scholarly journals Risk Factors for COVID-19 Mortality Among People Living with HIV: A Scoping Review

2022 ◽  
Author(s):  
Karan Varshney ◽  
Prerana Ghosh ◽  
Helena Stiles ◽  
Rosemary Iriowen
Keyword(s):  
Risk Factors ◽  
Scoping Review ◽  
Death Rate ◽  
People Living With Hiv ◽  
Cd4 Cell Count ◽  
Racial Background ◽  
Scoping Reviews ◽  
Meta Analyses ◽  
Living With Hiv ◽  
Cd4 Cell

AbstractPeople living with HIV (PLWH) are particularly vulnerable to worsened outcomes of COVID-19. Therefore, the purpose of this work was to provide a scoping review of the literature to assess the risk factors for COVID-19 mortality among PLWH. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR), searches were conducted in PubMed, Scopus, Global Health, and WHO Coronavirus Database. Articles were eligible for inclusion if they were in English, included PLWH who died after COVID-19 infection, and described risk factors for mortality. Results were descriptively synthesized and pooled thereafter. Study quality was assessed using the Joanna Brigg Institute’s critical appraisal tools. 20 studies were eligible for inclusion, with the pooled death rate being 11.7%. Age was a major risk factor, especially after 50 (23.2%) and after 70 (41.8%), and males had a death rate nearly double that of females. As total comorbidities increased, the death rate also greatly increased; among those with comorbidities, the highest fatality rates were those with cardiovascular disease (30.2%), chronic kidney disease (23.5%), obesity (22.4%), and diabetes (18.4%). Other risk factors for mortality among PLWH included having a Black racial background, being an injection drug user, being a smoker, and having a CD4 cell count below 200. There is a need to better study confounding factors, and to understand how vaccination influences mortality risk. Overall, the findings highlight a need to ensure that focus is placed on the varying demographics of PLWH amidst COVID-19 control efforts.

scholarly journals The THE SPECTRUM OF OPPORTUNISTIC INFECTIONS AND ASSOCIATED FACTORS AMONG PEOPLE LIVING WITH HIV/AIDS ON HIGHLY ACTIVE ANTI-RETROVIRAL THERAPY AT MERPATI CLINIC, BALI, INDONESIA: A RETROSPECTIVE STUDY

2020 ◽  
pp. 68-71
Author(s):  
NOVIANA JOENPUTRI ◽  
KETUT SURYANA
Keyword(s):  
Retrospective Study ◽  
Marital Status ◽  
Cell Count ◽  
Associated Factors ◽  
Opportunistic Infections ◽  
People Living With Hiv ◽  
Cd4 Cell Count ◽  
Highly Active ◽  
Living With Hiv ◽  
Cd4 Cell

Objective: Infections contributed to higher morbidity and mortality in people living with HIV/AIDS (PLWHA) in both developed and developing countries. This study aimed to describe the spectrum of opportunistic infections (OIs) and associated factors among PLWHA on highly active antiretroviral therapy (HAART) at Merpati Clinic, Wangaya Regional General Hospital in Denpasar, Bali. Methods: This was a retrospective study. All of PLWHA, who still receiving HAART at Merpati Clinic from January 2018 to January 2020, who met inclusion and exclusion criteria, were included as subjects in this study. All data were collected through a review of the complete medical record of patients. Results: The prevalence of OIs in this study was 43.4%. Most PLWHA who experienced OIs were male (68.8%), age ≤40 y old with a median of age 36 y old, educational status senior high school (57.7%), married (62.1%), employed (89.7%), CD4 cell count ≥ 200 cells/µl (67.6%) and transmission route of HIV non-Intravenous (IV) drug user (99.2%). Sex, age, marital status, and CD4 cell count were significantly associated with OIs, p=0.000, p=0.005, p=0.005, and p=0.000, respectively. Conclusion: The commonest OI in this study was pulmonary tuberculosis. The presence of OIs was associated with sex, age of HIV diagnosis, marital status, and CD4 cell count. With the knowledge of OIs spectrum, clinicians are expected to be able to prevent, diagnose and treat OIs promptly to decrease the morbidity and mortality caused by OIs efficiently.

scholarly journals Validity of hemoglobin A1c for diagnosing diabetes among people with and without HIV in Uganda

