Opportunistic Infections and Malignancies in 173 Patients with HIV Infection

Choe, Kang Won; Oh, Myoung Don; Park, Sang Won; Kim, Hong Bin; Kim, Ui Seok; Kang, Seong Wook; Choi, Hee Jong; Shin, Dong Hyeon

Abstract

BACKGROUND
The frequency and type of major opportunistic infections (OI' s) in HIV-infected patients are different among various countries. To determine major OI' s in Korea, we analyzed OI' s in HIV-infected patients at an university-affiliated teaching hospital in Korea.
METHODS
We reviewed medical records for the HIV-infected patients seen at Seoul National University Hospital from 1985 to April 1998. OI' s were diagnosed according to the definition proposed by CDC (1993).
RESULTS
One hundred and seventy three patients were analyzed. Over 70% of the patients were followed for more than 6 months. CD4 + lymphocyte counts at the initial visit ranged 200 to 500/mm 3 in 55% of the patients, and was less than 200/mm 3 in 26%. Tuberculosis was the most frequent OI (25%), followed by candidiasis (21%), herpes zoster (20%), and pneumocystis carinii pneumonia (10%). Kaposi' s sarcoma developed in 3 patients (2%), non-Hodgkin' s lymphoma in 2 (1%). Eleven patients (6%) developed peripheral neuropathy, and 8 patients (5%) had HIV encephalopathy. There was no case of toxoplasmosis. The AIDS defining conditions for the 61 AIDS patients was comprised of 39 (64%) tuberculosis, 6 (10%) esophageal candidiasis, and 6 (10 %) pneumocystis carinii pneumonia. Twenty four patients died; 7 patients died of pneumonia and 4 patients committed suicide. There was no long-term nonprogressor.
CONCLUSION
Tuberculosis was the most frequent OI in Korean HIV-infected patients. Candidiasis, herpes zoster, and cytomegalovirus diseases were also common. Compared to those in the United States and European countries, the prevalence of toxoplasmosis and Kaposi' s sarcoma were relatively low. Pneumonia was the major cause of death.