scholarly journals Human Immunodeficiency Virus and Tuberculosis Coinfection in a Tertiary Hospital in Southern Brazil: Clinical Profile and Outcomes

2018 ◽  
Vol 11 ◽  
pp. 117863611881336 ◽  
Author(s):  
Francine Teixeira ◽  
Sonia M Raboni ◽  
Clea EL Ribeiro ◽  
João CB França ◽  
Anne C Broska ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Extrapulmonary Tuberculosis ◽  
Laboratory Data ◽  
Case Fatality ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
People Living With Hiv ◽  
High Morbidity ◽  
Cross Sectional ◽  
Immunodeficiency Virus

Worldwide, the convergence of tuberculosis (TB) and human immunodeficiency virus type 1 (HIV-1) infection epidemics is a public health challenge. In Brazil, TB is the leading cause of death by infectious disease in people living with HIV (PLWH). This study aimed to report the clinical, demographic, epidemiological, and laboratory data for TB in PLWH. This cross-sectional study involved a retrospective analysis of data for patients with TB/HIV coinfection who attended from 2006 to 2015 through a review of medical records. A total of 182 patients were identified, of whom 12 were excluded. Patients were divided according to whether they had pulmonary tuberculosis (PTB; n = 48; 28%) or extrapulmonary tuberculosis (EPTB; n = 122; 72%). The diagnosis was laboratory confirmed in 75% of PTB patients and 78.7% of EPTB patients. The overall 1-year mortality rate was 37.6%, being 22.9% in PTB patients and 69% in EPTB patients; 84% of these deaths were TB-related. The CD4+ count and disseminated TB were independent risk factors for death. The frequency of resistance among Mycobacterium tuberculosis (MTB) isolates was 14%. TB in PLWH is associated with high morbidity and mortality, and severe immunosuppression is a risk factor for death. Appropriate measures for early TB detection should reduce the case fatality rate in high-burden settings.

scholarly journals Renal Echogenicity as a Predictor of Human Immunodeficiency Virus–Associated Nephropathy: A Cross-Sectional Study at a Tertiary Hospital in Lagos, Southwest Nigeria

2018 ◽  
Vol 34 (4) ◽  
pp. 261-272
Author(s):  
Cletus Uche Eze ◽  
Charles Ugwoke Eze ◽  
Adekunle A. O. Adeyomoye
Keyword(s):  
Human Immunodeficiency Virus ◽  
Serum Creatinine ◽  
Area Under The Curve ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Cd4 Count ◽  
Cross Sectional ◽  
Immunodeficiency Virus ◽  
Southwest Nigeria ◽  
Grade 3

The objective of this study was to determine the accuracy of sonography in a human immunodeficiency virus–associated nephropathy (HIVAN) diagnosis. A sample of 340 HIVAN patients underwent laboratory CD4+ count, serum creatinine/glomerular filtration rate (GFR) estimation, and sonographic echogenicity grading. The accuracy of sonography in predicting an HIVAN diagnosis was calculated. Mean CD4+ count, serum creatinine, and GFR for male and female HIVAN patients was 153.1 ± 103.2 cells/mm3 and 121.9 ± 91.0 cells/mm3, 218.4 ± 147.4 mmol/L and 222.0 ± 150.4 mmol/L, and 50.1 ± 23.6 mL/min/1.73 m2 and 39.3 ± 20.6 mL/min/1.73 m2, respectively; 56.9% of patients had echogenicity grade 3. On the basis of CD4+ count, serum creatinine, and GFR, the area under the curve was 0.76 and ≈ 1, respectively; the area under the curve was 0.63, 0.79, 0.70, 0.79 and 0.91, 0.99, 1, 1 for grades 0, 1, 2, and 3 echogenicity, respectively. With a high level of apathy to voluntary HIV/AIDS screening and late patient presentation, sonography (grade 3 renal echogenicity) can assist in predicting an HIVAN diagnosis.

scholarly journals Drug-induced hepatotoxicity among TB/HIV co-infected patients in a referral hospital, Ethiopia

