Canadian Consensus Guidelines for the Management of Cytomegalovirus Disease in HIV/AIDS

BACKGROUND: The management of HIV-infected patients with cytomegalovirus (CMV) disease has changed significantly with the availability of highly active antiretroviral therapy (HAART).OBJECTIVES: These updated guidelines are intended to provide practical help to physicians managing HIV-positive patients with or at risk for CMV disease.METHODS: The 10 members of the Canadian CMV Disease in HIV/AIDS Consensus Group were infectious disease specialists, a primary care physician and ophthalmologists with expertise in HIV and CMV infection. Financial support by Hoffmann-La Roche Canada Ltd was unrestricted, and was limited to travel expenses and honoraria. The consensus group met in June and October 2002. Key areas to be considered were identified, and group members selected, reviewed and presented relevant recent literature for their assigned section for the group's consideration. Evidence was assessed based on established criteria, which were expert opinions of the members. Draft documents were circulated to the entire group and modified until consensus was reached. The final guidelines represent the group's consensus agreement. The guidelines were approved by the Canadian Infectious Disease Society.RESULTS AND CONCLUSIONS: The guidelines address symptom monitoring, screening for early detection and prevention, and treatment using oral, intravenous and intraocular anti-CMV therapies in conjunction with HAART.

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Supporting Adherence to Highly Active Antiretroviral Therapy and Protected Sex Among People Living with HIV/AIDS: The Role of Patient–Provider Communication in Rio De Janeiro, Brazil

AIDS Patient Care and STDs ◽

10.1089/apc.2006.20.637 ◽

2006 ◽

Vol 20 (9) ◽

pp. 637-648 ◽

Cited By ~ 19

Author(s):

Jessica Fehringer ◽

Francisco I. Bastos ◽

Elize Massard ◽

Leonardo Maia ◽

J.H. Pilotto ◽

...

Keyword(s):

Antiretroviral Therapy ◽

Highly Active Antiretroviral Therapy ◽

Rio De Janeiro ◽

People Living With Hiv ◽

Provider Communication ◽

Highly Active ◽

Patient Provider Communication ◽

Living With Hiv ◽

Hiv Aids

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Risco cardiovascular: marcadores antropométricos, clínicos e dietéticos em indivíduos infectados pelo vírus HIV

Revista de Nutrição ◽

10.1590/s1415-52732011000100008 ◽

2011 ◽

Vol 24 (1) ◽

pp. 79-88 ◽

Cited By ~ 2

Author(s):

Luísa Helena Maia Leite ◽

Ana Beatriz de Mattos Marinho Sampaio

Keyword(s):

Antiretroviral Therapy ◽

Highly Active Antiretroviral Therapy ◽

Rio De Janeiro ◽

Highly Active ◽

Hiv Aids

OBJETIVO: Descrever marcadores antropométricos, clínicos e dietéticos associados ao risco cardiovascular em indivíduos infectados pelo vírus HIV. MÉTODOS: Realizou-se um estudo transversal com 100 indivíduos, adultos, com HIV/Aids, da cidade do Rio de Janeiro. O risco cardiovascular foi estimado pelo escore de risco de Framingham. O consumo alimentar foi avaliado por meio de um recordatório de 24 horas e de uma lista de frequência de consumo de alimentos. Para comparar variáveis, foram utilizados o teste t de Student e o teste Qui-quadrado. RESULTADOS: Dentre os indivíduos avaliados, 63% eram homens, com idade média de 41,8, DP=9,6 anos, 77% faziam uso de antirretrovirais. Escore de risco de Framingham >10% foi identificado em 53% dos indivíduos. Os principais fatores de risco cardiovascular potencialmente modificáveis identificados foram: lipoproteína de alta densidade baixo (70%), hipercolesterolemia (35%), hipertensão arterial (35%), seguidos de tabagismo (23%) e glicose alta (21%). Indivíduos com escore de risco de Framingham >10% apresentavam uma tendência para consumir dietas mais ricas em colesterol (p=0,720), em sódio (p=0,898), em açúcares/doces (p=0,032) e pobres em fibras (p=0,273), associadas a um maior consumo de bebidas alcoólicas (p=0,053). A avaliação dos hábitos de vida revelou maior prevalência de tabagismo e maior nível de sedentarismo no grupo com escore de risco de Framingham >10, porém não significativos. CONCLUSÃO: Os resultados deste estudo mostram que pacientes com HIV/Aids sob terapia Highly Active Antiretroviral Therapy e com mais altos escore de risco de Framingham não seguem as medidas preventivas contra doenças cardiovasculares e devem ser permanentemente encorajados a fazer escolhas alimentares saudáveis, parar de fumar e aumentar a atividade física.

