Proposed Antiretroviral Therapy Guidelines for Prophylaxis of Occupationally Related HIV Seroconversion A Practical Approach

1996 ◽  
Vol 17 (10) ◽  
pp. 672-674
Author(s):  
Aaron E. Glatt
Keyword(s):  
New York ◽  
Human Immunodeficiency Virus ◽  
Antiretroviral Therapy ◽  
Healthcare Workers ◽  
Medical Center ◽  
Therapy Guidelines ◽  
Antiretroviral Prophylaxis ◽  
New Information ◽  
Immunodeficiency Virus ◽  
Hiv Seroconversion

AbstractRecent research indicates that antiretroviral prophylaxis significantly reduces occupationally related human immunodeficiency virus (HIV) seroconversion. This article outlines principles on which guidelines were based for treating aggressively those healthcare workers (HCWs) exposed to HIV occupationally at the Catholic Medical Center in Jamaica, New York. These recommendations attempt to provide HCWs with the best possible available antiretroviral therapy to treat occupational HIV seroconversion. New options must continue to be explored as new information becomes available.

scholarly journals Trends in Mortality From Human Immunodeficiency Virus Infection, 1984–2016: An Autopsy-Based Study

2019 ◽  
Vol 144 (5) ◽  
pp. 572-579 ◽  
Author(s):  
Sobia Nizami ◽  
Cameron Morales ◽  
Kelly Hu ◽  
Robert Holzman ◽  
Amy Rapkiewicz
Keyword(s):  
New York ◽  
Human Immunodeficiency Virus ◽  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Highly Active Antiretroviral Therapy ◽  
Opportunistic Infections ◽  
City Hospital ◽  
Aids Epidemic ◽  
Highly Active ◽  
Immunodeficiency Virus

Context.— With increasing use and efficacy of antiretroviral therapy for human immunodeficiency virus (HIV) infection, deaths from acquired immunodeficiency syndrome (AIDS)–defining conditions have decreased. Objective.— To examine trends in the cause of death of HIV-infected patients who underwent autopsy at a major New York City hospital from 1984 to 2016, a period including the major epochs of the AIDS epidemic. Design.— Retrospective review of autopsy records and charts with modeling of trends by logistic regression using polynomial models. Results.— We identified 252 autopsies in adult patients with AIDS (by 1982 definition) or HIV infection. Prior to widespread use of highly active antiretroviral therapy, in 1984–1995, on average 13 autopsies per year were done. Post–highly active antiretroviral therapy, the average number of autopsies declined to 4.5 per year. The fitted mean age at death was 35 years in 1984 and increased curvilinearly to 46 years (95% CI, 43–49) in 2016 (P < .001). By regression analysis, mean CD4+ T-cell count increased from 6 in 1992 to 64 in 2016 (P = .01). The proportion of AIDS-defining opportunistic infections decreased, from 79% in 1984–1987 to 41% in 2008–2011 and 29% in 2012–2016 (P = .04). The frequency of nonopportunistic infections, however, increased from 37% in 1984–1987 to 73% in 2008–2011 and 57% in 2012–2016 (P = .001). The frequency of AIDS-defining and other malignancies did not change significantly during the study period. The prevalence of atherosclerosis at autopsy rose dramatically, from 21% in 1988–1991 to 54% in 2008–2011 (P < .001). Conclusions.— Despite limitations of autopsy studies, many trends in the evolution of the HIV/AIDS epidemic are readily discernable.

scholarly journals The rapid CD4 + T-lymphocyte decline and human immunodeficiency virus progression in females compared to males

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Nader Parsa ◽  
Pari Mahlagha Zaheri ◽  
Ross G. Hewitt ◽  
Ali Karimi Akhormeh ◽  
Samira Taravatmanesh ◽  
...  
Keyword(s):  
New York ◽  
Human Immunodeficiency Virus ◽  
T Lymphocyte ◽  
Medical Center ◽  
Proportional Hazard ◽  
Erie County ◽  
Cell Counts ◽  
Hiv Progression ◽  
Immunodeficiency Virus ◽  
Univariate Analyses

Abstract CD4 + T-lymphocyte counts are used to assess CD4 + decline and the stage of human immunodeficiency virus (HIV) progression in HIV-infected patients. Clinical observation suggests that HIV progress more rapid in females than males. Of the original 5000 HIV-infected population of Western New York HIV/AIDS, Referral Center at Erie County Medical Center (ECMC), 1422 participated in the cohort study. We identified 333 HIV-infected patients with CD4 + T-cell-counts ≥ 500/µƖ, among them 178 met the inclusion criteria for the 10-year study. Females had higher mode (600 vs. 540) and mean (741.9 vs. 712.2) CD4 + counts than males at baseline. However, CD4 + declined faster among females in a shorter time than males (234.5 vs. 158.6, P < 0.004), with rapid HIV progression. Univariate analyses determined that females had a 40% higher risk for CD4 + decline than males. The bivariate analyses specified CD4 + decline remained greater in females than males. Multivariate analyses which employed Cox’s proportional Hazard-Model to adjust for numerous variables simultaneously identified women had almost twice the risk for CD4 + decline and rapid HIV progression than males (RR = 1.93; 95%CI 1.24, 2.99). Although the biological mechanism remains unknown, findings suggest gender differences in CD4 + decline, with a higher risk of rapid HIV progression and shorter longevity in females.

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