scholarly journals Otolaryngologic Lesions among Human Immunodeficiency Virus-infected Children

2018 ◽  
Vol 01 (02) ◽  
pp. 105-110
Author(s):  
Oluwabusayo Babatunde ◽  
Adebolajo Adeyemo ◽  
Regina Oladokun

Abstract Background Otolaryngologic (ORL) lesions are common in children. ORL lesions occur even more commonly and more severely in HIV-infected children. The few available literature has reported a high prevalence in human immunodeficiency virus (HIV)–infected children; however, there are inadequate data on the impact of HIV infection on hearing and the pattern of manifestations of ORL lesions among African children. Objectives This study was conducted to describe the prevalence and manifestations of ORL lesions among HIV-infected children and controls in Nigeria. Materials and Methods A prospective comparative cross-sectional study design was adopted. Clinical evaluation was done, and hearing assessment was done using otoacoustic emission for all participants and pure tone audiometry for participants aged ≥ 5 years. Hearing thresholds were defined according to the World Health Organization classification. Results One hundred children were studied: 50 HIV-infected and 50 HIV-negative children. The prevalence of ORL lesions among HIV-infected children was 66%, whereas it was 46% (p = 0.044) among HIV-negative children. ORL lesions were more prevalent among children between the 18-month and 5-year age group (p = 0.003) irrespective of HIV status. The lesions that were associated with HIV infection were cervical adenopathy (44%, p = 0.010) and hearing loss (36%, p = 0.023). Conclusion The frequency of ORL lesions is high in HIV-infected children, but improved outcomes following use of medications may be responsible for the slight disparity in prevalence when compared with HIV-negative children.

1998 ◽  
Vol 5 (4) ◽  
pp. 583-587 ◽  
Author(s):  
Suk W. Park ◽  
Walter Royal ◽  
Richard D. Semba ◽  
Gordon W. Wiegand ◽  
Diane E. Griffin

ABSTRACT Adhesion molecules, which play a major role in lymphocyte circulation, have not been well characterized in human immunodeficiency virus (HIV) infection. T-lymphocyte populations, including CD3, CD4, CD28, and adhesion molecules (L selectin, LFA-1, VLA-4, and ICAM-1) were measured by flow cytometry in a cross-sectional study of 100 HIV-infected and 49 HIV-seronegative adults. HIV-infected adults had lower numbers of CD3+ lymphocytes expressing L selectin (P < 0.0001) and VLA-4 (P < 0.01) and higher numbers of CD3+ lymphocytes expressing LFA-1bright (P < 0.002) than did HIV-negative adults. By CD4+-lymphocyte count category (>500, 200 to 500, or <200 cells/μl), HIV-infected adults with more advanced disease had lower percentages of CD3+ lymphocytes expressing L selectin and VLA-4 and higher percentages of CD3+ lymphocytes expressing LFA-1. The percentages of CD3+ CD28+ lymphocytes and of CD3+L selectin+ lymphocytes were positively correlated (Spearman coefficient = 0.86; P < 0.0001), and the percentage of CD3+ CD28+ lymphocytes and the CD3+ LFA-1bright lymphocyte/CD3+LFA-1dim lymphocyte ratio were negatively correlated (Spearman coefficient = −0.92; P <0.00001). The results of this study suggest that HIV infection is associated with altered expression of adhesion molecules.


PLoS ONE ◽  
2020 ◽  
Vol 15 (3) ◽  
pp. e0230727
Author(s):  
Marilza Campos de Magalhães ◽  
Juan Camilo Sánchez-Arcila ◽  
Ana Carolina de Brito Lyra ◽  
Luiz Felipe Boufleur Long ◽  
Isabelle Vasconcellos de Souza ◽  
...  

2021 ◽  
Vol 3 (2) ◽  
pp. 001-008
Author(s):  
Arinze Anthony Onwuegbuna ◽  
Akunne Ijeoma Apakama ◽  
Chuka Michael Okosa ◽  
Emeka Akujuobi Chianakwalam ◽  
Miriam-Benigna Chika Amobi ◽  
...  

