oa AIDS-defining opportunistic illnesses in Qatar, 2000–2016: a cohort study

Background: Human immunodeficiency virus (HIV) infection remains a major health problem since discovery of the virus in 1981^1,2. Globally, since the introduction of antiretroviral therapy in 1996, acquired immunodeficiency syndrome (AIDS) related deaths fell by more than 25% between 2005 and 2011. HIV related opportunistic illnesses (OIs) are less common, especially with the use of prophylaxis³. This study aims to assess the incidence of HIV infection and related OIs in Qatar over a 17-year period. Methods: This is a retrospective cohort study of all HIV infected patients registered in Qatar from 2000-2016. Incidence of HIV infection and related OIs were calculated per 100,000 population. Demographic and clinical characteristics were compared between two groups of patients with and without OIs. Results: In 167 cases with HIV infection, 54 (32.3%) had OIs. The average incidence rate of HIV infection over 16 years is 0.69 per 100,000 population, and the incidence rate for OIs is 0.27 per 100,000 population (Figure 1). The most common OIs is pneumocystis jirovecii pneumonia (PCP), seen in 25% of cases, followed by cytomegalovirus (CMV) retinitis with 7.2%, tuberculosis 5.4%, toxoplasmosis 4.2%, and less than 2% for Kaposi sarcoma and cryptococcal infection. The treatment outcome of cases with OIs was: cure in 59.3%, failure in 3.7%. Mortality within 3 months of OIs was 3.7%, whereas 33.4% accounted for loss to follow up after starting the treatment due to patients leaving the country. Most patients in both groups were young males. The CD4 lymphocyte count and percentage (CD4%), CD4/CD8 ratio and viral load were statistically significant risk factors in cases with OIs (p < 0.05). Presence of comorbidities was lower in patients with OIs (p = 0.032) (Table 1). Conclusion: Qatar has a low prevalence rate for HIV infection and related opportunistic illness. Early diagnosis and use of antiretroviral therapy are important measures to decrease the rate of opportunistic illness.