scholarly journals HBcAb Positivity Increases the Risk of Severe Hepatic Fibrosis Development in HIV/HCV-Positive Subjects From the ICONA Italian Cohort of HIV-Infected Patients

2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Vincenzo Malagnino ◽  
Carlotta Cerva ◽  
Antonella Cingolani ◽  
Francesca Ceccherini-Silberstein ◽  
Alessandra Vergori ◽  
...  
Keyword(s):  
Hiv Transmission ◽  
Cox Regression ◽  
Careful Monitoring ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
B Virus ◽  
Aids Diagnosis ◽  
Cd4 Cell ◽  
The Impact ◽  
Italian Cohort

Abstract Background The aim of this study was to investigate the impact of anti-HBc (HBcAb) positivity on the progression of liver fibrosis (Fibrosis-4 score >3.25) in the Italian cohort of HIV-infected individuals naïve to antiretroviral treatment (ICONA). Methods All patients with FIB-4 <3.25 at baseline were evaluated prospectively: 6966 people with HIV (PWH) were screened and classified based on hepatitis B virus (HBV) and hepatitis C virus (HCV) serology. Results Patients who were HBcAb+/HCV-/HBs antigen (HBsAg)- and HCV+/HBcAb+/HBsAg- or HBsAg+/HBcAb+/HCV- had CD4+ cell counts below the nadir and significantly higher prevalence of AIDS diagnosis at baseline than the other groups (P < .0001). A Cox regression model adjusted for age, HIV transmission mode, country of birth, and alcohol consumption showed a higher relative risk (HR) of progression to FIB-4 >3.25 in HCV+/HBcAb+/HBsAg- patients (HR, 7.2; 95% CI, 3 8–13.64). Conclusions HBcAb+ contributes to liver damage in HIV+/HCV+/HBcAb+/HBsAg- subjects. A careful monitoring for signs of previous HBV infection is needed in this kind of patients.

scholarly journals The impact of a very high purity factor VIII concentrate on the immune system of human immunodeficiency virus-infected hemophiliacs: a randomized, prospective, two-year comparison with an intermediate purity concentrate [see comments]

Blood ◽  
1991 ◽  
Vol 78 (8) ◽  
pp. 1919-1922 ◽  
Author(s):  
R de Biasi ◽  
A Rocino ◽  
E Miraglia ◽  
L Mastrullo ◽  
AA Quirino
Keyword(s):  
Human Immunodeficiency Virus ◽  
High Purity ◽  
Skin Testing ◽  
Clinical Status ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Immunodeficiency Virus ◽  
Cd4 Cell ◽  
The Impact ◽  
Very High

Abstract Pathophysiologic considerations as well as non-comparative clinical results suggest that very high purity concentrates may slow immunologic deterioration in human immunodeficiency virus (HIV)-infected hemophiliacs. In an attempt to evaluate this hypothesis, we prospectively compared CD4 cell counts, skin testing responses, and changes of the clinical status in 20 asymptomatic HIV-positive hemophiliacs, randomly assigned to continue the treatment with an intermediate purity concentrate or to receive a very high purity product, purified by immunoaffinity chromatography with monoclonal antibodies. In the group switched to the very high purity concentrate there was no significant change of the CD4 cell counts over the 96-week follow-up period, whereas in the group continued on the intermediate purity concentrate, a highly significant decline was detected (P less than .013). Furthermore, in the very high purity group, four of six anergic patients at entry acquired reactivity to skin testing. The results of this study clearly support the use of very high purity concentrates for the replacement therapy of HIV-infected hemophiliacs.

scholarly journals Effect of Macrolide Prophylactic Therapy on AIDS-Defining Conditions and HIV-Related Mortality

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S59-S59
Author(s):  
Mark Kristoffer Pasayan ◽  
Mary Lorraine Mationg ◽  
David Boettiger ◽  
Wilson Lam ◽  
Fujie Zhang ◽  
...  
Keyword(s):  
Sensitivity Analyses ◽  
Immune Recovery ◽  
Combination Antiretroviral Therapy ◽  
Cd4 Counts ◽  
Art Initiation ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Cd4 Cell ◽  
The Impact ◽  
Related Mortality

