Clinical presentation of hospitalized adult patients with HIV infection and AIDS in Bangkok, Thailand

Objective: To characterize the clinical spectrum of disease and immune stat us of adult HIV-1-infected patients in Bangkok. Design: Cross-sectional survey of hospital admissions. Methods: From November 1993 through June 1996, demographic, clinical, and l aboratory data were collected from HIV-infected inpatients (greater than or equal to 14 years old) at an infectious diseases hospital. Results: Of 16,717 persons admitted, 3112(18.6%) were HIV-seropositive, 226 1 of whom were admitted for the first time. Of 2261, 1926 (85.2%) were male , 1942 (85.9%) had been infected heterosexually or by means not related to drug use, 319 (14.1%) were injection drug users (IDUs), and 1553 (68.7%) ha d AIDS. The most common AIDS-defining conditions were extrapulmonary crypto coccosis (EPC; 38.4%), tuberculosis (TB; 37.4%), and wasting syndrome (NS; 8.1%). IDUs were more likely (p < .05) to have TB or WS but less likely (p < .05) to have EPC or Pneumocystis carinii pneumonia than patients with no history of injection drug use. Lymphocyte counts were measured for 2047 (90 .5%) patients; 81.8% had less than or equal to 1500 lymphocytes/mu l. Conclusion: These HIV-infected patients were admitted with severe immunosup pression. Cryptococcosis and TB are major problems and differ in prevalence among IDUs and persons infected sexually. Clinical and immunologic informa tion is critical in improving the lives of HIV-infected persons in Asia thr ough prevention, treatment, and prophylaxis.