Total lymphocyte count and hemoglobin combined in an algorithm to initiate the use of highly active antiretroviral therapy in resource-limited settings

AIDS ◽  
2003 ◽  
Vol 17 (9) ◽  
pp. 1311-1317 ◽  
Author(s):  
Lisa A Spacek ◽  
Michael Griswold ◽  
Thomas C Quinn ◽  
Richard D Moore
Keyword(s):  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Lymphocyte Count ◽  
Total Lymphocyte Count ◽  
Resource Limited Settings ◽  
Highly Active ◽  
Total Lymphocyte ◽  
Resource Limited

scholarly journals Perbandingan Kadar CD4 dan Total Lymphocyte Count dengan Kombinasi Highly Active Antiretroviral Therapy pada pasien HIV/AIDS di RSUP Dr.Kariadi Semarang

2020 ◽  
Vol 9 (1) ◽  
pp. 59
Author(s):  
Iraisa Rosaria
Keyword(s):  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Lymphocyte Count ◽  
Total Lymphocyte Count ◽  
Highly Active ◽  
Total Lymphocyte ◽  
Hiv Aids

Tujuan: Membuktikan perbedaan jenis pemberian kombinasi Highly Active Antiretroviral Therapy dengan perubahan kadar CD4 dan Total Lymphocyte Count pada pasien HIV/AIDS di RSUP Dr. Kariadi Semarang. Metode: Penelitian ini bersifat analitik yang dilakukan dengan rancangan studi potong lintang. Sampel diambil secara total sampling, yaitu seluruh pasien HIV/ AIDS yang berobat di RSUP Dr. Kariadi Semarang selama 2018 sampai 2019 yang memenuhi kriteria inklusi dan mendapat pengobatan salah satu dari kombinasi Highly Active Antiretroviral Therapy (HAART). Keenam jenis kombinasi HAART tersebut adalah kombinasi I (Efavirens+ Lamivudin+ Tenofovir), II (Evafirenz+ Lamivudin+Zidovudin), III(Nevirapine+ Lamivudin+ Tenofovir), IV (Lamivudine+Zidovudine+Nevirapine), V (Lamivudine+Tenofovir+Rilvipirine), VI (Tenofovir+ Rilvipirine+ Emtricitabine). Data dikumpulkan dari rekam medis pasien dan dianalisis dengan uji Kruskal-Wallis. Hasil:  Dari  89 pasien, didapatkan keenam kombinasi HAART tersebut memberikan efikasi yang baik berdasarkan kenaikan jumlah CD4 dan TLC rerata. Ada perbedaan kenaikan CD4 rerata yang bermakna pada pasien HIV/AIDS antara yang mendapat obat HAART kombinasi I (p  = 0,038), II (p = 0,034), IV (p  = 0,001), V (p  = 0,040), VI (p  = 0,006). Pada Total Lymphocyte Count  (TLC) didapatkan perbedaan kenaikan rerata (p< 0,05) pada  semua  kombinasi HAART. Simpulan: Tidak ada perbedaan jenis pemberian kombinasi Highly Active Antiretroviral Therapy dengan perubahan kadar CD4 dan Total Lymphocyte Count (p> 0,05) pada pasien HIV / AIDS di RSUP Dr. Kariadi Semarang.Kata kunci: CD4, highly active antiretroviral therapy, ODHA, total lymphocyte count

scholarly journals Prevalence of Anemia and Immunological Markers in HIV-Infected Patients on Highly Active Antiretroviral Therapy in Northeastern Nigeria

2013 ◽  
Vol 6 ◽  
pp. IDRT.S10477 ◽  
Author(s):  
Ballah Akawu Denue ◽  
Ibrahim Musa Kida ◽  
Ahmed Hammagabdo ◽  
Ayuba Dayar ◽  
Mohammed Abubakar Sahabi
Keyword(s):  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Lymphocyte Count ◽  
Total Lymphocyte Count ◽  
Cd4 Count ◽  
White Blood Count ◽  
Hiv Patients ◽  
Highly Active ◽  
Total Lymphocyte ◽  
The Impact

Background There are conflicting reports on the impact of highly active antiretroviral therapy (HAART) in resolving hematological complications. Whereas some studies have reported improvements in hemoglobin and other hematological parameters resulting in reduction in morbidity and mortality of HIV patients, others have reported no improvement in hematocrit values of HAART-treated HIV patients compared with HAART-naïve patients. Objective This current study was designed to assess the impact of HAART in resolving immunological and hematological complications in HIV patients by comparatively analyzing the results (immunological and hematological) of HAART-naive patients and those on HAART in our environment. Methods A total of 500 patients participated, consisting of 315 HAART-naive (119 males and 196 females) patients and 185 HAART-experienced (67 males and 118 females) patients. Hemoglobin (Hb), CD4+ T-cell count, total white blood count (WBC), lymphocyte percentage, plateletes, and plasma HIV RNA were determined. Results HAART-experienced patients were older than their HAART-naive counterparts. In HAART-naive patients, the incidence of anemia (packed cell volume [PCV] <30%) was 57.5%, leukopenia (WBC < 2.5), 6.1%, and thrombocytopenia < 150, 9.6%; it was, significantly higher compared with their counterparts on HAART (24.3%, 1.7%, and 1.2%, respectively). The use of HAART was not associated with severe anemia. Of HAART-naive patients, 57.5% had a CD4 count < 200 cells/μL in comparison with 20.4% of HAART-experienced patients ( P < 0.001). The mean viral load log10 was significantly higher in HAART-naive than in HAART-experienced patients ( P < 0.001). Total lymphocyte count < 1.0 was a significant predictor of <CD4 counts < 200 cells/μL in HAART-naïve patients, but this relationship was not observed in HAART-experienced patients. Conclusion HAART has the capability of reducing the incidence of anemia, other deranged hematological and immunological parameters associated with disease progression, and death in HIV-infected patients. Total lymphocyte count fails to predict CD4 count < 200 cells/μL in our cohort; thus, its use in the management and monitoring of HIV-infected patients in our settings is not reliable.

