Endocrine abnormalities in HIV infection

Oxford Textbook of Endocrinology and Diabetes ◽

10.1093/med/9780199235292.003.0186 ◽

2011 ◽

pp. 1563-1575

Author(s):

Takara L. Stanley ◽

Steven K. Grinspoon

Keyword(s):

Antiretroviral Therapy ◽

Hiv Infection ◽

Opportunistic Infections ◽

Sub Saharan Africa ◽

Gonadal Function ◽

Mineral Density ◽

Sub Saharan ◽

Salt And Water Balance ◽

Living With Hiv ◽

Untreated Individuals

Approximately 33 million people worldwide are living with HIV infection, and more than 2 million individuals are newly infected each year (1). Sub-Saharan Africa bears the majority of the disease burden, with 67% of all HIV cases and 75% of all HIV/AIDS related deaths occurring in this region (2). Although access to antiretroviral therapy has improved significantly over the past decade, antiretrovirals are available to only about 30% of those who need them (2). Availability of antiretroviral therapy greatly impacts the endocrine manifestations of HIV infection: individuals treated with antiretrovirals may develop peripheral fat loss, abdominal obesity, insulin resistance, and hyperlipidemia, whereas untreated individuals may develop undernutrition, wasting, and end-organ effects of opportunistic infections such as primary adrenal insufficiency secondary to adrenal destruction (Box 10.2.4.1). In all individuals with HIV infection, regardless of treatment, gonadal function, thyroid function, and bone mineral density may also be decreased, and salt and water balance may be affected (Box 10.2.4.2). The purpose of this chapter is to review the endocrine manifestations of HIV infection, including pathogenesis and treatment.

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OPPORTUNISTIC INFECTIONS DIAGNOSED IN PATIENTS INFECTED WITH THE HUMAN IMMUNODEFICIENCY VIRUS (HIV) AT THE SERVICE OF INFECTIOUS DISEASES OF UHC (UNIVERSITY HOSPITAL CENTER) YALGADO OUÉDRAOGO, BURKINA FASO

10.36106/paripex/7006220 ◽

2021 ◽

pp. 1-2

Author(s):

Savadogo M ◽

Diallo I ◽

Sondo K A

Keyword(s):

Infectious Diseases ◽

Hiv Infection ◽

Opportunistic Infection ◽

Antiretroviral Treatment ◽

Opportunistic Infections ◽

Sub Saharan Africa ◽

University Hospital ◽

Cross Sectional ◽

Sub Saharan ◽

Living With Hiv

Introduction: Sub-Saharan Africa remains one of the regions most affected by HIV infection with severe lethality.Most deaths of patients living with HIV are caused by opportunistic infections. Objective: to determine the prevalence of opportunistic infections among patients living with HIV in hospital serving infectious diseases of UHC YO of Ouagadougou. Patients and Methods:This is a cross-sectional descriptive study covering a 14-month period from 1 January 2017 to 28 February 2018. Included were all HIV-positive patients, hospitalized at the service of Infectious Diseases, in which an opportunistic infection was diagnosed on the basis of clinical and/or para-clinical arguments. Results: During the study period a total of 55 patients living with HIV were hospitalized in the infectious disease unit,35 of whom had at least one opportunistic infection or 63.6% of the patients.The average age of patients was 37 years with extremes of 18 and 66 years.Twenty-two patients were female versus 13 male, a sex ratio = 0.59. HIV1 was involved in 97% of patients.The mean TCD4 lymphocyte rate was 156 cell/mm3 with extremes of 7 and 718 cell/mm3.Tuberculosis and digestive mycosis were the most frequently diagnosed opportunistic infections. Opportunistic infection was the circumstance for HIV testing in two patients.She revealed immune restoration syndrome in two other patients.Nineteen patients were already on antiretroviral treatment upon admission to the service.Half of the patients on treatment were in therapeutic failure.The evolution was marked by 26.5% lethality. Conclusion:The frequency of opportunistic infections is high in patients living with HIV.Their prevention requires early detection of HIV infection and antiretroviral treatment.

