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.

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 Association between Virus-Specific Cytotoxic T-Lymphocyte and Helper Responses in Human Immunodeficiency Virus Type 1 Infection

1999 ◽  
Vol 73 (8) ◽  
pp. 6715-6720 ◽  
Author(s):  
Spyros A. Kalams ◽  
S. P. Buchbinder ◽  
E. S. Rosenberg ◽  
J. M. Billingsley ◽  
D. S. Colbert ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Human Immunodeficiency Virus Type ◽  
Virus Type ◽  
T Lymphocyte ◽  
Cytotoxic T Lymphocyte ◽  
Cell Counts ◽  
Wide Range ◽  
Immunodeficiency Virus ◽  
Hiv 1

ABSTRACT Cellular immune responses are thought to be an important antiviral host defense, but the relationship between virus-specific T-helper and cytotoxic-T-lymphocyte (CTL) responses has not been defined. To investigate a potential link between these responses, we examined functional human immunodeficiency virus type 1 (HIV-1)-specific memory CTL precursor frequencies and p24-specific proliferative responses in a cohort of infected untreated persons with a wide range of viral loads and CD4 cell counts. Levels of p24-specific proliferative responses positively correlated with levels of Gag-specific CTL precursors and negatively correlated with levels of plasma HIV-1 RNA. These data linking the levels of HIV-specific CTL with virus-specific helper cell function during chronic viral infection provide cellular immunologic parameters to guide therapeutic and prophylactic vaccine development.

scholarly journals Comparison of the Frequencies and Levels of Human Immunodeficiency Virus Type 1 Markers in Specimens from Chronically Infected Human T-Lymphocyte Cultures and from Patients

1999 ◽  
Vol 6 (3) ◽  
pp. 369-376
Author(s):  
Donald J. Witt ◽  
Christine C. Ginocchio ◽  
Xue-Ping Wang ◽  
Mi Khinkhin Soe Kaufman
Keyword(s):  
Human Immunodeficiency Virus ◽  
Viral Load ◽  
Human Immunodeficiency Virus Type ◽  
T Lymphocyte ◽  
Clinical Specimens ◽  
Cell Counts ◽  
Immunodeficiency Virus ◽  
Human T Lymphocyte ◽  
Hiv 1

ABSTRACT Together with CD4+-cell counts as an indicator of immune function, the use of human immunodeficiency virus type 1 (HIV-1) RNA levels as a direct marker of viral load has gained widespread attention for evaluation of patient clinical status. Results obtained with other HIV-1 markers for this purpose are often inconsistent. This study examined the relationship between various HIV-1 markers by using clinical specimens (plasma) from HIV-1-infected individuals at different stages of disease progression and supernatant fluid from four human T-lymphocyte cell lines chronically infected with HIV-1. Cell culture specimens were collected periodically over 7 days and were tested for HIV-1 RNA levels with a nucleic acid amplification assay, for p24 with an enzyme-linked immunosorbent assay, and for reverse transcriptase activity by isotope uptake. An increase in the level of each marker was observed over the 7-day period with each of the four HIV-1 strains tested (LAV1, HTLV-IIIB, MN, and ARV2); with these specimens, the frequency of detection for each marker was 100%. In the clinical specimens, HIV-1 RNA was detected more often (143 of 183 specimens [78%]) than was p24 (87 of 183 [48%]); little correlation between the levels of the two markers was seen. In these clinical specimens evaluated, CD4+-cell counts were better correlated with the frequency and levels of HIV-1 RNA than with p24. In specimens (n = 38) collected serially from six HIV-1-infected subjects, HIV-1 RNA was detected more often (33 of 38 [85%]) than p24 (23 of 38 [59%]). When reported by the assays used, the levels of both HIV-1 markers fluctuated over time for each of the subjects. Although the markers correlated in the in vitro systems studied, the observed differences in the correlation of levels and frequencies of HIV-1 markers in vivo indicate that p24 has less clinical utility than does viral load testing when used in conjunction with CD4+-cell counts as a measure of immune system functioning.

