Kumar S, Wanchu A, Abeygunasekera N, Sharma A, Singh S, Varma S
Department of Internal Medicine, PGIMER, Chandigarh, India.
Indian J Community Med. 2012 Jul;37(3):158-64. doi: 10.4103/0970-0218.99914.
Clinico-epidemiological profile of the Human immunodeficiency virus (HIV) epidemic in India is varied and depends on multitude of factors including geographic location. We analyzed the characteristics of HIV-infected patients attending our Immunodeficiency Clinic to determine any changes in their profile over five years.
A retrospective observational study.
The study sample included all patients with HIV infection from January 1, 2003 to December 31, 2007. Diagnosis of HIV was made according to National AIDS Control Organization guidelines.
Of 3 067 HIV-infected patients, 1 887 (61.5%) were male and 1 180 (38.5%) were female patients. Mean age of patients was 35.1 ± 9.0 years. Majority (91.8%) of patients were in the age group of 15 to 49 years. Progressively increasing proportion of female patients was noted from year 2004 onward. Median CD4 count at presentation in year 2003 was 197/μl (Interquartile range [IQR] = 82.5-373) while in year 2007 it was 186.5/μl (IQR = 86.3-336.8). Mean CD4 count of male patients was 203.7 ± 169.4/μl, significantly lower as compared with female patients, which was 284.8 ± 223.3/μl (P value ≤0.05). Every year, substantial proportions of patients presenting to clinic had CD4 count<200/μl indicating advanced disease. Predominant route of transmission was heterosexual in 2 507 (81.7%) patients. Tuberculosis and oropharyngeal candidiasis were the most common opportunistic infections (OIs). Cryptococcal meningitis was the most common central nervous infection. Our patients had comparatively lower median CD4 counts at the time of presentation with various OIs.
Patients had advanced stage of HIV infection at the time of presentation throughout five years. Females presented earlier during the course of HIV infection. There is need for early screening and increasing awareness in healthcare providers to make a diagnosis of HIV much sooner.
印度人类免疫缺陷病毒（HIV）流行的临床流行病学特征各不相同，取决于包括地理位置在内的多种因素。我们分析了在我们免疫缺陷诊所就诊的HIV感染患者的特征，以确定其特征在五年间是否有任何变化。
一项回顾性观察研究。
研究样本包括2003年1月1日至2007年12月31日期间所有HIV感染患者。HIV诊断依据国家艾滋病控制组织指南进行。
在3067例HIV感染患者中，1887例（61.5%）为男性，1180例（38.5%）为女性患者。患者的平均年龄为35.1±9.0岁。大多数（91.8%）患者年龄在15至49岁之间。从2004年起，女性患者比例逐渐增加。2003年就诊时的CD4计数中位数为197/μl（四分位间距[IQR]=82.5 - 373），而2007年为186.5/μl（IQR = 86.3 - 336.8）。男性患者的平均CD4计数为203.7±169.4/μl，与女性患者相比显著更低，女性患者为284.8±223.3/μl（P值≤0.05）。每年到诊所就诊的患者中，很大比例的患者CD4计数<200/μl，表明疾病处于晚期。主要传播途径为异性传播的患者有2507例（81.7%）。结核病和口腔念珠菌病是最常见的机会性感染（OI）。隐球菌性脑膜炎是最常见的中枢神经系统感染。我们的患者在出现各种OI时CD4计数中位数相对较低。
在整个五年期间，患者就诊时处于HIV感染晚期。女性在HIV感染过程中就诊更早。需要进行早期筛查并提高医疗服务提供者的意识，以便更早地诊断HIV。
