194 Opportunistic infections and clinical profile of HIV/AIDS patients: A study from eastern region of Nepal Khanal VK, 1 Jha N, 1 Karki P, 2 Paudel IS 1 1 School of Public Health and Community Medicine BPKIHS, 2 Department of Internal medicine BPKIHS Corresponding Author: Dr .Vijay Kumar Khanal, Assistant Professor, School of Public Health and Community Medicine, B P Koirala Institute of Health Sciences, Dharan, Nepal, Email: vijaykhanal75@gmail.com, vijay.khanal@bpkihs.edu ABSTRACT There is a wide spread availability of highly active antiretroviral treatment but opportunistic illnesses still occur and result in an increased risk of mortality among persons with HIV/AIDS. The spectrum of illness that one observes, changes as the CD4+ cell count declines. The close relationship between clinical manifestation and CD4+ cell count has made measurement of the latter a routine part of evaluation of the progress of HIV infection in individuals. The objective of this study was to reveal the clinical spectrum and explore the different types of opportunistic infections in HIV/AIDS patients. A total of 234 patients with HIV/AIDS from three ART centers of Eastern Nepal were purposively selected for this cross sectional study conducted from May 2009 to April 2010. Statistical analysis was done using SPSS version 11.5. Chi-squared test and Student’s t test were applied to find the association between the variables. A p-value less than 0.05 was considered to be significant. Out of the 234 patient, 85% were found to be symptomatic. Most common presenting symptoms were weight loss (74.4%) followed by fever (59.4%). Around 64% of HIV/AIDS patients had a CD 4+ cell count below 200 cells/mm 3 . Most common opportunistic infections were tuberculosis (51.1%) followed by oral candidiasis (21.7%). A significant relationship (p<0.001) between decrease in CD 4+ cell count and occurrence of opportunistic infections in HIV/AIDS patients was seen. Keywords: HIV/AIDS, Opportunistic infection, CD4+Tcell, Tuberculosis, Nepal Zonal Hospital Bhadrapur). Out of 234 patients 20patients were taken from Mechi zonal hospital, 70 patients were taken from Koshi Zonal hospital and144 patients were taken from BPKIHS. Most of the patients were taken from BPKIHS because this is the only tertiary care hospital in eastern region where laboratory facility forCD4+T cell count and diagnosis of advance opportunistic infections is available. The statistical analysis was done by using software SPSS version 11. 5. Chi-square test and t test was applied to find out the significant association among the variables. P value <0.05 was considered to be significant. Informed consent was obtained from the patients. Confidentiality of the patients was maintained. Ethical clearance was taken from the ethical committee of the institute Results Among the 234 respondents almost 85 %were found symptomatic before diagnosis of disease. Most common complaint in both sexes were weight loss (74.4%) followed by fever (59.4%) (Table1). HIV infection results in progressive loss of CD4+T cell from circulation as well as its depletion from body store. Table 2 shows that 64% of HIV/ AIDS patients had CD4+T cell counts below 200 cell/ mm 3 . INTRODUCTION Since the beginning of the human immunodeficiency virus (HIV) epidemic, opportunistic infections have been recognized as common complications of HIV infection. 1-3 HIV is a slow acting retrovirus that typically takes years to produce illness in an infected person. Over several years of illness, an HIV positive person’s immune system is gradually weakened due to reduction ofCD4+Tcell in body and various pathogens take advantage of this weakened state to attack and cause illness of various kinds. These types of infections in HIV positive person are called “opportunistic infections”. People with advanced human immunodeficiency virus (HIV) infection are vulnerable because they take advantage of the opportunity offered by a weakened immunesystem. 1, 2, 4 so the aim of the study is reveal the clinical spectrum and explore the various type of OI in HIV/ AIDS patients. MATERIALS AND METHODS This is a cross sectional study with purposive sampling from May 2009 – April 2010.The study was undertaken in all three ART centers of eastern Nepal (BP Koirala institute of Health sciences Dharan, Koshi Zonal Hospital Biratnagar and Mechi Original Article Nepal Med Coll J 2014; 16(2-4): 194-197