scholarly journals 2228 The association of gastrointestinal symptoms and hypertension in persons living with HIV on HAART

2018 ◽  
Vol 2 (S1) ◽  
pp. 88-88
Author(s):  
Kierra R. Butler ◽  
Faye Harrell ◽  
Wendy A. Henderson
Keyword(s):  
African Americans ◽  
Gastrointestinal Symptoms ◽  
Hiv Viral Load ◽  
Cardiovascular Comorbidities ◽  
Highly Active ◽  
Increased Risk ◽  
Co Morbidity ◽  
Persons Living With Hiv ◽  
Reported Data ◽  
Living With Hiv

OBJECTIVES/SPECIFIC AIMS: The advent of Highly Active Antiretroviral Treatments (HAART) has allowed HIV-positive individuals to live longer in recent years. This has resulted in a higher incidence of mortalities occurring in these individuals due to cardiovascular pathologies, as opposed to deaths due to HIV. Even with long-term HAART, persons living with HIV (PLWHIV) still exhibit inflammation, which is associated with deleterious cardiovascular outcomes. PLWHIV on HAART have a higher prevalence of hypertension, which is associated with an increased risk of cardiovascular events. Moreover, chronic inflammation has been shown to be related to the translocation of microbes and endotoxins across the gastrointestinal tract. Such microbial translocation (MT) is increased in individuals with digestive disorders and their associated symptoms (e.g., diarrhea, abdominal pain, and nausea). This study aims to explore the pathologies common to both MT-induced inflammation and cardiovascular symptoms by examining the associations between gastrointestinal symptoms and hypertension in PLWHIV on HAART. METHODS/STUDY POPULATION: The sample included 351 PLWHIV on HAART. Pre-existing de-identified data were analyzed. Sample demographics included 56.98 % African Americans, 41.31% Caucasians, ages 20–66 years (mean age=43.65years), 21% female, 89% male, HIV viral load, CD4 counts. Self-reported data from the Symptom Co-Morbidity Questionnaire and Socio-demographic questionnaire were analyzed with SPSS v.24. RESULTS/ANTICIPATED RESULTS: In total, 86 PLWHIV (24.50%) stated that they have hypertension; 39 subjects (45.3%) reported having diarrhea, 30 subjects (34.8%) reported nausea, and 12 (13.9%) reported constipation and vomiting. Among ethnicities with hypertension and gastrointestinal symptoms, African Americans compared with Caucasians had a higher percentage of diarrhea (28% vs. 17%), nausea (21% vs. 11%), constipation (11% vs. 2%), and vomiting (8% vs. 5%). Women compared with men reported a higher percentage of nausea (28% vs. 24%) and constipation (8% vs. 6%). Men compared with women reported a higher percentage of diarrhea (38% vs. 7%) and vomiting (8% vs. 5%). DISCUSSION/SIGNIFICANCE OF IMPACT: These data support the need for targeted screening to include both blood pressure and associated gastrointestinal symptoms. Further studies supporting these results may assist practitioners to target treatments that may prevent cardiovascular comorbidities.

scholarly journals Outcomes of retained and disengaged pregnant women living with HIV in Uganda

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0251413
Author(s):  
Agnes N. Kiragga ◽  
Ellon Twinomuhwezi ◽  
Grace Banturaki ◽  
Marion Achieng ◽  
Juliet Nampala ◽  
...  
Keyword(s):  
Post Partum ◽  
Urban Environments ◽  
Hiv Viral Load ◽  
Viral Loads ◽  
Women Living With Hiv ◽  
Resource Limited ◽  
Increased Risk ◽  
Exposed Infant ◽  
Public Clinics ◽  
Living With Hiv

