scholarly journals Prevalence and Correlates of Unknown HIV Infection among Patients Seeking Care in a Public Hospital Emergency Department

2008 ◽  
Vol 123 (3_suppl) ◽  
pp. 41-50 ◽  
Author(s):  
Nicola M. Zetola ◽  
Beth Kaplan ◽  
Teri Dowling ◽  
Trevor Jensen ◽  
Brian Louie ◽  
...  
Keyword(s):  
Emergency Department ◽  
Hiv Infection ◽  
San Francisco ◽  
Public Hospital ◽  
Significant Proportion ◽  
Infection Prevalence ◽  
Infection Status ◽  
Hiv Diagnosis ◽  
Acute Hiv Infection ◽  
Cross Sectional

Objectives. Screening for human immunodeficiency virus (HIV) infection in the emergency department (ED) has been proposed as an effective approach to increase early HIV diagnosis. To evaluate the potential for the implementation of routine screening, we determined the prevalence of unknown HIV infection among patients being seen in an urban public hospital ED. Methods. We conducted a cross-sectional study among patients presenting to the San Francisco General Hospital's ED during March 2007. We reviewed patients' medical records to determine HIV infection status. In patients with unknown or negative HIV-infection status, we tested de-identified remnant blood specimens by HIV-antibody and nucleic-acid assays. We used a sensitive/less sensitive testing algorithm to determine the duration of HIV infection. Results. During the study period, 1,820 patients had blood collected for clinical evaluation. Of those patients, 146 (8.0%) were known to be HIV-infected. Among the remaining 1,674 patients with unknown HIV-infection status, HIV-infection prevalence was 0.9% (15 of 1,674, 95% confidence interval [CI] 0.55, 1.47). In addition, one case of acute HIV infection (HIV-antibody negative, HIV RNA detected) was identified. Patients with unknown HIV infection vs. those who were uninfected were more likely to be homeless (odds ratio [OR] = 3.89, 95% CI 1.32, 11.45, p<0.05) and 18 to 30 years of age (OR=3.15, 95% CI 1.03, 9.61, p<0.05). Conclusions. In a sample of patients visiting a county ED, the relative prevalence of unknown HIV infection (10%) was modest and less than national estimates (25%). Acutely HIV-infected patients might account for a significant proportion of those with unknown HIV infection in an ED setting.

scholarly journals FRAILTY AND CONSTELLATIONS OF FACTORS IN AGING HIV-INFECTED AND UNINFECTED WOMEN - THE WOMEN’S INTERAGENCY HIV STUDY

2016 ◽  
pp. 1-6
Author(s):  
D.R. GUSTAFSON ◽  
Q. SHI ◽  
M. THURN ◽  
S. HOLMAN ◽  
H. MINKOFF ◽  
...  
Keyword(s):  
At Risk ◽  
Hiv Infection ◽  
Frailty Index ◽  
Accelerated Aging ◽  
Early Death ◽  
Infection Prevalence ◽  
Middle Aged ◽  
Cross Sectional ◽  
Moderate Drinking ◽  
Hiv Women

Background: Biological similarities are noted between aging and HIV infection. Middle-aged adults with HIV infection may present as elderly due to accelerated aging or having more severe aging phenotypes occurring at younger ages. Objectives: We explored age-adjusted prevalence of frailty, a geriatric condition, among HIV+ and at risk HIV- women. Design: Cross-sectional. Setting: The Women’s Interagency HIV Study (WIHS). Participants: 2028 middle-aged (average age 39 years) female participants (1449 HIV+; 579 HIV-).Measurements: The Fried Frailty Index (FFI), HIV status variables, and constellations of variables representing Demographic/health behaviors and Aging-related chronic diseases. Associations between the FFI and other variables were estimated, followed by stepwise regression models. Results: Overall frailty prevalence was 15.2% (HIV+, 17%; HIV-, 10%). A multivariable model suggested that HIV infection with CD4 count<200; age>40 years; current or former smoking; income ≤$12,000; moderate vs low fibrinogen-4 (FIB-4) levels; and moderate vs high estimated glomerular filtration rate (eGFR) were positively associated with frailty. Low or moderate drinking was protective. Conclusions: Frailty is a multidimensional aging phenotype observed in mid-life among women with HIV infection. Prevalence of frailty in this sample of HIV-infected women exceeds that for usual elderly populations. This highlights the need for geriatricians and gerontologists to interact with younger ‘at risk’ populations, and assists in the formulation of best recommendations for frailty interventions to prevent early aging, excess morbidities and early death.