Abstract Background Mycobacterium avium–intracelllulare complex (MAC) prophylaxis is recommended for patients with CD4 counts of < 50 cells/mm3. With the significant decrease in incidence of disseminated MAC infection and the effective immune recovery due to the availability of combination antiretroviral therapy (ART), the benefits of giving MAC prophylaxis were investigated. This study examined the impact of macrolide prophylaxis on AIDS-defining conditions and HIV-associated mortality in a cohort of HIV-infected patients on ART. Methods TREAT Asia HIV Observational Database (TAHOD) patients aged ≥18 years with a CD4 count < 50 cells/mm3 at ART initiation were included. The effect of macrolide prohylaxis on HIV-associated mortality or an AIDS event (as a combined outcome) and HIV-associated mortality alone were evaluated using competing risk regression. Sensitivity analysis was conducted to assess whether results were consistent in patients with a CD4 < 100 cells/mm3 at ART initiation. Results Of 1,345 eligible patients (78% male with median age at ART initiation of 34.8 years), 10.6% received macrolide prophylaxis. The rates of the combined outcome and HIV-associated mortality per 100 patient years were 7.35 [95% confidence interval (CI): 6.04–8.95] and 3.14 (95% CI: 2.35–4.19), respectively. After adjusting for possible confounders, macrolide use was associated with a significantly decreased risk of HIV-associated mortality (HR 0.10, 95% CI: 0.01–0.80, P = 0.031) but not the combined outcome (HR 0.86, 95% CI: 0.32–2.229, P = 0.764). Sensitivity analyses showed that, among patients with a CD4 < 100 cells/ mm3 at ART initiation, these results were consistent. Conclusion Macrolide prophylaxis is associated with significantly improved survival among Asian HIV-infected patients with very low CD4 cell counts. The benefits of giving macrolide prophylaxis remain despite the availability of effective ART. Disclosures All authors: No reported disclosures.

Ten-year trends in CD4 cell counts at HIV and AIDS diagnosis in a London HIV clinic

AIDS ◽  
2000 ◽  
Vol 14 (5) ◽  
pp. 561-571 ◽  
Author(s):  
Philippa J. Easterbrook ◽  
Ly Me Yu ◽  
Els Goetghebeur ◽  
Fiona Boag ◽  
Ken McLean ◽  
...  
Keyword(s):  
Hiv And Aids ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Aids Diagnosis ◽  
Cd4 Cell

scholarly journals Disseminated disease due to non-tuberculous mycobacteria in HIV positive patients: A retrospective case control study

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254607
Author(s):  
Nils Wetzstein ◽  
Ari Geil ◽  
Gerrit Kann ◽  
Annette Lehn ◽  
Gundolf Schüttfort ◽  
...  
Keyword(s):  
Case Control Study ◽  
Case Control ◽  
Medical Attention ◽  
Retrospective Case ◽  
Hiv Patients ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Cd4 Cell ◽  
The Impact ◽  
Control Study

Introduction Disseminated infection due to non-tuberculous mycobacteria has been a major factor of mortality and comorbidity in HIV patients. Until 2018, U.S. American guidelines have recommended antimycobacterial prophylaxis in patients with low CD4 cell counts, a practice that has not been adopted in Europe. This study aimed at examining the impact of disseminated NTM disease on clinical outcome in German HIV patients with a severe immunodeficiency. Materials and methods In this retrospective case control study, HIV patients with disseminated NTM disease were identified by retrospective chart review and matched by their CD4 cell counts to HIV patients without NTM infection in a 1:1 alocation. Primary endpoints were mortality and time to first rehospitalisation. In addition, other opportunistic diseases, as well as antimycobacterial and antiretroviral treatments were examined. Results Between 2006 and 2016, we identified 37 HIV patients with disseminated NTM disease. Most of them were suffering from infections due to M. avium complex (n = 31, 77.5%). Time to event analysis showed a non-significant trend to higher mortality in patients with disseminated NTM disease (p = 0.24). Rehospitalisation took place significantly earlier in patients with disseminated NTM infections (median 40.5 days vs. 109 days, p<0.0001). Conclusion In this retrospective case control study, we could demonstrate that mortality is not significantly higher in HIV patients with disseminated NTM disease in the ART era, but that they require specialised medical attention in the first months following discharge.

scholarly journals Impact of HBV and HCV coinfection on CD4 cells among HIV-infected patients: a longitudinal retrospective study

