Incidence of Opportunistic Infections among Adult HIV Positive People Receiving Co-trimoxazole Prophylaxis

In Ethiopia, Co-trimoxazole prophylaxis therapy (CPT) used to prevent opportunistic infections among people living with HIV is the standard of practice; however incidence of opportunistic infection and their predictors are rarely documented in the country. This was a retrospective follow up study to describe the incidence and predictors of opportunistic infections among 244 adults receiving CPT. Participants were followed for a median time of 72 weeks. During a study period a total of 53opportunistic infections were recorded; making the overall incidence rate 23.9/100 person-years. High incidence of opportunistic infections is likely to occur if: the clients were married (adjusted hazard ratio (AHR) 1.965;(95% CI: 1.109, 3.451), had history of tuberculosis treatment (AHR: 2.34(95% CI:1.05, 5.24)), patients who are indicated for CPT because of both clinical and WHO clinical staging criteria(AHR 2.418 (95% CI:1.02, 5.72 ),and had poor adherence to CPT (AHR, 2.11 (95% CI: 1.19-3.72)). Eventhough adherence is non-substitutable strategy to prevent opportunistic infection, the cohort of HIV patients failed to adhere to CPT, which in turn resulthigh incidence of opportunistic infections among them, therefore improving adherence as guideline should be a priority to prevent OIs among people living with HIV in the study region.

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Incidence of Opportunistic Infections among Adult HIV Positive People Receiving Co-trimoxazole Prophylaxis

International Journal of Public Health Science (IJPHS) ◽

10.11591/.v4i3.4729 ◽

2015 ◽

Vol 4 (3) ◽

pp. 172

Author(s):

Yihun Tariku G ◽

Yaliso Yaya ◽

Degu Jerene ◽

Alemu Tamiso

Keyword(s):

Opportunistic Infection ◽

Opportunistic Infections ◽

Clinical Staging ◽

People Living With Hiv ◽

Study Region ◽

History Of ◽

Standard Of Practice ◽

Prophylaxis Therapy ◽

Living With Hiv

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Predictors of virological failure among people living with HIV receiving first line antiretroviral treatment in Myanmar: retrospective cohort analysis

AIDS Research and Therapy ◽

10.1186/s12981-021-00336-0 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Anita Mesic ◽

Alexander Spina ◽

Htay Thet Mar ◽

Phone Thit ◽

Tom Decroo ◽

...

Keyword(s):

Viral Load ◽

Virological Failure ◽

Antiretroviral Treatment ◽

People Living With Hiv ◽

First Line ◽

Hiv Viral Load ◽

Loss To Follow Up ◽

History Of ◽

Living With Hiv

Abstract Background Progress toward the global target for 95% virological suppression among those on antiretroviral treatment (ART) is still suboptimal. We describe the viral load (VL) cascade, the incidence of virological failure and associated risk factors among people living with HIV receiving first-line ART in an HIV cohort in Myanmar treated by the Médecins Sans Frontières in collaboration with the Ministry of Health and Sports Myanmar. Methods We conducted a retrospective cohort study, including adult patients with at least one HIV viral load test result and having received of at least 6 months’ standard first-line ART. The incidence rate of virological failure (HIV viral load ≥ 1000 copies/mL) was calculated. Multivariable Cox’s regression was performed to identify risk factors for virological failure. Results We included 25,260 patients with a median age of 33.1 years (interquartile range, IQR 28.0–39.1) and a median observation time of 5.4 years (IQR 3.7–7.9). Virological failure was documented in 3,579 (14.2%) participants, resulting in an overall incidence rate for failure of 2.5 per 100 person-years of follow-up. Among those who had a follow-up viral load result, 1,258 (57.1%) had confirmed virological failure, of which 836 (66.5%) were switched to second-line treatment. An increased hazard for failure was associated with age ≤ 19 years (adjusted hazard ratio, aHR 1.51; 95% confidence intervals, CI 1.20–1.89; p < 0.001), baseline tuberculosis (aHR 1.39; 95% CI 1.14–1.49; p < 0.001), a history of low-level viremia (aHR 1.60; 95% CI 1.42–1.81; p < 0.001), or a history of loss-to-follow-up (aHR 1.24; 95% CI 1.41–1.52; p = 0.041) and being on the same regimen (aHR 1.37; 95% CI 1.07–1.76; p < 0.001). Cumulative appointment delay was not significantly associated with failure after controlling for covariates. Conclusions VL monitoring is an important tool to improve programme outcomes, however limited coverage of VL testing and acting on test results hampers its full potential. In our cohort children and adolescents, PLHIV with history of loss-to-follow-up or those with low-viremia are at the highest risk of virological failure and might require more frequent virological monitoring than is currently recommended.

