Clinical characteristics and treatment outcomes of opportunistic infections in advanced HIV disease patients among men who have sex with men in Vietnam: A prospective cross-sectional study.

Abstract

Background: Opportunistic infections (OIs) in patients with advanced HIV disease remain a serious health issue, particularly in low-and middle-income countries.

Objectives: This study aims to describe the clinical characteristics and factors associated with mortality among hospitalized advanced HIV-infected men who have sex with men (MSM).

Methods: A prospective cross-sectional study was conducted at the Hospital for Tropical Diseases in Ho Chi Minh City between March and June 2023. Data was collected through interviews and medical record reviews. A multivariate logistic regression model was employed to assess factors associated with hospitalization outcomes, with statistical significance set at p < 0.05.

Results: The study included 121 participants, with 61.3% aged 25-34 years and 42.2% classified as underweight. Only 35.5% of patients received OI preventive treatment. Comorbidities were noted as follows: hepatitis B (12.4%), hepatitis C (2.5%), and syphilis (43.8%). A total of 41.3% of patients had at least one OI, with Mycobacterium tuberculosis being the most common (46.3%), followed by Pneumocystis jirovecii pneumonia (44.6%) and Cryptococcus neoformans (19%). Sepsis was present in 20.7% of patients. The in-hospital mortality rate was 19%. Factors significantly associated with mortality included being underweight, HBV coinfection, C. neoformans infection, lack of OI preventive treatment, and sepsis.

Conclusion: The study reveals a high inpatient mortality rate among advanced HIV-infected MSM, even among relatively young patients. Increased mortality was associated with being underweight, having sepsis, HBV coinfection, C. neoformans infection, and not receiving OI preventive treatment.