scholarly journals Immunological and virological discordance among people living with HIV on highly active antiretroviral therapy in Tigray, Northern Ethiopia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Genet Gebrehiwet Hailu ◽  
Araya Gebreyesus Wasihun
Keyword(s):  
Risk Factors ◽  
Treatment Adherence ◽  
Highly Active Antiretroviral Therapy ◽  
Cd4 Count ◽  
People Living With Hiv ◽  
Northern Ethiopia ◽  
Highly Active ◽  
Associated Risk Factors ◽  
Study Participants ◽  
Living With Hiv

Abstract Background People living with human immunodeficiency virus (HIV) with immuno-virological discordant responses are at an increased risk to develop acquired immunodeficiency syndrome (AIDS) and severe non AIDS events which are risk factors for death. This study was aimed to assess prevalence of immuno- virological discordant responses and associated risk factors among highly active antiretroviral therapy (HAART) users in Tigray, Northern Ethiopia. Methods A cross sectional study was conducted from September to December 30, 2016 on 260 people living with HIV who started first line HAART from January 2008 to March 2016 at Mekelle hospital and Ayder comprehensive specialized hospital. Baseline and follow-up clinical data and CD4+ result were collected from patient charts. Besides, socio-demographic data and blood samples for CD4 + count and viral load measurement were collected during data collection period. Fisher’s exact test, bivariate and multivariate logistic regressions were used for data analysis. P-value < 0.05 with 95% CI was considered as statistically significant. Result Among the 260 study participants, 8.80% (95% Confidence Interval (CI) =8.77–8.84%) and 2.70% (95% CI = 2.68–2.72%) had virological and immunological discordant responses, respectively with an overall immuno-virological discordance response of 11.50% (95% CI = 11.46–11.54%). The median age of the study participants at HAART initiation was 35 (IQR: 28–44 years). More than half (58.1%) of the study participants were females. Age at or below 35 years old at HAART initiation (AOR ((95% CI) = 4.25(1.48–12.23), p = 0.007)), male gender ((Adjusted Odds Ratio (AOR) (95% CI) =1.71(1.13–1.10), p = 0.029)), type of regimen given ((AOR(95% CI) = 0.30 (0.10–0.88), p = 0.028)) and good treatment adherence ((AOR (95% CI) = 0.12 (0.030–0.0.48), p = 0.003)) were associated risk factors for virological discordant response. Likewise, immunological discordant response was associated with tuberculosis co-infections (p = 0.016), hepatitis B virus co-infections (p = 0.05) and low CD4+ count (≤100 cells/μl) at baseline (p = 0.026). Conclusions Over all, immuno-virological discordance response was 11.5% in the study area. Males, low baseline CD4+ count, poor/fair treatment adherence, and TB and HBV co-infections were significantly associated with higher immuno-virological discordance. We recommend that decision of patient treatment outcome, regimen change and patient management response should be done using trends of both viral load and CD4+ count concurrently.

scholarly journals Beyond biomarkers and towards functional outcomes for adult persons living with HIV. A cross sectional survey in Blantyre Urban, Malawi.

2019 ◽  
Author(s):  
Steven Derrick Manyozo ◽  
Nesto Tarimo ◽  
Gift Kawalazira ◽  
Adamson Sinjani Muula
Keyword(s):  
Risk Factors ◽  
International Classification Of Functioning ◽  
Categorical Variables ◽  
People Living With Hiv ◽  
Cross Sectional ◽  
Mental Functions ◽  
Persons Living With Hiv ◽  
Associated Risk Factors ◽  
Study Participants ◽  
Living With Hiv

