Treatment Outcomes of Opportunistic Infections (Cryptococcal, Toxoplasmosis and Pneumocystis Pneumonia) and Associated Factors among Admitted HIV/AIDS Patients at University of Gondar Comprehensive and Specialized Hospital, Northwest Ethiopia

Abstract

Abstract

Background: Opportunistic infections are infections that take the advantage of weakness in immune defenses by human immunodeficiency virus or by medication to cause health problem and are caused by a multitude of organisms.

Objective: To assess the treatment outcomes of cryptococcal meningitis, toxoplasmosis and pneumocystis pneumonia infection among HIV patients

Method: Cross sectional study design was conducted on adult HIV/AIDS patients with cryptococcal meningitis, toxoplasmosis and pneumocystis pneumonia infections who were admitted from 2014 to may 2019 at University of Gondar comprehensive and specialized hospital. All adult HIV/AIDS patients with cryptococcal meningitis, toxoplasmosis and pneumocystis pneumonia infection who were admitted from January 2014 to may 2019 was the sample size and 357 records were reviewed. The data was analyzed by using SPSS version 20 and binary logistic regression analysis was used. Crude and adjusted odds ratios with the corresponding 95% confidence intervals were computed. P-value <0.05 was considered as statistically significant in the study.

Result: A total of 357 records (163 cases of cryptococcal meningitis, 90 cases of toxoplasmosis and 104 cases of pneumocystis pneumonia) were reviewed. One hundred seventy deaths (76 due to cryptococcal meningitis, 40 due to toxoplasmosis and 54 due to pneumocystis pneumonia) had been recorded. Factors associated with death includes seizure, brain lesion, duration of symptoms, Leukopenia, recent CD4 level and hemoglobin level at opportunistic infection diagnosis time for cryptococcal meningitis; weight loss, duration of symptoms, brain nodules, recent CD4 level, lactate dehydrogenase level, erythrocyte sedimentation rate level and hemoglobin level at opportunistic infection diagnosis time for toxoplasmosis and bilateral infiltration, diffusion infiltrate, body weight at opportunistic infection diagnosis time, lactate dehydrogenase level and recent CD4 level for pneumocystis pneumonia.

Conclusion: Treatment outcome of cryptococcal meningitis, toxoplasmosis and PCP still needs a further great effort. They are still a life threatening diseases and common cause death in patients with AIDS. Factors associated with death from opportunistic infections includes seizure, brain lesion, duration of symptoms, Leukopenia, recent CD4 level, hemoglobin level at opportunistic infection diagnosis time ,weight loss, brain nodules, lactate dehydrogenase level, erythrocyte sedimentation rate level, bilateral infiltration, diffusion infiltrate and body weight at opportunistic infection diagnosis time

Key words: Pneumocystis pneumonia, cryptococcal meningitis, toxoplasmosis, HIV patients, treatment outcome