scholarly journals Prevalence of HIV-Associated Neurocognitive Disorder (HAND) among Patients Attending a Tertiary Health Facility in Northern Nigeria

2016 ◽  
Vol 16 (1) ◽  
pp. 48-55 ◽  
Author(s):  
Abdulkareem Jika Yusuf ◽  
Abdulaziz Hassan ◽  
Aisha Indo Mamman ◽  
Haruna Mohammed Muktar ◽  
Aishatu Maude Suleiman ◽  
...  
Keyword(s):  
Viral Load ◽  
Health Facility ◽  
Depression Scale ◽  
Cd4 Count ◽  
Word Recall ◽  
Hiv Positive ◽  
Neurocognitive Disorder ◽  
Cross Sectional ◽  
Cognitive Complaint ◽  
Hiv Associated Neurocognitive Disorder

Background: HIV-associated neurocognitive disorder (HAND) is a great source of morbidity in sub-Saharan African region. However, the magnitude of this problem remains largely uninvestigated despite having the largest number of population with HIV/AIDS. The aim of this study is to determine the prevalence of HAND among patients attending a tertiary health facility in Nigeria. Method: We conducted a cross-sectional study among HIV-positive patients on antiretroviral therapy (ART) for at least 1 year. They were assessed using the International HIV Dementia Scale, Word Recall Test, Stick Design Test, Subjective Cognitive Complaint Questionnaire, Alcohol Use Disorder Identification Test, Drug Abuse Screening Test, Center for Epidemiological Study–Depression Scale, Instrumental Activity of Daily Living, and neurological examination. The CD4 count and viral load were determined for all the participants. A consensus diagnosis was made on each case based on the Frascati criteria. Data obtained were analyzed using “SPSS” for Windows version 15. Results: A total of 418 HIV-positive patients participated in the study, of which 325 (77.8%) are females. The mean age (standard deviation) of the participants was 37.2 (9.3) years. The prevalence of HAND was 21.5% (95% confidence interval [CI] = 17.6%-25.4%), of which 9.6% were asymptomatic. The significant predictors of HAND in this study are duration of illness (odds ratio [OR] = 1.33 P < .001), detectable viral load (OR = 0.19, P < .001), CD4 count (OR = 0.99, P < .001), education (OR = 0.94, P = .011), stopping medication (OR = 3.55 P = .01), and severity of illness (OR = 1.24, P = .005). Conclusion: One-fifth of the HIV-positive patients in this study had HAND. Various sociodemographic and clinical features were related to the prevalence of HAND.

scholarly journals HIV associated neurocognitive dysfunction and its association with CD4 count in HIV positive patients-a hospital based study

2017 ◽  
Vol 5 (10) ◽  
pp. 4259
Author(s):  
Neeraj Balaini ◽  
Ashima Sharma ◽  
Sudhi Sharma ◽  
Ashok Sharma
Keyword(s):  
Severe Disease ◽  
Cd4 Count ◽  
Hiv Positive ◽  
Neurocognitive Disorder ◽  
Neurocognitive Dysfunction ◽  
Cd4 Cell Count ◽  
Medical College ◽  
Hiv Associated Neurocognitive Disorder ◽  
One Year ◽  
Gandhi Medical College

Background: The main objective of the present work was to study the neurocognitive dysfunction in HIV positive patients and to determine its relation with CD4 count. Further, an attempt has also been made to study the relationship of neurocognitive dysfunction with cART regimen.Methods: The study was a prospective observational study, conducted over a period of one year (from July 2012 to June 2013) in the Department of Medicine in collaboration with the Department of Psychiatry at Indira Gandhi Medical College and Hospital, Shimla.Results: HIV associated neurocognitive dysfunction (HAND) was found in 39.04% patients. Mean duration from diagnosis of HIV to detection of HAND was 3.77 ± 1.7 years. Mean nadir CD4 cell count was 126.1/mm3. 39.04% patients (n=41) were found to have HIV associated neurocognitive disorder out of 105 screened patients. 95.1% patients (n=39) had asymptomatic neurocognitive impairement, 4.9% patients (n=2) had mild cognitive impairment and 2.08% patients (n=1) had HIV associated dementia. Out of 41 patients having HIV associated neurocognitive disorder, 68.3% patients (n=28) were having CD4 count less than 150. Those having CD4 count less than 150/mm3 had scored less on dementia scales indicating severe disease. 31.7% patients (n=13) were having HIV associated neurocognitive disorder (HAND) and CD4 count was more than 150/mm3.Conclusions: The conclusion of the study is that HIV associated neurocognitive disorder is common and asymptomatic neurocognitive impairement is the commonest type of HIV associated neurocognitive disorder in HIV positive patients. It can be detected while patient is asymptomatic with help of simple neurocognitive tests. Although few studies reported higher prevalence of HIV associated neurocognitive disorder among patients on certain combined antiretroviral therapy (cART) regimen but our study didn’t indicate any such association.

