scholarly journals Treatment of HIV and Use of HAART in HIV Infected Patients with Acute Septic Shock

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S434-S434
Author(s):  
Christopher Polk ◽  
Samuel Webb ◽  
Nigel Rozario ◽  
Charity Moore ◽  
Michael Leonard
Keyword(s):  
Healthcare System ◽  
Opportunistic Infections ◽  
Tertiary Care ◽  
Hiv Positive ◽  
Virologic Suppression ◽  
Care Hospital ◽  
Research Support ◽  
Hiv Patients ◽  
Clinical Patient ◽  
The Impact

Abstract Background For HIV patients admitted with sepsis, ARVs are often stopped or held due to myriad concerns including drug interactions, acute renal failure, gastrointestinal dysfunction, or inability to administer crushed medications down feeding tubes. We seek to examine prescription patterns of HAART for HIV positive patients admitted for sepsis in our healthcare system and the impact of HAART prescription on patient outcomes. Methods We identified HIV positive patients from an institutional database of patients admitted for sepsis within our multi-hospital healthcare system and retrospectively extracted further clinical patient and laboratory information as well as information on HAART prescription by chart review. The impact of HAART prescription and immunologic and virologic parameters of HIV infection on mortality was examined. Results Inpatient mortality was 35% in HIV patients admitted for sepsis, compared with 17% for all patients with sepsis in our healthcare system. Opportunistic infections were identified in only 25% of patients while 56% had other infections identified. Only 55% of patients had HAART prescribed while inpatient. CD4 count, virologic suppression, APACHE score, presence of an opportunistic infection, admission to a tertiary care hospital, and inpatient prescription of HAART were all predictors of survival. Conclusion Immunologic and virologic status at time of admission predicted survival in HIV patients admitted for sepsis but prescription of HAART to HIV patients admitted for sepsis may increase survival. Disclosures C. Polk, Gilead Sciences: Investigator, Research support; Viiv Healthcare: Investigator, Research support

scholarly journals Treatment outcome of antiretroviral treatment naive HIV infected patients initiated on antiretroviral therapy in a tertiary care hospital in South India

2018 ◽  
Vol 6 (5) ◽  
pp. 1704
Author(s):  
Rajendra Prasad S. ◽  
Subhash Chandra B. J.
Keyword(s):  
Side Effects ◽  
Antiretroviral Treatment ◽  
Opportunistic Infections ◽  
Tertiary Care ◽  
Cd4 Count ◽  
Clinical Profile ◽  
Hiv Positive ◽  
Care Hospital ◽  
Route Of Transmission ◽  
The Mean

Background: About 2.1 million people are infected with HIV in India. Clinical profile of patients has evolved over a period of time in the Antiretroviral treatment (ART) era. This study was done to document the clinical presentation of patients in a tertiary care in Mysuru in Karnataka. The aim of the study was to follow the patients who were initiated on ART over a period of time and to know its effect on the clinical outcome and overall morbidity and mortality of the patients.Methods: A prospective study of HIV positive patients who were initiated on ART was done regarding clinical profile and outcome over a period of one and a half to two years depending on when they were initiated on ART.Results: Totally 183 patients were registered during the period, out of which 114 patients (62.29%) were males and the rest were females (37.70%). The commonest route of transmission was heterosexual route seen in 97.3% (178). Most (56.8%) of the patients were asymptomatic. The mean basal CD4 count was 162.70. The mean age of patients was 39.07. The mean BMI was 20.29. A 23.5% (43) had one or other side effects. Anemia (44.2%) was the most common side effects seen. There were 18 deaths (12.2%). A 39.34% (72) patients had opportunistic infections (OI), the commonest being tuberculosis 45(%).Conclusions: It was concluded that patients with low CD4 count, low BMI were more prone for Opportunistic infections and death. Early initiation of ART can prevent such incidences and improve the quality of life of HIV positive patients.

