A Technique for Accurate Use of CD4+ Cell Counts

AbstractNon-communicable diseases are increasing faster in HIV/AIDS patients than in the general population. We studied the association between hypertension and other possible confounding factors on viral load and CD4-cell counts in hypertensive and non-hypertensive HIV/AIDS patients receiving antiretroviral therapy (ART) at a large hospital in Eswatini over a 4-year period. We performed a retrospective longitudinal review of the medical records of 560 ART patients divided into non-hypertension and hypertension groups (n = 325 and n = 235) from July 27 to September 8, 2018. Generalized Estimated Equation was used to analyze the longitudinal data. Hypertensive patients were more likely to have improved CD4-cell counts than non-hypertensive patients (OR = 1.83, [1.37–2.44]). ART patients with hypertension were more likely to have detectable viral loads, though not significant (OR = 1.37 [0.77–2.43]). In non-hypertensive patients, second line ART was significantly associated with viral load (OR = 8.61 [2.93–25.34]) and adverse side effects (OR = 3.50 [1.06–11.54]), while isoniazid preventive therapy was significantly associated with CD4-cell counts (OR = 1.68 [1.16–2.45]). In hypertensive patients, factors associated with viral load were WHO HIV stage (OR = 2.84 [1.03–7.85]) and adherence (OR = 8.08 [1.33–49.04]). In both groups, CD4-cell counts significantly and steadily increased over time (p-value < 0.001). Results show a significant association between hypertension and CD4 cell counts but not viral load. In ART patients with and without hypertension, the factors associated with prognostic markers were different. More attention may need to be paid to ART patients with well controlled HIV status to monitoring and controlling of hypertension status.

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Causes and outcomes of hospitalizations among people living with HIV in Georgia’s referral institution, 2012–2017

International Journal of STD & AIDS ◽

10.1177/0956462420984701 ◽

2021 ◽

Vol 32 (7) ◽

pp. 662-670

Author(s):

Nino Rukhadze ◽

Ole Kirk ◽

Nikoloz Chkhartishvili ◽

Natalia Bolokadze ◽

Lali Sharvadze ◽

...

Keyword(s):

Multivariate Analysis ◽

Clinical Immunology ◽

Fatal Outcome ◽

Cd4 Count ◽

People Living With Hiv ◽

Lethal Outcome ◽

Cell Counts ◽

Cd4 Cell Counts ◽

Living With Hiv ◽

Cd4 Cell

We assessed trends in causes and outcomes of hospitalization among people living with HIV (PLWH) admitted to the Infectious Diseases, AIDS and Clinical Immunology Research Center (IDACIRC) in Tbilisi, Georgia. Retrospective analysis included adult PLWH admitted to IDACIRC for at least 24 h. Internationally validated categorization was used to split AIDS admissions into mild, moderate, and severe AIDS. A total of 2085 hospitalizations among 1123 PLWH were registered over 2012–2017 with 65.1% (731/1123) of patients presenting with CD4 count <200. Of 2085 hospitalizations, 931 (44.7%) were due to AIDS-defining illnesses. In 2012, AIDS conditions accounted for 50.3% of admissions compared to 41.6% in 2017 ( p = 0.16). Overall, 167 hospitalizations (8.0%) resulted in lethal outcome. AIDS admissions had higher mortality than non-AIDS admissions (11.5% vs 5.2%, p < 0.0001). Among 167 deceased patients, 137 (82.0%) had CD4 count <200 at admission. In multivariate analysis, factors significantly associated with mortality included severe AIDS versus non-AIDS admission (OR 2.81, 95% CI: 1.10–7.15), CD4 cell counts <50 (OR 4.34, 95% CI: 2.52–7.47), and 50–100 (OR 2.37, 95% CI: 1.27–4.42) versus >200. Active AIDS disease remains a significant cause of hospitalization and fatal outcome in Georgia. Earlier diagnosis of HIV is critical for decreasing AIDS hospitalizations and mortality.

