Patterns of Opportunistic Infections and Antiretroviral Therapy Efficacy in Newly Diagnosed Human Immunodeficiency Virus-1 Patients: A Descriptive Study in India

Background: Human immunodeficiency virus (HIV) prevalence in India has decreased from 0.55% in 2000 to 0.21% in 2021. Despite this decline, high prevalence rates persist in certain regions. HIV often remains undetected during its latent phase, leading to diagnosis with acquired immunodeficiency syndrome (AIDS)-defining opportunistic infections (OIs) such as tuberculosis, cryptococcosis, and others. This study investigates the clinical presentation, management, and outcomes of HIV patients with OIs and evaluates the effectiveness of antiretroviral therapy (ART). Materials and methods: This ambispective descriptive study was conducted over 6 months at a 1,000-bed tertiary-care teaching hospital in New Delhi, including 100 patients with confirmed HIV-1 infection. Randomized sampling was used, adhering to National AIDS Control Organization (NACO) guidelines for inclusion. Data collected included sociodemographic details, clinical symptoms, clusters of differentiation 4 (CD4) counts, and human immunodeficiency virus ribonucleic acid (HIV RNA) viral loads at baseline and after 6 months of ART. Diagnosis of OIs followed NACO guidelines. Data were analyzed using SPSS version 29. Results: The cohort consisted of 82 males and 18 females, primarily aged 21–60 years. At presentation, 45% were asymptomatic. Among symptomatic patients, fever (25%), weight loss (17%), and diarrhea (13%) were common. Tuberculosis was the most frequent OI. Regimens of tenofovir disoproxil fumarate, lamivudine, and dolutegravir were most commonly used. Baseline CD4 counts were distributed as >350, <200, and 201–349 cells/mm³, with lower counts linked to severe OIs. All patients achieved viral load suppression 6 months after initiation of ART. Average HIV RNA viral load decreased from 3,43,073 copies/mL at baseline to 202 copies/mL after 6 months of ART. Conclusion: The study highlights the challenges of early HIV detection and the effectiveness of ART in controlling viral load. With many patients presenting asymptomatically, regular health screenings are crucial. The reduced viral load with ART underscores its efficacy, emphasizing the need for improved public health strategies and early diagnosis.