2019 ◽  
Vol 30 (5) ◽  
pp. 479-485
Author(s):  
James Muchira ◽  
Eileen Stuart-Shor ◽  
Jen Manne-Goehler ◽  
Janet Lo ◽  
Alexander C Tsai ◽  
...  
Keyword(s):  
Hemoglobin A1c ◽  
Fasting Blood Glucose ◽  
High Specificity ◽  
Sub Saharan Africa ◽  
People Living With Hiv ◽  
Cd4 Cell Count ◽  
Sub Saharan ◽  
And Gender ◽  
Living With Hiv ◽  
Cd4 Cell

Sub-Saharan Africa (SSA) is facing a growing co-epidemic of chronic HIV infection and diabetes. Hemoglobin A1c (A1c) may underestimate glycemia among people living with HIV (PLWH). We estimated the validity of A1c to diagnose diabetes among PLWH and HIV-uninfected persons in rural Uganda. Data were derived from a cohort of PLWH and age- and gender-matched HIV-uninfected comparators. We compared A1c to fasting blood glucose (FBG) using Pearson correlations, regression models, and estimated the sensitivity and specificity of A1c for detecting diabetes with FBG ≥126 mg/dL as reference standard. Approximately half (48%) of the 212 participants were female, mean age of 51.7 years (SD = 7.0) at enrollment. All PLWH (n = 118) were on antiretroviral therapy for a median of 7.5 years with mean CD4 cell count of 442 cells/µL. Mean FBG (89.7 mg/dL) and A1c (5.6%) were not different between PLWH and HIV-uninfected ( P > 0.50) groups, but the HIV-uninfected group had a higher prevalence of A1c >5.7% (33% vs. 20%, P = 0.024). We found a relatively strong correlation between A1c and FBG (r = 0.67). An A1c ≥6.5% had a poor sensitivity (46%, 95% CI 26–67%) but high specificity (98%, 95% CI 96–99%) for detecting diabetes. More work is needed to define an optimal A1c for screening diabetes in SSA.

scholarly journals CD4+ cell count stratification to guide tuberculosis preventive therapy for people living with HIV

AIDS ◽  
2020 ◽  
Vol 34 (1) ◽  
pp. 139-147 ◽  
Author(s):  
Lelia H. Chaisson ◽  
Valeria Saraceni ◽  
Silvia Cohn ◽  
Dena Seabrook ◽  
Solange C. Cavalcante ◽  
...  
Keyword(s):  
Cell Count ◽  
Preventive Therapy ◽  
People Living With Hiv ◽  
Cd4 Cell Count ◽  
Living With Hiv ◽  
Cd4 Cell

scholarly journals Human cytomegalovirus infection, viraemia and retinitis among people living with HIV/AIDS in Kano, North-Western Nigeria

2021 ◽  
Vol 9 (8) ◽  
pp. 2191
Author(s):  
Chinagozi P. Edwin ◽  
Sadiq Hassan ◽  
Philips I. Ebisike ◽  
Saudat G. Habib ◽  
Taiwo G. Amole ◽  
...  
Keyword(s):  
Human Cytomegalovirus ◽  
Hcmv Infection ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
People Living With Hiv ◽  
Cd4 Cells ◽  
Cross Sectional ◽  
Cd4 Cell Count ◽  
Living With Hiv ◽  
Cd4 Cell

