scholarly journals Contribution of Genetic Background and Clinical Risk Factors to Low-Trauma Fractures in Human Immunodeficiency Virus (HIV)-Positive Persons: The Swiss HIV Cohort Study

2016 ◽  
Vol 3 (2) ◽  
Author(s):  
Thomas Junier ◽  
Margalida Rotger ◽  
Emmanuel Biver ◽  
Bruno Ledergerber ◽  
Catalina Barceló ◽  
...  
Keyword(s):  
Risk Factors ◽  
Human Immunodeficiency Virus ◽  
Cohort Study ◽  
General Population ◽  
Genetic Background ◽  
Incidence Density ◽  
Hiv Positive ◽  
Genome Wide ◽  
Immunodeficiency Virus ◽  
The Impact

Abstract Background.  The impact of human genetic background on low-trauma fracture (LTF) risk has not been evaluated in the context of human immunodeficiency virus (HIV) and clinical LTF risk factors. Methods.  In the general population, 6 common single-nucleotide polymorphisms (SNPs) associate with LTF through genome-wide association study. Using genome-wide SNP arrays and imputation, we genotyped these SNPs in HIV-positive, white Swiss HIV Cohort Study participants. We included 103 individuals with a first, physician-validated LTF and 206 controls matched on gender, whose duration of observation and whose antiretroviral therapy start dates were similar using incidence density sampling. Analyses of nongenetic LTF risk factors were based on 158 cases and 788 controls. Results.  A genetic risk score built from the 6 LTF-associated SNPs did not associate with LTF risk, in both models including and not including parental hip fracture history. The contribution of clinical LTF risk factors was limited in our dataset. Conclusions.  Genetic LTF markers with a modest effect size in the general population do not improve fracture prediction in persons with HIV, in whom clinical LTF risk factors are prevalent in both cases and controls.

scholarly journals Frailty Is Associated With Mortality and Incident Comorbidity Among Middle-Aged Human Immunodeficiency Virus (HIV)–Positive and HIV-Negative Participants

2020 ◽  
Vol 222 (6) ◽  
pp. 919-928 ◽  
Author(s):  
Eveline Verheij ◽  
Gregory D Kirk ◽  
Ferdinand W Wit ◽  
Rosan A van Zoest ◽  
Sebastiaan O Verboeket ◽  
...  
Keyword(s):  
Risk Factors ◽  
Human Immunodeficiency Virus ◽  
Strong Predictor ◽  
Hiv Positive ◽  
Geriatric Population ◽  
Mortality And Morbidity ◽  
Immunodeficiency Virus ◽  
The Impact ◽  
Hiv Negative

Abstract Background Frailty is associated with mortality and morbidity in the general geriatric population, but less is known about its impact among the aging but generally younger population with human immunodeficiency virus (HIV). Methods The impact of frailty on all-cause mortality during 6 years of follow-up and incident comorbidity during 4 years of follow-up was assessed among 598 HIV-positive and 550 comparable HIV-negative participants aged ≥ 45 years of the AGEhIV Cohort Study. Frailty encompasses 5 domains; weight loss, low physical activity, exhaustion, decreased grip strength, and slow gait speed. Presence of ≥ 3 denotes frailty, 1–2 prefrailty, and 0 robust. Multivariable Cox and logistic regression models were used to assess the independent relationships of frailty with both outcomes, adjusting for HIV infection and traditional risk factors. Results At baseline, 7.5% (n = 86) of participants were frail. During follow-up, 38 participants died. Mortality rate was significantly higher among frail participants: 25.7/1000 person-years of follow-up (PYFU) (95% confidence interval [CI], 14.2–46.4) compared with prefrail (7.2/1000 PYFU [95% CI, 4.7–11.2]) and robust (2.3/1000 PYFU [95% CI, 1.1–4.9]). In fully adjusted analyses, frailty remained strongly associated with death (hazard ratio, 4.6 [95% CI, 1.7–12.5]) and incident comorbidity (odds ratio, 1.9 [95% CI, 1.1–3.1]). No interactions were observed between frailty and HIV status in all analyses. Conclusions Frailty is a strong predictor of both mortality and incident comorbidity independent from other risk factors. Clinical Trials Registration NCT01466582.

scholarly journals Prenatal Human Immunodeficiency Virus Testing and Patient Management by Obstetricians in a High Seroprevalence Community