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Epidemiology ofMycoplasmaacquisition in male HIV-1 infected patients: a multistage cross-sectional survey in Jiangsu, China

Epidemiology and Infection ◽

10.1017/s0950268815000461 ◽

2015 ◽

Vol 143 (15) ◽

pp. 3327-3334 ◽

Cited By ~ 5

Author(s):

L.-S. CHEN ◽

J.-R. WU ◽

B. WANG ◽

T. YANG ◽

R. YUAN ◽

...

Keyword(s):

Risk Factors ◽

Highly Active Antiretroviral Therapy ◽

Protective Factor ◽

Ureaplasma Urealyticum ◽

Venous Blood ◽

Mycoplasma Hominis ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Highly Active ◽

Hiv Aids

SUMMARYMycoplasmainfections are most frequently associated with disease in the urogenital or respiratory tracts and, in most cases, mycoplasmas infect the host persistently. In HIV-infected individuals the prevalence and role of genital mycoplasmas has not been well studied. To investigate the six species ofMycoplasmaand the risk factors for infection in Jiangsu province, first-void urine and venous blood samples were collected and epidemiological questionnaires were administered after informed consent. A total of 1541 HIV/AIDS patients were recruited in this study. The overall infection rates of sixMycoplasmaspecies were:Ureaplasma urealyticum(26·7%),Mycoplasma hominis(25·3%),M. fermentans(5·1%),M. genitalium(20·1%),M. penetrans(1·6%) andM. pirum(15·4%). TheMycoplasmainfection rate in the unmarried group was lower than that of the married, divorced and widowed groups [adjusted odds ratio (aOR) 1·432, 95% confidence interval (CI) 1·077–1·904,P< 0·05]. The patients who refused highly active antiretroviral therapy (HAART) had a much higher risk ofMucoplasmainfection (aOR 1·357, 95% CI 1·097–1·679,P< 0·05). Otherwise, a high CD4+T cell count was a protective factor againstMycoplasmainfection (aOR 0·576, 95% CI 0·460–0·719,P< 0·05). Further research will be required to confirm a causal relationship and to identify risk factors forMycoplasmainfection in HIV/AIDS populations.

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Níveis de atividade física e alterações metabólicas em pessoas vivendo com HIV/AIDS

Revista Brasileira de Medicina do Esporte ◽

10.1590/s1517-86922012000600001 ◽

2012 ◽

Vol 18 (6) ◽

pp. 356-360 ◽

Cited By ~ 3

Author(s):

Jayder Lucas Hotts Romancini ◽

Débora Guariglia ◽

Nelson Nardo Jr. ◽

Patrícia Herold ◽

Giuliano Gomes de Assis Pimentel ◽

...

Keyword(s):

