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 Assessment of adherence to ATT among HIV-TB co-infected patients attending the ART centre of a tertiary care hospital of Jharkhand

2019 ◽  
Vol 6 (2) ◽  
pp. 619
Author(s):  
Abhishek Kumar ◽  
Vivek Kashyap
Keyword(s):  
Prospective Study ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Hiv Positive ◽  
Care Hospital ◽  
Medical Sciences ◽  
Cd4 Cell Count ◽  
Common Opportunistic Infection ◽  
Cd4 Cell

Background: Despite being preventable and curable, TB is the leading cause of HIV associated mortality. It is the most common opportunistic infection among HIV positive individuals with CD4 cell count <500/ mm3. Worldwide the number of people infected with both HIV & TB is rising. The objective of the study was to describe the socio-demographic profile of HIV-TB co-infected patients and to assess the adherence of HIV TB Co-infected patients to anti tubercular treatment (ATT) attending ART Centre, RIMS, Ranchi.Methods: It was a hospital based prospective study done at Rajendra Institute of Medical Sciences (RIMS), Ranchi. Duration of study was 14 months. A total of 117 patients were registered during the study period and were followed up for adherence to ATT.Results: Out of 117 patients 4 were excluded. Among 113 patients, mostly were male (74.3%) and from rural background (69.9%). Majority (94.7%) of the patients came for regular follow up and took medicines as advised. Adherence was significantly associated with education (p=0.025).Conclusions: In this study it was concluded that education significantly affected adherence to ATT among HIV-TB Co-infected patients of ART Centre of RIMS, Ranchi.

FACTORS ASSOCIATED WITH THE OUTCOME OF ATT AMONG HIV-TB COINFECTED PATIENTS ATTENDING THE ART CENTRE OF A TERTIARY CARE HOSPITAL OF JHARKHAND: A PROSPECTIVE HOSPITAL BASED STUDY

2021 ◽  
pp. 3-4
Author(s):  
Abhishek Kumar ◽  
Mithilesh Kumar ◽  
Vivek Kashyap
Keyword(s):  
Tertiary Care Hospital ◽  
Treatment Success ◽  
Tertiary Care ◽  
Demographic Variables ◽  
Hiv Positive ◽  
Care Hospital ◽  
Medical Sciences ◽  
Cd4 Cell Count ◽  
Tb Treatment ◽  
Cd4 Cell

Background: Despite being preventable and curable, TB is the leading cause of HIV associated mortality. It is the most common opportunistic 3 infection among HIV positive individuals with CD4 cell count < 500/mm . Worldwide the number of people infected with both HIV& TB is rising. Objectives: To assess the treatment outcome of HIV-TB Co-infected patients on Anti Tubercular treatment (ATT) attending ART Centre, RIMS, Ranchi. Methods: It was a hospital based prospective study done at the ART centre of Rajendra Institute of Medical Sciences (RIMS), Ranchi. Duration of study was 14 months. Atotal of 117 patients were registered during the study period and were followed up for outcome of ATT. Results: Out of 117 patients 4 were excluded and from remaining 113 patients, treatment success was found to be 88.5%. No signicant association was found among any of the socio-demographic variables and outcome of TB treatment. Conclusion: In this study it was concluded that sociodemographic prole had no signicant association (p>0.05) with the outcome of TB treatment and treatment success (Cured & Treatment completed) was found in 88.5% of the HIV-TB co-infected patients

scholarly journals Kaposi Sarcoma in HIV Infected Patients

2016 ◽  
Vol 62 (2) ◽  
pp. 285-288
Author(s):  
Raluca Jipa ◽  
Oana Săndulescu ◽  
Eliza Manea ◽  
Şerban Benea ◽  
Otilia Benea ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Kaposi Sarcoma ◽  
Stage Iv ◽  
Care Hospital ◽  
Gastrointestinal Involvement ◽  
Late Presenters ◽  
Cd4 Cell Count ◽  
Poor Risk ◽  
Cd4 Cell