Acute HIV Infection in a Patient with Repeat HIV Antibody/Antigen Negative Results Presenting at an Urban Emergency Department: A Case Report

2019 ◽  
Vol 57 (4) ◽  
pp. e113-e116
Author(s):  
Jason Wilson ◽  
Geetha Sanmugalingham ◽  
Oluwatobi Ozoya ◽  
Larissa Pierce ◽  
Kelsey Hundley ◽  
...  
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Hiv Infection ◽  
Acute Hiv Infection ◽  
Negative Results ◽  
Acute Hiv ◽  
Urban Emergency Department

scholarly journals Decreased Seroreactivity in Individuals Initiating Antiretroviral Therapy during Acute HIV Infection

2019 ◽  
Vol 57 (10) ◽  
Author(s):  
Mark M. Manak ◽  
Linda L. Jagodzinski ◽  
Ashley Shutt ◽  
Jennifer A. Malia ◽  
Mike Leos ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Western Blot ◽  
Research Collaboration ◽  
Virologic Suppression ◽  
Infection Status ◽  
Acute Hiv Infection ◽  
Western Blot Assay ◽  
Acute Hiv ◽  
Hiv 1

ABSTRACTAntiretroviral therapy (ART) during acute HIV infection (AHI) interrupts viral dynamics and may delay the emergence of serological markers targeted by current HIV screening and confirmatory assays, thus creating challenges for correctly classifying HIV infection status. The performance of three HIV antigen/antibody combination (HIV Ag/Ab Combo) assays (the Bio-Rad GS, Abbott Architect, and Bio-Rad BioPlex 2200 assays) was evaluated with samples collected from RV254/South East Asia Research Collaboration in HIV 010 (RV254/SEARCH010) study (Bangkok, Thailand) participants at weeks 12 and 24 following the initiation of ART at Fiebig stage I (FI) (n = 23), FII (n = 39), or FIII/IV (n = 22). Supplemental, confirmatory testing was performed by the Geenius HIV 1/2 and HIV-1 Western blot assays (Bio-Rad). Samples from 30 untreated, HIV-1-infected individuals demonstrated robust HIV Ag/Ab Combo assay reactivity with well-developed HIV-1 Western blotting profiles by 24 weeks after infection. In contrast, 52.2% of samples from individuals initiating ART at FI, 7.7% of samples from individuals initiating ART at FII, and 4.5% of samples from individuals initiating ART at FIII/IV were nonreactive by the HIV Ag/Ab Combo assays, with 36.4 to 39.1% of samples having low signal-to-cutoff (S/CO) results by the Architect and BioPlex assays (S/CO < 10). Seroreversion from a reactive to a nonreactive status was observed in 10 individuals initiating ART at FII and 3 individuals initiating ART at FIII/IV. The Geenius and HIV-1 Western blot assay results were negative or indeterminate for 73.9% and 69.6% of individuals, respectively, treated at FI; 50.0% and 26.3% of individuals, respectively, treated at FII; and 54.5% and 40.9% of individuals, respectively, treated at FIII/IV. Virologic suppression of HIV-1 by ART during AHI impedes seroconversion to biomarkers of infection, limiting the utility of HIV Ag/Ab Combo and supplemental, confirmatory assays for infection status determination.

scholarly journals 246 Empiric Antiretroviral Therapy for Acute HIV Infection in the Emergency Department