Antiretroviral Therapy ◽

Highly Active Antiretroviral Therapy ◽

Highly Active ◽

Terapia Antirretroviral ◽

De Medicina ◽

Hiv Aids

Com a introdução da highly active antiretroviral therapy (HAART) - terapia antirretroviral fortemente ativa - o curso da infecção pelo HIV sofreu profundas modificações; ocorreu aumento da sobrevida e melhora na qualidade de vida, com restauração parcial do sistema imune. Após cerca de 10 anos do uso da HAART, começaram a aparecer os efeitos da combinação tratamento/vírus. Estes incluem alterações no metabolismo dos lipídios com hipertrigliceridemia, hipercolesterolemia, resistência insulínica, hiperglicemia e redistribuição da gordura corporal que são fatores de risco para doença cardiovascular. Estudos observacionais em pessoas vivendo com HIV/AIDS mostram que o indivíduo, ao se descobrir portador da doença, acaba sentindo medo ou vergonha, reduzindo o círculo social, atividades de trabalho e lazer, e se isolando em casa ou em pequenos grupos os quais tenham em comum a identidade de portadores HIV/AIDS. O objetivo deste trabalho foi avaliar a relação entre o nível de atividade física habitual e de lazer de pessoas vivendo com HIV/AIDS e sua relação com alterações metabólicas. Os pacientes foram classificados em sedentários e ativos, utilizando o questionário de atividade física habitual proposto por Baecke e validado para pacientes HIV/AIDS. Para classificação utilizou-se as recomendações do Colégio Americano de Medicina do Esporte. O metabolismo foi avaliado por meio das dosagens de glicemia de jejum, colesterol total, HDL-colesterol, LDL-colesterol e triglicérides, utilizando-se kits comerciais. A amostra foi composta por 65 pacientes HIV que utilizavam terapia HAART há pelo menos cinco anos. Foram classificados 64,6% como sedentários e 35,4% ativos. O estudo mostra uma relação direta entre nível de atividade física e melhores níveis de HDL-colesterol em pacientes HIV/AIDS. O HDL-colesterol é uma lipoproteína de proteção cardiovascular e, embora outros parâmetros avaliados não tenham mostrado diferença, estes resultados apontam a necessidade de estudos adicionais sobre fatores de risco e atividade física para pacientes HIV/AIDS, possibilitando propostas de intervenções específicas para esses pacientes.

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Successful management of HIV infection in a patient with ulcerative colitis; a case report

Journal of Preventive Epidemiology ◽

10.34172/jpe.2021.17 ◽

2021 ◽

Vol 6 (1) ◽

pp. e17-e17

Author(s):

Zain Majid ◽

Shoaib Ahmed Khan ◽

Hina Ismail ◽

Nishat Akbar ◽

Rajesh Mandhwani ◽

...

Keyword(s):

Infectious Disease ◽

Ulcerative Colitis ◽

Hiv Infection ◽

Highly Active Antiretroviral Therapy ◽

Tumor Necrosis ◽

Successful Management ◽

Highly Active ◽

Resource Limited ◽

Immunodeficiency Virus ◽

Necrosis Factor

Human immunodeficiency virus (HIV) is an infectious disease that is rarely seen in ulcerative colitis patients. Both diseases commonly involve the colon. It has been shown that treating these patients with anti-tumor necrosis factor (anti-TNF) therapy leads to remission of both conditions. We hereby present the case of a 7-year-old boy who was initially managed as a case ulcerative colitis after undergoing extensive workup and later on tested positive for HIV infection and was managed via mesalamine and highly active antiretroviral therapy (HAART). Mesalamine therapy along with HAART can be used to treat ulcerative colitis patients infected with HIV infection in resource limited countries.

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Depression and suicidal ideation among HIV seropositive patients attending the special treatment clinic of the University of Calabar Teaching Hospital, Calabar, Nigeria

Calabar Journal of Health Sciences ◽

10.25259/cjhs_27_2020 ◽

2021 ◽

Vol 4 ◽

pp. 64-70

Author(s):

Elvis Mbu Bisong ◽

Chidi John Okafor ◽

Agam Ebaji Ayuk ◽

Udeme Essien Asibong ◽

Henry Ohem Okpa

Keyword(s):

