Cytomegalovirus Disease in AIDS: The Edinburgh Experience

1992 ◽  
Vol 3 (5) ◽  
pp. 324-328 ◽  
Author(s):  
I Cheong ◽  
P J Flegg ◽  
R P Brettle ◽  
P D Welsby ◽  
S M Burns ◽  
...  
Keyword(s):  
Lymphocyte Count ◽  
Injection Drug Users ◽  
Drug Users ◽  
Hiv Positive ◽  
Homosexual Men ◽  
Viral Culture ◽  
Cd4 Lymphocyte Count ◽  
The Mean ◽  
Cd4 Lymphocyte ◽  
Cmv Disease

Retrospective analysis of medical records of 557 HIV positive patients (including 113 with AIDS) revealed 17 patients with an antemortem clinical diagnosis of cytomegalovirus (CMV) disease. This group comprised 7 injection drug users (2 male and 5 female) and 10 homosexual men. Males were significantly older than females, and homosexual men were significantly older than drug users at the time of diagnosis of CMV. All 17 patients had evidence of retinitis, and 6 also had evidence of extraocular disease. CMV retinitis was the AIDS defining diagnosis in two patients, and the attack rate of CMV in all AIDS patients progressively increased with time, with a 3-year CMV-free survival of 57%. Fifteen patients with CMV disease had evidence of previous CMV infection (CMV IgG positive), with 7 also having a positive CMV IgM and 10 a positive viral culture. The mean CD4+ lymphocyte count at diagnosis of CMV was 17 cells/mm3, compared with 68 cells/mm3 at diagnosis of AIDS. Therapy was unsatisfactory, often being complicated by marrow suppression. Relapse occurred in 11 patients after initial improvement but despite this only 3 patients died with severe visual impairment. The mean survival after a diagnosis of CMV was 10.5 months. This study confirms that disease caused by CMV is usually a late manifestation of AIDS, and the increasing prevalence among patients with AIDS implies that, the longer the survival, the greater the risk of disease. Frequent fundoscopy in HIV positive patients is of paramount importance particularly in patients who have a CD4+ lymphocyte count of less than 100 cells/mm3.

scholarly journals Clinical and radiographic features of HIV-related pulmonary tuberculosis according to the level of immunosuppression

2007 ◽  
Vol 40 (6) ◽  
pp. 622-626 ◽  
Author(s):  
Guilherme Freire Garcia ◽  
Alexandre Sampaio Moura ◽  
Cid Sérgio Ferreira ◽  
Manoel Otávio da Costa Rocha
Keyword(s):  
Weight Loss ◽  
Mycobacterium Tuberculosis ◽  
Pulmonary Tuberculosis ◽  
Bronchoalveolar Lavage ◽  
Lymphocyte Count ◽  
Radiographic Features ◽  
Cd4 Lymphocyte Count ◽  
The Mean ◽  
Cd4 Lymphocyte ◽  
Primary Pattern

Medical charts and radiographs from 38 HIV-infected patients with positive cultures for Mycobacterium tuberculosis from sputum or bronchoalveolar lavage were reviewed in order to compare the clinical, radiographic, and sputum bacilloscopy characteristics of HIV-infected patients with pulmonary tuberculosis according to CD4+ lymphocyte count (CD4). The mean age of the patients was 32 years and 76% were male. The median CD4 was 106 cells/mm³ and 71% had CD4 < 200 cells/mm³. Sputum bacilloscopy was positive in 45% of the patients. Patients with CD4 < 200 cells/mm³ showed significantly less post-primary pattern (7% vs. 63%; p = 0.02) and more frequently reported weight loss (p = 0.04). Although not statistically significant, patients with lower CD4 showed lower positivity of sputum bacilloscopy (37% vs. 64%; p = 0.18). HIV-infected patients with culture-confirmed pulmonary tuberculosis had a high proportion of non-post-primary pattern in thoracic radiographs. Patients with CD4 lower than 200 cells/mm³ showed post-primary patterns less frequently and reported weight loss more frequently.

