scholarly journals High Prevalence of Hearing Impairment in HIV-Infected Peruvian Children

2011 ◽  
Vol 146 (2) ◽  
pp. 259-265 ◽  
Author(s):  
Christina K. Chao ◽  
Josephine A. Czechowicz ◽  
Anna H. Messner ◽  
Jorge Alarcón ◽  
Lenka Kolevic Roca ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cell Count ◽  
Hearing Impairment ◽  
Clinical Care ◽  
Univariate Analysis ◽  
Public Hospitals ◽  
Cd4 Cell Count ◽  
High Prevalence ◽  
Cerebral Infection ◽  
Cd4 Cell

Objectives. To measure the prevalence and to identify risk factors of hearing impairment in human immunodeficiency virus-infected children living in Peru. Study design. Cross-sectional observational study. Setting. Two public hospitals and 1 nonprofit center in Lima, Peru, between August 2009 and April 2010. Subjects. A total of 139 HIV-infected children, ages 4 to 19 years. Methods. Hearing impairment and otologic health were assessed with pure tone audiometry, tympanometry, and otoscopy. The primary outcome was hearing loss, defined as average threshold >25dB for 0.5, 1, 2, and 4 kHz, in one or both ears. Historical and socioeconomic information was obtained through parental survey and medical chart review. Statistical analysis included univariate analysis and multivariate logistic regression. Results. Fifty-four (38.8%) of 139 children had hearing impairment. On multivariate analysis, risk factors included: tympanic membrane perforation (odds ratio [OR] 7.08; 95% confidence interval [CI], 1.65-30.5; P = .01), abnormal tympanometry (OR 2.71; 95% CI, 1.09-6.75; P = .03), cerebral infection (OR 11.6; 95% CI, 1.06-126; P = .05), seizures (OR 5.20; 95% CI, 1.21-22.4; P = .03), and CD4 cell count <500 cells/mm3 (OR 3.53; 95% CI, 1.18-10.5; P = .02). Conclusions. The prevalence of hearing impairment in HIV-infected children in Lima, Peru was 38.8%. Middle ear disease, prior cerebral infection, and low CD4 cell count were significantly associated with hearing impairment. The high prevalence of hearing impairment emphasizes the need for periodic hearing assessment in the routine clinical care of HIV-infected children.

scholarly journals RISK FACTORS FOR THE DEVELOPMENT OF NON-HODGKIN’S LYMPHOMA IN PATIENTS WITH HIV AND HEPATITIS С COINFECTION

2013 ◽  
Vol 18 (5) ◽  
pp. 4-8
Author(s):  
E. L Melnikova ◽  
E. V Volchkova ◽  
E. V Ivannikov ◽  
A. Ya Olshansky ◽  
V. N Vdovina ◽  
...  
Keyword(s):  
Risk Factors ◽  
Viral Load ◽  
Cell Count ◽  
Hodgkin's Lymphoma ◽  
Virologic Suppression ◽  
Hiv Viral Load ◽  
Cd4 Cell Count ◽  
The Mean ◽  
Hcv Coinfection ◽  
Cd4 Cell

The objective of the study was to investigate risk factors for the development of non-Hodgkin's lymphoma (NHL) in HIV-infected patients with hepatitis С virus (HCV) coinfection. A total of 37 HIV-positive subjects with NHL treated in the Moscow Center for Prevention and Control of AIDS between 2009 and 2013 were included in the study. HIV patients were divided into 2 groups: 23 cases with HCV coinfection and 14 patients without HCV coinfection. At the time of making the diagnosis of NHL 90% of patients had CD4 cell count < 350 cell/mm 3. The mean CD4 cell count in the first group (120±123 cell/mm 3) was significantly lower (p=0,035), than in patients without HCV coinfection (267±253 cell/mm3). At the time of making the diagnosis of NHL 70% of patients had HIV viral load ≥5,00 log10. The mean viral load was 5,47±1,09 log10 copies/ml in the first group and 4,06±2,03 log10 copies/ml in the second group (p=0,033). At the time of making the diagnosis of NHL 78% of patients did not receive combination antiretroviral therapy (cART). In most patients who received cART virologic suppression unsufficient and CD4 cell count remained to be low. Risk factors associated with an increased risk of NHL in HIV-infected patients with HCV coinfection are low CD4 cell count, high HIV viral load and lack of effective cART. Timely initiation of cART followed by complete virologic suppression and CD4 recovery are key factors to prevent NHL in HIV-infected patients.

