THAA0304 | CLINICAL AND IMMUNOLOGICAL PROFILE OF ADULT PATIENTS WITH ADVANCED HIV DISEASE AT QUELIMANE CENTRAL HOSPITAL, MOZAMBIQUE

Muhamed Assane¹, Celisa De Assis^1|2, Neivaldo Murrube^3|4 | ¹Quelimane Central Hospital, Quelimane, Mozambique; ²Faculty of Medicine, Licungo University, Quelimane, Mozambique; ³Faculty of Health Sciences, Lúrio University, Nampula, Mozambique; ⁴Polytechnic Institute of Bragança, Bragança, Portugal

It is estimated that one in every three people living with HIV (PLHIV) and under follow-up care has advanced HIV disease (AHD) and is at high risk of dying from a severe opportunistic infection (classified as WHO stage 3 or 4) if timely access to appropriate medication is not ensured. In Mozambique, AHD is associated with a high mortality rate ranging from 25% to 50%, with one-third of these deaths occurring within the first 48 hours after hospital admission. This study aims to evaluate the clinical and immunological profiles of patients with advanced HIV disease at Quelimane Central Hospital, Mozambique. A cross-sectional study was conducted at Quelimane Central Hospital. Data were gathered from 173 patients over the age of 14, chosen through systematic random sampling, and treated from January to December 2024 in the internal medicine ward. Data was gathered utilizing a pre-structured form derived from medical records. Socio-demographic characteristics, as well as clinical and immunological profiles, were analyzed using the Chi-squared test. Factors associated with delayed initiation of treatment were investigated using logistic regression models with a 95% confidence interval, employing R Studio software. 173 medical records were analyzed, of which 66.3% were from female patients. The median age among those diagnosed with AHD was 41 years for men and 35 years for women (p < 10⁻⁴). Clinical symptoms were the main reason for an AHD diagnosis. Among the cases, tuberculosis was the most common infection, accounting for 47 cases (27.1%). The median CD4+ T-cell count was 156 cells/mm³ for men and 176 cells/mm³ for women (p = 0.016). These factors were significantly associated with delayed initiation of treatment (p < 0.05). Multivariate analysis revealed that with each additional year of age, the risk of initiating treatment at an advanced stage increased by 1.2%. Clinical symptoms remain the primary trigger for screening and thus for initiating treatment, which explains the high proportion of patients who begin treatment at an advanced stage. Opportunistic infections continue to be prevalent at the time of diagnosis. Public health authorities should prioritize early HIV screening and diagnosis to improve outcomes.