CD4 lymphocyte count in HIV positive persons exposed to cryptococcus neo formans

1995 ◽  
Vol 283 (1) ◽  
pp. 127-135 ◽  
Author(s):  
K. Arasteh ◽  
M. L’age ◽  
U. Futh ◽  
G. Grosse ◽  
F. Staib
Keyword(s):  
Lymphocyte Count ◽  
Hiv Positive ◽  
Cd4 Lymphocyte Count ◽  
Cd4 Lymphocyte

scholarly journals Risk factors associated with low CD4+ lymphocyte count among HIV-positive pregnant women in Nigeria

2009 ◽  
Vol 106 (3) ◽  
pp. 227-231 ◽  
Author(s):  
Alash'le Abimiku ◽  
Pacha Villalba-Diebold ◽  
Jelpe Dadik ◽  
Felicia Okolo ◽  
Edwina Mang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Lymphocyte Count ◽  
Hiv Positive ◽  
Factors Associated ◽  
Cd4 Lymphocyte Count ◽  
Cd4 Lymphocyte

Risk factors and cumulative incidence of anaemia among HIV-infected injection drug users

2002 ◽  
Vol 13 (2) ◽  
pp. 119-123 ◽  
Author(s):  
Richard D Semba ◽  
Nina Shah ◽  
David Vlahov
Keyword(s):  
Risk Factors ◽  
Cumulative Incidence ◽  
Injection Drug Users ◽  
Drug Users ◽  
Female Gender ◽  
Injection Drug ◽  
Cd4 Lymphocyte Count ◽  
Increase Odds Ratio ◽  
Cd4 Lymphocyte

Risk factors for anaemia and cumulative incidence of anaemia were examined in a longitudinal cohort study of 622 injection drug users (IDUs) (8885 visits) in Baltimore, Maryland, from 1988 to 2000. At enrolment, 19.6% subjects were anaemic (16.1% of men and 30.5% of women, P<0.0001) and 8.4% had microcytic anaemia (6.7% of men and 14.0% of women, P=0.006). Cumulative incidence of anaemia was 82.2% (87.9% of men and 100% of women, P<0.0001) during a median of 7.5 years follow-up. Factors associated with anaemia included age (per 5 year increase, odds ratio (OR)=1.22; 95% confidence interval (CI): 1.10, 1.36), female gender (OR=1.62; 95% CI: 1.16, 2.27), CD4+ lymphocyte count <200 cells/ µl (OR 1.85; 95% CI: 1.52, 2.24), weight loss (OR 1.55; 95% CI: 1.26, 1.91), oral thrush (OR 1.53; 95% CI: 1.21, 1.94), Mycobacterium avium complex infection (OR 1.30; 95% CI: 1.04, 1.64), and zidovudine use (OR 1.24; 95% CI: 1.04, 1.48). Higher body mass index (OR 0.92; 95% CI: 0.88, 0.95) and marijuana use (OR 0.75; 95% CI: 0.61, 0.92) were associated with a lower risk of anaemia. The cumulative incidence of anaemia is high among IDUs, and women are at highest risk of anaemia.

scholarly journals Factors Associated with Late Presentation of HIV and Estimation of Antiretroviral Treatment Need according to CD4 Lymphocyte Count in a Resource-Limited Setting: Data from an HIV Cohort Study in India

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Gerardo Alvarez-Uria ◽  
Manoranjan Midde ◽  
Raghavakalyan Pakam ◽  
Shanmugamari Kannan ◽  
Lakshminarayana Bachu ◽  
...  
Keyword(s):  
Lymphocyte Count ◽  
Late Presentation ◽  
Hiv Treatment ◽  
Cd4 Count ◽  
Hiv Positive ◽  
Antenatal Screening ◽  
Factors Associated ◽  
Number Of Patients ◽  
Cd4 Lymphocyte Count ◽  
Cd4 Lymphocyte