2016 ◽  
Vol 68 (4) ◽  
pp. S96
Author(s):  
K. Stanley ◽  
S. Arora ◽  
A. Klonoff ◽  
M. Lora ◽  
M. Menchine ◽  
...  
Keyword(s):  
Emergency Department ◽  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Acute Hiv Infection ◽  
Acute Hiv

Identification of Acute HIV Infection Using Fourth-Generation Testing in an Opt-Out Emergency Department Screening Program

2014 ◽  
Vol 64 (5) ◽  
pp. 537-546 ◽  
Author(s):  
Kara I. Geren ◽  
Frank Lovecchio ◽  
Jason Knight ◽  
Robert Fromm ◽  
Eric Moore ◽  
...  
Keyword(s):  
Emergency Department ◽  
Hiv Infection ◽  
Screening Program ◽  
Fourth Generation ◽  
Acute Hiv Infection ◽  
Opt Out ◽  
Acute Hiv

Leishmania infantum: illness, transmission profile and risk factors for asymptomatic infection in an endemic metropolis in Brazil

Parasitology ◽  
2016 ◽  
Vol 144 (4) ◽  
pp. 546-556 ◽  
Author(s):  
LETÍCIA HELENA DOS SANTOS MARQUES ◽  
IARA CAIXETA MARQUES DA ROCHA ◽  
ILKA AFONSO REIS ◽  
GISELE MACEDO RODRIGUES DA CUNHA ◽  
EDWARD OLIVEIRA ◽  
...  
Keyword(s):  
Risk Factors ◽  
Leishmania Infantum ◽  
Disease Incidence ◽  
Significant Proportion ◽  
Cross Sectional Study ◽  
Asymptomatic Infection ◽  
Infection Prevalence ◽  
Prevalence Rates ◽  
Cross Sectional ◽  
Relative Risks

SUMMARYTo evaluate the distribution of asymptomatic infection by Leishmania infantum in a metropolis in Brazil with different relative risks (RRs) for disease and risk factors associated with the infection, an ecological study was conducted using a Bayesian approach to estimate the RR of human visceral leishmaniasis (HVL) based on cases between 2008 and 2011. The areas were categorized and selected according to disease incidence: low (area-1), medium (area-2) and high (area-3). Cross-sectional study enrolling 935 children was used to estimate the prevalence of infection by L. infantum. Volunteers from these three areas were tested for L. infantum infection by ELISA (rK39 and soluble antigens). Infection prevalence rates were estimated and compared with the RR of disease. Multilevel logistic regression model evaluated the relationship between infection and the analysed variables. The RR of HVL was distributed heterogeneously in the municipality. The infection prevalence rates were: 34·9% in area-1; 29·3% in area-2; and 33·6% in area-3, with no significant differences between these areas. The variables ‘Presence of backyards in the neighbourhood’ and ‘Younger children’ were associated with L. infantum infection. We conclude that infection by L. infantum affects a significant proportion of the infant population regardless of the RR of disease.

200 Patients With Acute HIV Infection Present to the Emergency Department With Nonspecific Symptoms

2017 ◽  
Vol 70 (4) ◽  
pp. S80
Author(s):  
K. Stanley ◽  
A. Klonoff ◽  
K. Jacobson ◽  
M. Menchine ◽  
S. Arora
Keyword(s):  
Emergency Department ◽  
Hiv Infection ◽  
Acute Hiv Infection ◽  
Acute Hiv

scholarly journals HIV/AIDS knowledge, attitude and prevention assessment of residents in Liangshan prefecture: A cross-sectional survey

2019 ◽  
Author(s):  
Gang Tian ◽  
Zhangrui Zeng ◽  
Jun Long ◽  
Shaohua Wang ◽  
Hu Fu ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Local Community ◽  
Age Distribution ◽  
Infection Prevalence ◽  
Cross Sectional ◽  
Hiv Test ◽  
Community Residents ◽  
Prevention Methods ◽  
Suicidal Ideas ◽  
Hiv Aids

