Perioperative outcomes in human immunodeficiency virus-infected patients – the PRO HIV study

2018 ◽  
Vol 29 (10) ◽  
pp. 968-973 ◽  
Author(s):  
Divyashree Shanthamurthy ◽  
Abi Manesh ◽  
Naveena GP Zacchaeus ◽  
Lisa R Roy ◽  
Priscilla Rupali
Keyword(s):  
Surgical Procedures ◽  
Median Duration ◽  
Surgical Outcomes ◽  
Surgical Outcome ◽  
Tertiary Care ◽  
Perioperative Outcomes ◽  
Care Hospital ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Cd4 Cell

It is estimated that a quarter of patients with HIV/AIDS undergo at least one surgical procedure in their life time. Surgical outcomes in these patients from developing countries are poorly characterized and surgeons are often concerned about poor surgical outcomes, especially when their CD4 cell counts are less than 200 cells/µl. This study evaluated the surgical outcomes of HIV-infected patients undergoing various surgical procedures over a six-year period in a large tertiary care hospital from South India. Two hundred and ninety-three patients underwent 374 surgical procedures during the study period. The median duration of HIV prior to surgery was 1.9 years (range 0–18.8 years). Two-thirds (58%) were on highly active antiretroviral therapy (HAART) at the time of surgery with the median duration of this treatment being 38 months (n = 194). About one-third (35%) of surgical procedures were performed as an emergency. Abdomino-pelvic surgeries were the most common (225, 60%). Adverse surgical outcome defined as death or post-operative infection was seen in 25 (6.6%). The post-operative infection rate was 5% (20/374). The most common of these was surgical site infection observed in nine (60%) followed by pneumonia in five patients (33%) and urinary tract infection in one patient. Day 30 mortality was 2% (n = 8) and a quarter of these were reported to be related to post-operative infectious complications. On multivariate analysis, only preoperative haemoglobin of less than 10 g/dl was significantly associated with a poor surgical outcome. HIV-related parameters such as CD4 cell counts, duration of HIV infection and HAART regimen did not seem to contribute towards an adverse surgical outcome.

Homelessness among an inpatient HIV-positive cohort at a tertiary care hospital in central London

2020 ◽  
Vol 31 (7) ◽  
pp. 705-707
Author(s):  
Venkateshwaran Sivaraj ◽  
Rudiger Pittrof ◽  
Olubanke Davies ◽  
Ranjababu Kulasegaram
Keyword(s):  
Bacterial Infections ◽  
Substance Misuse ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Hiv Positive ◽  
Care Hospital ◽  
Hiv Viral Load ◽  
Cd4 Cell Count ◽  
Cell Counts ◽  
Cd4 Cell

A cohort review was conducted at a central London tertiary care hospital trust on the prevalence of homelessness among human immunodeficiency virus (HIV)-positive inpatients over a year. Data were collected on the duration of inpatient stay, co-morbidities including acquired immune deficiency syndrome (AIDS)-defining illnesses, co-infections, initiation of antiretroviral therapy, CD4 cell count, HIV viral load and substance misuse. Homeless people were found to be at high risk for hepatitis C, mental health illness, substance misuse including injecting drug use, recurrent bacterial infections, AIDS-associated illnesses, lower CD4 cell counts and HIV viremia. They also had more missed HIV outpatient appointments. It was highlighted that a multidisciplinary approach in their care was necessary to address their needs and reduce the morbidity burden in this cohort.

scholarly journals CD4 T Cell Count in Newly diagnosed PTB Patients With Reference to their HIV Sero status

2017 ◽  
Vol 15 (2) ◽  
pp. 32-39
Author(s):  
Piyush Rajbhandari ◽  
Shyamal Kumar Bhattacharya ◽  
Rajendra Gurung ◽  
Nimesh Poudyal ◽  
Bickram Pradhan
Keyword(s):  
T Cells ◽  
Cell Count ◽  
Tertiary Care ◽  
Healthy Population ◽  
Care Hospital ◽  
National Guidelines ◽  
Infected Population ◽  
Cell Counts ◽  
The Mean ◽  
Cd4 Cell