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STUDI RETROSPEKTIF KETAHANAN HIDUP ORANG DENGAN INFEKSI HIV/AIDS (ODHA) DI RSUD DR. ACHMAD MOCHTAR BUKITTINGGI

Human Care Journal ◽

10.32883/hcj.v3i3.89 ◽

2019 ◽

Vol 3 (3) ◽

pp. 175

Author(s):

Sukarsi Rusti

Keyword(s):

Opportunistic Infection ◽

Opportunistic Infections ◽

Analysis Data ◽

P Value ◽

People Living With Hiv ◽

Chi Square ◽

The People ◽

Living With Hiv ◽

Hiv Aids

HIV/AIDS disease is a health problem in indonesia. The problem cause of the number of morbility and mortality that still hight. It is cause of long term infection, adherance consuming the drungs and opportunistic that can deastroy the imun system of People Living With HIV/AIDS (PLHIV). The purpose of this research is to identify the factors related to the people living with PLHIV in Achmad Muchtar Hospital Bukittinggi2016.This research was conducted by a retrospective cohort design approach, doing research of the death of people who living with HIV by observing the patient’s medical record from 2014-2015. The research of study were 215 patient’s who is criteria inclusion. Analysis data using test chi-square. who became the independent variable is long infection, adherance comsuming the Anti Retroviral (ARV) , and opportunistic infection and dependent variable that survive the HIV people life.The research showed that among 215 patients with the number of deaths 39 people ( 18,% ), stages 3 and 4 (>5 th) is 89 people ( 41.4% ), not adherence is 77 people ( 35.8% ), and who suffered an opportunistic infection were 61 people (28.4% ). The statistical test relationships survival of people living with HIV with long-term infection obtained p value = 0,000 and RR = 0,019 ( confidence interfal 95 % with alpha = 0.05 ), adherance comsuming the ARV obtained p value = 0,000 and RR = 0,494 ( confidence interfal 95 % with alpha = 0.05 ), infection opportunistic obtained p value = 0,000 and RR = 0,361 ( confidence interfal 95 % with αlpha = 0.05 ).From these findings, it can be concluded that the long-term infection, adherence ARV and opportunistic infections associated with survival of people living with HIV. Of the three variables obtained interrelated and value the highest association is long-term infection.

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1313. Complementary Effects of Medical Follow-up and Virologic Suppression for Reincarcerated Inmates Living with HIV

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.1176 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S474-S474

Author(s):

Melissa E Badowski ◽

R Kane Stafford ◽

Brian W Drummond ◽

Thomas D Chiampas ◽

Sarah M Michienzi ◽

...

Keyword(s):

