Clinical profile and factors associated with mortality in hospitalized patients with HIV/AIDS: a retrospective analysis from Tripoli Medical Centre, Libya, 2013.

In Libya, little is known about HIV-related hospitalizations and in-hospital mortality. This was a retrospective analysis of HIV-related hospitalizations at Tripoli Medical Centre in 2013. Of 227 cases analysed, 82.4% were males who were significantly older (40.0 versus 36.5 years), reported injection drug use (58.3% versus 0%) and were hepatitis C virus co-infected (65.8% versus 0%) compared with females. Severe immunosuppression was prevalent (median CD4 count = 42 cell/µL). Candidiasis was the most common diagnosis (26.0%); Pneumocystis pneumonia was the most common respiratory disease (8.8%), while cerebral toxoplasmosis was diagnosed in 8.4% of patients. Current HAART use was independently associated with low risk of in-hospital mortality (OR 0.33), while central nervous system symptoms (OR 4.12), sepsis (OR 6.98) and low total lymphocyte counts (OR 3.60) were associated with increased risk. In this study, late presentation with severe immunosuppression was common, and was associated with significant in-hospital mortality.

Clinical profile and factors associated with mortality in hospitalized patients with HIV/AIDS: a retrospective analysis from tripoli medical centre, Libya, 2013

In Libya, little is known about HIV-related hospitalizations and in-hospital mortality. This was a retrospective analysis of HIV-related hospitalizations at Tripoli Medical Centre in 2013. Of 227 cases analysed, 82.4% were males who were significantly older [40.0 versus 36.5 years], reported injection drug use [58.3% versus 0%] and were hepatitis C virus co-infected [65.8% versus 0%] compared with females. Severe immunosuppression was prevalent [median CD4 count = 42 cell/micro L]. Candidiasis was the most common diagnosis [26.0%]; Pneumocystis pneumonia was the most common respiratory disease [8.8%], while cerebral toxoplasmosis was diagnosed in 8.4% of patients.Current HAART use was independently associated with low risk of in-hospital mortality [OR 0.33], while central nervous system symptoms [OR 4.12], sepsis [OR 6.98]and low total lymphocyte counts [OR 3.60]were associated with increased risk.In this study, late presentation with severe immunosuppression was common, and was associated with significant in-hospital mortality

En Libye, les connaissances sur les hospitalisations et la mortalite en milieu hospitalier liees au VIH sont rares. Nous avons procede a une analyse retrospective des hospitalisations liees au VIH au centre medical de Tripoli en 2013. Sur 227 cas analyses,82,4 % etaient des hommes nettement plus ages [40,0 contre 36,5 ans], qui declaraient s'injecter des drogues [58,3 % contre 0 %]et qui etaient atteints d'une co-infection par le virus de l'hepatite C [65,8 % contre 0 %] comparativement aux femmes.L'immunosuppression severe etait prevalente [numeration des lymphocytes T-CD4 = 42 cellules/micro L]. Le diagnostic le plus frequent etait la candidose [26,0 %]; la pneumonie a Pneumocystis etait la maladie respiratoire la plus frequente [8,8 %], tandis que la toxoplasmose cerebrale etait diagnostiquee chez 8,4 % des patients]. Un traitement antiretroviral hautement actif en cours etait independamment associe a un faible risque de mortalite en milieu hospitalier [OR 0,33], tandis que les symptomes du systeme nerveux central [OR 4,12], la septicemie [OR 6,98] et les faibles numerations lymphocytaires totales [OR 3,60] etaient associes a un risqué accru.Dans cette etude,une presentation tardive accompagnee d'une immunosuppression severe etait frequente,et etait associee a une mortalite elevee en milieu hospitalier

Risk factors and genotypes of hepatitis C virus infection in libyan patients.