Background: Human Immunodeficiency Virus remains an important cause of morbidity and mortality especially in sub-Saharan Africa. Despite the availability of highly active antiretroviral therapy, many people with this disease still present with its ocular complications. Cataracts remain the commonest reason for blindness in Nigeria and globally. The prevalence of HIV infection among cataract patients in south east Nigeria has remained unknown. Objectives: To determine the prevalence of human immunodeficiency virus among cataract patients in south east Nigeria. Materials and Methods: This was a retrospective cross-sectional study. The case files of all who had cataract surgery between September 1st, 2020 to March 31st, 2021 at City of Refuge Specialist Eye Clinic Onitsha, Nigeria was obtained from the Medical Record Department of the hospital to extract relevant information and demographic data. The outcome measures included the prevalence of HIV, as well as the gender and the age of affected cataract patients. Data was analyzed using SPSS 26.0 IBM Corporation. Fisher’s exact test was performed for categorical data, and Student’s t-test was applied to continuous variables depending on their distribution. A p value of <0.05 was considered statistically significant. Results: In this study, 423 participants who underwent cataract surgery were included for analysis of which 16 were HIV positive. The overall seroprevalence of HIV among the study population was 3.78% with HIV prevalence showing the female to male ratio of 1:1. Up to 70.81% of the patients were at least 60 years of age. Although there was a statistically significant difference between the prevalence of HIV and seasonal presentation (p=0.015), there was no statistically significant relationship between the participants age and gender (p=0.195), prevalence of HIV and the participants’ age categories (p=0.149) or participants’ settlements (p=0.219). Conclusion: The prevalence of HIV among cataract patients in this study was 3.78%. This study confirms that HIV infections are an important public problem among cataract patients in Nigeria. Our findings draw attention to the significant burden HIV has on cataract surgery in Nigeria. We recommend advocacy for the national policymakers to initiate HIV tests in routine ophthalmology services.


2021 ◽  
Vol 14 (1) ◽  
pp. 329-334
Author(s):  
Sri Agung Aryastuti ◽  
Sri Ratna Dewi ◽  
Sri Masyeni

Anemia is a common condition found among Human Immunodeficiency Virus (HIV)-infected patients. T-cells that are infected with HIV virus can directly suppress the growth of progenitor cells in the bone marrow so that affecting the hemopoiesis resulted in anemia. These hematological abnormalities could potentially cause serious clinical implications. This study was conducted to determine the prevalence of anemia in HIV-infected patients in Bali. It was ahospital based cross-sectional studyconducted at two public hospital in Bali-Indonesia. A total of 243 medical record data from HIV-infected patients atWangaya Hospital Denpasar Bali and Sanjiwani Hospital Gianyar Bali between 2009 -2017 were included in analysis. Prevalence of anemia in antiretroviral (ART)-naïve patients and in patients on ART were 60.8% and 40.3%, respectively. Leucopenia and thrombocytopenia were found 8.2% and 9.4%, respectively, in ART-naïve group. While in patients with ART group leucopenia and thrombocytopenia were accounted for 6.9% and 4.3%, respectively. There was a significant difference in prevalence of anemia between ART-naïve patients and patients on ART (60.8% vs. 40.3%; p < 0.05). Although the prevalence of anemia was lower in patients on ART, but anemia continues to be common in a substantial portion of HIV-infected persons. Another studies are still needed to addressing the impact of anemia on HIV-infected individuals, as well as treatment strategies and future research directions.


PLoS ONE ◽  
2020 ◽  
Vol 15 (2) ◽  
pp. e0227763 ◽  
Author(s):  
Marilza Campos de Magalhães ◽  
Juan Camilo Sánchez-Arcila ◽  
Ana Carolina de Brito Lyra ◽  
Luiz Felipe Boufleur Long ◽  
Isabelle Vasconcellos de Souza ◽  
...  

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Walusa Assad Gonçalves-Ferri ◽  
◽  
Fábia Martins Pereira-Cellini ◽  
Kelly Coca ◽  
Davi Casale Aragon ◽  
...  

