AIDS-defining illnesses at initial diagnosis of HIV in a large Guatemalan cohort

Samuel W. Reinhardt, Andrej Spec, Johanna Meléndez, Andrea Alonzo Cordon, Ian Ross, William G. Powderly, Carlos Mejia Villatoro

Research output: Contribution to journalArticle

Abstract

Background. Anecdotal evidence suggests that a high proportion of patients diagnosed with HIV in Guatemala present with AIDS. There remain limited data on the epidemiology of AIDS-defining illnesses (ADIs) in Central America. Methods. We conducted a retrospective cohort study of all patients living with HIV at the largest HIV clinic in Guatemala. Charts were analyzed for clinical and demographic data. Presence of an ADI was assessed by US Centers for Disease Control definitions; patients who presented with an ADI were compared with those without ADI using descriptive statistics. Results. Of 3686 patients living with HIV, 931 (25.3%) had an ADI at HIV diagnosis, 748 (80.3%) of whom had CD4 counts lower than 200 cells/mm 3 . Those with ADIs were more likely to be male (67.5% vs 54.6%; P < .0001) and heterosexual (89.4% vs 85.0%; P = .005). The most common ADIs were Mycobacterium tuberculosis (55.0%), Pneumocystis jirovecii pneumonia (13.7%), esophageal candidiasis (13.4%), and histoplasmosis (11.4%). Histoplasmosis and HIV wasting syndrome were both more common among rural patients. Conclusions. In this large Guatemalan cohort of patients currently living with HIV, a significant portion presented with an ADI. These data inform the most common ADIs diagnosed among survivors, show that histoplasmosis is more commonly diagnosed in rural patients, and suggest that HIV wasting syndrome may reflect missed histoplasmosis diagnoses.

Original languageEnglish (US)
Pages (from-to)1-5
Number of pages5
JournalOpen Forum Infectious Diseases
Volume3
DOIs
StatePublished - Jan 1 2016

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Acquired Immunodeficiency Syndrome
HIV
Histoplasmosis
HIV Wasting Syndrome
Guatemala
Pneumocystis carinii
Central America
Pneumocystis Pneumonia
Candidiasis
Heterosexuality
Centers for Disease Control and Prevention (U.S.)
CD4 Lymphocyte Count
Mycobacterium tuberculosis
Survivors
Epidemiology
Cohort Studies
Retrospective Studies
Demography

All Science Journal Classification (ASJC) codes

  • Oncology
  • Clinical Neurology

Cite this

Reinhardt, S. W., Spec, A., Meléndez, J., Cordon, A. A., Ross, I., Powderly, W. G., & Villatoro, C. M. (2016). AIDS-defining illnesses at initial diagnosis of HIV in a large Guatemalan cohort. Open Forum Infectious Diseases, 3, 1-5. https://doi.org/10.1093/ofid/ofx249
Reinhardt, Samuel W. ; Spec, Andrej ; Meléndez, Johanna ; Cordon, Andrea Alonzo ; Ross, Ian ; Powderly, William G. ; Villatoro, Carlos Mejia. / AIDS-defining illnesses at initial diagnosis of HIV in a large Guatemalan cohort. In: Open Forum Infectious Diseases. 2016 ; Vol. 3. pp. 1-5.
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abstract = "Background. Anecdotal evidence suggests that a high proportion of patients diagnosed with HIV in Guatemala present with AIDS. There remain limited data on the epidemiology of AIDS-defining illnesses (ADIs) in Central America. Methods. We conducted a retrospective cohort study of all patients living with HIV at the largest HIV clinic in Guatemala. Charts were analyzed for clinical and demographic data. Presence of an ADI was assessed by US Centers for Disease Control definitions; patients who presented with an ADI were compared with those without ADI using descriptive statistics. Results. Of 3686 patients living with HIV, 931 (25.3{\%}) had an ADI at HIV diagnosis, 748 (80.3{\%}) of whom had CD4 counts lower than 200 cells/mm 3 . Those with ADIs were more likely to be male (67.5{\%} vs 54.6{\%}; P < .0001) and heterosexual (89.4{\%} vs 85.0{\%}; P = .005). The most common ADIs were Mycobacterium tuberculosis (55.0{\%}), Pneumocystis jirovecii pneumonia (13.7{\%}), esophageal candidiasis (13.4{\%}), and histoplasmosis (11.4{\%}). Histoplasmosis and HIV wasting syndrome were both more common among rural patients. Conclusions. In this large Guatemalan cohort of patients currently living with HIV, a significant portion presented with an ADI. These data inform the most common ADIs diagnosed among survivors, show that histoplasmosis is more commonly diagnosed in rural patients, and suggest that HIV wasting syndrome may reflect missed histoplasmosis diagnoses.",
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Reinhardt, SW, Spec, A, Meléndez, J, Cordon, AA, Ross, I, Powderly, WG & Villatoro, CM 2016, 'AIDS-defining illnesses at initial diagnosis of HIV in a large Guatemalan cohort', Open Forum Infectious Diseases, vol. 3, pp. 1-5. https://doi.org/10.1093/ofid/ofx249

AIDS-defining illnesses at initial diagnosis of HIV in a large Guatemalan cohort. / Reinhardt, Samuel W.; Spec, Andrej; Meléndez, Johanna; Cordon, Andrea Alonzo; Ross, Ian; Powderly, William G.; Villatoro, Carlos Mejia.

In: Open Forum Infectious Diseases, Vol. 3, 01.01.2016, p. 1-5.

Research output: Contribution to journalArticle

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AU - Reinhardt, Samuel W.

AU - Spec, Andrej

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AU - Cordon, Andrea Alonzo

AU - Ross, Ian

AU - Powderly, William G.

AU - Villatoro, Carlos Mejia

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Y1 - 2016/1/1

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