2020 ◽  
Vol 13 (1) ◽  
Author(s):  
Abebe Zeleke ◽  
Bethelihem Misiker ◽  
Teshager Aklilu Yesuf
Keyword(s):  
Body Mass Index ◽  
Human Immunodeficiency Virus ◽  
Body Mass ◽  
Statistical Significance ◽  
Extrapulmonary Tuberculosis ◽  
Cross Sectional Study ◽  
Referral Hospital ◽  
Drug Induced ◽  
Cross Sectional ◽  
Immunodeficiency Virus

Abstract Objectives Anti-tuberculosis drug-induced hepatotoxicity is a common serious adverse drug reaction. This study intended to determine the prevalence and associated factors of drug-induced hepatotoxicity among tuberculosis and human immunodeficiency virus co-infected patients in Dessie referral hospital northeast Ethiopia. Results In this cross-sectional study 84 patients were enrolled retrospectively. Data from September 1/2015 to August 30/2018 were extracted from March 1/2019 to April 1/2019. Association between dependent and independent variables was determined using the odds ratio and a P value of < 0.05 was considered as statistical significance. Out of 84 patients, 17 patients developed drug-induced hepatotoxicity which makes the prevalence of drug-induced hepatotoxicity 20.2%. The result revealed that the presence of disseminated or extrapulmonary tuberculosis [(AOR: 7.728, 95% CI (1.516–39.404)] and/or body mass index less than 18.5 kg/m2 [(AOR = 5.593, 95% CI (1.180–26.519)] were a risk factor for drug-induced hepatotoxicity. Tuberculosis and human immunodeficiency virus co-infected patients with extra- pulmonary tuberculosis and/or body mass index less than 18.5 kg/m2 should be closely followed and supervised for the development of hepatotoxicity.

scholarly journals Sexual partnerships of people living with HIV / Aids: sexual orientation, sociodemographic, clinical and behavioral aspects

2019 ◽  
Vol 18 (2) ◽  
pp. 25-62
Author(s):  
Layze Braz de Oliveira ◽  
Artur Acelino Francisco Luz Nunes Queiroz ◽  
Christefany Régia Braz Costa ◽  
Rosilane De Lima Brito Magalhães ◽  
Telma Maria Evangelista de Araújo ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Sexual Orientation ◽  
Cross Sectional Study ◽  
Consistent Condom ◽  
People Living With Hiv ◽  
Chi Square ◽  
Cross Sectional ◽  
Exact Test ◽  
Behavioral Variables ◽  
Immunodeficiency Virus

Objetivo: Analizar la influencia de la orientación sexual de las variables socio-demográficas, clínicas y de comportamiento entre las parejas sexuales de las personas que viven con el Virus de la inmunodeficiencia humana/Síndrome de inmunodeficiencia adquirida. Métodos: Estudio transversal realizado en un servicio de asistencia médica especializada en el tratamiento de personas con el Virus de la Inmunodeficiencia Humana, con 173 participantes. En el análisis de los resultados se utilizó el test Chi-cuadrado de Pearson o exacto de Fisher. Resultados: Se identificó asociación entre la orientación sexual y las variables: sexo, edad, estado civil, grupo de edad, escolaridad, renta, forma de exposición, tipo de asociación, uso consistente del preservativo, presencia de infección, práctica sexual, presencia del compañero en las consultas de rutina, divulgación del VIH al compañero y considerar importante la divulgación de su condición serológica para el compañero. Conclusión: Establecer un emparejamiento sexual en el contexto del VIH y tener una orientación no heterosexual presentó diferencias estadísticas entre las variables sociodemográficas y comportamentales. Objective: To analyze the influence of sexual orientation on sociodemographic, clinical and behavioral variables among sexual partners of people living with Human immunodeficiency virus/Acquired immunodeficiency syndrome. Methods: A cross-sectional study carried out in a medical assistance service specialized in the treatment of people with Human Immunodeficiency Virus, with 173 participants. Pearson's Chi-square or Fisher's exact test was used to analyze the results. Results: We identified an association between sexual orientation and variables such as gender, age, marital status, age, education, income, type of exposure, type of birth, consistent condom use, presence of infection, sexual practice, partner in routine consultations, disclosure of HIV to the partner and considers disclosure of their condition to the partner. Conclusion: Establishing a sexual partnership in the context of HIV and having a non-heterosexual orientation presented statistical differences between sociodemographic and behavioral variables. Objetivo: Analisar a influência da orientação sexual sobre as variáveis sociodemograficas, clínicas e comportamentais entre parcerias sexuais de pessoas que vivem com vírus da imunodeficiência humana/Síndrome da imunodeficiência adquirida. Métodos: Estudo transversal realizado em um serviço de assistência médica especializada no tratamento de pessoas com o Vírus da Imunodeficiência Humana, com 173 participantes. Na análise dos resultados utilizou-se o teste Qui-quadrado de Pearson ou exato de Fisher. Resultados: Identificou-se associação entre a orientação sexual e as variáveis: sexo, idade, estado civil, faixa etária, escolaridade, renda, forma de exposição, tipo de parceria, uso consistente do preservativo, presença de infecção, prática sexual, acompanhamento do parceiro nas consultas de rotina, divulgação do HIV para o parceiro e considerar importante a divulgação da sua condição sorológica para o parceiro. Conclusão: Estabelecer uma parceria sexual no contexto do HIV e ter uma orientação não-heterossexual apresentou diferenças estatísticas entre as variáveis sociodemográficas e comportamentais.