BACKGROUND: The prevalence and incidence of HCV infection varies geographically due to exposure to different risk factors. Identification of HCV genotype is important to defining the epidemiology of the disease. The objective of this study was to describe genotype distribution and its relation to risk factors among HCV infected patients attending virology clinic of the Department of Infectious Diseases at the Tripoli Medical Centre. METHODS: The medical records of 891 Libyan chronic HCV infected patients registered and followed up from January 2003 to January 2007 were reviewed. Data gathered includes patient's age, gender, risk factors and family history of HCV infection. Statistical analysis was performed using t, x2 and contingency coefficient tests. RESULTS: The mean age was 40.22±13.09 years. Two thirds of patients were males. Normal alanine aminotransferase (ALT) at diagnosis was found in 62% of the patients. HCV RNA<2 million copies at diagnosis was found among 54% of patients. HCV genotype 1 (G1) was the most frequent (30.9%), followed by G4 (29.2%). Genotype 2 affected 19.3% and G3 13.6%. No classification of HCV genotype was available for 2% of the patients. Many subtypes of HCV were detected with different frequencies (G1a and b, G2a, b, c and a/c, G3a and G4a and c/d). All genotypes of HCV were more common among males (P<0.001). Genotype 3 was the most frequent among male patients (88.6%). Regarding the risk factors, 33% of patients had a history of hospitalization and/or surgical procedures, and 22.7% had a history of blood transfusion. A past history of intravenous drug abuse (IVDA) was reported by 15% of the patients, and 15.9% reported a history of dental procedures. The relationship between the genotype of HCV and risk factors was statistically significant (P<0.001). No history of risky exposure was found among 10.8% of patients. CONCLUSION: Genotypes 1 and 4 were more predominant among HCV infected patients. Males were affected more than females and they presented themselves to the clinic at a younger age. The results of this study strongly suggest the need for implementing strict infection control measures in hospitals and dental clinics to reduce the nosocomial transmission of HCV, as well as measures to control the problem of intravenous drug users in the community.

Risk Factors and Genotypes of Hepatitis C Virus Infection in Libyan Patients

Background: The prevalence and incidence of HCV infection varies geographically due to exposure to different risk factors. Identification of HCV genotype is important to defining the epidemiology of the disease. The objective of this study was to describe genotype distribution and its relation to risk factors among HCV infected patients attending virology clinic of the Department of Infectious Diseases at the Tripoli Medical Centre. Methods: The medical records of 891 Libyan chronic HCV infected patients registered and followed up from January 2003 to January 2007 were reviewed. Data gathered includes patient/'s age, gender, risk factors and family history of HCV infection. Statistical analysis was performed using t, x2 and contingency coefficient tests. Results: The mean age was 40.22±13.09 years. Two thirds of patients were males. Normal alanine aminotransferase (ALT) at diagnosis was found in 62% of the patients. HCV RNA < 2 million copies at diagnosis was found among 54% of patients. HCV genotype 1 (G1) was the most frequent (30.9%), followed by G4 (29.2%). Genotype 2 affected 19.3% and G3 13.6%. No classification of HCV genotype was available for 2% of the patients. Many subtypes of HCV were detected with different frequencies (G1a and b, G2a, b, c and a/c, G3a and G4a and c/d). All genotypes of HCV were more common among males (P<0.001). Genotype 3 was the most frequent among male patients (88.6%). Regarding the risk factors, 33% of patients had a history of hospitalization and/or surgical procedures, and 22.7% had a history of blood transfusion. A past history of intravenous drug abuse (IVDA) was reported by 15% of the patients, and 15.9% reported a history of dental procedures. The relationship between the genotype of HCV and risk factors was statistically significant (P<0.001). No history of risky exposure was found among 10.8% of patients. Conclusion: Genotypes 1 and 4 were more predominant among HCV infected patients. Males were affected more than females and they presented themselves to the clinic at a younger age. The results of this study strongly suggest the need for implementing strict infection control measures in hospitals and dental clinics to reduce the nosocomial transmission of HCV, as well as measures to control the problem of intravenous drug users in the community