Introduction Loss-to-follow-up among women living with HIV (WLWHIV) may lead to unfavorable outcomes for both mother and exposed infant. This study traced WLWHIV disengaged from care and their infants and compared their outcomes with those retained in care. Methods The study included WLWHIV who initiated ART during pregnancy at six public clinics in Uganda. A woman was defined as disengaged (DW) if she had not attended her 6-week post-partum visit by 10 weeks after her estimated date of delivery. DW were matched with retained women (RW) by age and duration on ART. Nurse counselors traced all selected DW via telephone and community visits to assess vital status, infant HIV sero-status and maternal HIV viral load through blood draws. Results Between July 2017 and July 2018, 734 women (359 DW and 375 RW) were identified for the study. Tracing was attempted on 349 DW and 160 (44.6%) were successfully located and enrolled in the study. They were matched with 162 RW. Among DW, 52 (32.5%) transferred to another health facility. Very few DW, 39.0% were HIV virally suppressed (<1000 copies/ml) compared to RW 89.5%, P<0.001). Among 138 babies born to DW, 4.3% tested positive for HIV compared to 1.4% among babies born to RW (P = 0.163). Conclusion Pregnant and breastfeeding WLWHIV who disengage from care are difficult to find in urban environments. Many have detectable viral loads, leading to the potential for an increased risk of MTCT. Efforts to reduce disengagement from care are critical for the successful elimination of MTCT in resource-limited settings.

Prevention of sudden cardiac death in persons living with HIV infection

2021 ◽  
Vol 19 ◽  
Author(s):  
Jean-Jacques Monsuez ◽  
Marilucy Lopez-Sublet
Keyword(s):  
Sudden Cardiac Death ◽  
Hiv Infection ◽  
Cardiac Death ◽  
Left Ventricular ◽  
Qt Interval Prolongation ◽  
Increased Risk ◽  
Persons Living With Hiv ◽  
Artery Disease ◽  
Optimized Treatment ◽  
Living With Hiv

: Persons living with HIV infection (PLWH) have been recognized to have an increased risk of sudden cardiac death (SCD). Prevention of this risk should theoretically be included in their long-term management. However, only a few approaches have been proposed to optimize such interventions. Targeting detection of the commonly associated conditions such as coronary artery disease, left ventricular dysfunction, heart failure, QT interval prolongation and ventricular arrhythmias is the first step of this prevention. However, although detection of the risk of SCD is a suitable challenge in PLWH, it remains uncertain whether optimized treatment of the identified risks would unequivocally translate into a decrease in SCD rates.

scholarly journals Burden of Suicidal Ideation and Attempt among Persons Living with HIV and AIDS in Semiurban Uganda

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Godfrey Zari Rukundo ◽  
Brian Leslie Mishara ◽  
Eugene Kinyanda
Keyword(s):  
Suicidal Ideation ◽  
Hiv And Aids ◽  
Hiv Care ◽  
State Anger ◽  
Increased Risk ◽  
Persons Living With Hiv ◽  
Considerable Morbidity ◽  
Living With Hiv ◽  
The Impact ◽  
Hiv Aids

Although the impact of HIV/AIDS has changed globally, it still causes considerable morbidity and mortality, including suicidality, in countries like Uganda. This paper describes the burden and risk factors for suicidal ideation and attempt among 543 HIV-positive attending two HIV specialized clinics in Mbarara municipality, Uganda. The rate of suicidal ideation was 8.8% (n=48; 95% CI: 6.70–11.50) and suicidal attempt was 3.1% (17, 95% CI 2.00–5.00). The factors associated with increased risk for suicidal ideation and attempts were state anger (OR = 1.06, 95% CI: 1.03–1.09;p=0.001); trait anger (OR 1.10, 95% CI 1.04–1.16,p=0.002); depression (OR 1.13, 95% CI 1.07–1.20,p=0.001); hopelessness (OR 1.12, 95% CI 1.02–1.23,p=0.024); anxiety (OR 1.06, 95% CI 1.03–1.09); low social support (OR 0.19, 95% CI 0.07–0.47,p=0.001); inability to provide for others (OR 0.19, 95% CI 0.07–0.47,p=0.001); and stigma (OR 2.48, 95% CI 1.11–5.54,p=0.027). At multivariate analysis, only state anger remained statistically significant. HIV/AIDS is associated with several clinical, psychological, and social factors which increase vulnerability to suicidal ideation and attempts. Making suicide risk assessment and management an integral part of HIV care is warranted.

scholarly journals Does Older Age Confer an Increased Risk of Incident Neurocognitive Disorders Among Persons Living with HIV Disease?