Viral Load ◽

Suicidal Ideation ◽

Highly Active Antiretroviral Therapy ◽

Cd4 Count ◽

Special Treatment ◽

Prevalence Rates ◽

Highly Active ◽

Study Participants ◽

Hiv Seropositive ◽

Hiv Aids

Objectives: The introduction of highly active antiretroviral therapy and innovations in healthcare has contributed in improving the lives of persons living with human immunodeficiency virus (HIV)/AID. Patients infected with HIV are more susceptible to develop psychiatric illnesses. Depression is common among patients suffering from chronic illness such as HIV/AIDS and can exacerbate these illnesses. Depression has been observed to be twice as common in HIV seropositive individuals than in the general population. Undiagnosed and untreated depression in patients suffering from HIV/AIDS could lead to poor adherence to medications and lower quality of life. Depression is associated with rapid HIV disease progression. The diagnosis of HIV infection may be associated with feelings of anger, denial, sadness, guilt feelings, loss of self-esteem among others. These negative feelings could lead to suicidal ideation and attempted suicide or suicide. We sought to determine the prevalence rates, sociodemographics and predictors, of depression and suicidal ideation among study participants. Material and methods: Two hundred and two adult participants who met the inclusion criteria were recruited into the study. Mini International Neuropsychiatric Interview English version 6.0.0 was employed to diagnose depression and suicidal ideation. Data were analyzed using Statistical Package for the Social Sciences version 20.0. Significant levels were set at P < 0.05. Results: This study revealed prevalence rates of 11.4% for depression and 7.9% for suicidal ideation among study participants. Majority of the participants were females in the young age group category of 30–40 years (45%) with mostly secondary education (47.8%), most had a higher CD4 count greater than 200 cells/µL (82.6%) and were mainly on zidovudine/lamivudine/nevirapine combination therapy (56.5%). Mean age, CD4 count, and viral load levels were lower in HIV patients with depression but were not statistically significant (P > 0.05). CD4 count and viral load were not significantly associated with suicidal ideation. Lower age (30–40 years) was significantly associated with suicidal ideation (P < 0.05). Suicidal ideation is a predictor of depression in the same way depression is a predictor of suicidal ideation (P < 0.05). Conclusion: Routine screening for depression and suicidal ideation especially among younger HIV/AIDS patients is recommended in the clinic setting.

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Influence of Spirituality and Religion on Adherence to Highly Active Antiretroviral Therapy in Adult HIV/AIDS Patients in Calabar, Nigeria

Recent Advances in Biology and Medicine ◽

10.18639/rabm.2017.03.456895 ◽

2017 ◽

Vol 03 ◽

pp. 48

Author(s):

Agam Ebaji Ayuk ◽

Ndifreke Udonwa ◽

Abraham Gyuse ◽

◽

...

Keyword(s):

Chronic Illness ◽

Antiretroviral Therapy ◽

Religious Coping ◽

Highly Active Antiretroviral Therapy ◽

Aids Patients ◽

Strict Adherence ◽

Highly Active ◽

Spirituality And Religion ◽

Positive Religious Coping ◽

Hiv Aids

The emergence of a chronic medical illness such as Human Immune Deficiency Virus and Acquired Immunodeficiency Syndrome (HIV/AIDS) may be the time when people turn to the Sacred through spirituality and religion. HIV is a chronic illness that requires strict adherence to medication regimens that may be influenced by spirituality/religion. This study was aimed at finding the association between spirituality/religion and adherence to highly active antiretroviral therapy (HAART) in adult HIV/AIDS patients. This is a cross-sectional descriptive study of 370 patients. Adherence was measured using an adapted adult AIDS clinical trial group (AACTG) and visual analogue scale (VAS) tools. Spirituality was assessed using Functional Assessment of Chronic Illness Therapy-Spirituality Expanded (FACIT-Sp-Ex) scale, religiosity with Duke University Religion index (DUREL), and religious coping with Brief Religious Coping (RCOPE) scale. Adherence rates were 86.2 and 43.8% using AACTG and VAS tools, respectively. Statistical significant correlation was found between spirituality and adherence to HAART (r = 0.265; p = 0.00). Also, significant correlation was found between positive religious coping and adherence (r = 0.15, p = 0.003). Odds ratio indicated that female respondents were 1.6 times more likely to be adherent, compared with males. Similarly, every unit rise in spirituality score yielded a 1.3 times increased likelihood of adherence to HAART on multiple logistic regression of adherence to HAART with relevant predictors. Both spirituality and positive religious coping have positive influence on optimal adherence. Therefore, the training of health care personnel to assess and provide spiritual care and involvement of chaplains/religious leaders is advocated for improved adherence.

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