Clinical and Biological Features Of Multiple Myeloma (MM) and Monoclonal Gammopathies In Patients With Human Immunodeficiency Virus (HIV) Infection

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 5348-5348
Author(s):  
Alexis Talbot ◽  
Laurence Gérard ◽  
Raphael Szalat ◽  
David Boutboul ◽  
Stephanie Harel ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
Plasma Cell ◽  
T Lymphocyte ◽  
Clinical Course ◽  
Age At Diagnosis ◽  
Monoclonal Gammopathies ◽  
Cell Counts ◽  
Monoclonal Gammapathy ◽  
Immunodeficiency Virus

Abstract Background Monoclonal gammopathies (MoG) and HIV infection are two common diseases. A higher incidence of MoG of undetermined significance (MGUS) has been suggested in HIV patients (pts). The clinical outcome of MGUS and the characteristics of MM in such patients are largely unknown. In the last decade, therapeutics advances have improved the prognosis of both diseases. We report the laboratory findings and clinical course of 18 HIV infected patients with a detectable serum monoclonal protein( MGUS, MM, plasma cell leukemia) treated in our center. Patients, disease and methods Patients’ demographic characteristics, stage of HIV infection and clinical course were studied. Laboratory studies included determination of CD 4 T-lymphocyte cell counts, HIV loads, serum protein electrophoresis, Ig isotype, hemoglobin, serum β2-microglobulin, calcium and creatinine levels, bone marrow aspiration with cytogenetic analysis at diagnosis. Results 18 pts (9 MGUS/stage I asymptomatic myeloma, 6 stage III myeloma, 1 leukemia plasma cell and 2 multiple plasmocytomas) were studied. The median age at diagnosis was 54.5 years (38,75). The median age at diagnosis of HIV infection was 42 years (29,68). the time Median between seropositivity and monoclonal gammopathy was 10.5 years. 1 patient's HIV status was discovered during the treatment of myeloma. 14 patients received protease inhibitors, including 9 before developing gammopathy. The monoclonal gammapathy was IgG Kappa for 9 patients,IgG Lambda for 6. At the diagnosis of gammopathyt the median CD 4 T lymphocyte count was 442 cells/µL(range 190-915). Half of the patients had negative HIV viral load (the median of the others was 9904 copies/ml). A polyclonal hypergammaglobulinemia (median 15.4 g / l (3.6, 26.9)) was found in addition to the Ig monoclonal in 17 patients and one patient had a symptomatic immunoparesis with repeated infections. Two patients with asymptomatic MM progressed with a period of time of 6and 11 years. All patients with symptomatic myeloma had bone lesions, 3 had an hypercalcemia ( including a case of primary hyperparathyroidism), 2 patients had kidney injury ( 1 end stage renal disease requiring hemodialysis). Extramedullary lesions were found in 5 patients (lymph node). 11 patients have been treated with chemotherapy, 4 received autologous stem cell transplantation and 7 relapsed. The median event free survival was 4 years. 4 patients died of disease. The overal survivalwas 4.25 years. Conclusion The presence of a monoclonal gammapathy or asymptomatic myeloma with infection by the human immunodeficiency virus does not seem to change the clinical presentation at diagnosis. The prognosis myeloma does not seem different from the HIV non infected patients population infected and justifies a similar therapeutic approach, including therapeutic intensification and novel agents. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Risk Factors for Unfavorable Treatment Outcomes among the Human Immunodeficiency Virus-Associated Tuberculosis Population in Tashkent City, Uzbekistan: 2013–2017

2021 ◽  
Vol 18 (9) ◽  
pp. 4623
Author(s):  
Sherali Massavirov ◽  
Kristina Akopyan ◽  
Fazlkhan Abdugapparov ◽  
Ana Ciobanu ◽  
Arax Hovhanessyan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Human Immunodeficiency Virus ◽  
Treatment Outcomes ◽  
Sputum Smear ◽  
People Living With Hiv ◽  
Tb Treatment ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Immunodeficiency Virus ◽  
Positive Sputum Smear