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Faculty Opinions recommendation of Early versus delayed initiation of antiretroviral therapy for concurrent HIV infection and cryptococcal meningitis in sub-saharan Africa.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.3212959.2897058 ◽

2010 ◽

Author(s):

Jeremy Day

Keyword(s):

Antiretroviral Therapy ◽

Hiv Infection ◽

Cryptococcal Meningitis ◽

Sub Saharan Africa ◽

Delayed Initiation ◽

Sub Saharan

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Migration as a Risk Factor for HIV Infection among Youths in Sub-Saharan Africa

The Annals of the American Academy of Political and Social Science ◽

10.1177/0002716213482440 ◽

2013 ◽

Vol 648 (1) ◽

pp. 136-158 ◽

Cited By ~ 4

Author(s):

Monica A. Magadi

Keyword(s):

Risk Factor ◽

Hiv Infection ◽

Urban Areas ◽

Young Female ◽

Sub Saharan Africa ◽

Demographic And Health Surveys ◽

Country Level ◽

Female Migrants ◽

Sub Saharan ◽

Living With Hiv

Of the estimated 10 million youths living with HIV worldwide, 63 percent live in sub-Saharan Africa. This article focuses on migration as a risk factor of HIV infection among the youths in sub-Saharan Africa. The study is based on multilevel modeling, applied to the youth sample of the Demographic and Health Surveys (DHS), conducted from 2003 to 2008 in nineteen countries. The analysis takes into account country-level and regional-level variations. The results suggest that across countries in sub-Saharan Africa, migrants have on average about 50 percent higher odds of HIV infection than nonmigrants. The higher risk among migrants is to a large extent explained by differences in demographic and socioeconomic factors. In particular, migrants are more likely to be older, to have been married, or to live in urban areas, all of which are associated with higher risks of HIV infection. The higher risk among youths who have been married is particularly pronounced among young female migrants.

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Community Education in New HIV Prevention Technologies Research

Handbook of Research on Technoethics ◽

10.4018/978-1-60566-022-6.ch022 ◽

2009 ◽

pp. 328-338

Author(s):

Busi Nkala

Keyword(s):

Hiv Infection ◽

Community Involvement ◽

New Technologies ◽

Community Education ◽

Sub Saharan Africa ◽

Contributing Factors ◽

Survival Sex ◽

Sub Saharan ◽

Living With Hiv ◽

Health Programmes

An estimated 39.5 million people are living with HIV worldwide. There were 4.3 million new infections in 2006 with 2.8 million (65%) of these occurring in sub-Saharan Africa with important increases in Eastern Europe and Central Asia, where there are some indications that infection rates have risen by more than 50% since 2004. In 2006, 2.9 million people died of AIDS-related illnesses (UNAIDS, 2006). The continued increase in new HIV infection is a call for concern. It is imperative that more innovative ways of combating the infections are found sooner. There is an enormous body of evidence that HIV infection is caused mainly by sexual contact. There is also undisputed evidence that there are other contributing factors such as extreme poverty, survival sex, gender inequality, lack of education, fatalism, religious barriers and others. This chapter seeks to support the need to do more research in finding new technologies and innovative ways of dealing with the spread of HIV. The chapter suggests that the involvement of researched communities be effectively involved. Involving communities in finding solutions will help, in that research protocols and health programmes will take into account the cultural acceptability of the new technologies and systems and ensure that recipients of health services become effective organs of change. The chapter seeks to highlight the fact that, if the recipients are involved in all stages of development of health programmes, including technologies, we may begin to see changes in how new technologies are taken up or may shift toward getting technologies that are acceptable. There are various suggested and implemented ways which aid in achieving the protection for individuals and communities; such as community involvement, community participation and community education (Collins, 2002; Gupta 2002), this chapter will focus on community education and a proposal for a community principle.

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Mapping evidence on adolescents’ HIV-positive status disclosure in sub-Saharan Africa: a protocol for a scoping review

Systematic Reviews ◽

10.1186/s13643-020-01546-9 ◽

2020 ◽

Vol 9 (1) ◽

Author(s):

Patience Adzordor ◽

Clement Avoka ◽

Vitalis Bawontuo ◽

Silas Agbesi ◽

Desmond Kuupiel

Keyword(s):