scholarly journals Viral suppression among HIV-positive patients on antiretroviral therapy in northwestern Nigeria: an eleven-year review of tertiary care centre records, January 2009–December 2019

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Suleiman Bello Abdullahi ◽  
Olayinka Rasheed Ibrahim ◽  
Abdulkadir Baba Okeji ◽  
Rabilu Iliyasu Yandoma ◽  
Ibrahim Bashir ◽  
...  
Keyword(s):  
Viral Load ◽  
Viral Suppression ◽  
Treatment Success ◽  
Tertiary Care ◽  
Cd4 Count ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
First Line ◽  
Tertiary Care Centre ◽  
Cross Sectional

Abstract Background Human Immuno-Deficiency Virus (HIV) remains one of the world’s significant public health challenges. Viral suppression is the key indicator for treatment success in People living with HIV (PLHIV). We determined the level of viral suppression, and its associated factors among PLHIV attending Federal Medical Centre Katsina (FMC Katsina), Nigeria. Methods This retrospective descriptive cross-sectional study was conducted on 913 HIV positive adults enrolled in care between January 2009 and December 2019. Information on socio-demographics, clinical, immunological, Viral load (VL), and other relevant parameters were extracted from the patients’ care records. The primary outcome was the proportion of patients that achieved viral suppression. We also analyzed variables that were associated with VL suppression. Results Of 913, records of 831 (91.0%) registered patients were analyzed. During the period, 751 (90.4%) achieved viral suppression, 427 (51.4%) had CD4 counts  ≥ 500 and 477 (57.4%) were on HAART for ≥ 5 years. Majority, 793 (95.4%) were on first-line HAART regimen (Tenofovir-Lamivudine-Dolutegravir or Abacavir-Lamivudine-Dolutegravir), and 809 (97.4%) in the non-advanced stage (WHO stages 1 and 2). The median (interquartile range) of viral load was 20 (20–40) vs 19,989 (3311–110,340) cp/ml in virally suppressed, and unsuppressed  respectively. Factors associated with viral suppression included being unemployed (Adjusted OR [AOR] 4.9, 95% CI 2.771, 8.539), educated (AOR 4.2, 95% CI 1.098, 16.223), having a baseline CD4 count ≥ 500 cells/µl (AOR 2.7, 95% CI 1.588, 4.625), and being on first line HAART regimen [AOR 7.0, 95% CI 3.220, 15.648]. Conclusions Our study demonstrated a good viral suppression among PLHIV on HAART. Variables associated with viral suppression included unemployment, formal education, high baseline CD4 count, and first line HAART regimen.

scholarly journals Retinal Microvasculopathy Is Common in HIV/AIDS Patients: A Cross-Sectional Study at the Cape Coast Teaching Hospital, Ghana

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Emmanuel Kwasi Abu ◽  
Samuel Abokyi ◽  
Dorcas Obiri-Yeboah ◽  
Richard Kobina Dadzie Ephraim ◽  
Daniel Afedo ◽  
...  
Keyword(s):  
Viral Load ◽  
Teaching Hospital ◽  
Clinical Stage ◽  
Cross Sectional Study ◽  
Cd4 Count ◽  
Hiv Positive ◽  
Sectional Study ◽  
Cape Coast ◽  
Cross Sectional ◽  
Ocular Disorders

Purpose. The purpose of this study was to evaluate the ocular disorders in HIV positive patients attending the Cape Coast Teaching Hospital, Ghana. Methods. A cross-sectional study using systematic random sampling was conducted on 295 HIV positive patients. Data collection consisted of semistructured questionnaires, laboratory investigation, medical profile, and ophthalmic examination. Statistical association tests including χ2, independent t-test, and ANOVA were done. A p value ≤ 0.05 was considered statistically significant. Results. Of the 295 participants, 205 (69.5%) were on antiretroviral therapy while 90 (30.3%) were not on therapy. Majority of the participants (162, 54.9%) were in clinical stage two, followed by stages three (68, 23.1%), one (62, 21%), and four (3, 1%), respectively. The overall prevalence of ocular disorders was 5.8%. The most common HIV related ocular disorder was HIV retinal microvasculopathy (58.8%), followed by herpes zoster ophthalmicus and Toxoplasma retinochoroiditis, both representing 11.8% of ocular disorders seen. Cytomegalovirus retinitis, Bell’s palsy, and optic neuritis were the least common (5.9%). CMV retinitis recorded the highest viral load of 1,474,676 copies/mL and mean CD4 count of 136 cells/mm3. The mean CD4 count for participants with HIV related ocular disorders was significantly lower compared to participants without disorders (t=2.5, p=0.012). Participants with ocular disorders also recorded significantly higher mean viral loads than those who did not have ocular disorders (t=2.8, p=0.006). Conclusion. Lower CD4 counts and high viral load copies were associated with the manifestation of HIV related ocular disorders.

