Opportunistic infections and clinico-epidemiological factors in HIV/AIDS casesseen in a tertiary care hospital in Nepal

Opportunistic infections are the leading cause of morbidity and mortality among HIV/AIDS patients. The spectrum of opportunistic pathogens involved in such infections in Nepal is not well documented. A cross sectional (hospital-based) study was carried out at the AIDS clinic of Manipal Teaching Hospital, Pokhara, Nepal. A total of 404 clinically suspected cases of HIV/AIDS seen at the clinic between July 2001 and December 2002, were screened for HIV. Seventy four (18.3%) were sero-positive for HIV. Fever was the commonest presenting symptoms 48.6% followed by cough and dyspnoea 36.5%, weight loss 36.5% and pulmonary tuberculosis 21.6%. Fifty five of the 74 (74.3%) HIV positive cases were in the age group 20-39 years. Heterosexual mode of acquisition/transmission was seen in 60.8% and 21.6% were intravenous drug abusers (IVDA). A total of 45 opportunistic pathogenic isolates were recovered from the 74 patients. Mycobacterium tuberculosis was the commonest pathogen 60%, followed by Cryptosporidium spp 13.3% and Candida spp 11.1%. Four patients died during the period of study giving a mortality rate of 5.4%. This study shows that HIV/AIDS is rapidly becoming a grave concern in the Pokhara valley of Nepal. Intensive and effective health education programmes among the target population may be a cost effective method to curb the rising prevalence of HIV/AIDS in a developing country like Nepal. Also, further regional studies are required to establish more detailed epidemiological database of opportunistic infections in HIV/AIDS patients in Nepal.Keywords: HIV/AIDS, opportunistic infections, NepalAfrican Journal of Clinical and Experimental Microbiology Vol. 6 (3) 2005: 239-24