scholarly journals SAT0078 SAFETY OF LOW DOSE METHOTREXATE (MTX) IN HUMAN IMMUNODEFICIENCY VIRUS (HIV) INFECTION

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 974.2-974
Author(s):  
A. Gunay ◽  
A. Davidson ◽  
I. Colmegna ◽  
D. Lacaille ◽  
H. Loewen ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Adverse Events ◽  
Low Dose ◽  
Opportunistic Infections ◽  
Case Reports ◽  
Cross Sectional Study ◽  
Study Quality ◽  
Sectional Study ◽  
Cross Sectional ◽  
Immunodeficiency Virus

Background:Increased awareness of the efficacy of MTX in rheumatic disease is leading to more MTX use in patients from HIV endemic areas. While HIV related immunosuppression may contribute to improvement of some rheumatic diseases, immune reconstitution from highly active antiretroviral therapy (HAART) may lead to exacerbation or presentation of autoimmune disorders for which MTX therapy may be warranted. Most management guidelines for rheumatic disease do not address MTX use in the context of HIV.Objectives:To systematically review the published literature on the safety of using MTX ≤30 mg per week in HIV.Methods:We searched CINAHL, Embase, Global, MEDLINE and World of Science databases (Jan 1990 to May 2018) for terms including ‘methotrexate’ and ‘human immunodeficiency virus’. We also searched citations from review articles. Titles, abstracts or full manuscripts were screened independently by 2 reviewers to identify studies reporting HIV in patients taking MTX. Study quality was assessed using the McGill Mixed Methods Appraisal Tool (MMAT). Data was extracted on MTX and HIV adverse events (MTX toxicity, HIV viral load, CD4 count). Descriptive summaries are presented for studies providing outcomes in patients taking MTX ≤30 mg per week.Results:After removing duplicates and studies not meeting criteria or not providing sufficient information, 42 of the 2714 identified reports were included (1 clinical trial, 2 cohort, 1 cross-sectional study, 38 case reports/case series). Most reports (81%) originated from USA or Europe. Study quality was generally good with most studies fulfilling 50-100% of MMAT criteria. The randomized controlled trial (USA) assessing MTX on atherosclerotic disease in HIV showed that adverse events were more common in MTX versus placebo (12.8% vs 5.6%, p non-inferiority <0.05) and included infection, transient CD4 and CD8 drop, pulmonary toxicity, and death (1 attributed to MTX/HIV, 1 unrelated). One cohort study (South Africa) reported 43 RA patients on MTX who acquired HIV. In this cohort, RA generally improved despite only 5 individuals continuing MTX. No data on MTX adverse event rates was reported. One cohort study (USA) reported 13 HIV patients with myositis. One received MTX (with other immunosuppression) without MTX adverse effects but died due to AIDS. A cross-sectional study (France) of 43 HIV pts with autoimmune disease reported one patient on MTX (and other immunosuppression) developed an adverse event (cytopenia) compared to 5/33 patients not on MTX (cytopenia). The 38 case reports/series described 54 individuals with HIV receiving MTX. Of these studies, 27 (describing 42 subjects) reported on MTX adverse events and 35 (describing 46 subjects) reported on HIV adverse events. MTX adverse events developed in 29 subjects (hematologic 13, renal/hepatic 1, opportunistic infections 10, other events 2). HIV adverse events were noted in 23 subjects (Kaposi’s sarcoma 4, CD4 decrease 16, HIV viral titer increase 4). Five deaths were reported (2 infection, 1 infection and wasting, 2 HIV related deaths). Most subjects also received corticosteroids or other immunosuppressants including biologics.Conclusion:There remains limited data on the safety of low dose MTX in HIV. Surveillance for HIV is warranted for individuals on MTX who are at risk for acquiring HIV. Caution and careful monitoring for MTX toxicity, opportunistic infections and HIV state is suggested if MTX is used in the setting of HIV particularly if combined with other immunosuppression.References:[1] Clin Infectious Disease 2019:68[2] J Rheumatology 2014:41[3] Arthritis and Rheumatism 2003:49[4] Medicine 2017:96Acknowledgments :Funding from International League Against RheumatismMcGill University Global Health Scholar AwardsDisclosure of Interests:Alize Gunay: None declared, Anna Davidson: None declared, Ines Colmegna: None declared, Diane Lacaille: None declared, Hal Loewen: None declared, Michele Meltzer: None declared, Yewondwossen Mengistu: None declared, Rosie Scuccimarri: None declared, Zenebe Yirsaw: None declared, Sasha Bernatsky: None declared, Carol Hitchon Grant/research support from: UCB Canada; Pfizer Canada

