ĐẶC ĐIỂM DỊCH TỄ, LÂM SÀNG, MIỄN DỊCH Ở BỆNH NHÂN NHIỄM HIV MỚI ĐƯỢC ĐIỀU TRỊ ARV TẠI BỆNH VIỆN BỆNH NHIỆT ĐỚI NĂM 2023 – 2024

Abstract

Background: HIV/AIDS remains a global pandemic, as well as a significant health issue in Vietnam. In 2023, approximately 249,000 people in Vietnam were living with HIV, with 13,445 new cases and 1,623 HIV-related deaths. Consequently, understanding the epidemiological, clinical, and paraclinical characteristics of HIV-infected patients newly initiating antiretroviral therapy (ART) will provide valuable insights into the development of treatment and prevention strategies for HIV/AIDS. Objective: To describe the epidemiological, clinical, and paraclinical characteristics of newly diagnosed HIV patients at the Hospital for Tropical Diseases. Methods: A descriptive cross-sectional study was conducted at the HIV/AIDS outpatient clinic of the Tropical Disease Hospital from October 2023 to July 2024. Inclusion criteria were: (1) patients aged ≥18 years; (2) three positive HIV antibody tests; (3) initiation of ART within one month prior to study enrollment. Exclusion criteria were: (1) critically ill patients requiring emergency care or hospitalization; (2) patients unable to read, understand, or recall the study procedures; (3) patients unwilling to participate in the study. Results: A total of 76 cases were recorded. The median age of the patients was 33 years (range: 26–42.8 years), with 81.6% male patients. 76.3% had a secondary education or higher, and 75% were employed. The predominant mode of HIV transmission was sexual contact, accounting for 90.8%, with two-thirds of cases being men who have sex with men (MSM). Sexually transmitted infections (STIs) were present in 13.1% of cases, with syphilis accounting for 9.2%. More than half of the patients were diagnosed with HIV at clinical stages 3 or 4. The most common opportunistic infections were oral-esophageal candidiasis (26.3%), tuberculosis (22.4%), and Pneumocystis pneumonia (PCP) (15.8%). Regarding immune characteristics, the median initial CD4⁺ count was 101 cells/mm³, with 60.5% of patients categorized as having severe immunosuppression. Conclusion: The epidemiological, clinical, and paraclinical characteristics of HIV-infected patients have shown significant changes, with an increasing proportion of sexual transmission, particularly among MSM. The high rate of sexually transmitted infections, especially syphilis, was observed. The majority of patients were diagnosed at advanced stages of the disease. Among opportunistic infections, pulmonary tuberculosis remains highly prevalent. Recommendations: It is essential to strengthen public awareness efforts to enable early detection of HIV/AIDS and opportunistic infections, especially tuberculosis. Routine screening for sexually transmitted infections, especially syphilis, should be implemented.