Prevalence of opportunistic infections in HIV-positive patients in Bahrain: a four-year review (2009-2013)

Abstract

Introduction: This study aimed to examine the prevalence of opportunistic infections in HIV-infected patients in Bahrain and its relation to absolute CD4 count, CD4%, and CD4/CD8 ratio.

Methodology: This retrospective cohort study used laboratory records (January 2009 - May 2013) from a major hospital in Bahrain. Opportunistic infections (OIs); absolute CD4 counts, CD4%, and CD4/CD8 ratio were recorded.

Results: CD4% and absolute CD4 count in HIV patients with associated infections (157 ± 295) was significantly lower than in those without associated infections (471 ± 285) (p < 0.001). There was no significant difference in CD4/CD8 ratio between the two groups. Infection with Staphylococcus aureus was the commonest infection, present in 9.8% of total HIV-infected patients and 28.7% of members of the AIDS patient group with OIs, followed by yeast infections (9.2% and 27.2%, respectively). Mycobacterium tuberculosis was present in 3.6% of total HIV-infected patients and 10.6% of the group with OIs, while mycobacteria other than tuberculosis (MOTT) was present in 2.5% and 7.5%, respectively. Pneumocystis jirovecii pneumonia (PCP) was observed in 5.1% and 15.1%, respectively. Herpes simplex II (HSV-II) was observed in 3% and 9%, respectively, while Cytomegalovirus antigenemia was only present in 2% and 6%, respectively. Streptococcus pneumoniae, Streptococcus milleri, Stenotrophomonas maltophilia, and Citrobacter species were bacterial infections observed least frequently.

Conclusions: Studying the pattern of OIs in HIV-infected patients in Bahrain is of paramount importance due to the scarcity of data in the Arab world. This will help to improve physicians’ awareness to improve care of HIV-infected patients.