Epidemiology and infectious complications of human immunodeficiency virus antibody positive patients

From July 1, 1991 to March 31, 1992, 156 patients (pts) with positive antibody titers to the human immunodeficiency virus (HIV) were seen in our clinic. A retrospective review of the epidemiology and infectious complications of these patients is presented. There were 129 males and 27 females (4.8:1, ratio). Only 10/156 (12.8%) were non-whites (13 blacks and 7 hispanics). The majority, 126 (80.7%), were 25 to 44 years old. The most common risk factor was homosexuality or bisexuality 100 (64.1%), followed by heterosexual acquisition 25 (16%), intravenous drug abuse 23 (13.7%), unknown 6 (3.8%) and transfusion-related 3 (1.9%). Sixty-five pts had no infections. In the remaining 91 pts, the infections noted were: candidiasis (54 pts); Pneumocystis carinii pneumonia (25 pts); Herpes simplex (13 pts); cytomegalovirus (CMV) retinitis (11 pts) and CMV esophagitis (1 pt), central nervous system toxoplasmosis (8); Herpes zoster (6 pts); cryptococcal meningitis (5 pts); Mycobacterium avium complex bacteremia (4 pts); Molluscum contagiosum, hepatitis-B, staphylococcal infection, perirectal abscess and oral hairy leukoplakia (2 pts each); syphilis, cryptosporidiosis, nocardiosis, histoplasmosis and laryngeal papillomatosis (1 pt each). Infections were multiple in 57/91 (62%) pts and tend to occur more often when the helper cells are < 200 47/57 (82%) pts. Appropriate antimicrobials for prophylaxis and maintenance therapy appeared to decrease the occurrence or relapse of infections such as pneumocystosis, candidiasis, cryptococcosis, tuberculosis and toxoplasmosis.