2018 ◽  
Vol 12 (11) ◽  
pp. 1009-1018
Author(s):  
Claudinei Mesquita da Silva ◽  
Leyde Daiane de Peder ◽  
Eraldo S Silva ◽  
Isolde Previdelli ◽  
Omar Cleo Neves Pereira ◽  
...  
Keyword(s):  
Genotype 3 ◽  
Cd4 Cell Count ◽  
Hcv Genotype ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Hcv Genotype 1 ◽  
Hcv Coinfection ◽  
Cd4 Cell ◽  
The Impact

Introduction: The impact of hepatitis B virus (HBV) and hepatitis C virus (HCV) coinfection on CD4 cells in patients with human immunodeficiency virus (HIV) is unclear. We aimed to examine the impact of HBV and HCV coinfection on CD4 cell count and CD4/CD8 ratio in adults with HIV. Methodology: We conducted a longitudinal retrospective study in Brazil between January 1, 2002, and June 30, 2016, including 205 patients with HIV monoinfection, 37 with HIV-HBV coinfection, 35 with HIV-HCV coinfection, and 62 with HIV-HCV (48 HCV genotype 1 and 14 HCV genotype 3). Results: Median duration of follow-up was 2,327 (interquartile range: 1,159–3,319) days. An increased CD4 cell count and CD4/CD8 ratio over time was observed in all groups receiving combined antiretroviral therapy (cART). Patients with HIV-HBV or HIV-HCV coinfection and those with HIV monoinfection, showed comparable CD4 cell counts and CD4/CD8 ratios during pre-ART. There was also no statistically significant difference in CD4/CD8 ratio between HIV-HBV or HIV-HCV coinfection groups and the HIV monoinfection group during follow-up on cART. However, CD4 cell counts were significantly lower in HIV-HCV patients than in HIV monoinfection patients during follow-up on cART. HIV patients with HCV genotype 3 coinfection showed significantly lower CD4/CD8 ratio during follow-up on cART than those coinfected with HCV genotype 1 coinfection. No statistically significant effect of coinfection was observed on the efficacy of cART. Conclusions: HIV-infected patients are more likely to show better immunological responses to cART when they are not coinfected with HCV.

scholarly journals The impact of a very high purity factor VIII concentrate on the immune system of human immunodeficiency virus-infected hemophiliacs: a randomized, prospective, two-year comparison with an intermediate purity concentrate [see comments]

Blood ◽  
1991 ◽  
Vol 78 (8) ◽  
pp. 1919-1922
Author(s):  
R de Biasi ◽  
A Rocino ◽  
E Miraglia ◽  
L Mastrullo ◽  
AA Quirino
Keyword(s):  
Human Immunodeficiency Virus ◽  
High Purity ◽  
Skin Testing ◽  
Clinical Status ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Immunodeficiency Virus ◽  
Cd4 Cell ◽  
The Impact ◽  
Very High

Pathophysiologic considerations as well as non-comparative clinical results suggest that very high purity concentrates may slow immunologic deterioration in human immunodeficiency virus (HIV)-infected hemophiliacs. In an attempt to evaluate this hypothesis, we prospectively compared CD4 cell counts, skin testing responses, and changes of the clinical status in 20 asymptomatic HIV-positive hemophiliacs, randomly assigned to continue the treatment with an intermediate purity concentrate or to receive a very high purity product, purified by immunoaffinity chromatography with monoclonal antibodies. In the group switched to the very high purity concentrate there was no significant change of the CD4 cell counts over the 96-week follow-up period, whereas in the group continued on the intermediate purity concentrate, a highly significant decline was detected (P less than .013). Furthermore, in the very high purity group, four of six anergic patients at entry acquired reactivity to skin testing. The results of this study clearly support the use of very high purity concentrates for the replacement therapy of HIV-infected hemophiliacs.

Comparison of Demographic, Epidemiological, Immunological, and Clinical Characteristics of Patients with HIV Mono-infection Versus Patients Co-infected with HCV or/and HBV: A Serbian Cohort Study

2018 ◽  
Vol 16 (3) ◽  
pp. 222-230 ◽  
Author(s):  
J. Ranin ◽  
D. Salemovic ◽  
B. Brmbolic ◽  
J. Marinkovic ◽  
I. Boricic ◽  
...  
Keyword(s):  
Natural History ◽  
Hiv Infection ◽  
Highly Active Antiretroviral Therapy ◽  
Clinical Characteristics ◽  
Cell Counts ◽  
Therapy Initiation ◽  
Cd4 Cell Counts ◽  
History Of ◽  
Cd4 Cell ◽  
The Impact