2015 ◽  
Vol 29 (5) ◽  
pp. 656-677 ◽  
Author(s):  
David P. Sheppard ◽  
Steven Paul Woods ◽  
Mark W. Bondi ◽  
Paul E. Gilbert ◽  
Paul J. Massman ◽  
...  
Keyword(s):  
Neurocognitive Disorders ◽  
Older Age ◽  
Hiv Disease ◽  
Increased Risk ◽  
Persons Living With Hiv ◽  
Living With Hiv

scholarly journals Risk of adverse COVID-19 outcomes for people living with HIV: a rapid review and meta-analysis

2020 ◽  
Author(s):  
Maya Mellor ◽  
Anne Bast ◽  
Nicholas Jones ◽  
Nia Roberts ◽  
Jose Ordonez-Mena ◽  
...  
Keyword(s):  
Viral Load ◽  
T Cell ◽  
Meta Analysis ◽  
Cd4 T Cell ◽  
Rapid Review ◽  
People Living With Hiv ◽  
Hiv Viral Load ◽  
Increased Risk ◽  
Living With Hiv ◽  
Cd4 T Cell Count

Objective: To assess whether people living with HIV (PLWH) are at increased risk of COVID-19 mortality or adverse outcomes, and whether antiretroviral therapy (ART) influences this risk. Design: Rapid review with meta-analysis and narrative synthesis. Methods: We searched databases including Embase, Medline, medRxiv, and Google Scholar up to 26th August 2020 for studies describing COVID-19 outcomes in PLWH and conducted a meta-analysis of higher quality studies. Results: We identified 1,908 studies and included 19 in the review. In a meta-analysis of five studies, PLWH had a higher risk of COVID-19 mortality (hazard ratio (HR) 1.93, 95% Confidence Interval (CI): 1.59-2.34) compared to people without HIV. Risk of death remained elevated for PLWH in a subgroup analysis of hospitalised cohorts (HR 1.54, 95% CI: 1.05-2.24) and studies of PLWH across all settings (HR 2.08, 95%CI: 1.69-2.56). Eight other studies assessed the association between HIV and COVID-19 outcomes, but provided inconclusive, lower-quality evidence due to potential confounding and selection bias. There were insufficient data on the effect of CD4+ T cell count and HIV viral load on COVID-19 outcomes. Eleven studies reported COVID-19 outcomes by ART-regimen. In the two largest studies, tenofovir-disoproxil-fumarate (TDF)-based regimens were associated with a lower risk of adverse COVID-19 outcomes, although these analyses are susceptible to confounding by comorbidities. Conclusion: Evidence is emerging that suggests a moderately increased risk of COVID-19 mortality amongst PLWH. Further investigation into the relationship between COVID-19 outcomes and CD4+ T cell count, HIV viral load, ART and the use of TDF is warranted.

Cardiovascular Disease

2019 ◽  
pp. 453-468
Author(s):  
David A. Wohl ◽  
Jeffrey T. Kirchner
Keyword(s):  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Hiv Infection ◽  
Increased Risk ◽  
Persons Living With Hiv ◽  
Living With Hiv ◽  
Chronic Hiv Infection

Upon completion of this chapter, the reader should be able to • To gain a greater understanding of the pathophysiology of CVD and myocardial infarction in persons living with HIV infection. • To understand the link of chronic HIV infection as it relates to increased risk of CVD and myocardial infarction....

Marijuana use and undetectable HIV viral load in persons living with HIV in Florida

2015 ◽  
Vol 156 ◽  
pp. e47
Author(s):  
Robert Cook ◽  
Zhi Zhou ◽  
Chukwuemeka Okafor ◽  
Christa Cook ◽  
Larry Burrell ◽  
...  
Keyword(s):  
Viral Load ◽  
Marijuana Use ◽  
Hiv Viral Load ◽  
Persons Living With Hiv ◽  
Living With Hiv

scholarly journals 931. Congestive Heart Failure in Persons Living with HIV: Are we providing standard of care?