We describe the CD4 lymphocyte count at HIV presentation in an HIV cohort from a rural district of India. The majority of patients were diagnosed for their HIV-related symptoms, although a sizeable proportion of women were diagnosed because of antenatal screening or for having an HIV-positive partner. Patients diagnosed of HIV for antenatal screening or having an HIV-positive sexual partner had higher CD4 lymphocyte count than patients having tuberculosis or HIV-related symptoms. The proportion of patients diagnosed with CD4 count <200 and <350 cells/mm3were 46% and 68.7%, respectively, and these figures did not change during the five years of the study. Factors associated with late presentations were male sex, older age, not having a permanent house, and, in women, lower education and being a widow or separated. With the implementation of 2010 WHO guidelines, the number of newly diagnosed patients who will require HIV treatment will increase 13.8%. If the CD4 count threshold for initiating HIV treatment is increased from 350 to 500 cells/mm3, the number of patients in need of treatment would increase 15.7%. Therefore, new strategies for avoiding HIV late presentation are urgently needed in developing countries.

scholarly journals Is Injection Serosorting Occurring among HIV-Positive Injection Drug Users? Comparison by Injection Partner’s HIV Status

2011 ◽  
Vol 88 (6) ◽  
pp. 1031-1043 ◽  
Author(s):  
Yuko Mizuno ◽  
David W. Purcell ◽  
Lisa R. Metsch ◽  
Cynthia A. Gomez ◽  
Amy R. Knowlton ◽  
...  
Keyword(s):  
Injection Drug Users ◽  
Drug Users ◽  
Injection Drug ◽  
Hiv Positive ◽  
Hiv Status

Combination Therapy With Stavudine and Didanosine in Children With Advanced Human Immunodeficiency Virus Infection: Pharmacokinetic Properties, Safety, and Immunologic and Virologic Effects

PEDIATRICS ◽  
1996 ◽  
Vol 97 (6) ◽  
pp. 886-890
Author(s):  
Mark W. Kline ◽  
Courtney V. Fletcher ◽  
Marianne E. Federici ◽  
Alice T. Harris ◽  
Kim D. Evans ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Combination Therapy ◽  
Lymphocyte Count ◽  
Hiv Disease ◽  
Hiv Rna ◽  
Immunodeficiency Virus ◽  
Pharmacokinetic Properties ◽  
Cd4 Lymphocyte Count ◽  
Cd4 Lymphocyte ◽  
Advanced Hiv Disease

Objectives. To obtain preliminary information on the pharmacokinetic properties, tolerance, safety, and antiviral activity of combination therapy with stavudine and didanosine in children with advanced human immunodeficiency virus (HIV) infection. Methods. Eight children (median age, 6.6 years; range, 2.8 to 12 years) with advanced HIV disease (median CD4+ lymphocyte count at baseline, 42 cells/µL; range, 8 to 553 cells/µL) were treated with stavudine (2 mg/kg per day in two divided doses) and didanosine (180 mg/m2 per day in two divided doses) for 24 weeks. Seven children had histories of prior zidovudine therapy. All children had received stavudine alone for 19 to 33 months before the addition of didanosine to the treatment regimen. Children were assessed clinically and with laboratory studies at baseline, weekly through week 4 of combination therapy, and every 4 weeks thereafter. Results. Analysis of stavudine and didanosine plasma half-life values, clearances, and area under the plasma concentration-versus-time curves revealed no obvious clinical pharmacokinetic interaction between the drugs through study week 12. Combination therapy was well tolerated, and there were no drug-associated clinical or laboratory adverse events. Signs and symptoms of peripheral neuropathy were not observed. All three children with baseline CD4+ lymphocyte counts greater than 50 cells/µL had greater than 20% increases in their counts within the first 12 weeks of therapy; CD4+ lymphocyte count increases were not observed in the other children. Plasma HIV RNA concentrations showed median declines of 0.88 log10 (range, -3.41 log10 to 0.31 log10) and 0.30 log10 (range, -0.63 log10 to 0.89 log10) at study weeks 12 and 24, respectively. Conclusions. Combination therapy with stavudine and didanosine was well tolerated and safe in this small group of children with advanced HIV disease. Plasma HIV RNA concentration declines suggest a favorable effect of therapy on virus load. These findings should be confirmed, and the regimen's clinical efficacy should be examined, in controlled studies of HIV-infected children with less-advanced disease.

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