High Prevalence of Advanced HIV Disease at Diagnosis in a Multi-Center Study: Urgent Need for Early Intervention

Berhanu M. Abera^1, , Zekarias S. Ayalew¹, Abel T. Tasamma¹, Amir Muhdin², Eyob Beyene³, Anteneh Eshetu³, Eskedar F. Azerefegne³, Tilahun Bizuayehu³, Yared Getachew¹, Biruk Abate¹, Asrat Berihun¹, Sibehatleab T. Mulate¹, Abel Andargie⁴, Surafel Adugna¹, Mehariw W. Netsere⁵, Kemer Kedir⁶, Zelalem B. Ayele¹, Abraham Workneh⁷, Bereket Abraha Molla¹ and Wondwossen A. Degu³

¹Department of Internal Medicine, Addis Ababa University, Addis Ababa, Ethiopia

²Department of Emergency and Critical Care Medicine, Addis Ababa University, Addis Ababa, Ethiopia

³Division of infectious disease, Addis Ababa University, Addis Ababa, Ethiopia

⁴Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia

⁵Department of Internal Medicine, St. Paul Hospital Millennium College, Addis Ababa, Ethiopia

⁶Department of Oral and Maxillofacial Surgery, Addis Ababa University, Addis Ababa, Ethiopia

⁷Department of Trauma and Orthopedic Surgery, Addis Ababa University, Addis Ababa, Ethiopia

Cite this paper:
Berhanu M. Abera, Zekarias S. Ayalew, Abel T. Tasamma, Amir Muhdin, Eyob Beyene, Anteneh Eshetu, Eskedar F. Azerefegne, Tilahun Bizuayehu, Yared Getachew, Biruk Abate, Asrat Berihun, Sibehatleab T. Mulate, Abel Andargie, Surafel Adugna, Mehariw W. Netsere, Kemer Kedir, Zelalem B. Ayele, Abraham Workneh, Bereket Abraha Molla and Wondwossen A. Degu. High Prevalence of Advanced HIV Disease at Diagnosis in a Multi-Center Study: Urgent Need for Early Intervention. American Journal of Infectious Diseases and Microbiology. 2024; 12(2):37-43. doi: 10.12691/ajidm-12-2-3

Abstract

Introduction: Many patients having HIV present to the health care system with advanced HIV disease. Patients with advanced HIV disease have CD4 cell count of less than 200cells/mm3 or WHO stage III or IV clinical events. The primary culprits responsible for severe morbidity and mortality are tuberculosis, severe bacterial infections and cryptococcal meningitis. Methods: A retrospective multi-centered facility based cross-sectional study was conducted among newly diagnosed HIV patients whose age was ≥ 15 years over a period of one year (October 2023-January 2024). The prevalence of advanced HIV disease was estimated with advanced HIV disease defined as WHO clinical stage 3, stage 4 or CD4 count less than 200 cells/μ. The baseline characteristic of the study participants was compared with and without advanced HIV disease. Pretested and structured questionnaires were adopted. The data was checked for completeness, cleaned and exported to SPSS version 26 for analysis. Descriptive statistics, chi square test, nonparametric tests and multi variable logistic regression were used for data analysis. P-value less than 0.05 were considered to be statistically significant. Results: Among the 400 patients, about 49% of them were males and 51% were females. The prevalence of advanced HIV disease at presentation was 65.5%. The patients were likely to be bedridden (AOR 10.6, 95% CI 1.24-91, P =0.03), have lower BMI (AOR 3.2, 95% CI 1.14-8.9, P =0.03) and diagnosed due to presence of symptoms of opportunistic infections (AOR 44.6, 95% CI 22.8-87.2, P <0.001). Conclusions: The study showed that advanced HIV disease was very high among newly diagnosed HIV patients emphasizing timely intervention to reduce the increased morbidity and mortality associated with advanced HIV disease.

Keywords:
Advanced HIV disease prevalence Associated factors CD4 count Ethiopia mortality

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