Abstract:
Background
Human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) have
caused the world most shocking tragedy and risk. Morbidity and mortality can occur due to
direct effect of virus itself, Opportunistic infection related or malignancies. While the causative
agents of the secondary infections are characteristically opportunistic organisms such as P.
jiroveci, atypical mycobacterium, CMV, and other organisms that do not ordinarily cause disease
in the absence of a compromised immune system, they also include common bacterial and
mycobacterial pathogens. Overall, the clinical spectrum of HIV disease is constantly changing as
patients live longer and new and better approaches to treatment and prophylaxis are developed.
In addition to the classic AIDS-defining illnesses, patients with HIV infection also have an
increase in serious non-AIDS illnesses, including non-AIDS related cancers and cardiovascular,
renal, and hepatic disease. Non-AIDS events dominate the disease burden for patients with HIV
infection receiving ART, While AIDS-related illnesses are the leading cause of death in patients
with HIV infection, they account for fewer than 50% of deaths. Non-AIDS-defining
malignancies, liver disease, and cardiovascular disease each account for 10–15% of deaths in
patients with HIV infection. Efforts have been made to reduce HIV/AIDS-related mortality by
delivering antiretroviral therapy treatment. ART has modified the natural history of HIVinfection: the incidence of opportunistic infection has decreased and mortality associated to HIV
has improved dramatically. It is worrisome that even with the provision of free ARV drugs in
many parts of Sub-Saharan African many HIV/AIDS patients from this region still suffer from
advanced HIV related diseases, whereas in the developed world, morbidity is mainly due to HIVunrelated diseases. The reasons for hospitalization have changed; OIs are no longer the most
common reason for admission. Mortality among patients on HAART is associated with high
baseline levels of HIV RNA, WHO stage III or IV at the beginning of treatment, low body mass
index, severe anemia, low CD4+ cell count, type of ART treatment, gender, resource-poor
settings, and poor adherence to HAART.