scholarly journals Total lymphocyte count as a tool for timing opportunistic infection prophylaxis in resource-limited settings: a study from India

2010 ◽  
Vol 4 (10) ◽  
pp. 645-649 ◽  
Author(s):  
Sreenivasan Srirangaraj ◽  
Dasegowda Venkatesha
Keyword(s):  
Opportunistic Infection ◽  
Predictive Value ◽  
Lymphocyte Count ◽  
Total Lymphocyte Count ◽  
Active Tuberculosis ◽  
Cd4 Count ◽  
Resource Limited Settings ◽  
Cd4 Counts ◽  
Total Lymphocyte ◽  
Resource Limited

Introduction: In resource-limited settings, due to the high cost of CD4 cell count testing, physicians must decide about opportunistic infection (OI) prophylaxis without a laboratory evaluation of HIV stage and level of immune suppression. This study aimed to evaluate the correlation of total lymphocyte count (TLC), an inexpensive laboratory parameter, to CD4 count, and to determine a range of TLC cut-offs for the initiation of OI prophylaxis that is appropriate for resource-limited settings. Methodology: Spearman correlation between CD4 count and TLC was assessed in patients attending the Anti-Retroviral Therapy (ART) centre at Mysore, India. Positive predictive value (PPV), negative predictive value (NPV), sensitivity, and specificity of various TLC cut-offs were computed for CD4 counts < 200 cells/mm3. Correlation and statistical indices were computed for all patients and for HIV patients with active tuberculosis. Results: Good correlation was noted between the 106 paired TLC and CD4 counts (r = 0.3497).TLC < 1200cells/mm3 had 88.14% sensitivity and 34.78% specificity for CD4 count < 200 cells/mm3. In those patients with active tuberculosis, TLC< 2000cells/mm3 had 95.24% sensitivity and 100% specificity for CD4 count < 200cells/ mm3. Conclusions: TLC could serve as a low-cost tool for determining when to initiate prophylaxis in resource-constrained settings.

scholarly journals Implementing a pharmacovigilance program to evaluate cutaneous adverse drug reactions in an antiretroviral access program

2012 ◽  
Vol 6 (11) ◽  
pp. 806-808
Author(s):  
Tinashe Mudzviti ◽  
Marvelous Sibanda ◽  
Samuel Gavi ◽  
Charles Chiedza Maponga ◽  
Gene D Morse
Keyword(s):  
Antiretroviral Therapy ◽  
Adverse Drug Reactions ◽  
Highly Active Antiretroviral Therapy ◽  
Family Care ◽  
Monitoring And Evaluation ◽  
Drug Reactions ◽  
Resource Limited Settings ◽  
Drug Regulatory Authority ◽  
Highly Active ◽  
Resource Limited

Introduction: Cutaneous adverse drug reactions (cADRs) can cause significant morbidity and distress in patients, especially in the HIV-infected population on antiretroviral therapy. Adverse drug reaction monitoring and ascertaining causality in resource-limited settings remain serious challenges. This study was conducted to evaluate causality and measure the incidence of cADRs in HIV-infected patients on highly active antiretroviral therapy. The study was also designed to test a three-step approach in the monitoring and evaluation of ADRs in resource-limited settings. Methodology: A retrospective review of patient medical records was performed at the Parirenyatwa Family Care Centre, Harare, Zimbabwe. Cases of cADRs were reported to the Medicines Control Authority of Zimbabwe, the main drug regulating body in Zimbabwe, for assessment and causality classification. Results: We reviewed 221 randomly selected patient records to determine whether any diagnoses of cADRs were made by clinicians. Causality assessment revealed that 13.1% of cADRs were due to an offending agent in the antiretroviral therapy versus an initial incidence of 17.6% which had been determined by the physicians. Conclusions: cADRs had an incidence of 13.1% within the population under study due to non nucleoside reverse transcriptase inhibitors (NNRTIs). Most reactions were caused by the NNRTIs which contributed 72.4 % of all cADRs. A panel of experts from the drug regulatory authority can be used as an implementation based mechanism in ascertaining causality objectively in settings where resources are constrained.

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