1994 ◽  
Vol 2 (1) ◽  
pp. 25-29
Author(s):  
William R. Robinson ◽  
Michael Fleischer
Keyword(s):  
Risk Factors ◽  
Human Immunodeficiency Virus ◽  
Management Strategies ◽  
Prenatal Testing ◽  
Human Immunodeficiency Virus Testing ◽  
Hiv Positive ◽  
High Seroprevalence ◽  
Immunodeficiency Virus ◽  
Hiv Seropositive ◽  
Virus Testing

Objective: In order to determine the practice habits of obstetricians concerning frequency of prenatal human immunodeficiency virus (HIV) testing and management strategies for HIV-seropositive obstetric patients, we conducted a telephone survey of practicing obstetricians over a 3-month period.Methods: In the New Orleans metropolitan area, 71/104 (68%) obstetricians participated and completed the survey.Results: Of these obstetricians, 43/71 (60.6%) test all new obstetric patients for HIV; 64/71 (84.5%) routinely ask the patients about risk factors for infection; and 28/71 (39.4%) have actually cared for an HIV-positive patient in their practice. Those obstetricians who routinely tested for HIV were more likely to have personally managed an infected patient and more likely to ask about risk factors. The number of obstetricians who would manage infected patients without consultative assistance was 8/71 (11%).Conclusions: We concluded that obstetricians in this community have largely accepted routinely offered prenatal testing and risk assessment, but they have assumed a relatively small role in risk reduction counseling and treatment.

scholarly journals Ischemic Stroke in an HIV Positive Patient: An Initial Presentation of Neurosyphilis

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Kalimullah Jan ◽  
Rebecca Hoe Hui Min ◽  
Tan Seow Yen ◽  
Shekhawat Ravindra Singh
Keyword(s):  
Risk Factors ◽  
Human Immunodeficiency Virus ◽  
Ischemic Stroke ◽  
Final Diagnosis ◽  
Initial Presentation ◽  
Neurological Deficits ◽  
Hiv Positive ◽  
Middle Cerebral Artery Territory ◽  
Immunodeficiency Virus ◽  
High Index Of Suspicion

Ischemic stroke occurring in patients with human immunodeficiency virus (HIV) needs to be approached with a vast differential diagnosis in mind. We report a case of middle-aged male patient with immune reconstituted HIV on therapy without known cardiovascular risk factors who had a right middle cerebral artery territory infarct. After a thorough evaluation, he received a final diagnosis of neurosyphilis-associated vasculitis leading to stroke. He recovered without any neurological deficits following treatment with intravenous benzylpenicillin. Neurosyphilis is an easily diagnosed and treatable cause of a stroke that can be an initial presentation of neurosyphilis but requires a high index of suspicion.

scholarly journals Aktinomikosis di tonsil lingualis dan supraglotis sebagai manifestasi klinis pertama pada pasien imunokompromais

2017 ◽  
Vol 47 (1) ◽  
pp. 81
Author(s):  
Raden Isma Nurul Aini ◽  
Sinta Sari Ratunanda ◽  
W. Wijana ◽  
Agung Dinasti Permana ◽  
Sally Mahdiani
Keyword(s):  
Risk Factors ◽  
Human Immunodeficiency Virus ◽  
Case Reports ◽  
Upper Esophageal Sphincter ◽  
Hiv Positive ◽  
Lingual Tonsil ◽  
Immunodeficiency Virus ◽  
Swallowing Difficulty ◽  
Esophageal Sphincter

