بررسی سندرمهای بالینی منجر به بستری در مبتلایان به اچ آی وی / ایدز حسب شمارش CD4 در بیمارستان سینا کرمانشاه

Introduction & Objective: Immunodeficiency duo to HIV infection can produce unusual diseases in infected individuals and CD4 count is the main predictor of the disease progression. In this study the clinical syndromes resulting hospitalization were considered according to CD4 count for the better diagnosis and treatment of clinical complications in HIV infected patients. Materials & Methods: This cross-sectional study was performed from March 2002 to March 2003 in Kermanshah Sina Hospital. HIV infection was confirmed with positive double ELISA and Western Blot. CD4 count was measured by flucytometery, clinical syndromes were collected with final diagnosis, and the rest of the data were gathered according to the patients' interviews. Statistical analysis was performed by SPSS 11.5. Results: During this study, 72 out of 215 admitted patients were enrolled. All of them were male with the mean age(±SD) of 33.4±9.1 years. 64 cases (88.9%) were addicted and 40 cases (55.6%) had prison history. Clinical and/or laboratory indicators of AIDS were observed in 32 cases (44.4%). The average of CD4 count was 356/mL. Patients with lymphadenopathy, neurologic and pneumonia syndromes had the least count of CD4 with the averages of 90, 241 and 269/ mL and patients with sepsis, endocarditis and hepatitis syndromes had the highest CD4 average count of 646, 394 and 373/mL respectively. Statistical correlations were observed between pneumonia syndrome and CD4 <200/mL (P= 0.005), and addiction history (P =0.0001). Suffering from hepatitis syndrome was also statistically correlated with being at prison. Conclusion: High prevalence of AIDS in our study was a trait which means high prevalence of asymptomatic HIV infection in general population. Also in patients with CD4<200/mL, especially those who are addicted, pneumonia syndrome may occur. Lymphadenopathy, neurologic and pneumonia syndromes are more common in CD4<300/mL whereas sepsis, endocarditis and hepatitis syndromes are common in CD4> 300/mL, that shows the effect of CD4 count in appearance of clinical syndromes. Unsafe injections in prisoners may cause acquisition of viral hepatitis in these patients.