scholarly journals HIV Prevalence and Risk Factors for Infants Born to Mothers on Arv Treatment at CHUB/Rwanda

2021 ◽  
Author(s):  
Bernard Nsengimana ◽  
Francois Nkurunziza ◽  
Wivine Mudahigwa Ntaganira ◽  
Ruth Uzayisenga ◽  
Gad Rutayisire
Keyword(s):  
Risk Factors ◽  
Viral Load ◽  
Hiv Transmission ◽  
Pediatric Population ◽  
Dried Blood Spots ◽  
Hiv Prevalence ◽  
Cd4 Count ◽  
Hiv Positive ◽  
Cross Sectional ◽  
Associated Risk Factors

Several factors enhance the possibility of vertical HIV transmission in the pediatric population. Unfortunately, the data of the prevalence of HIV and associated risk factors in these populations remain limited in Rwanda. The study aimed to assess HIV prevalence and risk factors for infants born to mothers on ARV treatment at CHUB/Rwanda. MethodsA cross-sectional study was carried out on infants who were born to mothers under ARV treatment at CHUB. The associated risk factors were retrospectively assessed using prevention vertical HIV transmission records, and Dried Blood spots (DBS) were prospectively tested using Polymerase Chain Reaction (PCR). Data were analyzed by logistic regression. Ethical clearance (Ref: CMHS/IRB/198/2017) was issued by University of Rwanda to fulfill research ethical consideration.ResultsAmong 185(100%) infants born to HIV-positive mothers under ARV treatment, 5(2.7%) were HIV positive. The most associated risk factors were increased to over 1log copies/ml mother&rsquo;s viral load (OR 9.3, 95% CI 1.01-85.45, P= 0.04) and mother&rsquo;s CD4 count lower than 350 cells/&micro;l (OR 6.4, 95% CI 1.03-40.06, P=0.04). The factors found to reduce the rate of vertical transmission of HIV were health facility as a delivery place (P=0.03), exclusive breastfeeding for 6 months (P= 0.006), and attending the antenatal care (P=0.01) while feeding children and vaginal delivery were associated risks but not statistically significant.ConclusionThe current study supports that the more mothers&rsquo; viral load and CD4 count decrease, so does the risk of HIV to their infants. A fact which indicates that both prevalence and risk factors remain an alarming issue. Much effort and multi-disciplinary approach are highly recommended.

scholarly journals Primary oral cryptococcosis in an HIV-positive woman with suppressed viral load and normal CD4 count: a rare case

2021 ◽  
Vol 14 (6) ◽  
pp. e242633
Author(s):  
Antonio Jose Reyes ◽  
Kanterpersad Ramcharan ◽  
Samuel Aboh ◽  
Stanley Lawrence Giddings
Keyword(s):  
Viral Load ◽  
Rare Case ◽  
Cd4 Count ◽  
Hiv Positive ◽  
Positive Woman

scholarly journals Linkage to intensive adherence counselling among HIV-positive persons on ART with detectable viral load in Gomba district, rural Uganda

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Rita Nakalega ◽  
Nelson Mukiza ◽  
Henry Debem ◽  
George Kiwanuka ◽  
Ronald Makanga Kakumba ◽  
...  
Keyword(s):  
Viral Load ◽  
Health Center ◽  
Health Facility ◽  
Transmission Risk ◽  
World Health ◽  
Hiv Positive ◽  
Art Adherence ◽  
Detectable Viral Load ◽  
Adherence Support ◽  
Adherence Counselling

