypathology. The prevalence of comorbid conditions observed include renal disease (14.4%), hypertension (6.2%), tuberculosis (3.4%), oral thrush (2.4%), malaria (1.6%), urinary tract infection (2.2%), hepatitis-B (1%), diabetes mellitus (0.6%), while oesophageal candidiasis, herpes zoster, hepatitis-C and toxoplasmosis were 0.2% each. Comorbidities of infective origin were found predominantly in patients with WHO clinical class 3 and 4, corresponding with declining CD4 cell counts. Renal disease was present in all four clinical stages of HIV.
Conclusion: Renal disease was the most prevalent comorbidity. Comorbidities of infective origin were found almost exclusively in patients with WHO clinical class 3 and 4. Findings highlight the need for detailed evaluation at initial presentation, prior to treatment initiation.
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