scholarly journals 1404. Tuberculosis and HIV Coinfection: A Review of 135 Cases Experience of the Infectious Diseases Department- CHU Mohamed VI- Marrakech

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S786-S786
Author(s):  
Zahid Talibi Alaoui ◽  
Mohammed Raiteb ◽  
Fatima Ihbibane ◽  
Nabila Soraa ◽  
noura Tassi
Keyword(s):  
Infectious Diseases ◽  
Hiv Infection ◽  
Extrapulmonary Tuberculosis ◽  
Nucleoside Analogs ◽  
University Hospital ◽  
Male Predominance ◽  
Highly Active ◽  
Hiv Coinfection ◽  
Common Opportunistic Infection ◽  
Lost To Follow Up

Abstract Background Tuberculosis is a health problem in Morocco, which is increasingly indicative of human immunodeficiency virus (HIV) infection. Objective To determine the epidemiological, clinical and paraclinical, therapeutic and evolutionary aspects of tuberculosis and HIV co-infection. Methods we report 135 cases co-infected with HIV and tuberculosis, collected by the infectious diseases department at the Mohammed VI University Hospital in Marrakech. This is a 12-year retrospective study (2007 to 2020) that involved all HIV-infected patients hospitalized for tuberculosis regardless of its location. Results The mean age of the patients was 40 years (17-73 years). A male predominance was noted in 69% of cases. In 74.6% of cases, tuberculosis was indicative of HIV infection. Nine patients were receiving antiretroviral (ARV) treatment at the time of the discovery of tuberculosis. There were 24% pulmonary tuberculosis, 25.3% extrapulmonary tuberculosis and 49% disseminated tuberculosis. Tuberculosis was confirmed in 31.7% of cases. At the time of tuberculosis diagnosis, the average CD4 count was 86 cells / mm. Quadruple therapy with isoniazid, rifampicin, pyrazinamide and ethambutol was started in 83% of patients. The average time to start ARVs was 7 weeks. All patients who received ARVs received a combination therapy comprising the combination of 2 nucleoside analogs and one non-nucleoside analog. At the end of our work, the evolution was favorable in 53% of cases, death occurred in 25% of cases, 18.6% of patients were lost to follow-up, two cases of failure and another of relapse. Immune restoration syndrome was noted in 8 cases. Drug toxicity was observed in 24.5% of patients, 73% of which was related to hepato-toxicity of antibacillary drugs. Conclusion Tuberculosis is the most common opportunistic infection in people with HIV. Despite the advent of highly active triple therapy, tuberculosis is still a major cause of death in HIV positive people. Disclosures All Authors: No reported disclosures

scholarly journals 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

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.

scholarly journals Opportunistic infections in patients with aids admitted to an university hospital of the Southeast of Brazil

2003 ◽  
Vol 45 (2) ◽  
pp. 69-74 ◽  
Author(s):  
Vandack Nobre ◽  
Emanuella Braga ◽  
Abdunnabi Rayes ◽  
José Carlos Serufo ◽  
Pérsio Godoy ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Hiv Infection ◽  
Opportunistic Infections ◽  
University Hospital ◽  
Highly Active ◽  
Female Rate ◽  
Before And After ◽  
Clinical Diagnoses ◽  
Group 2 ◽  
Male To Female

Opportunistic diseases in HIV-infected patients have changed since the introduction of highly active anti-retroviral therapy (HAART). This study aims at evaluating the frequency of associated diseases in patients with AIDS admitted to an university hospital of Brazil, before and after HAART. The medical records of 342 HIV-infected patients were reviewed and divided into two groups: group 1 comprised 247 patients before HAART and, group 2, 95 patients after HAART. The male-to-female rate dropped from 5:1 to 2:1for HIV infection. There was an increase in the prevalence of tuberculosis and toxoplasmosis, with a decrease in Kaposi's sarcoma, histoplasmosis and cryptococcosis. A reduction of in-hospital mortality (42.0% vs. 16.9%; p = 0.00002) has also occurred. An agreement between the main clinical diagnoses and autopsy findings was observed in 10 out of 20 cases (50%). Two patients with disseminated schistosomiasis and 2 with paracoccidioidomycosis are reported. Overall, except for cerebral toxoplasmosis, it has been noticed a smaller proportion of opportunistic conditions related to severe immunosuppression in the post HAART group. There was also a significant reduction in the in-hospital mortality, possibly reflecting improvement in the treatment of the HIV infection.

