Frequency And Outcome In AIDS Patients In A University Teaching Hospital – A Five Year Review

This study was carried out as part of a restrospective study on the pattern of in-patient admissions to a tertiary health institution situated in a semi-rural/urban community in Nigeria. It aimed at evaluating the changing frequency of AIDS amongst medical admissions as well as the morbidity and mortality among these patients. A total of 54 AIDS patients were admitted on the medical wards during the period 1993 to 1997, thus constituting 2.3% of all medical admissions. The frequency increased from 1.0% in 1993 to 7.2% in 1997. Out of the 54 AIDS patients seen, 38 were HIV I and II positive, 11 were HIV I positive and 5 were HIV II positive. There were 37 males and 17 females, giving a male:female ratio of 2:1. The commonest age of presentation was in the 4th decade but a rising trend was observed among females in the second and third decades towards the end of the study. Fifty-one of the study group (94%) were in the lower socio-economic class; 20 were long distance truck drivers/conductors (37%), 16 were inter-state traders (30%), 6 were house-wives (11%) and 4 were retired members of the armed forces (7%). Twenty-nine (54%) of the patients were married, 12 (22%) were single, 9 (17%) were divorcees while the marital status of the remaining 4 patients was not stated. Twenty-one patients (39%) were heterosexuals with multiple sexual partners while 25 (46%) were heterosexuals with single sexual partners. Blood transfusion was the predisposing factor in 6 (11%) of the patients while no obvious predisposing factor was identified in 2 (4%) of the patients. Homosexualism and intravenous drug usage were not reported in any of the subjects. The presenting features were diarrhoea, chronic weakness, weight loss chronic cough, generalised dermatitis and oesophageal candidoses. Abnormal haematological indices included anaemia, leucocytosis and leucopenia. Twenty-three patient (42%) died within 6 months of diagnosis in the hospital, 16 (30%) were discharged to Medical/Community medicine out-patient clinic for follow-up, 7 (13%) discharged themselves against medical advice and 8 (15%) were lost to follow-up. In conclusion, this study demonstrated an increasing frequency and mortality of AIDS among medical in-patients in a tertiary health institution located in a semi - rural area. A community based study would be needed to assess the seriousness of this infection and reflect the efficacy or other wise of current control measures. The association of tuberculosis and HIV infection was observed, thereby justifying the screening of such patients for tuberculosis. Nigerian Quarterly Journal of Hospital Medicine Vol.9, No.3 (1999) pp. 177-17