Abstract:
Objective
To describe the demographic pattern, modes of transmission,
clinical presentations and management of adult HIV positive
patients presenting at two HIV care centers in Pakistan over
the course of 20 years.
Method
This was a retrospective study of all HIV positive patients
presenting to the two HIV clinics. Medical records of all the
HIV positive patients were reviewed, and information about
age, gender, country of residence, mode of transmission, marital
status, travel history, WHO clinical stage, opportunistic
infections, treatment given and outcome were recorded on the
data extraction sheet shared between the two centers.
Results
647 patients were seen between January 1991 and March 2011.
The mean age of the patients was 35.6 years ± 12.8 SD; nearly
two thirds were male. The commonest mode of transmission
was heterosexual (67.1%). Over 50% presented in WHO class
3 and 4, while nearly a quarter were co-infected with tuberculosis.
348 patients were started on anti-retroviral therapy and 51.4%
are currently receiving treatment at these centers. Mortality
was highest among those who presented in pre morbid clinical
states.
Conclusions
The demographic pattern of HIV in Pakistan is evolving.
Heterosexual acquisition appears to be the predominant mode
of transmission, followed by intravenous drug usage.
