Clinical profile of HIV-infected, HAART- Na�ve patients admitted to a tertiary level hospital in Maseru, Lesotho

Abstract

Introduction: Southern Africa has one of the highest HIV prevalence rates globally. The HIV epidemic in the region is characterised by high rates of morbidity and mortality. The aim of this study was to document the clinical profiles of patients hospitalised for the treatment of HIV-related disorders in Maseru, Lesotho. Methods: A prospective observational study of 105 HIV-infected, HAART-na�ve patients admitted at Queen Elizabeth II Referral Hospital in Maseru.Results: The median age was 34 years and 50.5% were female. 74 patients (70.5%) had tested positive for HIV before admission. 85.9% of all patients had presented with Stage III or IV events at diagnosis of HIV infection. 69.5% of the patients were treated for opportunistic infections of which tuberculosis was the commonest (n = 43, 41.0%) followed by oral candidiasis (n = 19, 18.1%) and pneumonia (n = 11,10.5%). 35 patients (33.3%) had severe anaemia (Hb < 8g/dl). The median CD4 count was 73.5 cells/?l; 62 patients (59.0%) were in Stage III and 43 (41.0%) were in Stage IV of HIV infection. The median duration of hospitalisation was 9 days; prolonged hospitalisation was associated with extrapulmonary tuberculosis and cryptococcal meningitis. The in-hospital mortality was 30.5%; the mortality rate was higher among patients with advanced AIDS (Stage IV).Conclusions: The majority of the patients presented with HIV-related opportunistic infections. The main factors contributing to morbidity and mortality in this study were late presentation for diagnosis of HIV infection and treatment of HIV-related disorders.