Clinical and Demographic Pattern of HIV Positive Patients in Two Tertiary Care Hospitals in Pakistan: 20 Years Experience

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.