scholarly journals Infectious morbidity and mortality in the infectious diseases department of the CHU Yalgado Ouédraogo in Burkina Faso in 2019

2021 ◽  
Vol 7 (1) ◽  
pp. 097-100
Author(s):  
Mamoudou Savadogo ◽  
Ismaël Diallo ◽  
K Apoline Sondo
Keyword(s):  
Infectious Diseases ◽  
Hiv Infection ◽  
Public Health Problem ◽  
University Hospital ◽  
Major Public Health Problem ◽  
Pulmonary Infections ◽  
Cross Sectional ◽  
Duration Of Hospitalization ◽  
One Year ◽  
Tract Infections

Introduction: Infectious diseases remain a major public health problem in developing countries. The objective of this study was to determine the epidemiological and clinical profile of infectious pathology in the infectious diseases department of CHU Yalgado Ouédraogo in Ouagadougou. Patients and method: This was a cross-sectional and retrospective study that took place in the infectious diseases department of the Yalgado Ouédraogo University Hospital from January 1, 2019 to December 31, 2019. Were included all patients hospitalized in the said service during the study period. For each patient retained sociodemographic, clinical and diagnostic data were collected. Results: In one year, 159 patients had been hospitalized in the infectious diseases department of the YO UHC. The mean age of the patients was 42±9 years with extremes of 15 and 80 years. The female sex was the most represented (55.5%) with a sex ratio of 0.8. The majority of patients (64%) came from the province of Kadiogo. The most frequently diagnosed infectious diseases were HIV infection (24%), pulmonary infections (21.8%), malaria (14%), dengue fever (9%), urinary tract infections (7.5%), meningitis (3.8%), typhoid fever (3%), rabies (3%), chicken pox (3%), tetanus (3.8%), toxoplasmosis (3.8%), and cutaneous leishmaniosis (3%). The signs of severity presented by our patients were dominated by dyspnea, severe anemia, and severe dehydration. The delay of consultation was 13.5 days and the average duration of hospitalization was 9.8 days, with a hospital mortality of 24%. Conclusion: HIV infection, malaria and pulmonary infections were the most frequent reasons for hospitalization. It is therefore important to strengthen the technical facilities of hospitals for early diagnosis and appropriate management of infectious pathology

Prevalence of and Risk Factors for Low Free Testosterone Levels in Japanese Men with Well-controlled Human Immunodeficiency Virus Infection

2020 ◽  
Vol 18 (5) ◽  
pp. 381-386
Author(s):  
Yusuke Yoshino ◽  
Ichiro Koga ◽  
Yoshitaka Wakabayashi ◽  
Takatoshi Kitazawa ◽  
Yasuo Ota
Keyword(s):  
Risk Factors ◽  
Human Immunodeficiency Virus ◽  
Standard Deviation ◽  
Hiv Infection ◽  
Free Testosterone ◽  
Serum Levels ◽  
University Hospital ◽  
Rapid Decline ◽  
Total Testosterone ◽  
Immunodeficiency Virus

