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Regional Differences in the Prevalence of Major Opportunistic Infections among Antiretroviral-Naive Human Immunodeficiency Virus Patients in Japan, Northern Thailand, Northern Vietnam, and the Philippines
- Source :
- The American Journal of Tropical Medicine and Hygiene. 97(1):49-56
- Publication Year :
- 2017
- Publisher :
- The American Society of Tropical Medicine and Hygiene, 2017.
-
Abstract
- To identify regional differences in the distribution of opportunistic infections (OIs) among human immunodeficiency virus (HIV)-infected patients in Asia, the medical records of antiretroviral therapy (ART)-naive patients who attended the following tertiary hospitals from 2003 to 2011 were reviewed: Nagoya Medical Center (NMC, Nagoya, Japan), Lampang Hospital (LPH, Lampang, northern Thailand), Bach Mai Hospital (BMH, Hanoi, northern Vietnam), and Philippine General Hospital (PGH, Manila, Philippines). Logistic regression analyses were performed to identify associations between country of origin and risk of major OIs. In total, 1,505 patients were included: NMC, N = 365; LPH, N = 442; BMH, N = 384; and PGH, N = 314. The median age was 32 years, and 73.3% of all patients were male. The median CD4 count was 200 cells/μL. Most patients at NMC and PGH were men who have sex with men. Injection drug users were most common at BMH (35.7%). Mycobacterium tuberculosis (TB) was most common at PGH (N = 75) but was rare at NMC (N = 4). Pneumocystis pneumonia (PCP) prevalence was highest at NMC (N = 74) and lowest at BMH (N = 13). Multivariable logistic regression showed increased odds of TB at PGH (adjusted odds ratio [aOR] = 42.2, 95% confidence interval [CI] = 14.6?122.1), BMH (aOR = 12.6, CI = 3.9?40.3), and LPH (aOR = 6.6, CI = 2.1?21.1) but decreased odds of PCP at BMH (aOR = 0.1, CI = 0.04?0.2) and LPH (aOR = 0.2, CI = 0.1?0.4) compared with those at NMC. The cryptococcosis risk was increased at LPH (aOR = 6.2, CI = 0.9?41.0) compared with that at NMC. Cytomegalovirus (CMV) retinitis prevalences were similar in all countries. OI prevalence remained high among ART-naive patients in our cohort. The risks of TB, PCP, and cryptococcosis, but not CMV retinitis, differed between countries. Improved early HIV detection is warranted.<br />The American Journal of Tropical Medicine and Hygiene, 97(1), pp.49-56; 2017
- Subjects :
- 0301 basic medicine
Adult
Male
medicine.medical_specialty
Tuberculosis
AIDS-Related Opportunistic Infections
Philippines
Retinitis
HIV Infections
Pneumocystis pneumonia
Men who have sex with men
Cohort Studies
03 medical and health sciences
0302 clinical medicine
Japan
Virology
Internal medicine
medicine
Odds Ratio
Prevalence
Humans
030212 general & internal medicine
Geography
Pneumonia, Pneumocystis
Odds ratio
Cryptococcosis
Articles
Middle Aged
medicine.disease
Thailand
030104 developmental biology
Infectious Diseases
Vietnam
Cohort
Cytomegalovirus Infections
Parasitology
Female
Cohort study
Subjects
Details
- Language :
- English
- ISSN :
- 00029637
- Volume :
- 97
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- The American Journal of Tropical Medicine and Hygiene
- Accession number :
- edsair.doi.dedup.....27a6cbc0782e514c33553d5c86f14b77