Tuberculosis (TB) and human immunodeficiency virus (HIV) co-infection poses a growing clinical challenge. People living with HIV have a higher chance of developing TB, and once the disease has progressed, are at greater risk of having unfavorable TB treatment outcomes. Data on TB treatment outcomes among the HIV-associated TB population in Uzbekistan are limited. Thus, we conducted a cohort study among 808 adult patients with HIV-associated TB registered at the Tashkent TB referral hospital from 2013–2017 to document baseline characteristics and evaluate risk factors for unfavorable TB treatment outcomes. The data were collected from medical records and ambulatory cards. About 79.8% of the study population had favorable treatment outcomes. Antiretroviral therapy (ART) coverage at the admission was 26.9%. Information on CD4-cell counts and viral loads were largely missing. Having extrapulmonary TB (aOR 2.21, 95% CI: 1.38–3.53, p = 0.001), positive sputum smear laboratory results on admission (aOR 1.62, 95% CI: 1.07–2.40), diabetes (aOR 5.16, 95% CI: 1.77–14.98), and hepatitis C (aOR 1.68, 95% CI: 1.14–2.46) were independent risk factors for developing unfavorable TB treatment outcomes. The study findings provide evidence for targeted clinical management in co-infected patients with risk factors. Strengthening the integration of TB/HIV services may improve availability of key data to improve co-infection management.

scholarly journals Frequency of Cytomegalovirus Viral Load in Iranian Human Immunodeficiency Virus-1-Infected Patients with CD4+ Counts <100 Cells/mm3

Intervirology ◽  
2021 ◽  
pp. 1-5
Author(s):  
Mohammad Reza Jabbari ◽  
Hoorieh Soleimanjahi ◽  
Somayeh Shatizadeh Malekshahi ◽  
Mohammad Gholami ◽  
Leila Sadeghi ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Viral Load ◽  
Cell Count ◽  
Previous History ◽  
Cd4 Count ◽  
Cd4 Cell Count ◽  
Cell Counts ◽  
Immunodeficiency Virus ◽  
Cd4 Cell ◽  
Hiv 1

<b><i>Objectives:</i></b> The aim of present work was to assess cytomegalovirus (CMV) viremia in Iranian human immunodeficiency virus (HIV)-1-infected patients with a CD4+ count &#x3c;100 cells/mm<sup>3</sup> and to explore whether CMV DNA loads correlate with CD4+ cell counts or associated retinitis. <b><i>Methods:</i></b> This study was conducted at the AIDS research center in Iran on HIV-1-infected patients with CD4+ count &#x3c;100 cells/mm<sup>3</sup>, antiretroviral therapy-naive, aged ≥18 years with no previous history of CMV end-organ disease (CMV-EOD). <b><i>Results:</i></b> Thirty-nine of 82 patients (47.56%) had detectable CMV viral load ranging from 66 to 485,500 IU/mL. CMV viral load in patients with retinitis ranges from 352 to 2,720 IU/mL, and it was undetectable in 2 patients. No significant associations between CMV viremia and CD4+ cell count was found (<i>p</i> value = 0.31), whereas significant association of CMV viremia in HIV-infected patients with retinitis was found (<i>p</i> &#x3c; 0.02). <b><i>Conclusions:</i></b> We estimated the frequency of CMV viral load infection in Iranian HIV-1-infected patients with a CD4+ cell count &#x3c;100 mm<sup>3</sup>/mL in the largest national referral center for HIV-1 infection in Iran. Further research is required on the relevance of CMV viral load in diagnostic and prognostic value of CMV-EOD.

scholarly journals Interleukin-7-Dependent Production of RANTES That Correlates with Human Immunodeficiency Virus Disease Progression

2003 ◽  
Vol 77 (7) ◽  
pp. 4389-4395 ◽  
Author(s):  
Anuska Llano ◽  
Jordi Barretina ◽  
Arantxa Gutiérrez ◽  
Bonaventura Clotet ◽  
José A. Esté
Keyword(s):  
Human Immunodeficiency Virus ◽  
Disease Progression ◽  
Mononuclear Cells ◽  
Ex Vivo ◽  
Virus Disease ◽  
Chemokine Production ◽  
Interleukin 7 ◽  
Cell Counts ◽  
Immunodeficiency Virus