Hiv Care ◽

People Living With Hiv ◽

Virologic Suppression ◽

Management Support ◽

Chi Square ◽

History Of ◽

Secondary Endpoints ◽

Living With Hiv ◽

Hiv 1

Abstract Background Although prison presents an opportunity to achieve virologic suppression (VS) among people living with HIV, continued success is not guaranteed upon release. Methods A retrospective cohort study was performed in reincarcerated Illinois prisoners from January 1, 2016 to July 31, 2018. Patients were included if they were age ≥18 years, carried a diagnosis of HIV/AIDS, on antiretroviral therapy (ART) at the time of release, and had CD4 and HIV-1 RNA labs drawn within 6 months of release and reincarceration. Potential subjects were excluded if reincarcerated within 30 days due to a technical violation and not receiving ART at the time of prison release. Primary and secondary endpoints were percent of patients achieving VS upon reincarceration and percent of patients following at an HIV clinic while released. Statistical analysis included descriptive statistics, chi-square, and paired t-tests. Results Among 505 patients released during the study period, 95 patients were reincarcerated and 80 were included (Figure 1). Demographic information can be found in Table 1. Fifty-one patients (64%) reported follow-up at an HIV clinic while released, whereas 29 (36%) did not. Patients who had VS at the time of prison release were more likely to make their follow-up appointment (90%) compared with those who did not (69%) (P < 0.001). In addition, patients making their follow-up appointment were also more likely to have VS at the time of reincarceration (86% vs. 10%, P < 0.001). Recidivist patients adherent to ART were less likely to experience decreases in mean CD4 count (P = 0.03) (Table 2). Subjects reporting a history of substance use were more likely not to re-engage in post-release HIV care (P = 0.001), but no difference was noted in patients with a documented psychiatric history (P = 0.2). Conclusion Patients failing to meet VS at the time of prison release should be targeted for more intensive re-entry medical and case management support to ensure adherence to follow-up and maintenance of immunologic function. Disclosures All authors: No reported disclosures.

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Spectrum of Opportunistic Disease and Associated Factors among Patients Attending ART Clinic, Nekemte Specialized Hospital, Western Ethiopia

10.1101/2020.10.06.327668 ◽

2020 ◽

Author(s):

Meseret Belete Fite ◽

Demeke Jabessa Aga

Keyword(s):

Pulmonary Tuberculosis ◽

Medical Records ◽

Associated Factors ◽

Opportunistic Infections ◽

Oral Candidiasis ◽

Clinical Staging ◽

Bivariate Analysis ◽

Specialized Hospital ◽

Living With Hiv

AbstractIntroductionHuman immunodeficiency virus (HIV), the causal agent for Acquired I Immunodeficiency Syndrome (AIDS) is the world’s greatest severe public health and development contest. Since the beginning of the epidemic, 38 million of people are living with HIV/AIDS and 1.7 million people newly infected with HIV. Increased availability and accessibility of ART has essentially improved the survival rate, through lowering the incidence of OIs among peoples living with HIV/AIDS. Risk of developing Opportunistic infections in HIV patients depend on experience to potential pathogens, virulence of pathogens, degree of host immunity and the use of antimicrobial prophylaxis. In Ethiopia, however remarkable decline of new infection (81%) for decades, since 2008 HIV incidence rate began to rise by 10% and number of new infection diagnosed each year increased by 36% among all ages and doubled among adult. There is a limited studies describing the spectrum of opportunistic infection and associated factors in the study settings. Therefore, this study was aimed to determine the spectrum of Opportunistic infections in the study area.MethodsA Facility based retrospective cross-sectional study was employed from 2015-2019 G.C. The sample size was computed using single population proportion formula. Accordingly, four hundred ninety seven (497) medical records of study participants were reviewed. Simple random sampling technique was used to select the participants included in this study. Data were extracted from the ART follow up data-base and medical records of the patients by using a standardized check list, which was adapted from Federal ministry Of Health HIV ART. The contents of check list include: Socio-demographic characteristics and clinical information’s. Data had entered Epi data version and analyzed using SPSS version 5.3.1 and analyzed using SPSS version 20. Bivariate analysis with p-value <0.2 was done to see the association between outcome variable & independent variables. Variables with p < 0.2 in bivariate analysis were entered for multiple logistic regressions. At 95% confidence interval, explanatory variables with P <0.05 in multiple logistic regression analysis were considered as significantly association.ResultThe study found that, an overall prevalence of OIs was 62%. The finding of our study documented, from deferent HIV related OIs among patients on ART follow up at Nekemte Specialized Hospital ART clinic, the common types of OIs were; Pulmonary Tuberculosis (15.7%), Oral candidiasis (14.3%), Herpes Zoster (11.3%), Cryptococcus meningitides (5.9%), upper respiratory infection (5.8%, Persistent diarrhea (5.2%), and Extra pulmonary tuberculosis (3.8%). The occurrence of OIs on adult PLHIV patients who were with baseline WHO stage of I were 53% lower as compared to those who were with advanced baseline WHO stage of II and more {AOR: 0.468, 95 % CI (0.305-0.716). Moreover, Participants of Urban residents were 1.6 times more likely to develop OIs than those rural residents. Baseline WHO clinical staging and residence were identified as independent predictors of OIs among adult HIV infected patients.ConclusionAn overall prevalence of OIs was 62%. The prevalence of OIs is still high namely Pulmonary Tuberculosis, Oral candidiasis and Herpes Zoster are leading OIs among adult HIV infected patients. Baseline WHO clinical staging and residence were identified as independent predictors of OIs among adult HIV infected patientsRecommendationsHaving skilled health professionals, early diagnosis of OIs among HIV infected patients and having equipped laboratory diagnostic setup are mandatory to be able to deal with specific diagnosis and management of OIs. Further study is recommended to determine the relationship between residence and developing OIs among HIV patients on ART follow