Introduction: CD4 and CD8 T cells facilitate the containment of tuberculosis (TB) and has been postulated that there will be changes in their level in patients with TB. This study was carried out to analyze the CD4 cell counts in pulmonary tuberculosis (PTB) patients with reference to their HIV status.Methods: A cross-sectional study was conducted at the Department of Microbiology of a tertiary care hospital of eastern Nepal from May 2012 to April 2013. A total of 160 individuals, 40 each in the PTB, PTB/HIV, HIV and healthy population were included after obtaining informed consent. PTB and HIV diagnosis was made according to national guidelines. CD4 T cells were analyzed using a BD FACS Count Cytometer. Data were entered in Microsoft Excel 2007 and analyzed using SPSS version 11.7.Results: The mean absolute CD4 cells in PTB patient were 562.20 ± 197.3 cells/ul, which was a clear reduction (p < 0.001) when compared to the healthy population of this area (786.30 ± 239.17 cells/ul). There was significant decrease in the CD4 level among the HIV/TB patient (123.70 ± 99.4 cells/ul) as compared to PTB patient without HIV (p < 0.001). The study also noted that the mean CD4 cell level among HIV infected population (249.68 cells/ul) was higher compared to the HIV/TB co-infected population (p < 0.05).Conclusion: CD4 cell count can reflect the degree of immunosuppression in PTB patient irrespective of their HIV status but it cannot predict the disease severity in PTB patient.  

scholarly journals Spectrum of opportunistic infections in relation to CD4 counts in HIV/AIDS patients admitted in the department of general medicine of a tertiary care hospital

2019 ◽  
Vol 6 (3) ◽  
pp. 845
Author(s):  
Deepak Pandharpurkar ◽  
Nagender Devulapally ◽  
B. Gouthami ◽  
Gudikandula Krishna
Keyword(s):  
Cell Count ◽  
Opportunistic Infections ◽  
Tertiary Care ◽  
Pneumocystis Carinii ◽  
Fatal Outcome ◽  
Care Hospital ◽  
Becton Dickinson ◽  
Cell Counts ◽  
Cd4 Cell ◽  
Hiv Aids

Background: HIV/AIDS was first recognized in USA in 1981 when centre for disease control (CDC) reported unexplained occurrence of Pneumocystis carinii pneumonia in 5 healthy homosexuals. Soon it was recognized in drug abusers and blood transfusion recipients. The present study has been taken up with an aim to know the incidence of various opportunistic infections in HIV positive patients and to correlate different opportunistic infections (OIs) with the CD4+cellcount.Methods: Sample of 132 cases admitted in Gandhi hospital during the study period were taken. CD4+ counting of blood samples was done by Flow cytometry as per manufacturer’s instructions (FACS Calibur, Becton- Dickinson, Immunocytometry system). Correlation of CD4 cell counts was done with the respective opportunistic infections.Results: TB (50%) is the most frequent OI followed by candidiasis (49%), pneumocystis (16%) and others. The mean CD4 cell count in TB was 110.80/mL and in candidiasis 97.84/mL. Low values were observed in CMV (27/mL) and in toxoplasmosis (61.66/mL).Conclusions: In most of the patient’s respiratory system was the most common system involved by OIs and had CD4 T cell count below 200/mL. Early diagnosis and prompt treatment of opportunistic infections is important. This study helps the clinicians in proper guidance to come up before development of severe immunodeficiency to prevent serious and fatal outcome.

scholarly journals Mucocutaneous manifestations in newly diagnosed cases of HIV, correlation with CD4 counts and WHO staging at a tertiary care center

2017 ◽  
Vol 3 (3) ◽  
pp. 448
Author(s):  
Krishna Santosh ◽  
Chandan Ashokan ◽  
Avisa Vijay Mohan Rao
Keyword(s):  
Health Care ◽  
Hiv Infection ◽  
Tertiary Care ◽  
Clinical Staging ◽  
Age Group ◽  
Newly Diagnosed ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Route Of Transmission ◽  
Cd4 Cell