scholarly journals Consistent Patterns of Change during the Divergence of Human Immunodeficiency Virus Type 1 Envelope from That of the Inoculated Virus in Simian/Human Immunodeficiency Virus-Infected Macaques

2006 ◽  
Vol 80 (2) ◽  
pp. 999-1014 ◽  
Author(s):  
W.M. Blay ◽  
S. Gnanakaran ◽  
B. Foley ◽  
N. A. Doria-Rose ◽  
B. T. Korber ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Disulfide Bonds ◽  
Neutralizing Antibodies ◽  
Outer Region ◽  
Synonymous Substitution ◽  
Cross Sectional Study ◽  
Macaca Nemestrina ◽  
Cross Sectional ◽  
Immunodeficiency Virus ◽  
And Shifts

ABSTRACT We have analyzed changes to proviral Env gp120 sequences and the development of neutralizing antibodies (NAbs) during 1 year of simian/human immunodeficiency virus SHIV-89.6P infection in 11 Macaca nemestrina macaques. Seven macaques had significant env divergence from that of the inoculum, and macaques with greater divergence had higher titers of homologous NAbs. Substitutions in sequons encoding potential N-linked glycosylation sites (PNGs) were among the first to be established, although overall the total number of sequons did not increase significantly. The majority (19 of 23) of PNGs present in the inoculum were conserved in the sequences from all macaques. Statistically significant variations in PNGs occurred in multiple macaques within constrained regions we term “hot spots,” resulting in the selection of sequences more similar to the B consensus. These included additions on V1, the N-terminal side of V4, and the outer region of C2. Complex mutational patterns resulted in convergent PNG shifts in V2 and V5. Charge changes in Env V1V2, resulting in a net acidic charge, and a proline addition in V5 occurred in several macaques. Molecular modeling of the 89.6P sequence showed that the conserved glycans lie on the silent face of Env and that many are proximal to disulfide bonds, while PNG additions and shifts are proximal to the CD4 binding site. Nonsynonymous-to-synonymous substitution ratios suggest that these changes result from selective pressure. This longitudinal and cross-sectional study of mutations in human immunodeficiency virus (HIV) env in the SHIV background provides evidence that there are more constraints on the configuration of the glycan shield than were previously appreciated.