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Ophthalmological profile of patients living with HIV/AIDS

Vojnosanitetski pregled ◽

10.2298/vsp1010856j ◽

2010 ◽

Vol 67 (10) ◽

pp. 856-860

Author(s):

Katarina Jankovic-Terzic ◽

Vera Begic ◽

Bojana Dacic-Krnjaja

Keyword(s):

Opportunistic Infections ◽

Hiv Positive ◽

People Living With Hiv ◽

Ocular Complications ◽

Economic Implications ◽

Active Involvement ◽

The Individual ◽

Living With Hiv ◽

Hiv Aids

Introduction. Serbia has 2.287 registered HIV positive persons. A certain number has ocular complications which are mainly the result of opportunistic infections accompanying this illness. Due to a highly stigmatizing environment for people living with HIV/AIDS in Serbia, they do not always seek doctors assistance despite the fear of losing their sight. Case report. We presented ophthalmologic status of nine HIV positive persons, all at the different phases of the illness. The decrease in the visual acuity was the first symptom which led to the diagnosis of HIV infection in two of our patients. Conclusion. Ophthalmologist has an important role in the multidisciplinary approach to patients with HIV/AIDS from introducing the diagnosis to the follow-up and the treatment of ocular complications which may accompany this chronic illness. With the active involvement of eye professionals serious consequences can be prevented, which have not only medical but also social and economic implications on the individual and the society as a whole.

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Spectrum of Opportunistic Disease and Associated Factors Among Patients Attending ART Clinic, Nekemte Specialized Hospital, Western Ethiopia

10.21203/rs.3.rs-83239/v1 ◽

2020 ◽

Author(s):

meseret Belete Fite ◽

Demeke Jebessa Aga

Keyword(s):

