Opportunistic Respiratory Infections and their CD4 Cell Correlation among Newly Detected HIV Patients Attending K R Hospital Mysore

Background: About 70% of HIV infected people usually have one or many respiratory infections during the course of their HIV disease. Respiratory system involvement may lead to wide variety of pulmonary illness that includes HIV-related opportunistic infections caused by bacterial, mycobacterial, viral, fungal, parasitic pathogens and neoplasms. A wide clinical spectrum of respiratory illness was seen among HIV patients, in consonance with their varying immune status. The immune system is damaged by virus making the infected individual vulnerable to malignancies and opportunistic infections which are common in the chest. This study makes an attempt to correlate the pulmonary illness and CD4 counts as it will help in better understanding this deadly duo of HIV and opportunistic infections. Method: Total of 90 newly detected HIV patients above 18 years of age were included. Detailed clinical history taking and complete physical examination followed by specific tests including sputum analysis and chest radiographs were done .Their baseline CD4 counts were done to assess their degree of immunosuppression. Given pulmonary infections were then compared with CD4 count groups (CD4 countless and more than 200/cc). Result: The study had 90 cases with mean CD4 count of 201.76 cells/microL. Majority of the pulmonary illness were observed below the CD4 count of 200 cells/mm3. The study found that majority of patients with Pulmonary Tuberculosis had CD4 count >200 cells / μL (53.8%) and all patients with Extra-Pulmonary Tuberculosis had CD4 count <200 cells / μL. Conclusion: This study highlights that pulmonary tuberculosis still remains as the most common clinical entity in cases of HIV. This study also establishes that there is a higher prevalence of diseases such as PCP and extra pulmonary tuberculosis as the CD4 count level declines.