scholarly journals Anxiety and Depression Among Women Living with HIV: Prevalence and Correlations

2020 ◽  
Vol 16 (1) ◽  
pp. 59-66
Author(s):  
Abdilahi Yousuf ◽  
Ramli Musa ◽  
Muhammad Lokman Md. Isa ◽  
Siti Roshaidai Mohd Arifin
Keyword(s):  
Cell Count ◽  
Clinical Stage ◽  
Public Hospitals ◽  
Anxiety And Depression ◽  
Hiv Positive ◽  
Cd4 Cell Count ◽  
Women Living With Hiv ◽  
Hiv Positive Women ◽  
Living With Hiv ◽  
Cd4 Cell

Introduction: It has been found that HIV positive women are becoming increasingly affected by various illnesses, including Common Mental Disorders (CMDs) such as depression. Such comorbidity escalates the disease progression to the severe stage and commonly hinders treatment adherence. This study determined the prevalence of anxiety and depression amidst women living with HIV. Methods: Based on a cross-sectional and facility-based study, 357 HIV positive women were recruited using the systematic sampling technique from two public hospitals in Jijiga town, Ethiopia. The Hospital Anxiety and Depression Scale (HADS) was administered for screening, and followed by a pre-tested questionnaire that comprised of Perceived Social Support and HIV stigma. Results: The results revealed that the prevalence of both anxiety and depression amidst HIV positive women was 28.9% and 32.5%, respectively. In the multivariate analysis, it was discovered that lack of formal education, being divorced, unemployed, and earning a monthly income less than 1400 ETB (37.5 USD) were significantly associated with depression. Women with symptomatic HIV clinical stage III (AOR =2.06, 95% C.I (0.75-5.61), with CD4 cell count below 250 (AOR = 1.14, 95% C.I (0.57-2.28), and with co-infections (AOR= 1.04, 95% C.I (0.40-2.71) also suffered from depression. Conclusion: The study outcomes show that the prevalence of depression in women with HIV was 32.5%, but they were more likely to be depressed if they were illiterate, divorced, unemployed or had a financial burden. In addition, HIV positive women with less CD4 cell count and in the final clinical stage or suffered from a co-infection were also associated with depressive symptoms. This signifies the public health implications of psychological and cognitive morbidities of the illness among these women with chronic illnesses. Hence, future mental health interventions and HIV care should be integrated with substantial emphasis given to vulnerable groups, including HIV positive women.

scholarly journals Bone and joint tuberculosis in patients undergoing dialysis: clinical features, risk factors, and outcomes in 17 patients

2020 ◽  
Vol 48 (8) ◽  
pp. 030006052094550
Author(s):  
Xuehua Wu ◽  
Jing Liu ◽  
Guorong Wang ◽  
Fengfeng Wu
Keyword(s):  
Risk Factors ◽  
Cell Count ◽  
Clinical Features ◽  
Medical Records ◽  
Delayed Diagnosis ◽  
Cd4 Cell Count ◽  
Spine Tuberculosis ◽  
The Mean ◽  
Anti Tubercular Therapy ◽  
Cd4 Cell

Objective This study was performed to investigate the clinical features, risk factors, and outcomes of bone and joint tuberculosis in patients undergoing dialysis. Methods We systematically reviewed the medical records of 17 patients with bone and joint tuberculosis undergoing dialysis who were admitted to our hospital from January 2009 to January 2019. Results Seventeen patients with bone and joint tuberculosis undergoing dialysis were identified in this retrospective study, and 13 patients were undergoing hemodialysis. The mean age of the 17 patients was 61.3 years (range, 32–82 years), and 10 (58.9%) patients were male. Most of the patients had a low CD4+ cell count and low hemoglobin and albumin levels. Surgery was performed in 6 patients (35.3%), and 13 of the 17 patients (76.4%) were cured. Three patients had bone or spine sequelae, mainly because of a delayed diagnosis, and one patient died of heart failure. Conclusion These findings indicate that older age, a low CD4+ cell count, and low hemoglobin and albumin levels are possible risk factors for bone and spine tuberculosis in patients undergoing dialysis. If diagnosed early, most patients should have a good outcome after anti-tubercular therapy with or without surgery.