<p class="abstract"><strong><span lang="EN-US">Background:</span></strong>Mucocutaneous infections have played an important role in initial diagnosis of HIV infection and in clinical staging of the disease. Mucocutaneous manifestations in HIV infected individuals are myriad and can serve as a main indicator of other problems. Health care personnel involved in HIV health care must therefore have a clear idea of type, pattern, and prevalence of skin diseases in their locality. <span lang="EN-US">The objective of the study was </span>to determine the various mucocutaneous manifestations in newly diagnosed cases of HIV and to correlate them with CD4 cell counts. The manifestations and CD4 cell counts are correlated with WHO staging of the disease.</p><p class="abstract"><strong><span lang="EN-US">Methods:</span></strong>Data was collected from all the newly diagnosed cases of HIV presenting to the Department of Dermatology. Thorough clinical examination was done and findings were noted. CD4 cell counts were performed by FACS counter and supportive laboratory tests were done for diagnosis of other skin manifestations<span lang="EN-US">.<strong></strong></span></p><p class="abstract"><strong><span lang="EN-US">Results:</span></strong>250 cases were enrolled with males 148 and 102 females. Most common age group was middle age group and hetero sexual route was the most common route of transmission. Bacterial skin infections were more common and candidiasis was most common among fungal infections. Herpes zoster was most common in viral infections. Significant correlation was observed between CD4 cell counts and WHO clinical staging of disease. Majority of infections were more common at advanced stage of HIV.</p><p class="abstract"><strong><span lang="EN-US">Conclusions:</span></strong>To conclude, HIV-related mucocutaneous manifestations are a good clinical clue in diagnosis of advanced stages of HIV. Most of these manifestations can serve as diagnostic and prognostic markers in HIV infection. Management of HIV related mucocutaneous manifestations should always be precluded with a screening of CD4 cell counts. A lowered CD4 cell counts will prolong the duration of treatment and may significantly alter the outcome of the disease.</p>

scholarly journals Factors associated with prognostic or treatment outcomes in HIV/AIDS patients with and without hypertension in Eswatini

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sabelo Bonginkosi Dlamini ◽  
Hans-Uwe Dahms ◽  
Ming-Tsang Wu
Keyword(s):  
Viral Load ◽  
P Value ◽  
Aids Patients ◽  
Large Hospital ◽  
Hypertensive Patients ◽  
Factors Associated ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Cd4 Cell ◽  
Hiv Aids

AbstractNon-communicable diseases are increasing faster in HIV/AIDS patients than in the general population. We studied the association between hypertension and other possible confounding factors on viral load and CD4-cell counts in hypertensive and non-hypertensive HIV/AIDS patients receiving antiretroviral therapy (ART) at a large hospital in Eswatini over a 4-year period. We performed a retrospective longitudinal review of the medical records of 560 ART patients divided into non-hypertension and hypertension groups (n = 325 and n = 235) from July 27 to September 8, 2018. Generalized Estimated Equation was used to analyze the longitudinal data. Hypertensive patients were more likely to have improved CD4-cell counts than non-hypertensive patients (OR = 1.83, [1.37–2.44]). ART patients with hypertension were more likely to have detectable viral loads, though not significant (OR = 1.37 [0.77–2.43]). In non-hypertensive patients, second line ART was significantly associated with viral load (OR = 8.61 [2.93–25.34]) and adverse side effects (OR = 3.50 [1.06–11.54]), while isoniazid preventive therapy was significantly associated with CD4-cell counts (OR = 1.68 [1.16–2.45]). In hypertensive patients, factors associated with viral load were WHO HIV stage (OR = 2.84 [1.03–7.85]) and adherence (OR = 8.08 [1.33–49.04]). In both groups, CD4-cell counts significantly and steadily increased over time (p-value < 0.001). Results show a significant association between hypertension and CD4 cell counts but not viral load. In ART patients with and without hypertension, the factors associated with prognostic markers were different. More attention may need to be paid to ART patients with well controlled HIV status to monitoring and controlling of hypertension status.