Abstract Background The knowledge, attitude and prevention methods are crucial to avoid and prevent potential HIV infection especially in Liangshan prefecture, a high HIV infection prevalence area in China. Currently, as HIV/AIDS related studies were mainly based on sentinel surveillance groups and students, little information is known for local community residents. Our objectives were to survey HIV/AIDS related knowledge, attitude and prevention methods in these general populations to take targeted action for better prevention and control of HIV infection. Methods A large sample, multicounty based cross-sectional study was conducted to select seven counties randomly from 15 Yi ethnic counties plus the capital city, Xichang, for this study. A method of stratified cluster sampling was used to select 5500 local community residents in these eight counties from September 12, 2017 to October 23, 2018. Results Only 65.8% of respondents gave correct responses to all HIV/AIDS related knowledge and routes of transmission. The differences were significantly related to age distribution (P< 0.001), gender (P= 0.006), ethnicity (P< 0.001), educational level (P< 0.001), residence (P< 0.001) as well as fixed income or work (P< 0.001). Multicounty analysis showed the total correct answer rate of Xichang city was the highest (83.8%) in eight counties, whereas Meigu county (57.5%), Zhaojue county (50.9%) and Butuo country (48.2%) were the lowest. The positive answer rates of respondents to HIV/AIDS attitudes varied from 33.0% to 80.3%. 33.0% of the respondents wanted to have a child even though their spouse was infected with HIV, and 39.9% of the represents emerged in suicidal ideas if the HIV test results were positive. As for the prevention methods, 32.6% of the respondents did not use a condom during sexual intercourse, and 26.9% of the respondents did not approve to encourage free HIV screening. Conclusion It is urgent to strengthen the popularization of HIV/AIDS related knowledge and routes of transmission, and take targeted intervention and prevention policies for local community residents in Liangshan prefecture.

scholarly journals Disproportionate and increasing burden of HIV infection among men who have sex with men in Slovenia: surveillance data for 1999-2008

2009 ◽  
Vol 14 (47) ◽  
Author(s):  
I Klavs ◽  
N Bergant ◽  
Z Kastelic ◽  
A Lamut ◽  
T Kustec
Keyword(s):  
Hiv Infection ◽  
Mandatory Reporting ◽  
Infection Prevalence ◽  
Outpatient Services ◽  
Hiv Diagnosis ◽  
Male Clients ◽  
Hiv Test ◽  
Positive Prevention ◽  
Sex With Men ◽  
Sentinel Population

The report presents data on HIV infection among men who have sex with men (MSM) in Slovenia during 1999-2008. HIV surveillance was based on universal mandatory reporting of HIV/AIDS cases, monitoring HIV infection prevalence among sentinel populations of MSM and STI patients and selected behaviour indicators in a sentinel population of MSM. Among 48 newly diagnosed HIV cases reported for 2008, 34 were MSM. Since 1999, the annual reported rate of HIV diagnoses in MSM rose from 7.1 to 46.8 per million men aged 15-64 years (an increase of more than six times). During 1999-2008, the proportion of MSM diagnosed with AIDS within three months of HIV diagnosis declined from 60% to 21%, however, the corresponding rate per million men aged 15-64 increased from 4.3 to 9.6. During 1999-2008, HIV prevalence among male clients of STI outpatient services tested for syphilis (including a substantial proportion of MSM) increased from 0% to 3.4%, and it remained below 5% in a sentinel population of MSM in Ljubljana. In the same sentinel population of MSM, the proportion reporting HIV test last year increased from 29% in 2003 to 38% in 2008 while the proportion reporting condom use at last anal intercourse decreased from 81% in 2004 to 66% in 2008. The burden of HIV among MSM in Slovenia is disproportionately high and increasing fast. Promotion of safer sexual behaviour and HIV testing among MSM as well as positive prevention among MSM with diagnosed HIV infection are urgently needed.

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