Abstract Introduction Despite improvements in survival, reports indicate that people living with HIV are experiencing a range of physical, cognitive, mental and social health-related challenges associated with HIV, comorbidities and aging recently termed ‘disability’. Among adult persons living with HIV in Malawi, the prevalence of disability and associated risk factors are not known. This study was designed to assess the prevalence of impairments, activity limitations and associated risk factors among adults living with HIV in Blantyre urban, Malawi. Methods We conducted a quantitative cross sectional study among adult persons living with HIV in Blantyre urban from March to August 2018. Participants were recruited consecutively from 5 health centers. We used the WHO’s International Classification of Functioning, Disability and Health (ICF) for data collection. Written informed consent was sourced from study participants, permission was granted at each study site and the study received ethics approval from the College of Medicine Research Ethics Committee (COMREC). Descriptive statistics were used to summarize the data. Categorical variables were summarized as frequencies and percentages and continuous variables were summarized using means and standard deviation. Univariable and multivariable logistic regression were used to assess association between presence of disability and selected factors. Odds ratios (OR) and their 95% confidence intervals were calculated. Results Of the 277 participants enrolled in the study, 225 (81%) were female and 52 (19%) were male. The mean age of participants was 37 years ( std. dev 9.5 ). Impairments in mental functions were the most prevalent affecting 118 (43%) study participants. Energy and drive (18%), memory (14%) and sleep (13%) were the most affected mental functions. Impairments in the mental functions, genital urinary, reproductive, digestive, metabolic and endocrine systems were associated with higher odds of disability among the participants. Conclusions Our results indicate a high prevalence of impairments among persons living with HIV. Clinicians and rehabilitation personnel need to be proactive in identifying and managing impairments to promote health among HIV patients.

scholarly journals Efficacy of metronidazole to prevent active pulmonary tuberculosis in people living with HIV/AIDS on highly active anti-retroviral therapy: a prospective cohort study

2020 ◽  
Vol 8 (11) ◽  
pp. 3826
Author(s):  
Ketut Suryana
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Alcohol Consumption ◽  
Pulmonary Tuberculosis ◽  
Prospective Cohort ◽  
People Living With Hiv ◽  
Active Pulmonary Tuberculosis ◽  
Highly Active ◽  
Associated Risk Factors ◽  
Living With Hiv

Background: People living with HIV/AIDS (PLWHA) were more susceptible of Active Pulmonary Tuberculosis (APT) than non-PLWHA. Whether Metronidazole Preventive Therapy (MPT) may prevent APT, remain unclear. The objective of the study was to investigate efficacy of MPT and other associated risk factors of APT among PLWHA on Highly Active Anti Retroviral Therapy (HAART).Methods: A prospective cohort study included 182 PLWHA on HAART and asymptomatic tuberculosis (TB), 62 received MPT (first group) and 120 PLWHA did not receive MPT (second group). APT were diagnosed among the first group (4 participants) and the second group (26 participants). Monthly visit to replenish pills and to confirm APT. Efficacy of MPT to prevent APT, socio-demography and laboratory, were analyzed using Chi-square with significancy p<0.05.Results: Of 112 participants (62.20%) were males, 70 (37.80%) females, mean age (year) 37.31±9.83. Four (2.20%) of participants (first group) and 26 (14.47%) (second group) were confirmed APT (p=0.003). In bivariate analysis, sex (p=0.020), alcohol consumption (p=0.000); smoking (p=0.000), CD4 cell counts (<70 cell/µl) (p=0.001), previous history of TB (p=0.000) were the significant factors associated with APT. Participants who received MPT had a significantly lower risk of APT than participants who did not receive MPT (p=0.003). Other factors; weight, Hb, WBC, neutrophil, lymphocyte, Neutrophil Lymphocyte Ratio (NLR) were not significantly associated with APT.Conclusions: We found, a significant protective effect of MPT, prevent APT. Other significant associated risk factors of APT were sex (male), smoking, alcohol consumption, previous TB history, lower CD4 counts.

scholarly journals Prevalence of Toxoplasma gondii and Associated Risk Factors among People Living with HIV at Gondar University Hospital, Northwest Ethiopia

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Dagnachew Muluye ◽  
Yitayih Wondimeneh ◽  
Yeshambel Belyhun ◽  
Feleke Moges ◽  
Mengistu Endris ◽  
...  
Keyword(s):  
Risk Factors ◽  
Toxoplasma Gondii ◽  
University Hospital ◽  
People Living With Hiv ◽  
Cd4 Lymphocyte Count ◽  
Gondar University Hospital ◽  
Cd4 Lymphocyte ◽  
Associated Risk Factors ◽  
Study Participants ◽  
Living With Hiv