Objective:The study aimed to correlate the status of hepatitis C (HCV) and hepatitis B virus (HBV) co-infection in patients with human immunodeficiency virus (HIV) infection with clinical and demographic data prior to starting highly active antiretroviral therapy (HAART) and assess the impact of HCV and HBV co-infection on the natural history of HIV infection.Patients and Methods:The study involved a total of 836 treatment-naive patients with available serological status for HBV and HCV at the point of therapy initiation. Patients were stratified into four groups: HIV mono-infection, HIV/HCV, HIV/HBV, and HIV/HCV/HBV co-infection. Demographic, epidemiological, immunological and clinical characteristics were analyzed in order to assess the possible impact of HCV and HBV co-infection on HIV - related immunodeficiency and progression to AIDS.Results:The prevalence of HCV and HBV co-infection in our cohort was 25.7% and 6.3%, respectively. Triple HIV/HCV/HBV infection was recorded in 1.7% of the patients. In comparison with those co-infected with HCV, patients with HIV mono-infection had lower levels of serum liver enzymes activity and higher CD4 cell counts, and were less likely to have CD4 cell counts below100 cells/µL and clinical AIDS, with OR 0.556 and 0.561, respectively. No difference in the development of advanced immunodeficiency and/or AIDS was recorded between patients with HIV monoinfection and those co-infected with HBV, or both HCV/HBV.Conclusion:HIV/HCV co-infection was found to be more prevalent than HIV/HBV co-infection in a Serbian cohort. Co-infection with HCV was related to more profound immunodeficiency prior to therapy initiation, reflecting a possible unfavorable impact of HCV on the natural history of HIV infection.

scholarly journals Higher rate of long-term serologic response of four double doses vs. standard doses of hepatitis B vaccination in HIV-infected adults: 4-year follow-up of a randomised controlled trial

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Romanee Chaiwarith ◽  
Jutarat Praparattanapan ◽  
Wilai Kotarathititum ◽  
Jiraprapa Wipasa ◽  
Kanokporn Chaiklang ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Vaccination Schedule ◽  
Hepatitis B Vaccination ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Undetectable Plasma ◽  
B Virus ◽  
Cd4 Cell ◽  
Hiv 1

Abstract Background We previously reported that four doses or four double doses of hepatitis B vaccination regimens could not significantly increase a response rate compared with standard doses. However, the antibody levels were higher in the four doses and four double doses groups. This study followed those patients for at least 3 years and aimed to evaluate the immunogenicity of the three vaccination regimens. Methods HIV-infected adults who had CD4+ cell counts > 200 cells/mm3, undetectable plasma HIV-1 RNA, and negative for all hepatitis B virus markers were randomly assigned to receive one of three recombinant vaccines (Hepavax-Gene® Berna, Korea) regimens: 20 μg IM at months 0, 1, and 6 (standard doses group, n = 44), 20 μg IM at months 0, 1, 2, 6 (four doses group, n = 44), or 40 μg IM at months 0, 1, 2, and 6 (four double doses group, n = 44) between February 2011 and May 4, 2012. Of 132 participants, 126 were evaluated from August 2015 to January 2016; 42 in the standard doses, 43 in the four doses, and 41 in the four double doses groups. Results At a median duration of 49.7 months (range 46.7–53.7) after completion of the primary vaccination schedule, the percentages of responders with anti-HBs ≥ 10 mIU/mL were 57.1% (95% CI 41.5–72.8%) in the standard doses group; 76.7% (95% CI 63.6–89.9%) in the four doses group (P = 0.067 vs. the standard doses group); and 80.5% (95% CI 67.8–93.2%) in the four double doses group (P = 0.033 vs. the standard doses group). Factors associated with a responder were the vaccination schedule (either four doses or four double doses groups) and a younger age. Conclusions Despite the highly effectiveness of the standard hepatitis B vaccination regimen at 6 months after completion, the long-term immunogenicity was lower than the four double doses regimen among HIV-infected adults with CD4+ cell counts > 200 cells/mm3 and undetectable plasma HIV-1 RNA. The standard vaccination regimen may not be the best strategy to provide long-term immune response against hepatitis B virus among HIV-infected individuals. Trial registration NCT1289106, NCT02713620

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