Abstract Background Antiretroviral therapy (ART) adherence is a primary determinant of sustained viral suppression, HIV transmission risk, disease progression and death. The World Health Organization recommends that adherence support interventions be provided to people on ART, but implementation is suboptimal. We evaluated linkage to intensive adherence counselling (IAC) for persons on ART with detectable viral load (VL). Methods Between January and December 2017, we conducted a retrospective chart review of HIV-positive persons on ART with detectable VL (> 1000 copies/ml), in Gomba district, rural Uganda. We abstracted records from eight HIV clinics; seven health center III’s (facilities which provide basic preventive and curative care and are headed by clinical officers) and a health center IV (mini-hospital headed by a medical doctor). Linkage to IAC was defined as provision of IAC to ART clients with detectable VL within three months of receipt of results at the health facility. Descriptive statistics and multivariable logistic regression analyses were used to evaluate factors associated with linkage to IAC. Results Of 4,100 HIV-positive persons on ART for at least 6 months, 411 (10%) had detectable VL. The median age was 32 years (interquartile range [IQR] 13–43) and 52% were female. The median duration on ART was 3.2 years (IQR 1.8–4.8). A total of 311 ART clients (81%) were linked to IAC. Receipt of ART at a Health Center level IV was associated with a two-fold higher odds of IAC linkage compared with Health Center level III (adjusted odds ratio [aOR] 1.78; 95% CI 1.00–3.16; p = 0.01). Age, gender, marital status and ART duration were not related to IAC linkage. Conclusions Linkage to IAC was high among persons with detectable VL in rural Uganda, with greater odds of linkage at a higher-level health facility. Strategies to optimize IAC linkage at lower-level health facilities for persons with suboptimal ART adherence are needed.

scholarly journals Intakes of Vitamin a and Zinc and Markers of Oxidative Stress in Newly Diagnosed HIV-positive Participants in the MASH Cohort in Miami (P24-016-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Priscilla Clayton ◽  
Adriana Campa ◽  
Qingyun Liu ◽  
Sabrina Martinez ◽  
Leslie Seminario ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Mitochondrial Dna ◽  
Viral Load ◽  
Vitamin A ◽  
Hiv Positive ◽  
Oxidized Glutathione ◽  
Newly Diagnosed ◽  
Hiv Viral Load ◽  
Cross Sectional ◽  
Mitochondrial Dna Damage

Abstract Objectives HIV infection is characterized by increased oxidative stress. We examined the association of antioxidant intake with measures of oxidative stress and HIV disease progression in newly diagnosed HIV-infected participants. Methods Cross-sectional study of 52 newly-diagnosed HIV-positive participants in the MASH cohort. Blood was drawn for parameters of oxidative stress (oxidized glutathione % and oxidative mitochondrial DNA damage [8-oxo-dG]) and disease stage (CD4- cell counts; HIV-viral load). Questionnaires on demographics and 24-hour dietary recalls and Alcohol Use Disorders Identification Test (AUDIT) were administered. AUDIT scores ≥ 8 was considered hazardous drinking. Dietary intakes of vitamin A and Zinc were calculated. SPSS was used for analyses and Linear Regression Models were estimated. Results Participants were 74% male, 75% Black Non-Hispanic, and 21% Hispanics. Mean age was 42.3 ± SD10.2 years, CD4 count was 506.7 ± SD733.4 cells/µLA cross-sectional and HIV viral load was 3.63 ± SD1.23log10 copies/mL. Dietary intake of vitamin A (β = −0.001, SE = 0.0002, P = 0.044) and zinc (β = −0.0004, SE = 0.0002, P = 0.044) were inversely related with mitochondrial DNA damage (8-oxo-dG), after adjusting for education, race, age, gender, and excessive alcohol use. Oxidized glutathione percentage was directly associated with HIV-viral load (β = 0.81, SE = 0.4, P = 0.037) adjusting for age, gender, AUDIT ≥ 8 and BMI in linear regressions. Conclusions Lower intake of vitamin A and Zinc were associated with higher oxidative stress and higher HIV viral load. These findings suggest that antioxidant supplementation may be beneficial immediately after receiving a diagnosis of HIV infection as well as during antiretroviral treatment. Funding Sources Funded by the National Institute on Drug Abuse and the National Institute of Health.

scholarly journals Pregnant women’s retention and associated health facility characteristics in the prevention of mother-to-child HIV transmission in Indonesia: cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e034418
Author(s):  
Christina Lumbantoruan ◽  
Margaret Kelaher ◽  
Michelle Kermode ◽  
Endang Budihastuti
Keyword(s):  
Antenatal Care ◽  
Health Facility ◽  
Hiv Transmission ◽  
Cross Sectional Study ◽  
Health Facilities ◽  
Hiv Positive ◽  
Pmtct Programme ◽  
Cross Sectional ◽  
Hiv Epidemic ◽  
Mother To Child

