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Indian Journal of Community Medicine

A study of opportunistic infection in HIV-seropositive patients

Author(s): Mulla SA, Patel Manish G, Vaghela Geeta, Motala Nazima, Desai Vikas, Shrivastava Ratan K

Vol. 32, No. 3 (2007-07 - 2007-09)

SHORT ARTICLE

Year : 2007 | Volume : 32 | Issue : 3 | Page : 208-209

A study of opportunistic infection in HIV-seropositive patients

Mulla SA, Patel Manish G, Vaghela Geeta, Motala Nazima, Desai Vikas, Shrivastava Ratan K
Department of Microbiology, Government Medical College, Surat, Gujarat, India
Date of Submission 30-May-2006
Date of Acceptance 10-Aug-2007

Correspondence Address:
Mulla S A
Department of Microbiology, Government Medical College, Surat, Gujarat
India

Source of Support: None, Conflict of Interest: None
How to cite this article:
Mulla SA, Patel MG, Vaghela G, Motala N, Desai V, Shrivastava RK. A study of opportunistic infection in HIV-seropositive patients. Indian J Community Med 2007;32:208-9
How to cite this URL:
Mulla SA, Patel MG, Vaghela G, Motala N, Desai V, Shrivastava RK. A study of opportunistic infection in HIV-seropositive patients. Indian J Community Med [serial online] 2007 [cited 2007 Nov 30];32:208-9. Available from: http://www.ijcm.org.in/text.asp?2007/32/3/208/36831

The human immunodeficiency virus (HIV) infection leading to acquired immunodeficiency syndrome (AIDS) has now emerged as a major public health problem. The spectrum of opportunistic infections has been found to be varying from continent to continent and from region to region. In HIV-infected patients, progressive decline in their immunological response makes them susceptible to variety of common and opportunistic infections. These infections responsible for morbidity and mortality, vary from region to region.[1] With the advent of the AIDS pandemic, cases of Cryptococcal meningitis are also on the rise. Opportunistic infections are caused by either organisms of low or no virulence which are non-pathogenic for a person with intact immune system. The infection caused by known pathogen in such immunocompromized patients may present in different form like increased virulence, recurrence, multi-drug resistant, or atypical presentation. The present study was designed to determine the prevalence of HIV-associated opportunistic infections in south Gujarat region.

Materials and Methods

The present study describes the laboratory finding of 67 HIV-seropositive patients carried out at Department of Microbiology, Government Medical College, Surat. Their HIV status was confirmed by using three different tests (ELISA/Rapid/Simple). Necessary pre- and post-test counseling of the patients were carried out and relevant data were collected.

Sputum samples, stool samples, oral swabs, and cerebrospinal fluid (CSF) were collected taking all aseptic precaution. Wet preparation for oral swabs and formal ether concentrated preparation of the stool were examined. Gram's staining and Z-N staining of the sputum samples were carried out. Smears of the stool samples were stained with modified acid fast method and modified trichrome stain for intestinal protozoa. The CSF samples of the three patients who presented with meningitis were also processed. The wet mount, India ink preparation, and Gram's stain were examined.

Sputum samples were inoculated on MacConkey agar, Blood agar, and Chocolate agar for isolation of bacterial pathogens. They were also inoculated on L-J media after concentration by Petroff's method. The isolates obtained were identified by standard techniques. The oral swabs and CSF were cultured on Sabouraud dextrose agar. The growth obtained was identified by standard procedures.

Results

Majority of the patients in the present study were male heterosexuals (83.53%). A substantial number of the patients (76.11%) were in the reproductive age group, e.g., 20-39 years. Most of the patients in this study present with complain of cough (68.65%), fever (67.16%), weight loss (61.19%), and diarrhea (28.35%). Total of 72 organisms were isolated from 67 patients. In that, 32 had bacterial infections, 21 had fungal infections, and 19 had parasitic infections. Some patients presented with more than one infection. Candida (26.38%) was the commonest pathogen isolated followed by Mycobacterium tuberculosis (13.88%) and Cryptosporidium parvum (12.5%). Out of the three patients who presented with meningitis, Cryptococcus neoformans was isolated from two patients. List of the different isolates are given in [Table - 1].

Discussion

In the present study, the majority of the patients (76.58%) were in the reproductive age group and there was a male predominance (83.58%). This observation matches with the finding of other studier.[2][3] From different kinds of pathogens we isolated, Mycobacterium was the most common isolate. Other workers also found such result in their study. [1],[4] The other bacterial pathogens isolated in our study were varying from the study of other workers[5] who have reported Pseudomonas aeruginosa , Streptococcus pneumoniae , and Haemophilus influenzae to be predominant isolates. These variations could be due to geographic differences and also due to possible hospital acquired infections.

References

1. Ayyagari A, Sharma AK, Prasad KN, Dhole TN, Kishore J, Chaudhary G. Spectrum of opportunistic infections in Human Immunodeficiency Virus (HIV) infected cases in a tertiary care hospital. Indian J Med Microbiol 1999;17:78-80.
2. Sircar AR, Tripathi AK, Chaudhary SK, Misra R. Clinical profile of AIDS: A study of a referral hospital. J Assoc Physicians India 1998;46:775-8.
3. Talib SH, Singh J. A study on opportunistic enteric parasites in HIV seropositive patients. Indian J Pathol Microl 1998;41:31-7.
4. Aggarwal A, Arora U, Bajaj R, Kumari K. Clinico-Microbiological study in HIV seropositive patients. J Indian Acad Clin Med 2005;6:142-5.
5. Afessa B, Grren B. Bacterial pneumonia in hospitalized patients with HIV infection: The Pulmonary Complications, ICU Support and Prognostic Factors of Hospitalized Patients with HIV (PIP) Study. Chest 2000;117:1017-22.

Tables

Table 1: Different organisms isolated from human immunodeficiency virus-seropositive patients

Table 1: Different organisms isolated from human immunodeficiency virus-seropositive patients

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