scholarly journals Clinical features associated with neurosyphilis in people living with HIV and late latent syphilis

2022 ◽  
pp. 095646242110630
Author(s):  
Pedro Martínez-Ayala ◽  
Alejandro Quiñonez-Flores ◽  
Luz Alicia González-Hernández ◽  
Vida Verónica Ruíz-Herrera ◽  
Sergio Zúñiga-Quiñones ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Viral Load ◽  
T Cell ◽  
Cell Count ◽  
Retrospective Analysis ◽  
Laboratory Data ◽  
Neurological Symptoms ◽  
People Living With Hiv ◽  
Living With Hiv ◽  
Latent Syphilis

Background The diagnosis of neurosyphilis is a challenge, and the criteria for deciding when to perform a lumbar puncture are still controversial, especially in people living with HIV with a late latent syphilis diagnosis. Methods Retrospective analysis of demographic, clinical, and laboratory data of people with HIV and documented late latent syphilis or syphilis of unknown duration with a cerebrospinal fluid VDRL test. Results 122 patients were evaluated, of whom 52 had the diagnosis of neurosyphilis. Patients with and without neurosyphilis presented a similar viral load and lymphocyte CD4+ T-cell count. Neurological symptoms (OR 6.4, 95% CI 2.1–22.4; p < 0.01), serum VDRL titers of 1:32 ( p<0.01), 1:64 ( p = 0.055), and ≥1:128 ( p < 0.001) were associated with neurosyphilis. Furthermore, serum VDRL ≥1:32 were associated with (OR 24.9, 95% CI 5.45–154.9; p < 0.001) or without (OR 6.5, 95% CI 2.0–29.2; p = 0.004) neurological symptoms with neurosyphilis; however, VDRL ≤1:16 with neurological symptoms can be associated with neurosyphilis (OR 7.6, 95% CI 1.03–64.3; p = 0.046). Conclusion Neurological symptoms, particularly headache, were predictors of neurosyphilis in people with HIV irrespective of their viral load and lymphocyte CD4+ T-cell count in late latent syphilis. A serum VDRL ≥1:32 increased the risk of neurosyphilis in patients with or without any symptoms.

scholarly journals EBV AND HHV-6 CIRCULATING SUBTYPES IN PEOPLE LIVING WITH HIV IN BURKINA FASO, IMPACT ON CD4 T CELL COUNT AND HIV VIRAL LOAD

2017 ◽  
Vol 9 (1) ◽  
pp. 2017049 ◽  
Author(s):  
Lassina TRAORE ◽  
Ouéogo NIKIEMA ◽  
Abdoul Karim OUATTARA ◽  
Tegwindé Rébéca COMPAORE ◽  
Serge Théophile SOUBEIGA ◽  
...  
Keyword(s):  
Viral Load ◽  
T Cell ◽  
Cell Count ◽  
Cd4 Count ◽  
Cd4 T Cell ◽  
People Living With Hiv ◽  
Study Population ◽  
Living With Hiv ◽  
Hiv 1 ◽  
Cd4 T Cell Count

Epstein Barr Virus (EBV) and Human Herpes Virus 6 (HHV-6) are responsible for severe diseases, particularly in immunocompromised persons. There are poor data on the infection with these opportunistic viruses in Burkina Faso.The purpose of this study is to characterize EBV and HHV-6 subtypes and to assess their impact on CD4 T cell count, HIV-1 viral load and antiretroviral treatment in people living with HIV-1.The study population consisted of 238 HIV-positive patients with information on CD4 count, HIV-1 viral load and HAART. Venous blood samples collected on EDTA tubes were used for EBV and HHV-6 Real Time PCR subtyping.An infection rate of 6.7% (16/238) and 7.1% (17/238) were found respectively for EBV and HHV-6 in the present study. Among EBV infections, similar prevalences were noted for both subtypes (3.9% [9/238] for EBV-1 vs 4.6% [11/238] for EBV-2) with 2.1% (5/238) of co-infection. HHV-6A infection represented 6.3% (15/238) of the study population against 5.0% (12/238) for HHV-6B. . EBV-2 infection was significantly higher in patients with CD4 count ≥ 500 compared to those with CD4 count less than 500 cells (1.65% vs 8.56%, p = 0,011). The prevalence of EBV and HHV-6 infections were almost similar in HAART-naive and HAART-experienced patients.The present study provides information on the prevalence of EBV and HHV-6 subtypes in people living with HIV-1 in Burkina Faso. The study also suggests that HAART treatment has no effect on infection with these opportunistic viruses in people living with HIV-1.