Background: Human cytomegalovirus (HCMV) is a leading cause of opportunistic infection in HIV-infected patients. HCMV viraemia is an active infection marker and prelude to end-organ diseases (EODs), such as retinitis. The aim of the study was to assess the burden and associated factors of HCMV infection, viraemia and retinitis among HIV-infected patients in Nigeria.Methods: Comparative cross-sectional study of 160 HIV-infected adults, comprising 80 participants in each of <100/mm3 and ≥100 cells/mm3 CD4+ cell count groups, who attended HIV clinic at a tertiary hospital located in a major Nigerian city.  A questionnaire was used to collect data from eligible consenting participants and their case files. Sera from all participants were tested for anti-HCMV IgG using ELISA method, and plasma of seropositive participants were subjected to PCR for HCMV viraemia. Participants whose samples were HCMV viraemic were examined for HCMV retinitis using indirect ophthalmoscopy. Data was analyzed using Minitab vs 14.1.1PP.Results: All 160 participants tested positive for anti-HCMV IgG. HCMV viraemia was 14.4% (23 of 160) generally, but comparatively more among <100 CD4 cells/mm3 group (18.8%; 15 of 80) than in ≥100 cells/mm3 patient group (10%; 8 of 80). Only HCMV viraemic patients in <100 CD4 cells/mm3 group (20%; 3 of 15) were diagnosed with HCMV retinitis. WHO stage was associated with HCMV viraemia (χ2= 7.79, p=0.05) and HCMV retinitis (χ2= 4.60, p=0.03). The only predictor of HCMV retinitis was WHO staging I and II [aOR = 0.04, 95%CI (0.01- 0.52)].  Conclusions: Evidence of previous and active HCMV infection is prevalent among PLWHA in Nigeria with WHO staging being associated and a predictor of HCMV viraemia and retinitis, respectively.

scholarly journals Diet quality, food insecurity and risk of cardiovascular diseases among adults living with HIV/AIDS: a scoping review protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e047314
Author(s):  
Iyanuoluwa Oyedeji Oyetunji ◽  
Alastair Duncan ◽  
Sharmilah Booley ◽  
Janetta Harbron
Keyword(s):  
Cardiovascular Diseases ◽  
Food Insecurity ◽  
Diet Quality ◽  
Scoping Review ◽  
Search Strategy ◽  
Scale Up ◽  
Cochrane Library ◽  
People Living With Hiv ◽  
Scoping Reviews ◽  
Living With Hiv

IntroductionCardiovascular diseases (CVDs) are the single greatest contributor to global mortality. The successful introduction and scale-up of antiretroviral therapy (ART) delivered a reduction in HIV mortality. Consequently, an association was found between the scale-up of ART and an increased prevalence of comorbidities among people living with HIV (PLWH) such as hypertension and dyslipidaemia. A higher quality diet can delay the onset of comorbidities related to HIV infection. Diet quality and its methods of assessment are not fully established among PLWH. This review will identify the diet quality and food insecurity indices that have been used among PLWH and how these constructs are associated with risk of developing CVD.Methods and analysisThe frameworks recommended by Arksey and O’Malley and the Joanna Briggs Institute’s manual for conducting scoping reviews will be adopted. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines will be used for reporting. A search strategy was developed using keywords related to the topic. A preliminary MEDLINE (via PubMed) search was conducted on 11 November 2020 to develop a comprehensive search strategy. The final search will be conducted on PubMed, EbscoHost, Scopus, Web of Science and Cochrane Library databases. Titles and abstracts of retrieved records will be screened independently by two reviewers. Data will be extracted from records that meet the inclusion criteria using a predesigned charting tool. Discrepancies in decisions made by reviewers will be resolved by consensus or the decision of a third reviewer. Extracted data will be presented in tables or charts. A descriptive summary of the charts or tables will follow.Ethics and disseminationEthical approval is not required for a scoping review. Findings will inform other studies currently underway and will be presented at conferences and published in peer-reviewed journals.Registration numberhttps://osf.io/7k3ja.

Progressive phasing out of baseline CD4 cell count testing for people living with HIV in Kinshasa, DRC

AIDS ◽  
2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Nadine Mayasi Ngongo ◽  
Hippolyte Situakibanza Nani-Tuma ◽  
Marcel Mbula Mambimbi ◽  
Murielle Longokolo Mashi ◽  
Ben Bepouka Izizag ◽  
...  
Keyword(s):  
Cell Count ◽  
People Living With Hiv ◽  
Cd4 Cell Count ◽  
Living With Hiv ◽  
Cd4 Cell

The effect of probiotics on CD4 counts among people living with HIV: a systematic review

2016 ◽  
Vol 7 (3) ◽  
pp. 345-351 ◽  
Author(s):  
H. Miller ◽  
R. Ferris ◽  
B.R. Phelps
Keyword(s):  
Health Benefit ◽  
Cd4 Count ◽  
People Living With Hiv ◽  
Daily Consumption ◽  
Ongoing Research ◽  
Cd4 Cell Count ◽  
Search Terms ◽  
Immunodeficiency Virus ◽  
Living With Hiv ◽  
Cd4 Cell

