Study finds opportunistic infections in 1 in 5 adults with advanced HIV in Guyana

See full statement from the Georgetown Public Hospital Corporation:

One in five adults with advanced HIV disease included in a Guyanese study had at least one serious infection linked to a weakened immune system. More concerning, approximately one-third of these infections were detected in patients who had no obvious symptoms.
The findings highlight the importance of screening people with advanced HIV for infections, even when they appear healthy, and ensuring they receive timely treatment.

Dr Tariq Jagnarine presented the findings at the 19th Guyana Medical Research Conference, held under the theme “The Evolution of Medicine Through Technological Advancements and Beyond the Stethoscope.”

The study examined the use of rapid tests to detect tuberculosis (TB), cryptococcosis and histoplasmosis among 112 adults receiving HIV care at seven healthcare facilities across Guyana between February 2024 and March 2025.

These are known as opportunistic infections because they take advantage of a weakened immune system, making it harder for the body to fight disease.

Researchers found that 21.4 per cent of participants (24 out of 112) had at least one opportunistic infection. TB was the most commonly detected, affecting 15.2 per cent of participants, followed by cryptococcosis at 6.3 per cent and histoplasmosis at 2.7 per cent.

𝐖𝐡𝐲 𝐝𝐨𝐞𝐬 𝐭𝐡𝐢𝐬 𝐦𝐚𝐭𝐭𝐞𝐫?

HIV weakens the body’s ability to fight infections. As the immune system becomes more damaged, infections that might otherwise be controlled can become serious and potentially life-threatening.

The study found that approximately one-third of confirmed infections occurred in patients without obvious symptoms. This demonstrates why relying solely on visible signs of illness may result in infections going undetected.

Patients who tested positive for opportunistic infections also had higher mortality during the study’s follow-up period. Within 30 days, 20.8 per cent of patients with positive screening results had died, compared with 6.8 per cent of those who tested negative. By 90 days, the figures were 37.5 per cent and 11.4 per cent, respectively.

𝐅𝐢𝐧𝐝𝐢𝐧𝐠 𝐢𝐧𝐟𝐞𝐜𝐭𝐢𝐨𝐧𝐬 𝐢𝐬 𝐨𝐧𝐥𝐲 𝐭𝐡𝐞 𝐅𝐢𝐫𝐬𝐭 𝐒𝐭𝐞𝐩

The research also identified gaps in the treatment process. While all participants completed CD4 testing, 85 per cent completed the full rapid diagnostic screening panel. Approximately 69.3 per cent initiated antiretroviral therapy (ART), the medication used to control HIV, while 60.6 per cent received Septrin and only 38.3 per cent received tuberculosis preventive therapy.

Dr Jagnarine highlighted delayed initiation of ART as the strongest driver of adverse outcomes identified in the study, reinforcing the importance of connecting patients to treatment without unnecessary delays.

The researchers recommended routine screening for eligible patients entering or returning to HIV treatment services, alongside improved access to diagnostic tests, reliable medicine supplies and stronger treatment and follow-up programmes.

Although the study had limitations, including its relatively small sample size, it demonstrated that rapid screening for multiple infections could be implemented across participating healthcare facilities in Guyana.

Ultimately, the findings carry an important message: people with advanced HIV can have serious infections without showing obvious symptoms. Early screening can help identify these infections, but timely treatment and continued follow-up are essential to preventing avoidable complications and deaths