scholarly journals A STUDY ONCYTOPENIAS AND THE FACTORS ASSOCIATED WITH CYTOPENIAS AMONG HIV INFECTED PATIENTS ADMITTED AT A TERTIARY CARE HOSPITAL

2021 ◽  
Vol 9 (08) ◽  
pp. 172-179
Author(s):  
Manju Rose Sebastian ◽  
Seena Sankar ◽  
Mary George
Keyword(s):  
Opportunistic Infections ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Prevalence Ratio ◽  
Developed Countries ◽  
Categorical Variables ◽  
P Value ◽  
Care Hospital ◽  
Hiv Patients ◽  
Factors Associated

Introduction: India has the third highest burden of HIV in the world. Haematological complications are common in HIV patients, of which cytopenias are the most frequently encountered. The cytopenias have been found to adversely affect the outcome of HIV patients with greater mortality and decreased quality of life. Aims and Objective: To assess the prevalence of cytopenias among patients admitted in a tertiary care hospital and to assess the factors associated with the cytopenias. Materials and Methods: The present study was conducted in the department of general medicine at a tertiary care hospital and 191 patients admitted in the hospital during the study period were taken for the study. The baseline investigations at the time of admission were taken into consideration. Patients were interviewed and charts reviewed to collect the data. The data collected was analysed with SPSS-2018. Continuous variables were expressed as mean +/- standard deviation and as median and interquartile ranges as appropriate. Categorical variables were expressed as percentages and frequencies. Comparisons between data was done by student’s t test and chi square. The factors associated with various cytopenias was assessed using log binomial regression. A p value of < 0.05 was taken as significant. Results: The overall prevalence of any cytopenia was found to be 85.9%. The most common cytopenia was anaemia with a prevalence of 78.5% followed by thrombocytopenia and leucopenia with prevalences of 28.8% and 24.1% respectively. Anaemia was found to be more prevalent among females with a prevalence ratio of 3.05 (95% CI: 1.39- 10.16, p value 0.009) when compared to males. The most common cause of anaemia was found to be B12 deficiency. There was significant association between leucopenia and CDC staging with the prevalence of leucopenia being higher among patient with CDC stage 3. [Prevalence ratio:1.46 (95% CI 0.67-3.17, p 0.024)]. No significant association was found with gender, duration of HIV, ART regimen, CDC stage or presence of opportunistic infections and thrombocytopenia. Conclusion: The prevalence of cytopenias among HIV patients was found to high – 85.9% especially compared to other developed countries. The most common cytopenia among the patients was found to be anaemia with a prevalence of 78%. The next most common cytopenia was thrombocytopenia, followed by leucopenia. The factors associated with these cytopenias can help to screen for patients at higher risk of developing these cytopenias and hence establish preventive strategies against them.

A study of opportunistic infections in HIV positive patients at a tertiary care hospital at Sangli

2019 ◽  
Vol 10 (1) ◽  
pp. 38-41
Author(s):  
Harshad Adhav ◽  
◽  
Jayshree Awalekar ◽  
Rahul Surve ◽  
Ajinkya Nashte ◽  
...  
Keyword(s):  
Opportunistic Infections ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Hiv Positive ◽  
Care Hospital

scholarly journals Prevalence of tuberculosis in newly diagnosed HIV patients and its relationship with cluster of differentiation 4 count in a tertiary care hospital

2019 ◽  
Vol 6 (6) ◽  
pp. 1849
Author(s):  
Archana B. ◽  
Vivek K. U.
Keyword(s):  
Extrapulmonary Tuberculosis ◽  
Tertiary Care ◽  
Cd4 Count ◽  
Hiv Positive ◽  
Clear Correlation ◽  
Pulmonary Medicine ◽  
Care Hospital ◽  
Newly Diagnosed ◽  
Hiv Patients ◽  
Pulmonary Tb

