Use of cotrimoxazole prophylaxis in HIV infected in patients at a referral hospital.

ABSTRACT

OBJECTIVE: To assess the extent of use of cotrimoxazole prophylaxis in the prevention of opportunistic infections in HIV infected patients. SETTING: Parirenyatwa Hospital, a major referral and teaching hospital. DESIGN: A retrospective study. SUBJECTS: 234 HIV infected patients admitted between January and June 2004, with a history of symptoms falling into the WHO stage 3 AIDS, were included. MAIN OUTCOME MEASURES: Cotrimoxazole prophylaxis, PCP prevalence, and mortality. RESULTS: 234 patients' records were reviewed and 19% of the patients had received cotrimoxazole prophylaxis. PCP prevalence was 36% which was diagnosed mainly by clinical examination and sometimes with the additional help of chest X-rays. Of those who were on prophylaxis, 75% were on primary prophylaxis and the rest on secondary prophylaxis. All patients on prophylaxis were using cotrimoxazole, with the 960 mg once daily dosing being the most common regimen (96%). Receiving prophylaxis was associated with being female (p = 0.0067), widowed (p = 0.012), and taking ARV therapy (p = 0.0026). Prophylaxis significantly reduced mortality (p = 0.0017). The development of PCP was associated with a history oftuberculosis relapse (p = 0.022). CONCLUSION: Cotrimoxazole prophylaxis is important in reducing hospital admissions due to opportunistic infections and increasing survival especially in areas with limited access to antiretroviral therapy.