Pulmonary Tuberculosis ◽

Medical Records ◽

Associated Factors ◽

Opportunistic Infections ◽

Oral Candidiasis ◽

Clinical Staging ◽

Bivariate Analysis ◽

Specialized Hospital ◽

Living With Hiv

Abstract BackgroundHuman immunodeficiency virus (HIV), the causal agent for Acquired I Immunodeficiency Syndrome (AIDS) is the world’s greatest severe public health and development contest. Since the beginning of the epidemic, 38 million of people are living with HIV/AIDS and 1.7 million people newly infected with HIV. Increased availability and accessibility of ART has essentially improved the survival rate, through lowering the incidence of OIs among peoples living with HIV/AIDS. Risk of developing Opportunistic infections in HIV patients depend on experience to potential pathogens, virulence of pathogens, degree of host immunity and the use of antimicrobial prophylaxis. In Ethiopia, however remarkable decline of new infection (81%) for decades, since 2008 HIV incidence rate began to rise by 10% and number of new infection diagnosed each year increased by 36% among all ages and doubled among adult. There is a limited studies describing the spectrum of opportunistic infection and associated factors in the study settings. Therefore, this study was aimed to determine the spectrum of Opportunistic infections in the study area.MethodsA Facility based retrospective cross-sectional study was employed from 2015-2019 G.C. The sample size was computed using single population proportion formula. Accordingly, four hundred ninety seven (497) medical records of study participants were reviewed. Simple random sampling technique was used to select the participants included in this study. Data were extracted from the ART follow up data-base and medical records of the patients by using a standardized check list, which was adapted from Federal ministry Of Health HIV ART. The contents of check list include: Socio-demographic characteristics and clinical information’s. Data had entered Epi data version 5.3.1 and analyzed using SPSS version 20. Bivariate analysis with p-value <0.2 was done to see the association between outcome variable & independent variables. Variables with p < 0.2 in bivariate analysis were entered for multiple logistic regressions. At 95% confidence interval, explanatory variables with P <0.05 in multiple logistic regression analysis were considered as significantly association.ResultThe study found that, an overall prevalence of OIs was 62%. The finding of our study documented, from deferent HIV related OIs among patients on ART follow up at Nekemte Specialized Hospital ART clinic, the common types of OIs were; Pulmonary Tuberculosis (15.7%), Oral candidiasis (14.3%), Herpes Zoster (11.3%), Cryptococcus meningitides (5.9%), upper respiratory infection (5.8%, Persistent diarrhea (5.2%), and Extra pulmonary tuberculosis (3.8%). The occurrence of OIs on adult PLHIV patients who were with baseline WHO stage of I were 53% lower as compared to those who were with advanced baseline WHO stage of II and more {AOR: 0.468, 95 % CI (0.305-0.716). Moreover, Participants of Urban residents were 1.6 times more likely to develop OIs than those rural residents. Baseline WHO clinical staging and residence were identified as independent predictors of OIs among adult HIV infected patients.ConclusionAn overall prevalence of OIs was 62%. The prevalence of OIs is still high namely Pulmonary Tuberculosis, Oral candidiasis and Herpes Zoster are leading OIs among adult HIV infected patients. Baseline WHO clinical staging and residence were identified as independent predictors of OIs among adult HIV infected patients. Having skilled health professionals, early diagnosis of OIs among HIV infected patients and having equipped laboratory diagnostic setup are mandatory to be able to deal with specific diagnosis and management of OIs. Further study is recommended to determine the relationship between residence and developing OIs among HIV patients on ART follow

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Predictors of mortality among adult people living with HIV/AIDS on antiretroviral therapy at Suhul Hospital, Tigrai, Northern Ethiopia: a retrospective follow-up study

Journal of Health Population and Nutrition ◽

10.1186/s41043-019-0194-0 ◽

2019 ◽

Vol 38 (1) ◽

Author(s):

Kebede Haile Misgina ◽

Meresa Gebremedhin Weldu ◽

Tewodros Haile Gebremariam ◽

Negassie Berhe Weledehaweria ◽

Haileslasie Berhane Alema ◽

...

Keyword(s):

