Changing Spectrum of Opportunistic Illnesses among HIV-Infected Taiwanese Patients in Response to a 10-Year National Anti-TB Programme

• Main Authors: Chun-Yuan Lee, Pei-Hua Wu, Po-Liang Lu, Hung-Chin Tsai
• Format: Article
• Language: English
• Published: MDPI AG 2019-02-01
• Series: Journal of Clinical Medicine
• Subjects: AIDS-related opportunistic infections; HIV; Mycobacterium; tuberculosis; CD4 lymphocyte count
• Online Access: https://www.mdpi.com/2077-0383/8/2/163

The current trends and spectrum of acquired immunodeficiency syndrome (AIDS)-related opportunistic illnesses (AOIs) among newly diagnosed human immunodeficiency virus (HIV)-infected patients after the implementation of the 2006&#8315;2015 national anti-tuberculosis (TB) programmes in Taiwan remain unknown. We retrospectively reviewed 1757 patients at two centres in southern Taiwan between 2001 and 2015. Based on the anti-TB programme, patients were classified into periods 1 (2001&#8315;2005), 2 (2006&#8315;2010), and 3 (2011&#8315;2015). We further analysed factors associated with <i>Mycobacterium tuberculosis</i> (MTB) at presentation and during follow-up. The overall AOI incidence rate (23.6%) remained unchanged across the periods, with 81.4% of AOIs occurring at presentation. <i>Pneumocystis jirovecii</i> pneumonia was the leading AOI across the periods. MTB declined significantly from period 1 to period 3 (39.3% vs. 9.3%). Age and CD4+ cell count &lt;200 cells/&#181;L (vs. &#8805;501) were the risk factors associated with MTB at presentation, whereas period 2/3 (vs. period 1) was the protective factor. Intravenous drug use (vs. homosexual contact) was the risk factor associated with MTB during follow-up, and period 3 (vs. period 1) was the protective factor. AOI statistics in Taiwan must be closely monitored for fluctuations. Although MTB decreased substantially after implementation of the anti-TB programmes, additional efforts to reduce MTB are required.