AbstractObjective: The aim of the study was to describe clinical and laboratory characteristics in HIV-infected patients with Kaposi sarcoma (KS).Methods: We retrospectively studied data on HIV-infected patients hospitalized in one tertiary care hospital in Bucharest, Romania, in whom Kaposi Sarcoma was diagnosed, between January 2008 and November 2013.Results: We identified 27 HIV-infected patients diagnosed with KS within 6 years. They had a median age of 42 years old and a median CD4 cell count of 101 cells per mm3 at the time of KS diagnosis. All patients received antiretroviral therapy (ART), with 18 patients (66%) already on ART at the time of KS diagnosis. Most patients (59%) were classified as ACTG poor-risk and 56% as Mitsuyasu stage I. The overall prognosis was poor, with 41% mortality, in a median time span of 6 months, significantly correlated with gastrointestinal involvement (p=0.019), poor-risk KS in ACTG classification (p<0.001) and stage IV Mitsuyasu (p=0.006).Conclusion: KS remains an important cause of morbidity and mortality in patients with HIV infection, especially in late presenters.

Sero-Prevalence of Parvovirus B 19 Infection Among HIV Positive Patients Attending Tertiary Care Hospital in Central India

2017 ◽  
Vol 01 (04) ◽  
pp. 127-132
Author(s):  
Bhushan Shrikhande ◽  
Meena Mishra ◽  
Mohiuddin Qazi ◽  
Arvind Kurhade ◽  
Chandrashekhar Unakal ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Central India ◽  
Hiv Positive ◽  
Care Hospital ◽  
Parvovirus B 19

scholarly journals The correlation of tuberculosis smear results and immuno-suppression with CD4+ counts as a surrogate marker among HIV infected patients.

2021 ◽  
Author(s):  
Kingsley Kamvuma ◽  
Yusuf ademola ◽  
Warren Chanda ◽  
Christopher Newton Phiri ◽  
Sam Bezza Phiri ◽  
...  
Keyword(s):  
Cell Count ◽  
Surrogate Marker ◽  
Hiv Positive ◽  
Sputum Smear ◽  
Cd4 Cell Count ◽  
Cd4 Counts ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Study Participants ◽  
Cd4 Cell

Abstract Background: Human immunodeficiency virus (HIV) and M.tuberculosis are two intracellular pathogens that interact at the cellular, clinical and population levels. Since the recognition of AIDS in 1981, the number of reported cases of TB in the has increased substantially, especially in regions with high incidence of AIDS. The main aim of this study was to establish weather there is a relationship between sputum smear positives and low CD4 cell counts among HIV infected patients.Materials and methods: This was a retrospective study involving 473 participants. The patients recruited in this study were those who tested HIV positive and smear positive for TB. Their HIV status was determined by performing an HIV blood test, if they were HIV positive their CD4 cell count were then made.Results: This study examined the relation between smear positivity and low CD4 (below 200cells/µl) together with CD8 and CD3 markers as a measure of immune function among patients infected with HIV. The study participants’ constituted males 67% and females 33%. The overall mean age was 33.2 (SD 6.9) with the youngest and oldest participants being 18 and 60 respectively. It was found that smear positive results negatively (r=-0.13; p=0.021) correlated with CD4+ below 200 cells/µl. No correlation was observed between smear positives and CD8+ or CD3+ since the calculated correlation coefficient was not significant 0.007 (p=0.9) and 0.03 (p=0.6) respectively. There are more 3+ smear results below 200 cells/µl than the others while above 200 cells/µl 1+ was the most commonly reported smear result. The scanty smear positives were the least commonly reported result in the low and high CD4 counts. Conclusion: The smear positive result negatively correlated with a low CD4+ (r=-0.13; p=0.021) but no correlation with low CD+8 and CD+3 results was observed. The long held theory that low bacillary counts in patients with low CD4+ counts needs to be revisited. The reduction of CD4+ cell count parallels' that of the total lymphocyte count and is more marked in patients with high bacillary counts. Further, studies are required to confirm these findings

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.