Immune Deficiency ◽

Opportunistic Infections ◽

Clinical Stage ◽

People Living With Hiv ◽

Northern Ethiopia ◽

Predictors Of Mortality ◽

Follow Up Study ◽

Living With Hiv ◽

Hiv Aids

Abstract Background Ethiopia is striving to achieve a goal of “zero human immune deficiency virus/acquired immune deficiency syndrome (HIV/AIDS)-related deaths.” However, little has been documented on the factors that hamper the progress towards achieving this goal. Therefore, the ultimate aim of this study was to determine predictors of mortality among adult people living with HIV/AIDS on antiretroviral therapy (ART). Methods A retrospective follow-up study was employed on all adult HIV/AIDS patients who started ART between January 1 and December 30, 2010, at Suhul Hospital, Tigrai Region, Northern Ethiopia. Data were collected by trained fourth-year Public Health students using a checklist. Finally, the collected data were entered into SPSS version 16. Then after, Kaplan-Meier curves were used to estimate survival probability, the log-rank test was used for comparing the survival status, and Cox proportional hazards model were applied to determine predictors of mortality. Results The median follow-up period was 51 months (ranging between 1 and 60 months, inter-quartile range (IQR) = 14 months). At the end of follow-up, 37 (12.5%) patients were dead. The majority of these cumulative deaths, 19 (51.4%) and 29 (78.4%), occurred within 3 and 4 years of ART initiation respectively. Consuming alcohol (adjusted hazard ratio (AHR) = 2.23, 95% CI = 1.15, 4.32), low body weight (AHR = 2.38, 95% CI = 1.03, 5.54), presence of opportunistic infections (AHR = 2.18, 95% CI = 1.09, 4.37), advanced WHO clinical stage (AHR = 2.75, 95% CI = 1.36, 5.58), and not receiving isoniazid prophylactic therapy (AHR = 3.00, 95% CI = 1.33, 6.74) were found to be independent predictors of mortality. Conclusion The overall mortality was very high. Baseline alcohol consumption, low body weight, advanced WHO clinical stage, the presence of opportunistic infections, and not receiving isoniazid prophylactic therapy were predictors of mortality. Strengthening behavioral and nutritional counseling with close clinical follow-up shall be given much more emphasis in the ART care and support program.

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British HIV Association guidelines on the management of opportunistic infection in people living with HIV: the clinical management of gastrointestinal opportunistic infections 2020

HIV Medicine ◽

10.1111/hiv.13004 ◽

2020 ◽

Vol 21 (S5) ◽

pp. 1-19

Author(s):

DR Chadwick ◽

RK Sutherland ◽

S Raffe ◽

ERM Pool ◽

MBJ Beadsworth

Keyword(s):

Opportunistic Infection ◽

Clinical Management ◽

Opportunistic Infections ◽

People Living With Hiv ◽

Living With Hiv

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The factors associated with co-trimoxazole hypersensitivity in people living with HIV/AIDS: a retrospective study

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20204527 ◽

2020 ◽

Vol 7 (11) ◽

pp. 1726

Author(s):

Ketut Suryana ◽

Hamong Suharsono ◽

Mochamad P. Pujasakti

Keyword(s):

Retrospective Study ◽

Hypersensitivity Reaction ◽

Opportunistic Infection ◽

Fixed Dose ◽

People Living With Hiv ◽

Duration Of Treatment ◽

Factors Associated ◽

History Of ◽

Living With Hiv ◽

Hiv Aids

Background: Antibiotic adverse drug reactions (ADRs) can occurred during any treatment of infection, especially opportunistic infections in people living with HIV/AIDS (PLWHA). Co-trimoxazole is a sulfonamide fixed dose combination antibiotic, consisted of sulfamethoxazole and trimethoprim which is effective in treatment of several infections and for prophylaxis of pneumocystis jiroveci pneumonia. The universal use of co-trimoxazole for prophylaxis has been shown to decrease hospitalizations, morbidity and mortality among PLWHA, but potentially associated with ADRs include drug hypersensitivity reaction. The objective was to identify factors associated with co-trimoxazole hypersensitivity in PLWHA.Methods: A retrospective study were enrolled 404 participants PLWHA who were received co-trimoxazole due to co-trimoxazole prophylaxis therapy (CPT), between January 2015–December 2018. The independence variables such as age, sex, history of allergy, hypersensitivity reactions, duration of therapy (days), CD4 (cells/µl) and opportunistic infection to co-trimoxazole hypersensitivity reaction were analyzed using spearman test.Results: Mostly of the participants was male: 253 (62.60%). Eighteen (4.50%) with history of allergy, 64 (15.90%) were known co-trimoxazole hypersensitivity reaction. The most frequent clinical manifestation was maculopapular rash: 27 (42.3%), followed by urticaria alone: 17 (26.3%), fixed drug eruption: 12 (19.6%), and angioedema with or without urticaria: 8 (11.8%). The history of allergy, opportunistic infection and duration of treatment were associated factors to co-trimoxazole hypersensitivity reaction.Conclusions: This study was identified, that history of allergy, duration of treatment and opportunistic infection were factors associated with co-trimoxazole hypersensitivity in PLWHA.

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