Impact of Combined Anti-Retroviral Therapy on HIV-Associated Non-Hodgkin-Lymphoma - a Prospective European Multi-Cohort Study on Behalf of the Collaboration of Observational HIV Epidemiological Research Europe (COHERE) Study Group

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 878-878
Author(s):  
Julia Bohlius
Keyword(s):  
Risk Factors ◽  
Cell Count ◽  
Hodgkin Lymphoma ◽  
Cd4 Cell Count ◽  
Non Hodgkin Lymphoma ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
One Year ◽  
Cd4 Cell ◽  
Hiv 1

Abstract Background: Following its introduction in 1996, combination antiretroviral therapy (cART) has led to a substantial reduction in HIV-associated morbidity and mortality. The decline has, however, been less pronounced for non-Hodgkin lymphoma (NHL) than for other HIV-related complications, and NHL has become the most common cancer associated with HIV. Within the framework of a large prospective European multi-cohort project, the Collaboration of Observational HIV Epidemiological Research Europe (COHERE), we studied the incidence and risk factors for the development and survival of NHL in HIV-infected patients in the cART era. Methods: We analyzed the data of HIV- infected adult patients (aged >16 years) who were cART naïve at inclusion and started cART after 01.01.1998, at a time when cART had become well established and widely used in Europe. cART was defined as a regimen of at least 3 antiretroviral drugs. Patients had to have CD4 count measurements available before the start of cART and the diagnosis of NHL. Patients developing NHL before receiving cART (“not on cART”) and patients developing NHL while receiving cART (“on cART”) were analyzed separately. Both patients with Primary Brain Lymphoma (PBL) and systemic NHL were included in the analysis. Incidence rates were calculated based on the Poisson distribution; risk factors were estimated using crude and adjusted Weibull models, with random effects to account for heterogeneity between cohorts. Models with time varying covariates were used to explore the effects of CD4 cell counts and plasma HIV-RNA loads over time. Survival was estimated using Kaplan-Meier life table probabilities, with 95% confidence intervals (95% CI). Results: For the incidence analysis 56,305 patients from 22 cohort studies across Europe with 212,042 person-years at risk were evaluated. The incidence for NHL (both systemic NHL and PBL) in patients not on cART was 519 (95% CI 448 to 602) per 100,000 personyears compared to 229 (95% CI 208 to 252) per 100,000 person-years in those on cART. The corresponding rates for PBL were 57 (95% CI 36 to 89) per 100,000 person-years and 24 (95% CI 18 to 33) per 100,000 person years. In cART naïve patients risk factors for NHL were older age and low CD4 cell count nadirs. When included as time up-dated variables, high plasma HIV-1 RNA loads and low CD4 cell counts emerged as important risk factors. In patients receiving cART risk factors included low CD4 cell count nadirs, older age, and groups associated with HHV-8 infection, i.e. men having sex with men and patients with a previous diagnosis of Kaposi Sarcoma. Time up-dated HIV-1 RNA plasma concentration and CD4 cell count were also associated with developing NHL while on cART. For the survival analysis 847 NHL patients were eligible. Of those, 364 (43%) were cART naïve at diagnosis of NHL. After one year 66% (95% CI 63%–70%) of patients with systemic NHL and 54% (95% CI 43%–65%) of patients with PBL were alive. Risk factors for death were diagnosis of PBL, low CD4 cell count nadir and history of injection drug use. Conclusions: Combined anti-retroviral therapy reduces the risk of developing NHL. In the era of cART more advanced immunodeficiency is the dominant risk factors for developing NHL both in patients receiving and not receiving cART. Two thirds of patients diagnosed with HIV-related NHL other than PBL survive for longer than one year after diagnosis. Survival is poorer in patients diagnosed with PBL.