Abstract Background The World Health Organization recognizes exclusive breastfeeding a safe source of nutrition available for children in most humanitarian emergencies, as in the current pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Despite the Brazilian national guideline protecting breastfeeding practices, there are many concerns about protecting infants from their infected mothers. This study aimed to analyze how the Brazilian hospitals and maternity services promote and support mothers suspected or diagnosed with coronavirus disease (COVID-19). Methods This is a descriptive cross-sectional and multicenter study which collected data from 24 Brazilian hospitals and maternity services between March and July 2020. Representatives of the institutions completed a questionnaire based on acts to promote and support breastfeeding, the Baby-Friendly Hospital Initiative, and Brazil’s federal law recommendations. Results The results showed that in delivery rooms, 98.5% of the services prohibited immediate and uninterrupted skin-to-skin contact between mothers and their infants and did not support mothers to initiate breastfeeding in the first hour. On the postnatal ward, 98.5% of the services allowed breastfeeding while implementing respiratory hygiene practices to prevent transmission of COVID-19. Companions for mothers were forbidden in 83.3% of the hospitals. Hospital discharge was mostly between 24 and 28 h (79.1%); discharge guidelines were not individualized. Additionally, a lack of support was noticed from the home environment’s health community network (83.3%). Hospital and home breast pumping were allowed (87.5%), but breast milk donation was not accepted (95.8%). There was a lack of guidance regarding the use of infant comforting strategies. Guidelines specific for vulnerable populations were not covered in the material evaluated. Conclusions In Brazil, hospitals have not followed recommendations to protect, promote, and support breastfeeding during the COVID-19 outbreak. The disagreement between international guidelines has been a major issue. The absence of recommendations on breastfeeding support during the pandemic led to difficulties in developing standards among hospitals in different regions of Brazil and other countries worldwide. The scientific community needs to discuss how to improve maternal and infant care services to protect breastfeeding in the current pandemic.


2021 ◽  
pp. sextrans-2020-054768
Author(s):  
Iain Hyndman ◽  
Diarmuid Nugent ◽  
Gary George Whitlock ◽  
Alan McOwan ◽  
Nicolò Girometti

ObjectivesThe COVID-19 pandemic and its related restrictions have affected attendance to and delivery of UK sexual healthcare services (SHS). We surveyed the impact on sexual behaviour of men having sex with men (MSM) to inform future SHS provision.MethodsWe conducted a cross-sectional, anonymous, web-based survey among HIV-negative MSM at high risk of HIV infection who attended 56 Dean Street, a sexual health and HIV clinic. The survey was conducted over a 7-day period in August 2020. Data on sociodemographic characteristics, sexual behaviour and related mental well-being experienced during lockdown (defined as 23 March–30 June 2020) were extracted. Categorical and non-categorical variables were compared according to HIV pre-exposure prophylaxis (PrEP) use.Results814 MSM completed the questionnaire: 75% were PrEP users; 76% reported they have been sexually active, of which 76% reported sex outside their household. 75% reported fewer partners than prior to lockdown. Isolation/loneliness (48%) and anxiety/stress (27%) triggered sexual activity, and 73% had discussed COVID-19 transmission risks with their sexual partners. While 46% reported no change to emotions ordinarily experienced following sex, 20% reported guilt for breaching COVID-19 restrictions. 76% implemented one or more changes to their sexual behaviour, while 58% applied one or more steps to reduce COVID-19 transmission during sex. 36% accessed SHS and 30% reported difficulties in accessing testing/treatment. Of those who accessed SHS, 28% reported an STI diagnosis. PrEP users reported higher partner number, engagement in ‘chemsex’ and use of SHS than non-PrEP users.ConclusionsCOVID-19 restrictions had a considerable impact on sexual behaviour and mental well-being in our survey respondents. High rates of sexual activity and STI diagnoses were reported during lockdown. Changes to SHS provision for MSM must respond to high rates of psychological and STI-related morbidity and the challenges faced by this population in accessing services.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 974.2-974
Author(s):  
A. Gunay ◽  
A. Davidson ◽  
I. Colmegna ◽  
D. Lacaille ◽  
H. Loewen ◽  
...  