Causes and outcomes of hospitalizations among people living with HIV in Georgia’s referral institution, 2012–2017

2021 ◽  
Vol 32 (7) ◽  
pp. 662-670
Author(s):  
Nino Rukhadze ◽  
Ole Kirk ◽  
Nikoloz Chkhartishvili ◽  
Natalia Bolokadze ◽  
Lali Sharvadze ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Clinical Immunology ◽  
Fatal Outcome ◽  
Cd4 Count ◽  
People Living With Hiv ◽  
Lethal Outcome ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Living With Hiv ◽  
Cd4 Cell

We assessed trends in causes and outcomes of hospitalization among people living with HIV (PLWH) admitted to the Infectious Diseases, AIDS and Clinical Immunology Research Center (IDACIRC) in Tbilisi, Georgia. Retrospective analysis included adult PLWH admitted to IDACIRC for at least 24 h. Internationally validated categorization was used to split AIDS admissions into mild, moderate, and severe AIDS. A total of 2085 hospitalizations among 1123 PLWH were registered over 2012–2017 with 65.1% (731/1123) of patients presenting with CD4 count <200. Of 2085 hospitalizations, 931 (44.7%) were due to AIDS-defining illnesses. In 2012, AIDS conditions accounted for 50.3% of admissions compared to 41.6% in 2017 ( p = 0.16). Overall, 167 hospitalizations (8.0%) resulted in lethal outcome. AIDS admissions had higher mortality than non-AIDS admissions (11.5% vs 5.2%, p < 0.0001). Among 167 deceased patients, 137 (82.0%) had CD4 count <200 at admission. In multivariate analysis, factors significantly associated with mortality included severe AIDS versus non-AIDS admission (OR 2.81, 95% CI: 1.10–7.15), CD4 cell counts <50 (OR 4.34, 95% CI: 2.52–7.47), and 50–100 (OR 2.37, 95% CI: 1.27–4.42) versus >200. Active AIDS disease remains a significant cause of hospitalization and fatal outcome in Georgia. Earlier diagnosis of HIV is critical for decreasing AIDS hospitalizations and mortality.

scholarly journals Increased Hepatitis E Virus Seroprevalence Correlates with Lower CD4+ Cell Counts in HIV-Infected Persons in Argentina

PLoS ONE ◽  
2016 ◽  
Vol 11 (7) ◽  
pp. e0160082 ◽  
Author(s):  
José D. Debes ◽  
Maribel Martínez Wassaf ◽  
María Belén Pisano ◽  
María Beatriz Isa ◽  
Martin Lotto ◽  
...  
Keyword(s):  
Hepatitis E Virus ◽  
Hepatitis E ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Cd4 Cell

Factors associated with late presentation of HIV infection in Catalonia, Spain

2012 ◽  
Vol 23 (7) ◽  
pp. 475-480 ◽  
Author(s):  
N Vives ◽  
D Carnicer-Pont ◽  
P Garcia De Olalla ◽  
N Camps ◽  
A Esteve ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Late Presentation ◽  
Late Diagnosis ◽  
Cd4 Cell Count ◽  
Hiv Surveillance ◽  
Factors Associated ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Populations At Risk ◽  
Cd4 Cell

We sought to describe the prevalence, trends and factors associated with late diagnosis of HIV infection between 2001 and 2008 in Catalonia, Spain. Adults over 13 years of age with available CD4 cell counts, who were notified to the Catalonia Voluntary HIV Surveillance System between January 2001 and December 2008, were included in the study. Late presentation for HIV infection was defined as a CD4 cell count <350 cells/μL or with an AIDS-defining condition at presentation. Multivariable logistic regression was used to identify factors independently associated with late diagnosis of HIV. Of the 4651 newly diagnosed HIV-infected individuals with available CD4 counts, 2598 (55.9%) were diagnosed late. The proportion of people with a late diagnosis decreased from 60.4% in 2001 to 50% in 2008, a significant trend ( P < 0.001). Older age, male gender, foreign birth, heterosexuality and injecting drug use were independent risk factors for late diagnosis. Strategies to actively promote HIV testing to populations at risk of late diagnosis of HIV or those never attending health systems should be implemented.

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