Background: The change in the prevalence of hypogonadism with age in men with human immunodeficiency virus (HIV) infection is subject to debate. Objective: To address this issue, we diagnosed hypogonadism based on serum levels of free testosterone (fTST) rather than total testosterone which is thought to be an inaccurate indicator. We also determined the relationship between age and fTST levels and identified risk factors for hypogonadism in men with HIV infection. Method: We retrospectively reviewed fTST levels and associated clinical factors in 71 wellcontrolled HIV-infected men who were treated at Teikyo University Hospital between April 2015 and March 2016 and who had data available on serum fTST levels, measured >6 months after starting antiretroviral therapy. fTST was measured using radioimmunoassay on blood samples collected in the morning. Risk factors for hypogonadism were identified using Welch’s t-test and multiple regression analysis. Results: The men had a mean (± standard deviation) age of 47.4 ± 13.6 years, and mean (± standard deviation) serum fTST level of 13.0 ± 6.1 pg/mL. Fifteen (21.1%) men had hypogonadism based on a fTST <8.5 pg/mL. Serum fTST levels significantly decreased with age (−0.216 pg/mL/year). Older age and low hemoglobin levels were identified as risk factors for hypogonadism. Conclusion: The men in the study experienced a more rapid decline in fTST levels with age than men in the general population (−0.161 pg/mL/year). Serum fTST levels in men with HIV infection should be monitored, especially in older men and those with low hemoglobin levels.

Benefits and Limits of Antiretroviral Drug Monitoring in Routine Practice

2019 ◽  
Vol 17 (3) ◽  
pp. 190-197
Author(s):  
Thomas Maitre ◽  
Patrice Muret ◽  
Mathieu Blot ◽  
Anne Waldner ◽  
Michel Duong ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Therapeutic Range ◽  
Drug Monitoring ◽  
Antiretroviral Treatment ◽  
University Hospital ◽  
Therapeutic Drug ◽  
Routine Practice ◽  
Hiv Viral Load ◽  
Measured Concentration ◽  
The University

Background: HIV infection is a chronic disease for which therapeutic adherence and tolerance require particular attention. Objective: This study aimed to assess whether and when therapeutic drug monitoring (TDM) could be associated with a benefit in routine practice. Methods: All HIV-infected patients who underwent at least one TDM at the University Hospital of Dijon (France) between 1st January 2009 and 31st December 2012 were retrospectively included. Compliance with the recommendations, the results (antiretroviral concentrations), any subsequent therapeutic modifications, and the virological results at 4-8 months were analysed each time TDM was performed. TDM was defined as “practically relevant” when low or high antiretroviral concentrations led to a change in therapy. Results: Of the 571 patients who followed-up, 43.4% underwent TDM. TDM complying with recommendations (120 patients) was associated with a higher proportion of antiretroviral concentrations outside the therapeutic range (p=0.03). Antiretroviral treatment was modified after TDM in 22.6% of patients. Protease inhibitors, non-nucleoside reverse transcriptase inhibitors and raltegravir were more significantly modified when the measured concentration was outside the therapeutic range (p=0.008, p=0.05 and p=0.02, respectively). Overall, 11.7% of TDM was considered “practically relevant”, though there was no significant correlation between subsequent changes in antiretroviral treatment and undetectable final HIV viral load. Conclusions: TDM may be a useful tool in the management of HIV infection in specific situations, but the overall benefit seems moderate in routine practice. TDM cannot be systematic and/or a decision tool per se, but should be included in a comprehensive approach in certain clinical situations.

scholarly journals Primary Care Guidelines for the Management of Persons Infected With HIV: 2013 Update by the HIV Medicine Association of the Infectious Diseases Society of America

2013 ◽  
Vol 58 (1) ◽  
pp. e1-e34 ◽  
Author(s):  
Judith A. Aberg ◽  
Joel E. Gallant ◽  
Khalil G. Ghanem ◽  
Patricia Emmanuel ◽  
Barry S. Zingman ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Hiv Infection ◽  
Healthcare Providers ◽  
Health Problems ◽  
Antiretroviral Drugs ◽  
New Information ◽  
Immunodeficiency Virus ◽  
Care Guidelines ◽  
Evidence Based Guidelines ◽  
Specific Health

