Emergencies in HIV-positive patients

2010 ◽  
pp. 479-505
Author(s):  
Punit S. Ramrakha ◽  
Kevin P. Moore ◽  
Amir Sam
Keyword(s):  
Hiv Infection ◽  
Hiv Testing ◽  
Hiv Positive ◽  
Hiv Disease ◽  
Primary Hiv Infection ◽  
Clinical Indicator ◽  
Factors Influencing ◽  
Neurological Conditions

Emergency presentations of HIV infection 480 Factors influencing presentation in HIV disease 482 HIV testing 484 Clinical indicator diseases for adult HIV infection 486 Primary HIV infection (PHI) 487 Acute neurological conditions in HIV-positive patients: assessment 488 Acute neurological conditions in HIV-positive patients: investigations 490...

Constitutional Challenges to the Compulsory HIV Testing of Prisoners and the Mandatory Segregation of HIV-Positive Prisoners

1993 ◽  
Vol 73 (3) ◽  
pp. 391-422 ◽  
Author(s):  
KENNETH C. HAAS
Keyword(s):  
Risk Factor ◽  
Drug Use ◽  
Hiv Infection ◽  
Supreme Court ◽  
Hiv Testing ◽  
Intravenous Drug ◽  
Hiv Positive ◽  
Intravenous Drug Use ◽  
Homosexual Activity ◽  
Mandatory Testing

Intravenous drug use is both a common aspect of the pre-imprisonment lifestyles of many American prisoners and a leading risk factor for contracting HIV—the virus that causes AIDS. Moreover, incarcerated inmates frequently engage in behavior that can spread the disease, particularly homosexual activity and intravenous drug use. Correctional officials face increasing pressure to protect inmates and staff from HIV infection, and some have responded by implementing policies requiring all inmates to undergo HIV testing and by housing HIV-positive inmates in separate units. Screening and segregation policies, however, have been challenged on constitutional grounds by HIV-positive prisoners. This article examines the leading constitutional developments in this emerging area of law and finds that most courts so far have been inclined to reject constitutional challenges to mandatory testing and segregation policies. There are enough unsettled issues, however, to warrant expanded appellate review and eventual U.S. Supreme Court resolution of the key constitutional questions.

Symptomatic primary HIV infection or risk experiences? Circumstances surrounding HIV testing and diagnosis among recent seroconverters

2003 ◽  
Vol 14 (9) ◽  
pp. 601-608 ◽  
Author(s):  
Ann N Burchell ◽  
Liviana Calzavara ◽  
Nancy Ramuscak ◽  
Ted Myers ◽  
Carol Major ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Hiv Infection ◽  
Hiv Testing ◽  
Odds Ratio ◽  
Risk Behaviour ◽  
Primary Hiv Infection ◽  
Time Period ◽  
Physician Awareness ◽  
Negative Controls ◽  
Hiv Negative

Our objective was to understand the circumstances surrounding HIV testing among recent HIV seroconverters ( n = 80) compared to HIV-negative controls ( n = 106) in Ontario, Canada using self-reported interview data. Diagnosis of symptomatic primary HIV infection (SPHI) was defined as diagnosis by the participant's physician. Testing in response to symptoms was reported by 42% of seroconverters vs 12% of controls. More controls than seroconverters tested in response to risk behaviour (70% vs 50%) or from a desire to know their status (34% vs 12%). Among seroconverters, 76% reported 'flu-like' illness during the time period of infection, 66% had symptoms consistent with SPHI, and 35% reported a physician's diagnosis of SPHI. Compared to seroconverters with undiagnosed SPHI, more of those diagnosed with SPHI had rash (odds ratio = 4.5). SPHI plays a significant role in HIV testing and subsequent early diagnosis in this population. More seroconversions could be diagnosed with better patient and physician awareness of its symptoms.

scholarly journals The combination of CXCL9, CXCL10 and CXCL11 levels during primary HIV infection predicts HIV disease progression

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Xiaowan Yin ◽  
Zhuo Wang ◽  
Tong Wu ◽  
Meichen Ma ◽  
Zining Zhang ◽  
...  
Keyword(s):  
T Cell ◽  
Hiv Infection ◽  
Cell Count ◽  
Disease Progression ◽  
Risk Score ◽  
Point Group ◽  
Clinical Information ◽  
Hiv Disease ◽  
Set Point ◽  
Primary Hiv Infection