ABSTRACT There is a relationship between CD4-T-cell number and circulating interleukin 7 (IL-7) levels in human immunodeficiency virus (HIV)-positive individuals. Here, we show that IL-7 induced a dose-dependent production of CCL3 (MIP-1α), CCL4 (MIP-1β), and CCL5 (RANTES) in peripheral blood mononuclear cells (PBMC), ex vivo tonsil lymphoid tissue of HIV− individuals, and PBMC from HIV+ individuals, suggesting that IL-7 may regulate β-chemokine production in vivo. In a cross-sectional study of HIV+ individuals (n = 130), a weak but significant correlation between IL-7 and RANTES was noted (r = 0.379; P < 0.001). Remarkably, the correlation between IL-7 and RANTES increased to an r value of 0.798 (P < 0.001) if individuals with low CD4 cell counts (<200 cells/μl) were excluded from the analysis. Our results suggest that there is a relationship between IL-7 and the production of RANTES both in vitro and in vivo that is lost in immune-compromised patients (CD4 count of <200 cells/μl) but that could be restored by antiretroviral therapy. Unlike the case for IL-7, high levels of RANTES suggest an intermediate stage of HIV disease progression.

scholarly journals Evaluation of a New Single-Parameter Volumetric Flow Cytometer (CyFlowgreen) for Enumeration of Absolute CD4+ T Lymphocytes in Human Immunodeficiency Virus Type 1-Infected Thai Patients

2005 ◽  
Vol 12 (12) ◽  
pp. 1416-1424 ◽  
Author(s):  
Kovit Pattanapanyasat ◽  
Surada Lerdwana ◽  
Egarit Noulsri ◽  
Thanyanan Chaowanachan ◽  
Punneeporn Wasinrapee ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Human Immunodeficiency Virus Type ◽  
Virus Type ◽  
T Lymphocyte ◽  
Flow Cytometer ◽  
Single Parameter ◽  
Becton Dickinson ◽  
Flow Cytometric Method ◽  
Immunodeficiency Virus

ABSTRACT Use of the standard dual-platform flow cytometric method for determination of CD4+ T-lymphocyte counts, which needs both a flow cytometer (FCM) and hematological analyzer, would inevitably lead to increased variability. The development of new single-platform (SP) FCMs that provide direct CD4+ T-lymphocyte counts for improved assay precision and accuracy have recently attracted attention. This study evaluated one of those systems, CyFlowgreen (Partec), a single-parameter SP volumetric FCM. The performance of CyFlowgreen was compared with those of two reference standard SP microbead-based technologies of the three-color TruCOUNT tube with the FACScan FCM and a two-color FACSCount system (Becton Dickinson Biosciences). Absolute CD4+ and CD8+ T-lymphocyte counts in 200 human immunodeficiency virus type 1-seropositive blood specimens were determined. Statistical analysis for correlation and agreement were performed. A high correlation of absolute CD4 counts was shown when those obtained with CyFlowgreen were compared with those obtained with the bead-based three-color TruCOUNT system (R 2 = 0.96; mean bias, −69.1 cells/μl; 95% confidence interval [CI], −225.7 to +87.5 cells/μl) and the FACSCount system (R 2 = 0.97; mean bias, −40.0 cells/μl; 95% CI, −165.1 to +85.1 cells/μl). The correlation of the CD4+ T-lymphocyte counts obtained by the two bead-based systems was high (R 2 = 0.98). Interestingly, CyFlowgreen yielded CD4+ T-lymphocyte counts that were 21.8 and 7.2 cells/μl lower than those obtained with the TruCOUNT and the FACSCount systems, respectively, when CD4+ T-lymphocyte counts were <250 CD4+ T-lymphocyte counts/μl range or 17.3 and 5.8 cells/μl less, respectively, when CD4+ T-lymphocyte counts were <200 cells/μl. The single-parameter CyFlowgreen volumetric technology performed well in comparison with the performance of the standard SP bead-based FCM system. However, a multicenter comparative study is needed before this FCM machine is implemented in resource-limited settings.

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