Hiv Infection ◽

Scoping Review ◽

Keyword Search ◽

Sub Saharan Africa ◽

Hiv Positive ◽

People Living With Hiv ◽

Sub Saharan ◽

Living With Hiv ◽

Status Disclosure ◽

Hiv Aids

Abstract Background Sub-Saharan Africa (SSA) homes most of the people living with HIV/AIDS in the world. Adolescents/young people are a vulnerable population and at high risk of HIV infection. Identifying and bridging the research gaps on the disclosure of HIV-positive status among adolescents, particularly to their sexual partners, is essential to inform appropriate policy planning and implementation towards preventing HIV transmission. This study will aim to explore literature and describe the evidence on HIV-positive status disclosure among adolescents in SSA. Methods The framework provided by Arksey and O’Malley’s framework and improved by Levac and colleagues will be used to conduct a scoping review. A keyword search for relevant literature presenting evidence on HIV-positive status disclosure among adolescents in SSA will be conducted in CINAHL, PubMed, Science Direct, Google Scholar, and SCOPUS. Date limitations will be removed, but Boolean terms “AND” and “OR” as well as Medical Subject Headings terms will be included where possible and syntax modified to suit the database during the search. Additional relevant articles will be sought from the reference lists of all included studies using a snowballing method. Two reviewers will independently screen the articles at the abstract and full-text screening phases in order to reduce bias and improve the reliability of this study’s findings. A tabular form will be developed using Microsoft Word and piloted for data extraction. Thematic content analysis will be conducted, and a narrative summary of all relevant outcomes reported. Quality appraisal of the included studies for this proposed study will be performed utilizing the recent mixed methods appraisal tool. Discussion The evidence produced by this review may help inform policy and strategies to reduce the incidence of HIV infection among adolescents and improve social support for adolescents living with HIV/AIDS in SSA. It may also reveal literature gaps to guide future researches to further inform HIV policies for adolescents in SSA. Platforms such as peer review journals, policy briefs, and conferences will be used to disseminate this study’s findings.

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Cytomegalovirus Viremia Associated With Increased Mortality in Cryptococcal Meningitis in Sub-Saharan Africa

Clinical Infectious Diseases ◽

10.1093/cid/ciz864 ◽

2019 ◽

Vol 71 (3) ◽

pp. 525-531 ◽

Cited By ~ 1

Author(s):

Caleb Skipper ◽

Mark R Schleiss ◽

Ananta S Bangdiwala ◽

Nelmary Hernandez-Alvarado ◽

Kabanda Taseera ◽

...

Keyword(s):

Cryptococcal Meningitis ◽

Opportunistic Infections ◽

Survival Rates ◽

Hazard Ratio ◽

Sub Saharan Africa ◽

Persons Living With Hiv ◽

Median Plasma ◽

Sub Saharan ◽

Immunodeficiency Syndrome ◽

Living With Hiv

Abstract Background Cryptococcal meningitis and tuberculosis are both important causes of death in persons with advanced human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). Cytomegalovirus (CMV) viremia may be associated with increased mortality in persons living with HIV who have tuberculosis. It is unknown whether concurrent CMV viremia is associated with mortality in other AIDS-related opportunistic infections. Methods We prospectively enrolled Ugandans living with HIV who had cryptococcal meningitis from 2010–2012. Subsequently, we analyzed stored baseline plasma samples from 111 subjects for CMV DNA. We compared 10-week survival rates among those with and without CMV viremia. Results Of 111 participants, 52% (58/111) had detectable CMV DNA (median plasma viral load 498 IU/mL, interquartile range [IQR] 259–2390). All samples tested were positive on immunoglobin G serology. The median CD4+ T cell count was 19 cells/µL (IQR 9–70) and did not differ by the presence of CMV viremia (P = .47). The 10-week mortality rates were 40% (23/58) in those with CMV viremia and 21% (11/53) in those without CMV viremia (hazard ratio 2.19, 95% confidence interval [CI] 1.07–4.49; P = .03), which remained significant after a multivariate adjustment for known risk factors of mortality (adjusted hazard ratio 3.25, 95% CI 1.49–7.10; P = .003). Serum and cerebrospinal fluid cytokine levels were generally similar and cryptococcal antigen-specific immune stimulation responses did not differ between groups. Conclusions Half of persons with advanced AIDS and cryptococcal meningitis had detectable CMV viremia. CMV viremia was associated with an over 2-fold higher mortality rate. It remains unclear whether CMV viremia in severely immunocompromised persons with cryptococcal meningitis contributes directly to this mortality or may reflect an underlying immune dysfunction (ie, cause vs effect). Clinical Trials Registration NCT01075152.

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