Abstract Background Chemokines are small chemotactic cytokines involved in inflammation, cell migration, and immune regulation in both physiological and pathological contexts. Here, we investigated the profile of chemokines during primary HIV infection (PHI). Methods Fifty-four participants with blood samples before and during HIV infection and clinical information available were selected from an HIV-negative man who have sex with men (MSM) prospective cohort. Thirty chemokines and 10 cytokines were measured pre- and post-HIV infection in the same individuals using a Bio-Plex Pro™ Human Chemokine Panel. Results Levels of 18 chemokines/cytokines changed significantly during PHI relative to pre-HIV infection levels; 14 were up-regulated and 4 down-regulated. Among them, CXCL9, CXCL10, and CXCL11 were the most prominently raised. Levels of CXCL9 and CXCL10 were much higher in the high-set point group (log viral load (lgVL) ≥ 4.5) than those in the low-set point group (lgVL < 4.5) and levels of CXCL9, CXCL10, and CXCL11 were higher in the low-CD4+ T-cell count group (CD4+ T-cell count ≥ 500). A formula to predict HIV disease progression using a combination panel comprising CXCL9, CXCL10, and CXCL11 was developed, where risk score = 0.007 × CXCL9 + 0.004 × CXCL10 − 0.033 × CXCL11 − 1.724, with risk score values higher than the cutoff threshold (0.5211) indicating more rapid HIV disease progression. Conclusions A panel of plasma CXCL9, CXCL10, and CXCL11 measured during primary HIV-1 infection could predict long-term HIV disease prognosis in an MSM group and has potential as a novel biomarker in the clinic.

scholarly journals Fear of HIV Infection and Impact of Training on the Attitudes of Surgical and Emergency Nurses Toward Inpatient HIV Testing

2007 ◽  
Vol 28 (2) ◽  
pp. 230-233 ◽  
Author(s):  
Maria Gańczak ◽  
Peter Barss
Keyword(s):  
Hiv Infection ◽  
Hiv Testing ◽  
Surgical Patients ◽  
Hiv Positive ◽  
Emergency Nurses ◽  
Immunodeficiency Virus ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome ◽  
Testing Policies ◽  
Previous Training

This study evaluates the association between the degree of fear of human immunodeficiency virus (HIV) infection and support for different HIV testing policies. A strong fear of acquiring HIV infection at work was widespread among a sample of 601 Polish surgical and emergency nurses. Most favored inappropriate HIV testing of all surgical patients and inpatients. Previous training about HIV and acquired immunodeficiency syndrome (AIDS) and experience caring for HIV-positive patients had a significant impact on reducing support for testing of all inpatients but not for testing of surgical patients.

A new surveillance system for monitoring HIV infection in Victoria, Australia

Sexual Health ◽  
2007 ◽  
Vol 4 (3) ◽  
pp. 195 ◽  
Author(s):  
Rebecca Guy ◽  
Megan S. C. Lim ◽  
Yung-Hsuan J. Wang ◽  
Nicholas Medland ◽  
Jonathan Anderson ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Hiv Testing ◽  
Surveillance System ◽  
Risk Behaviour ◽  
Anal Intercourse ◽  
Unprotected Anal Intercourse ◽  
Hiv Positive ◽  
Sexual Risk Behaviour ◽  
Hiv Diagnosis ◽  
Hiv Test

Objectives: To establish a new mechanism for monitoring patterns of HIV infection, in the context of a sustained increase in HIV diagnosis among men who have sex with men (MSM) in Victoria. Methods: Between April 2004 and August 2005, a linked voluntary HIV sentinel surveillance system was implemented at five medical clinics with a high case load of MSM. Using a questionnaire, doctors collected HIV testing history, demographic and sexual risk behaviour information from all clients undergoing voluntary HIV testing. Questionnaires were linked with HIV test results. Logistic regression analysis was conducted to determine factors associated with HIV infection. Results: Of 3435 MSM tested for HIV at participating sites, 1.7%, (95% CI = 1.2–2.2) were newly diagnosed with HIV; between 2004 and 2005 the proportion increased from 1.3% (95% CI = 1.2–1.5) to 2.0% (95% CI = 1.8–2.2), P = 0.107. There was no significant change in the number of HIV tests conducted per month or in demographic characteristics, testing history and sexual behaviour characteristics between time periods. In multivariate analysis, reporting unprotected anal intercourse (UAI) with any partner, UAI with a HIV-positive partner/s and being aged 30–39 years or 40 years or greater were significantly associated with HIV infection. Conclusion: This new surveillance mechanism, based on linked testing at participating clinics, indicates that the increase in HIV notifications in 2005 was unrelated to changes in testing and data from a Melbourne sexual behavioural survey suggests the increase was more likely to be attributed to increases in transmission within the past few years. The sentinel system highlighted UAI, especially with HIV positive partner/s are important transmission factors.

