Immuno-Pathological Markers in Hiv/Aids Infection

ABSTRACT The AIDS pandemic and discovery of HIV, has produced a cohort of patients that thrust immunodeficiency and its associated infections into the lime light. Some opportunistic infections are indicators of HIV infection and are termed AIDS defining illnesses by the center for disease control and prevention. This study assesses the relationship between markers of HIV disease progression (AIDS defining illnesses) and CD4 lymphocyte count. Sputum samples of 234 HIV positive patients were analyzed using inverted giemsa technique for the presence of Pneumocystis jiroveci cysts; conventional Ziehl Neelsen stain for the presence of acid-fast-bacilli (AFB); and paraffin coated glass rod technique for the presence of cream/orange tufts around the rods suggestive of Nocardia specie and confirmed using biochemical tests. Stool samples of 202 HIV positive patients were also analyzed for the presence of opportunistic intestinal parasites. We considered five CD4 count strata (0 to 199, 200 to 299, 300 to 399, 400 to 499 and > 500 cells/µL) and the various opportunistic infections isolated were grouped based on their occurrence within each strata. Results were analyzed using Stata 10 and comparison of proportions were also analyzed using the chi-squared test or where appropriate the Fisher’s exact test.The prevalence of P. jiroveci, M.tuberculosis and Nocardia sp. at different CD4 count strata are as follows [0-199cells/ul (92%, 9.1% and 9.1%); 200-299 cells/ul (27.1%, 12.5% and 0%); 300-399 (6%, 16% and 0%), 400-499 (4.16%, 4.16% and 0); >500 (0%, 4.16% and 0%) respectively]. All cases of Nocardia sp. isolated was found in patients with CD4 count