scholarly journals Effect of Social Support on Quality of Life, CD4+ T-cell Count and Viral Load of People Living With HIV/AIDS

10.3823/2082 ◽  
2016 ◽  
Author(s):  
Gilmara Holanda Cunha ◽  
Marli Teresinha Gimeniz Galvão ◽  
Maria Luciana Teles Fiuza ◽  
Maria Amanda Correia Lima ◽  
Samyla Citó Pedrosa ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Social Support ◽  
Viral Load ◽  
T Cell ◽  
Cell Count ◽  
Cd4 T Cell ◽  
People Living With Hiv ◽  
Living With Hiv ◽  
Cd4 T Cell Count

scholarly journals Risk of adverse COVID-19 outcomes for people living with HIV: a rapid review and meta-analysis

2020 ◽  
Author(s):  
Maya Mellor ◽  
Anne Bast ◽  
Nicholas Jones ◽  
Nia Roberts ◽  
Jose Ordonez-Mena ◽  
...  
Keyword(s):  
Viral Load ◽  
T Cell ◽  
Meta Analysis ◽  
Cd4 T Cell ◽  
Rapid Review ◽  
People Living With Hiv ◽  
Hiv Viral Load ◽  
Increased Risk ◽  
Living With Hiv ◽  
Cd4 T Cell Count

Objective: To assess whether people living with HIV (PLWH) are at increased risk of COVID-19 mortality or adverse outcomes, and whether antiretroviral therapy (ART) influences this risk. Design: Rapid review with meta-analysis and narrative synthesis. Methods: We searched databases including Embase, Medline, medRxiv, and Google Scholar up to 26th August 2020 for studies describing COVID-19 outcomes in PLWH and conducted a meta-analysis of higher quality studies. Results: We identified 1,908 studies and included 19 in the review. In a meta-analysis of five studies, PLWH had a higher risk of COVID-19 mortality (hazard ratio (HR) 1.93, 95% Confidence Interval (CI): 1.59-2.34) compared to people without HIV. Risk of death remained elevated for PLWH in a subgroup analysis of hospitalised cohorts (HR 1.54, 95% CI: 1.05-2.24) and studies of PLWH across all settings (HR 2.08, 95%CI: 1.69-2.56). Eight other studies assessed the association between HIV and COVID-19 outcomes, but provided inconclusive, lower-quality evidence due to potential confounding and selection bias. There were insufficient data on the effect of CD4+ T cell count and HIV viral load on COVID-19 outcomes. Eleven studies reported COVID-19 outcomes by ART-regimen. In the two largest studies, tenofovir-disoproxil-fumarate (TDF)-based regimens were associated with a lower risk of adverse COVID-19 outcomes, although these analyses are susceptible to confounding by comorbidities. Conclusion: Evidence is emerging that suggests a moderately increased risk of COVID-19 mortality amongst PLWH. Further investigation into the relationship between COVID-19 outcomes and CD4+ T cell count, HIV viral load, ART and the use of TDF is warranted.

