INTERDISCIPLINARY IN MANAGING HIV/AIDS INFECTED PATIENTS – THE IMPORTANCE OF TEAMWORK

Abstract

The role of an interdisciplinary approach is useful in maintaining a good quality of life and low mortality rates among HIV-infected people. A better understanding of the evolution of comorbidities may help to improve the clinical management of HIV/AIDS patients. Material and methods: We performed a retrospective study between 1^st of January and the 1^st of December 2022 including 1157 patients who have been admitted to Iasi HIV/AIDS Regional Center, from “Sf. Parascheva” Clinical Hospital of Infectious Diseases, in order to identify the main factors that lead to major imbalances in the status of patients with HIV/AIDS infection, highlighting the most common comorbidities. Results: In the study period, 1,157 (70.46%) patients were admitted, and 89 cases (5.48%) were newly diagnosed. The study patients were virologically and immunologically evaluated. It was observed that 12.62% of cases had a CD4 level between 1-200 cells/mm³, in 58.95% of cases the CD4 value was between 201-500 cells/mm³, and 28.44% of patients had CD4 over 501 cells/mm³, with an average CD4 level of 375.28 cells/mm³. The average of HIV viral load was 107.46 copies/mL. Out of the total of 1157 cases, 146 (12.62%) patients had a CD4 level under 200 cells/mm³, considered to have a viro-immunological failure, and they were recommended other antiretroviral regimens, most of them being prescribed a single tablet regimen. Depending on the related comorbidities, 62.32% of the 1157 cases admitted in our clinic required interdisciplinary examinations. In descending order, the following conditions were the most common comorbidities that the patients presented: metabolic (45.20%), dermatological (31.20%), ENT (12.79%), gastrointestinal (10.29%), infectious diseases (9.16%), cardiovascular issues (5.10%), psychiatric disorders (4.06%), pulmonary (3.54%), neurological (2.68%), ophthalmic (1.21%), and hematological conditions (0.78%). Out of the newly diagnosed cases, 85.39% were recommended single tablet regimen and in 14,61% cases were given a regimen that took into account their comorbidities. A large percentage of patients (82.20%) were evaluated through psychological consultation to ensure compliance and adherence to antiretroviral treatment, thus helping a better understanding of their disease for effective management. Conclusions: Multidisciplinary strategies for HIV have become more prevalent as various scientific environments have evolved. Assessing risk behaviors, clinical manifestations, health status, psycho-behavioral and cultural factors, as well as HIV assistance have emerged.