Background:Increased awareness of the efficacy of MTX in rheumatic disease is leading to more MTX use in patients from HIV endemic areas. While HIV related immunosuppression may contribute to improvement of some rheumatic diseases, immune reconstitution from highly active antiretroviral therapy (HAART) may lead to exacerbation or presentation of autoimmune disorders for which MTX therapy may be warranted. Most management guidelines for rheumatic disease do not address MTX use in the context of HIV.Objectives:To systematically review the published literature on the safety of using MTX ≤30 mg per week in HIV.Methods:We searched CINAHL, Embase, Global, MEDLINE and World of Science databases (Jan 1990 to May 2018) for terms including ‘methotrexate’ and ‘human immunodeficiency virus’. We also searched citations from review articles. Titles, abstracts or full manuscripts were screened independently by 2 reviewers to identify studies reporting HIV in patients taking MTX. Study quality was assessed using the McGill Mixed Methods Appraisal Tool (MMAT). Data was extracted on MTX and HIV adverse events (MTX toxicity, HIV viral load, CD4 count). Descriptive summaries are presented for studies providing outcomes in patients taking MTX ≤30 mg per week.Results:After removing duplicates and studies not meeting criteria or not providing sufficient information, 42 of the 2714 identified reports were included (1 clinical trial, 2 cohort, 1 cross-sectional study, 38 case reports/case series). Most reports (81%) originated from USA or Europe. Study quality was generally good with most studies fulfilling 50-100% of MMAT criteria. The randomized controlled trial (USA) assessing MTX on atherosclerotic disease in HIV showed that adverse events were more common in MTX versus placebo (12.8% vs 5.6%, p non-inferiority <0.05) and included infection, transient CD4 and CD8 drop, pulmonary toxicity, and death (1 attributed to MTX/HIV, 1 unrelated). One cohort study (South Africa) reported 43 RA patients on MTX who acquired HIV. In this cohort, RA generally improved despite only 5 individuals continuing MTX. No data on MTX adverse event rates was reported. One cohort study (USA) reported 13 HIV patients with myositis. One received MTX (with other immunosuppression) without MTX adverse effects but died due to AIDS. A cross-sectional study (France) of 43 HIV pts with autoimmune disease reported one patient on MTX (and other immunosuppression) developed an adverse event (cytopenia) compared to 5/33 patients not on MTX (cytopenia). The 38 case reports/series described 54 individuals with HIV receiving MTX. Of these studies, 27 (describing 42 subjects) reported on MTX adverse events and 35 (describing 46 subjects) reported on HIV adverse events. MTX adverse events developed in 29 subjects (hematologic 13, renal/hepatic 1, opportunistic infections 10, other events 2). HIV adverse events were noted in 23 subjects (Kaposi’s sarcoma 4, CD4 decrease 16, HIV viral titer increase 4). Five deaths were reported (2 infection, 1 infection and wasting, 2 HIV related deaths). Most subjects also received corticosteroids or other immunosuppressants including biologics.Conclusion:There remains limited data on the safety of low dose MTX in HIV. Surveillance for HIV is warranted for individuals on MTX who are at risk for acquiring HIV. Caution and careful monitoring for MTX toxicity, opportunistic infections and HIV state is suggested if MTX is used in the setting of HIV particularly if combined with other immunosuppression.References:[1] Clin Infectious Disease 2019:68[2] J Rheumatology 2014:41[3] Arthritis and Rheumatism 2003:49[4] Medicine 2017:96Acknowledgments :Funding from International League Against RheumatismMcGill University Global Health Scholar AwardsDisclosure of Interests:Alize Gunay: None declared, Anna Davidson: None declared, Ines Colmegna: None declared, Diane Lacaille: None declared, Hal Loewen: None declared, Michele Meltzer: None declared, Yewondwossen Mengistu: None declared, Rosie Scuccimarri: None declared, Zenebe Yirsaw: None declared, Sasha Bernatsky: None declared, Carol Hitchon Grant/research support from: UCB Canada; Pfizer Canada


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