Long-term virological effectiveness with darunavir/ritonavir-based salvage therapy in people living with HIV/AIDS from São Paulo, Brazil

2020 ◽  
Vol 31 (10) ◽  
pp. 967-975
Author(s):  
Ariane Melaré Ramos dos Santos ◽  
Amaury Pachione Martins ◽  
Denise Juliato ◽  
Érique José Farias Peixoto de Miranda ◽  
Giselle Ibette Silva Lopez Lopes ◽  
...  
Keyword(s):  
T Cell ◽  
Cell Count ◽  
Salvage Therapy ◽  
Sao Paulo ◽  
Poor Adherence ◽  
Cd4 T Cell ◽  
People Living With Hiv ◽  
Living With Hiv ◽  
Cd4 T Cell Count

Even though darunavir/ritonavir (DRV/r) has high potency and a greater genetic barrier, there are few studies on the long-term effectiveness of DRV/r-based salvage therapy in people living with HIV (PLWH) in low and middle-income countries. This retrospective cohort study, from São Paulo, Brazil, included ART-experienced PLWH aged ≥18 years with virological failure (VF) who had started DRV/r plus an optimized background regimen (OBR) between 2008 and 2012. The proportion of patients with viral load (VL) <50 copies/mL, the improved mean CD4+ T cell count and the factors associated with VF during the 144-week follow-up were assessed. The study included 173 patients with the following characteristics [median (interquartile range)]: age 48 (42 -53) years; CD4+ T cell count, 229 (89 -376) cells/mm3; VL, 4.26 (3.70 -4.74) log10; 6 (4 -7) previous regimens; and 100 (38 -156) months of VF. After 144 weeks, 129 (75%) patients had VL< 50 copies/mL and a mean increase in the CD4+ T cell count of 190 cells/mm3. VL>100,000 copies/mL and poor adherence were associated with VF. DRV/r plus an OBR showed high long-term virological suppression and immunological recovery. VL>100,000 copies/mL and poor adherence were associated with VF at 144 weeks.

Prevalence, risk factors and impact of cellular immunity on intestinal parasitosis among people living with HIV at Auchi, Edo State, Nigeria

2021 ◽  
pp. 095646242110209
Author(s):  
Leonard I Uzairue ◽  
Marcus Oghena ◽  
Rex Ehizojie Ikede ◽  
Opeyemi Nifemi Aguda ◽  
Yusuff Adebayo Adebisi ◽  
...  
Keyword(s):  
Risk Factors ◽  
T Cell ◽  
Cell Count ◽  
Intestinal Parasites ◽  
Rural Setting ◽  
People Living With Hiv ◽  
Intestinal Parasitosis ◽  
Edo State ◽  
Living With Hiv ◽  
The Impact

This study was sought to determine the impact of CD4+ T-cell count and associated risk factors with intestinal parasitosis in people living with HIV (PLHIV) in Central Hospital, Auchi, Edo State, Nigeria. One hundred and seventy (170) HIV-seropositive subjects were enrolled in the study from 24 August 2015 to 22 January 2016. Sociodemographic data were assessed using structured questionnaires. Blood and stool samples were collected from every participant. CD4+ T-cell count and stool parasitology were performed. The prevalence of intestinal parasites was 44.7%. Helminthiasis (67%) was a predominant infection in the study, while 32.9% had protozoasis. Specifically, Ancylostoma duodenale (33.3%) was the most common helminth, and Trichuris trichiura (7.8%), the least. However, Strongyloides stercoralis, Ascaris lumbricoides and Hymenolepis nana were 13.7%, 31.5% and 13.7%, respectively. Cryptosporidium spp. (25.0%) was the only protozoan. Lower CD4+ T-cell count, ART naivety (OR = 2.62 p < 0.05), residence in a rural setting (OR = 0.89, p < 0.05), and farming occupation (OR = 1.70, p < 0.05) were associated with the prevalence of intestinal parasitosis among PLHIV. This study revealed a significantly high prevalence of intestinal parasitosis in ART naive PLHIV with reduced CD4+ count. Hence, it is recommended to frequently test for intestinal parasitosis and commencement of ART in all PLHIV to improve their health and longevity.