Background: Tuberculosis (TB) is the commonest opportunistic infection among Human Immunodeficiency Virus (HIV) positive patients in India and HIV/TB co-infection poses a major public health challenge in developing countries. It is estimated that 60-70% of HIV positive patients will develop tuberculosis in their lifetime. The aim of the present study is to record the clinical, radiological profile of pulmonary and Extrapulmonary Tuberculosis (EPTB) in HIV positive patients.Methods: This was a prospective study conducted in the department of Pulmonary medicine, Kempegowda institute of medical sciences. All newly diagnosed HIV patients during the study period were included and screened for tuberculosis irrespective of whether they had signs and symptoms.Results: Among 44(15.94%) patients among 276 HIV positive patients were diagnosed to have tuberculosis. Males (72.72%) were affected more than females (27.27%). Most common affected age group was 31-40 years with a mean age of 38.08 years. Unprotected heterosexual contact was the most common mode of HIV transmission. Fever, weight loss and cough were the commonest symptoms at presentation. Pulmonary TB was diagnosed in 10(22.7%) patients, EPTB in 30(68.3%) and disseminated TB in 4(9%) patients. All the pulmonary TB patients had CD4 count below 250, EPTB below 150 and disseminated TB patients below 50.6(13.63%) patients had pleural effusion, 5(11.36%) had abdominal TB, 5(11.36%) had tubercular meningitis, 4(9%) had intra thoracic lymphadenopathy and one (2.27%) patient had pericardial effusion. Low CD4 count (<150) had statically significant association with HIV/TB co-infection.Conclusions: The prevalence of HIV-TB co-infection was high. Moreover, HIV positive patients need early diagnosis and treatment of active TB. The study has shown clear correlation between clinical data and the laboratory parameter of immunodeficiency (CD4 count) and the temporal development of TB.

scholarly journals Incidence of brain parenchymal abnormality in a group of HIV positive patients admitted in tertiary care hospital: a prospective descriptive study

2018 ◽  
Vol 5 (4) ◽  
pp. 1543
Author(s):  
S. K. Nath ◽  
S. M. Sudumbrekar ◽  
Sumeet Arora ◽  
S. K. Rai
Keyword(s):  
Mr Imaging ◽  
Tertiary Care ◽  
Brain Lesion ◽  
Brain Lesions ◽  
Hiv Positive ◽  
Care Hospital ◽  
Female Ratio ◽  
Brain Parenchymal ◽  
The Impact ◽  
Parenchymal Abnormality

Background: Magnetic resonance imaging (MRI) has been used to examine the impact of human immunodeficiency virus (HIV) on the central nervous system (CNS) since the beginning of the disease. The objectives of this study were to determine the incidence of brain parenchymal abnormality in a group of HIV positive patients and to detect and study the profile of MRI patterns of brain lesions in HIV positive patients.Methods: In our study, total of 28 patients have been evaluated enrolled between 01 December 2013 to 30 December 2014.Results: During the study period 35 patients on immune-surveillance were screened for brain lesions of which 28 patients met the inclusion criteria and were included in study. The male-female ratio has been found to be 4.6:1 with the mean age of 43 (18-77). Majority of patients presented with headache as main clinical symptom. Out of which 20% normal, 13.3% NSWM, 13.3% atrophy, hematoma 6.6%, infarct 6.6%, toxoplasmosis 13.3%, PML 13.3%, NCC 6.6% and CMV encephalitis 6.6%. Altered mental status and neurological deficit 27.6% and 20.7%, respectively, were two other symptoms following headache. MR imaging detected neuroparenchymal abnormality in 20 (71.4%), out of 28 HIV positive patients. There was no neuroparenchymal abnormality seen in the rest of the 08 patientsConclusions: MR imaging detected neuroparenchymal abnormality in 20 (71.4%), out of 28 HIV positive patients. Based on our study we can conclude that the MRI of brain is the primary modality to detect the brain lesion in HIV positive patient even if he is asymptomatic clinically.