HIV testing in Swedish STD clinics 1986-1994

1998 ◽  
Vol 9 (8) ◽  
pp. 457-462 ◽  
Author(s):  
C Anagrius ◽  
A K Ruden ◽  
E Sandstrom
Keyword(s):  
Hiv Infection ◽  
Hiv Testing ◽  
National Policy ◽  
Contact Tracing ◽  
Hiv Positive ◽  
Clinical Routine ◽  
Sex With Men ◽  
Specific Reason

In 1986 Swedish STD clinicians decided on a national policy of offering HIV tests routinely to all their patients. During the period July 1986 through December 1994, 224,722 tests were performed. HIV tests for one or more specific reasons were carried out on 7 of the patients, and 20 requested the test solely because of anxiety. The remaining 73 , accepted the test as part of the clinical routine without giving any specific reason. Of those offered a test, 54 had been tested at least once before. Twenty three per cent did not accept the test. Among those tested, 373 persons 0.2 were found to have a newly detected HIV infection. Contact tracing was the reason for testing in 11 , whilst 32 were tested for other specific reasons, 29 requested testing for no stated specific reason and 28 had been tested as a routine. Of all the tested men who reported sex with men, 7 proved to be HIV positive. The 373 persons with newly detected HIV infection constituted 14 of the total newly detected cases in Sweden during the period in question.

scholarly journals Using repeated home-based HIV testing services to reach and diagnose HIV infection among persons who have never tested for HIV, Chókwè health demographic surveillance system, Chókwè district, Mozambique, 2014–2017

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242281
Author(s):  
Carol Lin ◽  
Isabelle Casavant ◽  
Alicia Jaramillo ◽  
Timothy Green
Keyword(s):  
Hiv Infection ◽  
Hiv Testing ◽  
Surveillance System ◽  
Hiv Prevalence ◽  
Demographic Surveillance System ◽  
Hiv Positive ◽  
Home Based ◽  
Testing Uptake ◽  
Hiv Testing Services ◽  
Testing Coverage

Background HIV prevalence in Mozambique (12.6%) is one of the highest in the world, yet ~40% of people living with HIV (PLHIV) do not know their HIV status. Strategies to increase HIV testing uptake and diagnosis among PLHIV are urgently needed. Home-based HIV testing services (HBHTS) have been evaluated primarily as a 1-time campaign strategy. Little is known about the potential of repeating HBHTS to diagnose HIV infection among persons who have never been tested (NTs), nor about factors/reasons associated with never testing in a generalized epidemic setting. Methods During 2014–2017, counselors visited all households annually in the Chókwè Health and Demographic Surveillance System (CHDSS) and offered HBHTS. Cross-sectional surveys were administered to randomly selected 10% or 20% samples of CHDSS households with participants aged 15–59 years before HBHTS were conducted during the visit. Descriptive statistics and logistic regression were used to assess the proportion of NTs, factors/reasons associated with never having been tested, HBHTS acceptance, and HIV-positive diagnosis among NTs. Results The proportion of NTs decreased from 25% (95% confidence interval [CI]:23%–26%) during 2014 to 12% (95% CI:11% –13%), 7% (95% CI:6%–8%), and 7% (95% CI:6%–8%) during 2015, 2016, and 2017, respectively. Adolescent boys and girls and adult men were more likely than adult women to be NTs. In each of the four years, the majority of NTs (87%–90%) accepted HBHTS. HIV-positive yield among NTs subsequently accepting HBHTS was highest (13%, 95% CI:10%–15%) during 2014 and gradually reduced to 11% (95% CI:8%–15%), 9% (95% CI:6%–12%), and 2% (95% CI:0%–4%) during 2015, 2016, and 2017, respectively. Conclusions Repeated HBHTS was helpful in increasing HIV testing coverage and identifying PLHIV in Chókwè. In high HIV-prevalence settings with low testing coverage, repeated HBHTS can be considered to increase HIV testing uptake and diagnosis among NTs.

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