scholarly journals Adjunct Therapy for CD4+ T-Cell Recovery, Inflammation and Immune Activation in People Living With HIV: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Yang Zhang ◽  
Taiyi Jiang ◽  
Aixin Li ◽  
Zhen Li ◽  
Jianhua Hou ◽  
...  
Keyword(s):  
Systematic Review ◽  
T Cell ◽  
Cell Count ◽  
Immune Activation ◽  
Meta Analysis ◽  
People Living With Hiv ◽  
Cell Recovery ◽  
Cell Counts ◽  
Living With Hiv

Background: HIV infection results in immune homeostasis perturbations, which is characterized by CD4+ T-cell depletion, immune activation, and inflammation. Effective antiretroviral therapy (ART) does not fully restore immunologic and clinical health in people living with HIV (PLWH). Various drugs have been used to improve their immune status and CD4+ T-cell counts, but no measures have been tested effective. Here we conduct a systematic review and meta-analysis of existing clinical studies on improving CD4+ T-cell count while decreasing inflammation and immune activation.Methods: We retrieved possible relevant publications from a total of five electronic databases and selected eligible studies, which dealt with outcomes of medical therapy for CD4+ T-cell count recovery, inflammation, and immune activation with or without ART. We paid particular attention to immunologic non-responders with a favorable treatment regimen.Results: Thirty-three articles were included in the systematic review and meta-analysis. However, there were no safe and effective medications specific for improving CD4+ T-cell reconstitution. The immunological benefits or adverse events mainly depend on the safety, dosage, and duration of the candidate medication use, as well as whether it is combined with ART.Conclusion: Under the “safe, combined, adequate and long (SCAL)” principles, alternative approaches are needed to accelerate the recovery of CD4+ T-cells, and to prevent adverse long-term outcomes in PLWH with standard ART treatment.

scholarly journals Should we perform the serum cryptococcal antigen test in people living with HIV hospitalized due to a community-acquired pneumonia episode?

2020 ◽  
Vol 31 (4) ◽  
pp. 345-350
Author(s):  
Adriana Paulino Silva ◽  
Carolina Toniolo Zenatti ◽  
Claudia Figueiredo-Mello ◽  
Marinella Della Negra ◽  
Anna S Levin ◽  
...  
Keyword(s):  
T Cell ◽  
Cell Count ◽  
Target Population ◽  
Community Acquired Pneumonia ◽  
Cd4 T Cell ◽  
People Living With Hiv ◽  
Cryptococcal Antigen ◽  
Trial Testing ◽  
Living With Hiv ◽  
Cd4 T Cell Count

Community-acquired pneumonia (CAP) is a common cause of hospitalization among people living with human immunodeficiency virus (PLWH), particularly those with severe immunosuppression. Pulmonary disease due to cryptococcosis is uncommonly reported and likely under-diagnosed. There is scarce information about cryptococcal antigen (CrAg) prevalence in PLWH with CAP. The objectives of this study were to identify among PLWH who were hospitalized with CAP: (i) the prevalence of serum CrAg positivity, (ii) the proportion with asymptomatic vs. symptomatic cryptococcosis; and (iii) the prevalence of serum CrAg positivity in CD4+ T-cell count <100 cells/mm3. We performed a sub-analysis of a prospective cohort of hospitalized adults enrolled into a randomized clinical trial testing therapy for CAP. We included 202 participants who had serum CrAg testing performed. We found a 3.5% prevalence of serum CrAg-positivity overall, being higher (5.7%) in CD4+ T-cell count <100 cells/mm3. Overall, asymptomatic and symptomatic cryptococcosis were present in 2.0% and 1.5%, respectively. This study identifies a target population for CrAg testing: PLWH hospitalized with diagnosis of CAP, particularly those with CD4+ T-cell count <100 cells/mm3 where the number needed to test was 18 to detect 1 CrAg-positive person. This approach may facilitate the detection of asymptomatic cryptococcal infection and allow a timely diagnosis of symptomatic cryptococcal disease.

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