scholarly journals A comparative evaluation of the effects of ZLN and TLE anti-retroviral regimens in HIV positive patients: A retrospective record-based study

2021 ◽  
Vol 64 ◽  
pp. 298-302
Author(s):  
Ritika Singla ◽  
Neetu Sharma
Keyword(s):  
Opportunistic Infections ◽  
Tertiary Care ◽  
Cd4 Count ◽  
Hiv Positive ◽  
Care Hospital ◽  
Immunodeficiency Virus ◽  
Group A ◽  
The Mean ◽  
The Difference ◽  
Group B

Objectives: Until 2012, zidovudine+lamivudine+nevirapine (ZLN) was the first line treatment for human immunodeficiency virus (HIV)-positive patients, whereas in 2013, tenofovir+lamivudine+efavirenz (TLE) was recommended as a preferred regimen due to less adverse drug reactions and better virological response. The present study was done to compare the change in CD4 count and emergence of opportunistic infections (OIs) in HIV-positive patients on ZLN and TLE regimens. Materials and Methods: This retrospective record-based study was conducted at anti-retroviral therapy (ART) center of a tertiary care hospital on 150 charts of patients on ZLN (Group A) and TLE (Group B) regimens each for 1 year. Data were analyzed using GraphPad Prism version 6. Results: The mean age of patients in Group A was 38.72 (±10.5) years and Group B 37.75 (±11.57) years (P = 0.4460). After 1 year of ART, the mean CD4 count (cells/mm3) increased in both groups (Group A: 223.51 [±111.21] to 415.37 [±218.16] [P = 0.0001] vs. Group B: 255.05 [±164.50] to 433.12 [±247.66] [P = 0.0001]). With the baseline counts being comparable (P = 0.0527), the difference in mean CD4 counts between the groups post-ART was not statistically significant (P = 0.5105). The incidence of OI was 45% in Group A as compared to 25% in Group B. Overall, the most prevalent OI was tuberculosis (TB) (13.33%). Conclusion: Both ZLN and TLE regimens are equally effective in improving the immunological status of HIV-positive patients. Patients on ZLN have higher incidence of OI than those on TLE. However, therapy should be individualized as per patient’s suitability.

scholarly journals A pattern of Opportunistic Infections among HIV In patients on Antiretroviral Therapy in a Tertiary Care Hospital in Coastal Karnataka: A Retrospective Evaluation

2020 ◽  
Vol 11 (4) ◽  
pp. 6385-6390
Author(s):  
Guntur Aishwarya ◽  
Sunil Pai B ◽  
Priyanka Kamath ◽  
Rakesh K B ◽  
Priya Rathi ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Opportunistic Infections ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Hiv Positive ◽  
Care Hospital ◽  
Retrospective Case ◽  
Case Record ◽  
Resource Limited ◽  
Immunodeficiency Virus

Though the incidence of opportunistic infection (OI) is reducing with combination antiretroviral therapy. In this study we aimed to identify the pattern of the occurrence of opportunistic infections in HIV (Human Immunodeficiency Virus) patients. This was a retrospective, case-record based, time-bound study over a four year period (2013-2016) which included HIV positive in-patients aged >18 years of age, of either gender on Antiretroviral Therapy (ART). Demographic details, details of HIV infection including baseline and all available CD4 counts, details of the medications were recorded. Adverse drug reactions (ADR) were recorded by reviewing patient records. Among the files checked, 298 inpatients were on ART regimens recommended by the National AIDS Control Organization (NACO), and were included in the study. Among them, 70.8% of patients developed atleast one OI, 29.8% developed two OIs, and 6.71% developed three OIs. The most common OI was pulmonary tuberculosis (48.3%). The most common ART regimen was a combination of Zidovudine + Lamivudine + Nevirapine. In our study, 70.8% of patients developed at least one OI, which suggests that despite availability of combination ART, OIs continue being a significant issue in patients with HIV in resource-limited settings.

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