Latar belakang: Aktinomikosis merupakan infeksi bakteri kronis yang jarang ditemukan (1:300.000orang per tahun). Berbagai faktor risiko dapat mengakibatkan infeksi tersebut, sehingga pengobatan perludilakukan berdasarkan etiologi dan faktor risiko.Tujuan: Melaporkan dan menganalisis kasus yangjarang, yaitu aktinomikosis di hipofaring dan laring pada penderita dengan HIV-positive, yang menutupidua-pertiga inlet laring dan sfingter esofagus atas.Kasus: Laki-laki berusia 21 tahun datang dengankeluhan sulit menelan dan rasa mengganjal di tenggorok sejak 2 bulan. Pada pemeriksaan rinolaringoskopididapatkan massa berbenjol pada tonsil lingualis dan supraglotis. Hasil biopsi menunjukkan peradangankronis karena Actinomyces sp. Metode: Pencarian literatur dilakukan melalui Pubmed, Proquest, ClinicalKey, dan Google Scholar, dengan tidak membatasi tahun pencarian jurnal. Berdasarkan kriteria inklusi daneksklusi, didapatkan tiga artikel yang telah dilakukan critical appraisal. Hasil: Tidak ditemukan publikasimengenai kasus aktinomikosis servikofasial pada pasien dengan human immunodeficiency virus (HIV)positif. Tiga artikel yang ditemukan menunjukkan bahwa aktinomikosis dapat timbul pada pasien yangimunokompromais dalam jangka waktu lama. Pada tiga artikel yang dianalisis, manajemen aktinomikosisdapat dilakukan dan memberikan hasil yang baik karena telah diketahui faktor risiko sebelumnya. Namunpada kasus ini, infeksi HIV (+) sebagai faktor risiko baru ditemukan setelah manajemen aktinomikosis,dengan tindakan pembedahan dan medikamentosa sehingga memengaruhi outcome dari manajemen pasientersebut.Kesimpulan: Analisis faktor risiko pada aktinomikosis, seperti keadaan defisiensi imun akibatinfeksi HIV, perlu diinvestigasi secara mendalam sehingga dapat memperbaiki outcome manajemen pasien.Kata kunci: Aktinomikosis, disfagia, faktor risiko, defisiensi imun, human immunodeficiency virus ABSTRACTSBackground: Actinomycosis is a rare chronic bacterial infection that could be found in humans(incidence rate is 1 per 300,000 per year). There are various risk factors which can promote infection,and the treatment should be based on etiology and risk factors. Purpose: To present and analyse a caseof HIV-positive 21-year-old man with cervicofacial actinomycosis in hypopharynx and larynx, closingtwo-third of laryngeal inlet and upper esophageal sphincter. Case: A 21-years old man came with chiefcomplain of swallowing difficulty and blocking sensation in the throat. Rhinolaryngoscopy revealedcauliflower-like masses on lingual tonsil and supraglottic. Biopsy result showed chronic inflammation dueto Actinomyces sp. Method: Search of literatures was conducted on Pubmed, Proquest, Clinical Key, andGoogle Scholar without limiting years of journals. Based on the inclusion and exclusion criteria, threearticles were obtained as full texts and considered useful for the authors to be analysed. Result: Authorsdid not find any case reports and other papers discussing cervicofacial actinomycosis with HIV-positivein national and international journals. Three articles revealed that infection due to Actimomyces sp. wasrelated with long-term immunosuppressed conditions. In these articles, actinomycosis managementsshowed good response since their risk factors were known. However in our case, HIV as a predisposingfactor was discovered postoperatively, and after pharmacological treatment of actinomycosis had beenadministerred, affecting outcome and next management of this patient. Conclusion: In-depth analysisof actinomycosis predisposing factors, HIV infection should be included in order to improve the patientmanagement outcome. Keywords: Actinomycosis, risk factor, immunocompromised, human immunodeficiency virus

scholarly journals Incidence and Risk Factors for Invasive Pneumococcal Disease and Community-acquired Pneumonia in Human Immunodeficiency Virus–Infected Individuals in a High-income Setting

2019 ◽  
Vol 71 (1) ◽  
pp. 41-50 ◽  
Author(s):  
Hannah M Garcia Garrido ◽  
Anne M R Mak ◽  
Ferdinand W N M Wit ◽  
Gino W M Wong ◽  
Mirjam J Knol ◽  
...  
Keyword(s):  
Risk Factors ◽  
Human Immunodeficiency Virus ◽  
General Population ◽  
Confidence Interval ◽  
Incidence Rate ◽  
Pneumococcal Disease ◽  
Incidence Rates ◽  
Community Acquired Pneumonia ◽  
Cd4 Counts ◽  
Immunodeficiency Virus