Probiotics are defined by the WHO as ‘live microorganisms which when administered in adequate amounts confer a health benefit on the host’. Ongoing research has shown probiotics provide benefits to humans, including protection and restoration of the gastrointestinal and other mucosal tracts. As human immunodeficiency virus (HIV) activates gut-associated lymphoid tissue (GALT), several studies have investigated the effect of probiotics on CD4 cell count and related outcomes among those living with HIV. These studies are summarised here. Manuscripts were identified using the search terms ‘probiotics’, ‘synbiotics’, ‘HIV’, and ‘CD4’, and were reviewed for relevance and inclusion of CD4 count as an immunologic endpoint. Bibliographies of relevant manuscripts were also reviewed for additional studies matching inclusion and exclusion criteria. The search yielded 91 results; 13 included relevant outcomes. Seven of these studies produced beneficial CD4 outcomes, while the remaining 6 reported on insignificant beneficial or negative CD4 outcomes. The studies summarised here collectively suggest that daily consumption of probiotics over a prolonged period of time may improve CD4 count in people living with HIV.

scholarly journals A comparative study: long and short term effect of a nutrition sensitive approach to delay the progression of HIV to AIDS among people living with HIV (PLWH) in Nigeria

2016 ◽  
Vol 6 (2) ◽  
pp. 79
Author(s):  
Abraham Mainaji Amlogu ◽  
Sundus Tewfik ◽  
Charles Wambebe ◽  
Ihab Tewfik
Keyword(s):  
Cell Count ◽  
Negative Impact ◽  
Scale Up ◽  
People Living With Hiv ◽  
Cd4 Cell Count ◽  
Biochemical Indices ◽  
Nutrition Sensitive ◽  
Living With Hiv ◽  
Cd4 Cell

ABSTRACTBackground: Malnutrition has a negative impact on optimal immune function, thus increasing susceptibility to morbidity and mortality among HIV positive patients. Evidence indicates that the prevalence of macro and micronutrient deficiencies (particularly magnesium, selenium, zinc, and vitamin C) has a negative impact on optimal immune function, through the progressive depletion of CD4 T-lymphocyte cells, which thereby increases susceptibility to morbidity and mortality among PLWH. Objective: To assess the effectiveness of a nutrition sensitive intervention to delay the progression of human immune-deficiency virus (HIV) to AIDS among people living with HIV in Abuja, Nigeria.Methods: A randomised control trial was carried out on 400 PLWH (adult, male and female of different religious background) in Abuja, Nigeria between January and December, 2012. Out of these 400 participants, 100 were randomly selected for the six months pilot study (January to June, 2012). The participants in the pilot study overlapped to form part of the scale-up participants (n 400) monitored from June to December, 2012. The comparative effect of daily consumed 354.92 kcal/d optimised meal for six and twelve months was ascertained through the nutritional status and biochemical indices of the study participants (n 100 pilot and n 400 scale-up interventions) who were/were not taking the intervention meal. The meal consisted of: Glycine max 50g; Pennisetum americanum 20g; Moringa oleifera 15g; Daucus carota spp.sativa 15g.Results: At the end of six months of the scale-up intervention, mean CD4 cell count (cell/mm3) for Pre-ART and ART Test groups increased by 6.31% and 12.12% respectively. Mean mid upper arm circumference (MUAC) for Pre-ART and ART Test groups increased by 2.72% and 2.52% within the same period (n 400). Comparatively, participants who overlapped from pilot to scale-up intervention (Long term use, n 100) were assessed for 12 months. Mean CD4 cell count (cell/mm3) for Pre-ART and ART Test groups increased by 2.21% and 12.14%. Mean MUAC for Pre-ART and ART Test groups increased by 2.08% and 3.95% respectively. Moreover, Student’s t-test analysis suggests a strong association between the intervention meal,  MUAC and CD4 count on long term use of optimised meal in the group of participants on antiretroviral therapy (ART) (P<0.05). Conclusion: Although the achieved results take the form of specific technology, it suggests that a prolong consumption of the intervention meal will be suitable to sustain the gained improvements in the anthropometric and biochemical indices of PLWHIV in Nigeria. Keywords: HIV; AIDS; Nutrition-sensitive approach; CD4 cell count; Macro and Micronutrients; ART; Tailored Functional Recipe - TFR.