Anorectal pathology amongst HIV infected patients attending the Douala General Hospital: a cross-sectional study

2016 ◽  
Vol 28 (4) ◽  
pp. 389-396 ◽  
Author(s):  
Henry Namme Luma ◽  
Servais Albert Fiacre Bagnaka Eloumou ◽  
Ellis Atemlefeh Fualefeh-Morfaw ◽  
Agnes Malongue ◽  
Elvis Temfack ◽  
...  
Keyword(s):  
Logistic Regression ◽  
General Hospital ◽  
Laboratory Data ◽  
Study Participant ◽  
Cross Sectional Study ◽  
Interquartile Range ◽  
People Living With Hiv ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated

While gastrointestinal disease is common among HIV infected individuals, the prevalence and distribution of ano-rectal pathology has not been well studied in our setting. The objective of this study therefore was to determine the prevalence and determinants of ano-rectal pathology in HIV infected patients attending the Douala General Hospital HIV treatment centre. A hospital-based cross-sectional study was undertaken. We collected socio-demographic, clinical and laboratory data using a structured questionnaire and patients’ files. Each study participant had a full physical and ano-rectal examination. We further studied factors associated with having at least one ano-rectal lesion by logistic regression reporting odds ratios (ORs) and their 95% confidence intervals (CI). We included 390 HIV infected patients. The mean age was 41 (SD: 8) years and 48% were men. Median duration since HIV diagnosis was 3 (interquartile range: 2–5) years and median CD4 cell count was 411 (interquartile range: 234–601) cells/mm3. Prevalence of ano-rectal pathology was 22.8% (95% CI: 18.7–27.3). Hemorrhoids and proctitis were most common lesions found; each in 10% of patients. From multivariate logistic regression, factors associated with ano-rectal pathology were CD4 < 350 cells/ml (OR: 2.1, 95% CI: 1.1–4.2), not on highly active antiretroviral therapy (OR: 2.2, 95% CI: 1.1–4.6), inpatient (OR: 2.3, 95% CI: 1.2–4.3), ano-rectal intercourse (OR: 5.0, 95% CI: 1.7–15.1), and more than one sexual partner (OR: 2.4, 95% CI: 1.3–4.2). Ano-rectal pathology is common amongst HIV infected patients. Care givers should actively investigate and treat them as this will improve the quality of life of people living with HIV/AIDS.

scholarly journals A High Prevalence Rate of a Positive Screen for Cognitive Impairment in Patients With Human Immunodeficiency Virus Attending an Irish Clinic

2016 ◽  
Vol 4 (1) ◽  
Author(s):  
Patricia H. McNamara ◽  
Robert Coen ◽  
Janice Redmond ◽  
Colin P. Doherty ◽  
Colm Bergin
Keyword(s):  
Human Immunodeficiency Virus ◽  
Cognitive Impairment ◽  
Large Scale ◽  
Screening Program ◽  
Cross Sectional Study ◽  
Hiv Positive ◽  
Study Cohort ◽  
Cross Sectional ◽  
Positive Screen ◽  
Immunodeficiency Virus

Abstract Background Human immunodeficiency virus (HIV)-associated neurocognitive disorders occurs in 20%–50% of HIV-positive patients. We undertook this study to assess the prevalence of a positive screen for cognitive impairment in the clinic population at our institution and to demonstrate the feasibility of implementing a screening program in routine clinical encounters. Methods This was a cross-sectional study, and patients were recruited prospectively between December 2010 and February 2013. Inclusion criteria were as follows: patients were HIV positive, over the age of 18, capable of giving informed consent, and had sufficient ability to communicate in English. Patients were screened for cognitive impairment using the Brief Neurocognitive Screen. Results A total of 604 patients were recruited, and 51.5% had a positive screen for cognitive impairment. The majority of the study cohort were male (78.8%), mean age was 40.9 (standard deviation, 10.2) years, 70.9% were Irish, the most common mode of transmission was men who have sex with men (49.3%), 83% were on antiretroviral therapy, and 88.7% were virally suppressed. Logistic regression showed that the main factors predictive of a positive screen for cognitive impairment were the endorsement of cognitive symptoms (P = .024), being born in Africa (P &lt; .000001), the use of benzodiazepines (P = .00341), being unemployed (P = .008), and consumption of more than 40 units of alcohol weekly (P = .035). There was a positive screen for depression in 9.1% and a positive screen for anxiety in 24.5%. Conclusions The study highlights the necessity for a structured, prospective, large-scale screening program for cognitive impairment across countries with limited resources and demonstrates the feasibility of easily implementing this with minimal training.

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