scholarly journals Prevalence of Human Immunodeficiency Virus in Antenatal Mothers in a Rural Tertiary Care Hospital

2014 ◽  
Vol 6 (3) ◽  
pp. 159-162
Author(s):  
Dhrubajyoti Sarkar ◽  
Banasree Bhadra ◽  
Suvobrata Sarkar ◽  
Biswajit Chakraborty
Keyword(s):  
Human Immunodeficiency Virus ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Rapid Test ◽  
Hiv Positive ◽  
Care Hospital ◽  
Counseling And Testing ◽  
Test Kit ◽  
Immunodeficiency Virus ◽  
Integrated Counseling

ABSTRACT Objective To know the prevalence of human immunodeficiency virus (HIV) among antenatal mothers. Materials and methods It is a retrospective study of antenatal mothers attending the integrated counseling and testing centre (ICTC), College of Medicine and JNM Hospital, Kalyani, from January 2009 to December 2013. Antenatal mothers were counseled and in those willing to undergo test rapid testing was done. First time positive cases were retested two more times by two different companies rapid test kit. The samples were considered as positive when found reactive by all three different methods. Results In our study, a total number of 11343 new antenatal mothers were registered. The pretest counseling could be done for 9437 antenatal mothers. After counseling, testing could be done in 9211 antenatal mothers. In our 5 years study period, a total of six cases were HIV positive. Out of these HIV positive cases, three were in 2009, no case was detected in 2010, one was in 2011, one in 2012 and one in 2013. Thus, the incidence of HIV (in tested mothers) is 0.13% in 2009, 0 in 2010, 0.06% in 2011, 0.07% in 2012 and 0.05% in 2013. Overall incidence was 0.065%. Conclusion There is a declining trend of HIV prevalence among antenatal mothers reflecting that prevention campaigns are working effectively. How to cite this article Bhadra B , S arkar D , S arkar S ,Chakraborty B. Prevalence of Human Immunodeficiency Virus in Antenatal Mothers in a Rural Tertiary Care Hospital. J South Asian Feder Obst Gynae 2014;6(3):159-162.

Opportunistic infection at the start of antiretroviral therapy and baseline CD4+ count less than 50 cells/mm3 are associated with poor immunological recovery

2019 ◽  
Vol 30 (2) ◽  
pp. 163-171
Author(s):  
Amod Tilak ◽  
Smita Shenoy ◽  
Muralidhar Varma ◽  
Asha Kamath ◽  
Amruta Tripathy ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Opportunistic Infection ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Hiv Positive ◽  
P Value ◽  
Care Hospital ◽  
Long Term Treatment ◽  
Immunological Recovery

AbstractIntroductionThere is a dearth of studies assessing the efficacy and immunological improvement in patients started on antiretroviral therapy (ART) in India. This study was undertaken to assess the 2-year treatment outcomes in HIV-positive patients initiated on ART in a tertiary-care hospital.MethodsAfter approval from the Institutional Ethics Committee, adult HIV-positive patients from a tertiary-care hospital, initiated on ART between January 2013 and February 2015, were included in the study. Data on clinical and immunological parameters were obtained from medical case records over a period of 2 years after initiation of therapy. Intention-to-treat analysis was done using a descriptive approach, using SPSS version 15 (SPSS Inc. Released 2006. SPSS for Windows, Version 15.0. Chicago, SPSS Inc.). A logistic regression analysis was done to assess the predictors for poor outcomes. A p-value <0.05 was considered statistically significant.ResultsART was initiated in 299 adult patients. At 1 and 2 years, the median (interquartile range) change in CD4+cell count was 65 (39, 98) cells/mm3and 160 (95, 245) cells/mm3. The change observed after 2 years of treatment initiation was statistically significant compared with that after 1 year. Three deaths occurred during the study period and 28 were lost to follow-up. Male sex, presence of at least one opportunistic infection at the start of therapy, and baseline CD4+count <50 cells/mm3were associated with poor immunological recovery.ConclusionsWith long-term treatment and regular follow-up, sustained clinical and immunological outcomes can be obtained in resource-limited settings.

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