Abstract Evidence-based guidelines for the management of persons infected with human immunodeficiency virus (HIV) were prepared by an expert panel of the HIV Medicine Association of the Infectious Diseases Society of America. These updated guidelines replace those published in 2009. The guidelines are intended for use by healthcare providers who care for HIV-infected patients. Since 2009, new antiretroviral drugs and classes have become available, and the prognosis of persons with HIV infection continues to improve. However, with fewer complications and increased survival, HIV-infected persons are increasingly developing common health problems that also affect the general population. Some of these conditions may be related to HIV infection itself or its treatment. HIV-infected persons should be managed and monitored for all relevant age- and sex-specific health problems. New information based on publications from the period 2009–2013 has been incorporated into this document.

scholarly journals Hematological Profile of HIV-Infected Patients on First-Line Highly Active Antiretroviral Therapy and Its Correlation With CD4 Count

2021 ◽  
Author(s):  
John Jospeh Diamond Princy ◽  
Kshetrimayum Birendra Singh ◽  
Ningthoujam Biplab ◽  
Ningthoukhongjam Reema ◽  
Rajesh Boini ◽  
...  
Keyword(s):  
Platelet Count ◽  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Highly Active Antiretroviral Therapy ◽  
Cd4 Count ◽  
Total Leukocyte Count ◽  
Hiv Patients ◽  
Positive Correlation ◽  
Highly Active ◽  
The Mean

Abstract Introduction Human immunodeficiency virus (HIV) infection is a state of profound immunodeficiency. Disorders of hematopoietic system are a common but often overlooked complication of HIV infection. This can manifest at any stage of the disease but more commonly in the advanced stage with low CD4 count. Anemia is the most common hematological abnormality in HIV patients and prevalence ranges from 1.3 to 95%. As HIV disease progresses, the prevalence and severity of anemia also increase. Hence, this study was undertaken to assess the hematological parameters of HIV-infected patients on highly active antiretroviral therapy (HAART) at different treatment durations with the hope to improve the HAART outcome in HIV patients and its correlation with CD4 count. Methods This prospective longitudinal study enrolled 134 HIV-infected patients admitted to or attending the OPD in the Department of Medicine or Antiretroviral Therapy (ART) Center (Center of Excellence), Regional Institute of Medical Sciences (RIMS), Imphal, Manipur, from 2018 to 2020. Complete hemogram, CD4 count, and other related-blood investigations were studied. Results The mean age of the study population was 39.9 ± 11.04 years. Of the 134 patients, 75 (56%) were males and 59 (44%) were females. Twelve (9%) patients had a history of injecting drug use (IDU). TLE (tenofovir, lamivudine, efavirenz) regimen was started on 112 (83.6%) patients and the majority of them (69/134 [51.5%]) had a CD4 count of 200 to 499 cells/mm3, which increased significantly 6 months after HAART to 99 to 1,149 cells/mm3, with a mean of 445 ± 217 cells/mm3. There were significant improvements in hemoglobin (Hb) levels, total leukocyte count (TLC), absolute neutrophil count (ANC), and absolute lymphocyte count (ALC) after HAART indicating a positive correlation with CD4 count (p < 0.05). Thrombocytopenia was observed higher after HAART when compared to baseline. There was a positive correlation between platelet count and CD4 count. However, the mean corpuscular volume (MCV) and erythrocyte sedimentation rate (ESR) had a negative correlation with CD4 count. Conclusion The study inferred a strong positive correlation between CD4 and Hb levels, TLC, ANC, ALC, and platelet count after HAART with improvement in these values as CD4 count increases. Specific treatment intervention based on the changes in the immunohematological profile trends can help prevent most of the adverse effects on HIV patients in our community.

scholarly journals Hepatic resection in children: highlighted and revisited steps

