Chris Hani Baragwanath Hospital (CHB) Neuropsychiatric unit: HIV Positive Psychiatric Patients on Antiretrovirals

Abstract

Aim:

To describe the characteristics of a group of HIV positive psychiatric patients on highly active antiretroviral therapy (HAART).

Method:

All mentally ill patients admitted to the psychiatric unit at CHB that were HIV positive where included in the audit. Patients that met the following criteria where initiated on HAART: CD4 of 200 or less cells/mm³; diagnosis of a WHO Stage 4 condition.

Results:

Since the inception of the service, the hospital admitted 573 mentally ill patients of which a group of 42 (7.3%) where confirmed as HIV positive. The mean age of the group was 39.2 years with a male: female ratio of 1:4.3. 42.9% of the patients presented with maniform symptoms. For 20 patients this was their first episode of mental illness. Only 11 (26.2%) patients were subjected to a CT scan and 18 (42.9%) to a lumbar puncture. In this group of HIV positive patients, 30 met the eligibility criteria and were commenced on HAART: 28 were treated with regimen 1b and 2 with regimen 1a. 16 patients had subsequent CD4 counts and 14 follow up viral loads performed. The viral loads of 13 patients had reached the required decrease in Log value at six weeks of HAART.

Conclusion:

A significant percent of all mentally ill patients admitted to the psychiatric unit at CHB are found to be HIV positive despite the fact that HIV screening is not done routinely on all patients. The majority of these patients have advanced disease and are eligible for HAART.