Plasma cytomegalovirus DNA, pp65 antigenaemia and a low CD4 cell count remain risk factors for cytomegalovirus disease in patients receiving highly active antiretroviral therapy

AIDS ◽  
2000 ◽  
Vol 14 (8) ◽  
pp. 1041-1049 ◽  
Author(s):  
Dominique Salmon-Céron ◽  
Marie-Christine Mazeron ◽  
Sophie Chaput ◽  
Norjis Boukli ◽  
Brigitte Senechal ◽  
...  
Keyword(s):  
Risk Factors ◽  
Antiretroviral Therapy ◽  
Cell Count ◽  
Highly Active Antiretroviral Therapy ◽  
Cytomegalovirus Disease ◽  
Cd4 Cell Count ◽  
Highly Active ◽  
Cd4 Cell

scholarly journals Determining the Factors Affecting the Survival of HIV Patients: Comparison of Cox Model and the Random Survival Forest Method

2019 ◽  
Vol 8 (2) ◽  
pp. 124-129
Author(s):  
Nasim Karimi ◽  
Maliheh Safari ◽  
Mohammad Mirzaei ◽  
Amir Kassaeian ◽  
Ghodratollah Roshanaei ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cell Count ◽  
Patient Survival ◽  
Cox Model ◽  
Hiv Patients ◽  
Cd4 Cell Count ◽  
Factors Affecting ◽  
History Of ◽  
Cd4 Cell ◽  
Random Survival Forest

Background: In recent years, sexually transmitted diseases such as AIDS have become an epidemic and are growing rapidly. Given the importance of controlling the disease in recent years, the awareness of the most important risk factors associated with patient survival is important. Therefore, this study aimed to determine the most important factors affecting the survival of HIV patients using the random survival forest (RSF) method. Materials and Methods: In this retrospective study, medical records of 769 HIV patients in Hamadan Health Center from 1997 to 2017 were used to determine the most important factors in patient survival using Cox proportional hazards model and RSF method. The Brier score and C-index were applied to compare the Cox model and RSF method. Results: Based on the results, 662 (86.1%) patients were male. The mean ± SD diagnosis age was 33.83 ± 9.63 years. Using Cox model, variables such as injection history, co-injection history, tuberculosis (TB) status, the first CD4 cell count, and the time of disease diagnosis until TB were determined to be variables affecting the survival of patients. According to the hazard ratio (HR), the risk of death for those with a history of injections was 12.328 times greater than that of noninjectors, and for those with TB, it was 13.565 times greater than that of non-TB patients. An increase in CD4 cell counts was associated with a decline in the risk of mortality. Based on the log-rank model, the variables such as the time until diagnosis of TB, the first CD4 cell count, ART, and history of co-injection had the highest impact on predicting the survival of HIV+ patients, respectively. Conclusion: In case of the presence of many risk factors and the relationship between risk factors, the use of RSF offers a better performance in determining the influential survival factors as compared to Cox model which has limiting presumptions.

scholarly journals A study of renal dysfunction among HIV-infected patients on tenofovir based ART regimen in the Northeast part of India

2020 ◽  
Vol 7 (8) ◽  
pp. 1227
Author(s):  
Lourembam Gayatri ◽  
Nang N. Manpang ◽  
Duyu Nobing ◽  
Dhanaraj S. Chongtham ◽  
M. Bijoy Singh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hiv Infection ◽  
Creatinine Clearance ◽  
Cell Count ◽  
Renal Dysfunction ◽  
Old Age ◽  
Medical Sciences ◽  
Hiv Patients ◽  
Cd4 Cell Count ◽  
Cd4 Cell

Background: Tenofovir is an integral part of the currently used antiretroviral therapy (ART) regime. However, nephrotoxicity has been a concern. This study has been undertaken to evaluate the prevalence and risk factors of renal dysfunction among HIV-patients on tenofovir containing ART regime.Methods: This cohort study was conducted at Regional Institute of Medical Sciences. HIV-patients newly started on tenofovir containing ART regime were subjected to detailed history, thorough physical examination, and routine investigations. Serum creatinine levels and creatinine clearance were measured at regular intervals.Results: Mean age of the patients was 42.37±10.8 years. Most of the patients had normal BMI (66%) and 22% were obese while 12% of the cases were underweight. Majority of the patients had CD4 count less than 350 cells/cumm. Renal dysfunction, defined as creatinine clearance <50 ml/min, developed in 9% of the patients at 3 months and in 33% of the patients at 6 months. Old age, low CD4 cell count, HCV co-infection, and advanced HIV infection were found to be important risk factors.Conclusions: Development of renal dysfunction is common among HIV patients receiving tenofovir-based ART regimen. Old age, low CD4 cell count, HCV co-infection, and advanced HIV infection were found to be important risk factors.