scholarly journals Antiretroviral treatment, prevention of transmission, and modeling the HIV epidemic: why the ART efficacy and effectiveness parameter matters

2017 ◽  
Author(s):  
Reuben Granich ◽  
Somya Gupta ◽  
Matt Wollmers ◽  
Brian Williams
Keyword(s):  
Viral Suppression ◽  
Hiv Infections ◽  
Population Based ◽  
People Living With Hiv ◽  
Cd4 Cell Count ◽  
Art Initiation ◽  
Effectiveness Model ◽  
Prevention Interventions ◽  
Living With Hiv ◽  
Cd4 Cell

AbstractIntroductionHIV remains a major public health threat with over 75 million deaths, 2 million annual infections and over 1 million HIV-associated TB cases a year. Population-based studies suggest a marked decline in incidence, prevalence and deaths, mostly likely due to treatment expansion, in countries in East and Southern Africa. This calls into question the ART efficacy, effectiveness and coverage parameters used by many modelers to project HIV incidence and prevalence.MethodsFor 2015 and 2016 we reviewed global and national mathematical modeling studies regarding ART impact (with or without other HIV prevention interventions) and/or 90-90-90 on either new HIV infections or investment or both. We reviewed these HIV epidemiologic and costing models for their structure and parameterization around ART; we directly compared two models to illustrate differences in outcome.ResultsThe nine models published in 2015 or 2016 included parameters for ART effectiveness ranging from 20% to 86% for ART effectiveness. Model 1 limits eligibility for ART initiation to 80% coverage of people living with HIV and with a CD4+ cell count below 350 cells/μL, 70% retention, and ART reduces transmission by 80%, with a derived ART effectiveness of 20%. Model 2 assumes 90-90-90 by 2020 (i.e., 73% viral suppression of estimated PLHIV), ART reduces transmission by 96% in those on ART and virally suppressed, and by 88% in those on ART but not virally suppressed with a derived effectiveness of 86% and consequent decline towards ending AIDS and HIV elimination. ART parameter selection and assumptions dominate and low ART effectiveness translates into lower impact.DiscussionUsing more realistic parameters for ART effectiveness suggests that through expanding access and supporting sustainable viral suppression it will be possible to significantly reduce transmission and eliminate HIV in many settings.

scholarly journals The HIV treatment cascade in people living with HIV in Iran in 2014: Mixed-method study to measure losses and reasons

2019 ◽  
Vol 30 (13) ◽  
pp. 1257-1264 ◽  
Author(s):  
Nima Ghalehkhani ◽  
Behnam Farhoudi ◽  
Mohammad Mehdi Gouya ◽  
Hamid Sharifi ◽  
SeyedAhmad SeyedAlinaghi ◽  
...  
Keyword(s):  
Cell Count ◽  
Hiv Treatment ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Cd4 Cell Count ◽  
Treatment Cascade ◽  
Cascade Analysis ◽  
Hiv Treatment Cascade ◽  
Living With Hiv ◽  
Cd4 Cell

The study assessed the HIV treatment cascade of people living with HIV (PLWH) in Iran and the reasons for gaps in HIV services in 2014. We did the cascade analysis using the WHO HIV test–treat–retain cascade analysis tool (2014). To measure the gaps, we checked the records for all PLWH reported to the national HIV surveillance till September 2014 to define how many were alive, linked to HIV care, assessed for CD4 cell count, started antiretroviral therapy (ART), and reported to be alive up to five years after ART. To assess the reasons for gaps in the cascade, we ran desk review, four focus group discussions and 51 in-depth interviews with key informants including PLWH. Spectrum model estimated 75,700 PLWH in Iran, of whom only 22,647 people (%30) were diagnosed. Of those who were diagnosed with HIV, 16,266 people (%72) had enrolled in HIV care. About 13% of all PLWH were retained in HIV care and only 9% (6745 people) had ever been tested for CD4 cell count. Only 8% (6018 people) of all PLWH had received ART by September 2014. We found the biggest gap in the HIV treatment cascade to be HIV diagnosis as only 30% of PLWH have been diagnosed. Innovative strategies to improve HIV testing, particularly those that work best for key populations, are critical to reach the 90–90-90 targets.

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