Abstract Background Although people living with human immunodeficiency virus (PLWH) are at increased risk of invasive pneumococcal disease (IPD) and community-acquired pneumonia (CAP), it is unclear whether this remains the case in the setting of early initiation of combination antiretroviral therapy (cART), at high CD4 cell counts. This is important, as pneumococcal vaccination coverage in PLWH is low in Europe and the United States, despite longstanding international recommendations. Methods We identified all CAP and IPD cases between 2008 and 2017 in a cohort of PLWH in a Dutch HIV referral center. We calculated incidence rates stratified by CD4 count and cART status and conducted a case-control study to identify risk factors for CAP in PLWH receiving cART. Results Incidence rates of IPD and CAP in PLWH were 111 and 1529 per 100 000 patient-years of follow-up (PYFU). Although IPD and CAP occurred more frequently in patients with CD4 counts <500 cells/μL (incidence rate ratio [IRR], 6.1 [95% confidence interval, 2.2–17] and IRR, 2.4 [95% confidence interval, 1.9–3.0]), the incidence rate in patients with CD4 counts >500 cells/μL remained higher compared with the general population (946 vs 188 per 100 000 PYFU). All IPD isolates were vaccine serotypes. Risk factors for CAP were older age, CD4 counts <500 cells/μL, smoking, drug use, and chronic obstructive pulmonary disease. Conclusions The incidence of IPD and CAP among PLWH remains higher compared with the general population, even in those who are virally suppressed and have high CD4 counts. With all serotyped IPD isolates covered by pneumococcal vaccines, our study provides additional argumentation against the poor current adherence to international recommendations to vaccinate PLWH.

scholarly journals The Role of Human Immunodeficiency Virus (HIV) Asymptomatic Status When Starting Antiretroviral Therapy on Adherence and Treatment Outcomes and Implications for Test and Treat: The Swiss HIV Cohort Study

2020 ◽  
Author(s):  
Tracy R Glass ◽  
Huldrych F Günthard ◽  
Alexandra Calmy ◽  
Enos Bernasconi ◽  
Alexandra U Scherrer ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Cohort Study ◽  
Viral Load ◽  
Antiretroviral Therapy ◽  
Clinical Outcomes ◽  
Unprotected Sex ◽  
Test And Treat ◽  
Universal Test And Treat ◽  
Immunodeficiency Virus ◽  
The Impact

Abstract Background Since the advent of universal test-and-treat , more people living with human immunodeficiency virus (PLHIV) initiating antiretroviral therapy (ART) are asymptomatic with a preserved immune system. We explored the impact of asymptomatic status on adherence and clinical outcomes. Methods PLHIV registered in the Swiss HIV Cohort Study (SHCS) between 2003 and 2018 were included. We defined asymptomatic as Centers for Disease Control and Prevention stage A within 30 days of starting ART, non-adherence as any self-reported missed doses and viral failure as two consecutive viral load>50 copies/mL after >24 weeks on ART. Using logistic regression models, we measured variables associated with asymptomatic status and adherence and Cox proportional hazard models to assess association between symptom status and viral failure. Results Of 7131 PLHIV, 76% started ART when asymptomatic and 1478 (22%) experienced viral failure after a median of 1.9 years (interquartile range, 1.1–4.2). In multivariable models, asymptomatic PLHIV were more likely to be younger, men who have sex with men, better educated, have unprotected sex, have a HIV-positive partner, have a lower viral load, and have started ART more recently. Asymptomatic status was not associated with nonadherence (odds ratio, 1.03 [95% confidence interval {CI}, .93–1.15]). Asymptomatic PLHIV were at a decreased risk of viral failure (adjusted hazard ratio, 0.87 [95% CI, .76–1.00]) and less likely to develop resistance (14% vs 27%, P < .001) than symptomatic PLHIV. Conclusions Despite concerns regarding lack of readiness, our study found no evidence of adherence issues or worse clinical outcomes in asymptomatic PLHIV starting ART.

Prevalence of and Risk Factors for Nasal Colonization WithStaphylococcus aureusAmong Human Immunodeficiency Virus-Positive Outpatients in Singapore

2004 ◽  
Vol 25 (5) ◽  
pp. 438-440 ◽  
Author(s):  
J. S. Villacian ◽  
T. Barkham ◽  
A. Earnest ◽  
N. I. Paton
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Human Immunodeficiency Virus ◽  
Antibiotic Use ◽  
Hiv Positive ◽  
Nasal Colonization ◽  
Immunodeficiency Virus ◽  
Mrsa Colonization

AbstractWe studied the prevalence of and risk factors forStaphylococcus aureusnasal colonization in HIV-positive outpatients in Singapore. Overall prevalence was 23% (45 of 195), with 3% (6 of 195) being MRSA. Recent antibiotic use and hospitalization were independent predictors of MRSA colonization. Isolates were genotypically identical to our hospital's inpatient circulating strain.

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