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Increased Hepatitis E Virus Seroprevalence Correlates with Lower CD4+ Cell Counts in HIV-Infected Persons in Argentina

PLoS ONE ◽

10.1371/journal.pone.0160082 ◽

2016 ◽

Vol 11 (7) ◽

pp. e0160082 ◽

Cited By ~ 19

Author(s):

José D. Debes ◽

Maribel Martínez Wassaf ◽

María Belén Pisano ◽

María Beatriz Isa ◽

Martin Lotto ◽

...

Keyword(s):

Hepatitis E Virus ◽

Hepatitis E ◽

Cell Counts ◽

Cd4 Cell Counts ◽

Cd4 Cell

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Factors associated with late presentation of HIV infection in Catalonia, Spain

International Journal of STD & AIDS ◽

10.1258/ijsa.2011.011280 ◽

2012 ◽

Vol 23 (7) ◽

pp. 475-480 ◽

Cited By ~ 19

Author(s):

N Vives ◽

D Carnicer-Pont ◽

P Garcia De Olalla ◽

N Camps ◽

A Esteve ◽

...

Keyword(s):

Hiv Infection ◽

Late Presentation ◽

Late Diagnosis ◽

Cd4 Cell Count ◽

Hiv Surveillance ◽

Factors Associated ◽

Cell Counts ◽

Cd4 Cell Counts ◽

Populations At Risk ◽

Cd4 Cell

We sought to describe the prevalence, trends and factors associated with late diagnosis of HIV infection between 2001 and 2008 in Catalonia, Spain. Adults over 13 years of age with available CD4 cell counts, who were notified to the Catalonia Voluntary HIV Surveillance System between January 2001 and December 2008, were included in the study. Late presentation for HIV infection was defined as a CD4 cell count <350 cells/μL or with an AIDS-defining condition at presentation. Multivariable logistic regression was used to identify factors independently associated with late diagnosis of HIV. Of the 4651 newly diagnosed HIV-infected individuals with available CD4 counts, 2598 (55.9%) were diagnosed late. The proportion of people with a late diagnosis decreased from 60.4% in 2001 to 50% in 2008, a significant trend ( P < 0.001). Older age, male gender, foreign birth, heterosexuality and injecting drug use were independent risk factors for late diagnosis. Strategies to actively promote HIV testing to populations at risk of late diagnosis of HIV or those never attending health systems should be implemented.

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CD4 Cell Counts at HIV Diagnosis among HIV Outpatient Study Participants, 2000–2009

AIDS Research and Treatment ◽

10.1155/2012/869841 ◽

2012 ◽

Vol 2012 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Kate Buchacz ◽

Carl Armon ◽

Frank J. Palella ◽

Rose K. Baker ◽

Ellen Tedaldi ◽

...

Keyword(s):

Hiv Testing ◽

Population Level ◽

Cd4 Count ◽

Hiv Diagnosis ◽

Cell Counts ◽

Late Hiv Diagnosis ◽

Cd4 Cell Counts ◽

The Usa ◽

Study Participants ◽

Cd4 Cell

Background. It is unclear if CD4 cell counts at HIV diagnosis have improved over a 10-year period of expanded HIV testing in the USA.Methods. We studied HOPS participants diagnosed with HIV infection ≤6 months prior to entry into care during 2000–2009. We assessed the correlates of CD4 count <200 cells/mm3at HIV diagnosis (late HIV diagnosis) by logistic regression.Results. Of 1,203 eligible patients, 936 (78%) had a CD4 count within 3 months after HIV diagnosis. Median CD4 count at HIV diagnosis was 299 cells/mm3and did not significantly improve over time (P=0.13). Comparing periods 2000-2001 versus 2008-2009, respectively, 39% and 35% of patients had a late HIV diagnosis (P=0.34). Independent correlates of late HIV diagnosis were having an HIV risk other than being MSM, age ≥35 years at diagnosis, and being of nonwhite race/ethnicity.Conclusions. There is need for routine universal HIV testing to reduce the frequency of late HIV diagnosis and increase opportunity for patient- and potentially population-level benefits associated with early antiretroviral treatment.

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