2019 ◽  
Vol 67 (1) ◽  
Author(s):  
Hesham Mohammed Abdelkader ◽  
Mohamed Abdel-Latif ◽  
Mohamed Abdelsattar ◽  
Ahmed Abdelhaseeb Youssef
Keyword(s):  
Blood Loss ◽  
Liver Tumors ◽  
University Hospital ◽  
Remnant Liver ◽  
Vascular Control ◽  
Biliary Leak ◽  
Intraoperative Bleeding ◽  
Male Predominance ◽  
Different Types ◽  
Minimize Blood Loss

Abstract Background Hepatectomy in children deserves exhaustive preoperative and intraoperative tools to define the anatomy, minimize blood loss, and confirm adequacy of liver tissue left. The aim of this study is to report our experience in surgical management of liver tumors. Results All liver resections performed in Ain-Shams University Hospital, by the same team, between July 2013 and June 2018 were retrospectively reviewed. Data related to basic demographics, indication for resection, methods of parenchymal resection, blood loss, hospital stay, morbidity, and mortality was collected. The study included 27 patients who underwent different types of hepatectomies. There was a male predominance. Age ranged from 6 months to 13 years. Weight ranged from 5.7 to 33.7 kg. Total operative time ranged from 68 to 322 min, while resection time ranged from 34 to 144 min. Blood loss ranged from 53 to 259 ml. Surgical morbidities included five patients with minor biliary leak, three patients had surgical site infection, and one patient had torsion of the remnant liver necessitating repositioning. Recurrence of the mass was faced in three patients with hepatoblastoma. There were two mortalities; one occurred as a sequela of massive intraoperative bleeding and the other took place due to postoperative hepatic insufficiency. Conclusion For a safe hepatectomy, thorough familiarity of the hepatic segmental anatomy together with the various techniques for parenchymal resection and vascular control is fundamental. Complications such as biliary leak and torsion of remnant can be easily avoided by simple measures.

scholarly journals Pharmacist-Driven Antibiotic Stewardship Program in Febrile Neutropenic Patients: A Single Site Prospective Study in Thailand

Antibiotics ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 456
Author(s):  
Kittiya Jantarathaneewat ◽  
Anucha Apisarnthanarak ◽  
Wasithep Limvorapitak ◽  
David J. Weber ◽  
Preecha Montakantikul
Keyword(s):  
Infectious Diseases ◽  
Antibiotic Stewardship ◽  
Empirical Therapy ◽  
University Hospital ◽  
Control Group ◽  
Great Opportunity ◽  
Stewardship Program ◽  
Determine Role ◽  
Neutropenic Patients ◽  
Infectious Diseases Consultation

The antibiotic stewardship program (ASP) is a necessary part of febrile neutropenia (FN) treatment. Pharmacist-driven ASP is one of the meaningful approaches to improve the appropriateness of antibiotic usage. Our study aimed to determine role of the pharmacist in ASPs for FN patients. We prospectively studied at Thammasat University Hospital between August 2019 and April 2020. Our primary outcome was to compare the appropriate use of target antibiotics between the pharmacist-driven ASP group and the control group. The results showed 90 FN events in 66 patients. The choice of an appropriate antibiotic was significantly higher in the pharmacist-driven ASP group than the control group (88.9% vs. 51.1%, p < 0.001). Furthermore, there was greater appropriateness of the dosage regimen chosen as empirical therapy in the pharmacist-driven ASP group than in the control group (97.8% vs. 88.7%, p = 0.049) and proper duration of target antibiotics in documentation therapy (91.1% vs. 75.6%, p = 0.039). The multivariate analysis showed a pharmacist-driven ASP and infectious diseases consultation had a favorable impact on 30-day infectious diseases-related mortality in chemotherapy-induced FN patients (OR 0.058, 95%CI:0.005–0.655, p = 0.021). Our study demonstrated that pharmacist-driven ASPs could be a great opportunity to improve antibiotic appropriateness in FN patients.

Sign in / Sign up

Export Citation Format

Share Document