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S498-S499
Author(s):  
Salil K Chowdhury ◽  
Jung M Seo ◽  
Steven Keller ◽  
Pallavi Solanki ◽  
Diana Finkel
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Ejection Fraction ◽  
Standard Of Care ◽  
Preserved Ejection Fraction ◽  
Aldosterone Antagonists ◽  
Reduced Ejection Fraction ◽  
Increased Risk ◽  
Persons Living With Hiv ◽  
Living With Hiv

Abstract Background With antiretroviral therapy, Human Immunodeficiency Virus (HIV) infection has become a life-long chronic condition. Persons Living with HIV (PLWH) have increased risk of cardiovascular diseases including congestive heart failure (CHF) and increased morbidity and mortality from these diseases due to factors such as HIV-induced chronic inflammation. This study will assess if providers at University Hospital in Newark, NJ are providing standard of care for CHF in PLWH. Methods This study was approved by Rutgers IRB (Pro2020000391). A database of 154 charts including all patients with diagnoses of both HIV and CHF was generated using ICD-10 codes for HIV and CHF. After screening, 79 patient charts were eligible. Patients were excluded if their CHF was managed elsewhere, if they were misdiagnosed or deceased. Nine were diagnosed with heart failure with preserved ejection fraction (HFpEF) defined as an ejection fraction above 50%. Seventy were diagnosed with heart failure with reduced ejection fraction (HFrEF) defined as an ejection fraction below 40%. Treatment was assessed using the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guidelines. Recommendations for treatment of HFrEF Recommendations for treatment of HFpEF Results For patients with HFrEF, 10% of eligible patients were not prescribed aldosterone antagonists due to an incorrect contraindication. Thirty eight percent of patients requiring consideration for device therapy were not considered. Fourteen percent of patients did not have NYHA/ACC/AHA class documented. Three additional charts were found to not follow class-based management. Thirty five percent of patients with hypertension did not have guideline-based titrated therapy. In terms of HFpEF, 43% of patients did not have proper hypertension treatment. Heart Failure with Reduced Ejection Fraction Heart Failure with Preserved Ejection Fraction Conclusion Adherence to evidence-based guidelines for CHF in PLWH is important due to their increased risk of mortality and morbidity. Improvements such as documentation of heart failure class, contraindications to medications, and consideration for devices may improve outcomes going forward. Disclosures All Authors: No reported disclosures

scholarly journals Driving Force of Covid-19 Among People Living With HIV/AIDS in Wuhan, China

2020 ◽  
Author(s):  
Wei Guo ◽  
Fangzhao Ming ◽  
Yu Dong ◽  
Qian Zhang ◽  
Lian Liu ◽  
...  
Keyword(s):  
T Lymphocyte ◽  
Lymphocyte Count ◽  
Driving Force ◽  
Driving Forces ◽  
People Living With Hiv ◽  
Hiv Diagnosis ◽  
Hiv Viral Load ◽  
Increased Risk ◽  
Living With Hiv ◽  
Hiv Aids

Abstract Background: Even people living with HIV/AIDS (PLWHA) were considered to be at increased risk of SARS-CoV-2 infection, the driving force among this group of individuals is still not clear. Methods: We investigated 1,701 PLWHA through a telephone interview and found 11 COVID-19 patients in four districts of Wuhan, China. The demographic features and major clinical characteristics of these patients were retrieved from the information management systems for COVID-19 patients of four districts’ CDC. Statistical analysis was performed to find out the driving force of COVID-19 among PLWHA.Results: The incidence proportion of COVID-19 in PLWHA is 0.6% (95% CI: 0.2% - 1.0%), which is comparable to the overall population incidence rate in Wuhan city (0.6%). Nine out of the 11 COVID-19/AIDS patients had relatively high CD4+ T lymphocyte count (>200/μl) and undetectable HIV viral load (＜20 copies/ml), and ten of them were on antiretroviral therapy. PLWHA who were old, had low CD4+ T lymphocyte count, infected HIV through homosexual activity, and had been diagnosed for HIV for a long time, were more likely to develop COVID-19.Conclusions: PLWHA has comparable COVID-19 morbidity rates as the general population, and older age, low CD4 count, long length since HIV diagnosis, and treatment-naive were potential driving forces of COVID-19 occurrence among PLWHA. Strategies in preventing SARS-CoV-2 infection among PLWHA with worse immune responses are needed. Article Summary Line: As COVID-19 continues to spread around the world, people living with HIV/AIDS (PLWHA) are also at risk of infection with SARS-CoV-2. We investigated the factors associated with SARS-CoV-2 infection among PLWHA in Wuhan, China.

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