ObjectivesDespite the national effort to integrate the Prevention of Mother-to-Child Transmission (PMTCT) programme into antenatal care clinics in Indonesia, the rate of mother-to-child HIV transmission remains high. This national study was conducted to describe PMTCT programme performance and to identify health facility characteristics associated with this performance in order to inform programme planning and policy development.DesignA retrospective cross-sectional study in December 2017.SettingAll health facilities providing PMTCT programmes in Indonesia.ParticipantsAll health facilities registering at least one woman in antenatal care in 2017.InterventionPMTCT data extraction from the national reporting system on HIV/AIDS and government reports.OutcomesWomen retention in the PMTCT programme for at least 3 months and associated health facility characteristics.ResultsA total of 373 health facilities registering 6502 HIV-positive women in antenatal care were included in the analysis. One-third of women (2099) never started antiretroviral treatment. Of the 4403 women who started, 2610 (57%) were retained; 462 (10%) were not retained; and the retention status of 1252 (28%) women referred out of the health facilities was unknown. Compared with primary health centres, hospitals were more likely to retain women (OR=2.88, 95% CI 2.19 to 3.79). The odds of retention were higher in hospital types A and B (OR=3.89, 95% CI 3.19 to 4.76), located within concentrated HIV epidemic areas (OR=2.09, 95% CI 1.83 to 2.38) and a high-priority area for the HIV programme (OR=1.83, 95% CI 1.60 to 2.09). We observed no differential retention between women who initiated PMTCT under different options (B+/non-B+).ConclusionsWe observed low retention of HIV-positive pregnant women in the PMTCT programme in Indonesia in 2017. Additional efforts are needed to improve women’s retention in the PMTCT programme. Retention could be increased through the delivery of PMTCT programmes by replicating strategies implemented at hospital types A and B located in concentrated HIV epidemic areas where an HIV programme is a high priority.

Global prevalence and burden of HIV-associated neurocognitive disorder

Neurology ◽  
2020 ◽  
Vol 95 (19) ◽  
pp. e2610-e2621 ◽  
Author(s):  
Yunhe Wang ◽  
Moxuan Liu ◽  
Qingdong Lu ◽  
Michael Farrell ◽  
Julia M. Lappin ◽  
...  
Keyword(s):  
Data Extraction ◽  
Sub Saharan Africa ◽  
People Living With Hiv ◽  
Neurocognitive Disorder ◽  
Cross Sectional ◽  
Asymptomatic Neurocognitive Impairment ◽  
Cd4 Cell Count ◽  
Hiv Associated Neurocognitive Disorder ◽  
Sub Saharan ◽  
High Level

ObjectiveTo characterize the prevalence and burden of HIV-associated neurocognitive disorder (HAND) and assess associated factors in the global population with HIV.MethodsWe searched PubMed and Embase for cross-sectional or cohort studies reporting the prevalence of HAND or its subtypes in HIV-infected adult populations from January 1, 1996, to May 15, 2020, without language restrictions. Two reviewers independently undertook the study selection, data extraction, and quality assessment. We estimated pooled prevalence of HAND by a random effects model and evaluated its overall burden worldwide.ResultsOf 5,588 records identified, we included 123 studies involving 35,513 participants from 32 countries. The overall prevalence of HAND was 42.6% (95% confidence interval [CI] 39.7–45.5) and did not differ with respect to diagnostic criteria used. The prevalence of asymptomatic neurocognitive impairment, mild neurocognitive disorder, and HIV-associated dementia were 23.5% (20.3–26.8), 13.3% (10.6–16.3), and 5.0% (3.5–6.8) according to the Frascati criteria, respectively. The prevalence of HAND was significantly associated with the level of CD4 nadir, with a prevalence of HAND higher in low CD4 nadir groups (mean/median CD4 nadir <200 45.2% [40.5–49.9]) vs the high CD4 nadir group (mean/median CD4 nadir ≥200 37.1% [32.7–41.7]). Worldwide, we estimated that there were roughly 16,145,400 (95% CI 15,046,300–17,244,500) cases of HAND in HIV-infected adults, with 72% in sub-Saharan Africa (11,571,200 cases, 95% CI 9,600,000–13,568,000).ConclusionsOur findings suggest that people living with HIV have a high burden of HAND in the antiretroviral therapy (ART) era, especially in sub-Saharan Africa and Latin America. Earlier initiation of ART and sustained adherence to maintain a high-level CD4 cell count and prevent severe immunosuppression is likely to reduce the prevalence and severity of HAND.

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