scholarly journals Prevalence and Risk Factors of Cytopenia in HIV-Infected Patients before and after the Initiation of HAART

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Lina Fan ◽  
Cuilin Li ◽  
Hongxin Zhao
Keyword(s):  
Risk Factors ◽  
Cell Count ◽  
Blood Cells ◽  
Stage Iv ◽  
Cd4 Cell Count ◽  
Highly Active ◽  
B Virus ◽  
Immunodeficiency Virus ◽  
Before And After ◽  
Cd4 Cell

Background. Cytopenia is a frequent hematological disorder in patients with human immunodeficiency virus (HIV) infection. However, the distribution and risk factors of cytopenia in patients starting highly active anti-retrovirus treatment (HAART) and the effect of HAART on cytopenia were not fully investigated. Methods. From November 2004 to August 2016, a retrospective study was conducted to evaluate the prevalence of cytopenia in 4325 HAART-naïve patients. Risk factors of cytopenia at baseline and on recovery from cytopenia were analyzed using logistic regression analysis after 24 months of HAART in Beijing Ditan Hospital. Results. The prevalence of cytopenia was 19.1% in HIV-naïve patients. Risk factors for cytopenia in HAART-naïve patients were a CD4 cell count<200 cells/μL, femaleness, WHO stage IV, coinfection with hepatitis B virus (HBV), BMI <18.5 kg/m2, a viral load ≥100,000 copies/ml, and age ≥40 years. In total, 70.2% and 76.4% of patients with cytopenia recovered after 6 and 24 months of HAART, respectively. The predictors of patients without normal blood cells after 24 months HAART were a CD4 cell count of <200 cells/μL at baseline, femaleness, WHO stage IV, coinfection with HBV, and treatment with AZT. Conclusion. Early detection could decrease the prevalence of HIV-related cytopenia, while starting HAART as early as possible seems to be effective for normalization of the blood cells in HIV-infected patients.

Incidence of HCV Reinfection Among HIV-Positive MSM and Its Association With Sexual Risk Behavior: A Longitudinal Analysis

2020 ◽  
Author(s):  
Astrid M Newsum ◽  
Amy Matser ◽  
Janke Schinkel ◽  
Marc van der Valk ◽  
Kees Brinkman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cell Count ◽  
Risk Behavior ◽  
Sexual Risk ◽  
Sexual Risk Behavior ◽  
Hcv Infection ◽  
Hiv Positive ◽  
Spontaneous Clearance ◽  
Cd4 Cell Count ◽  
Cd4 Cell

Abstract Background Human immunodeficiency virus (HIV)-positive men who have sex with men (MSM) are at high risk of hepatitis C virus (HCV) reinfection following clearance of HCV, but risk factors specifically for reinfection have never been comprehensively assessed. Methods Using data from a prospective observational cohort study among HIV-positive MSM with an acute HCV infection (MOSAIC), the incidence of HCV reinfection following spontaneous clearance or successful treatment was assessed. A univariable Bayesian exponential survival model was used to identify risk factors associated with HCV reinfection. Results In total, 122 HIV-positive MSM who had a spontaneously cleared or successfully treated HCV infection between 2003 and 2017 were included. During a median follow-up of 1.4 years (interquartile range [IQR] 0.5–3.8), 34 HCV reinfections were observed in 28 patients. The incidence of HCV reinfection was 11.5/100 person-years and among those with reinfection, median time to reinfection was 1.3 years (IQR 0.6–2.7). HCV reinfection was associated with receptive condomless anal intercourse, sharing of sex toys, group sex, anal rinsing before sex, ≥10 casual sex partners in the last 6 months, nadir CD4 cell count &lt;200 cells/mm3, and recent CD4 cell count &lt;500 cells/mm3. Conclusions Incidence of HCV reinfection was high and strongly associated with sexual risk behavior, highlighting the need for interventions to reduce risk behavior and prevent HCV reinfections among HIV-positive MSM.

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