Background. Toxoplasma gondii is an obligate intracellular protozoan parasite and is a major opportunistic pathogen in immune-compromised hosts. This study assessed the prevalence of T. gondii and associated risk factors among people living with HIV. Methods and Materials. A cross-sectional study was carried out among people living with HIV attending Gondar University Hospital. A structured and pretested questionnaire was used to collect sociodemographic factors, and 10mL of venous blood was collected for anti-Toxoplasma antibody test and determination of CD4 levels. Serum was tested in duplicate for anti-Toxoplasma antibody using rapid slide agglutination test. Results. A total of 170 study subjects were enrolled in the study. Seroprevalence of T. gondii among the study participants was 76.5% (95% CI: 69.0–82.8). High proportions of seropositive individuals (64.7%) were found under the child bearing age groups. The mean CD4+ lymphocyte count of HIV monoinfected participants was cells/mm3 while coinfected study participants had mean CD4+ lymphocyte count of cells/mm3 with value of 0.01. Conclusion. The seroprevalence of T. gondii among people living with HIV was high. Cautious followup of HIV-positive patients is needed to prevent development of toxoplasmic encephalitis and other related complications.

scholarly journals Stroke among highly active antiretroviral therapy-naive people living with the human immunodeficiency virus in China: a retrospective study of the characteristics, risk factors, and prognosis

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Ling Zhang ◽  
Yu Wang ◽  
Qiuhua Xu ◽  
Wei Zhang ◽  
Hongyuan Liang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Highly Active Antiretroviral Therapy ◽  
Age Groups ◽  
Severe Pneumonia ◽  
Cd4 Count ◽  
People Living With Hiv ◽  
Early Screening ◽  
Cns Diseases ◽  
Living With Hiv

Abstract Background We aimed to clarify the characteristics, risk factors, and prognosis of stroke among HAART-naive people living with HIV (PLWH) in China. Methods We selected HAART-naive PLWH admitted to Beijing Ditan Hospital, Capital Medical University, from 1 January 2009 to 31 December 2019. Demographic and clinical data were obtained by searching an anonymous electronic case system. Descriptive analysis and logistic regression and Cox proportional hazard models were used to determine the characteristics and predictors of stroke among all HAART-naive PLWH and evaluate the risk factors of mortality in HAART-naive PLWH with stroke. Results Stroke was diagnosed in 105 cases (3.7%) of 2867 HAART-naive PLWH. Multivariate logistic regression indicated that age of 30–55 years (OR 1.903, 95% CI 1.005–3.603, p = 0.048), age of ≥ 55 years (OR 4.104, 95% CI 1.928–8.737, p < 0.001), and CD4 count of < 200 cells/µL (OR 2.005, 95% CI 1.008–3.985, p = 0.047) were associated with increased odds of stroke. Diabetes (OR 3.268, 95% CI 1.744–6.125, p < 0.001), hypertension (OR 2.301, 95% CI 1.425–3.717, p = 0.001), syphilis (OR 2.003, 95% CI 1.300–3.089, p = 0.002), and complicated AIDS-defining CNS diseases (OR 7.719, 95% CI 4.348–13.703, p < 0.001) were risk factors for stroke. Of the 105 stroke patients, 12 (11.4%) died during hospitalisation, and the risk factors for mortality among patients with stroke were age of > 65 years (AHR: 8.783, 95% CI 1.522–50.668, p = 0.015), complicated severe pneumonia (AHR: 3.940, 95% CI 1.106–14.029, p = 0.034), and AIDS-defining CNS diseases (AHR: 19.766, 95% CI 3.586–108.961, p = 0.001). Conclusions For HAART-naive people living with HIV (PLWH), stroke occurred in various age groups, and early screening for stroke, timely intervention for risk factors among patients in various age groups, and controlling the CD4 count are extremely important in reducing the burden of stroke.

scholarly journals Depression and suicidal ideation among HIV seropositive patients attending the special treatment clinic of the University of Calabar Teaching Hospital, Calabar, Nigeria

2021 ◽  
Vol 4 ◽  
pp. 64-70
Author(s):  
Elvis Mbu Bisong ◽  
Chidi John Okafor ◽  
Agam Ebaji Ayuk ◽  
Udeme Essien Asibong ◽  
Henry Ohem Okpa
Keyword(s):  
Viral Load ◽  
Suicidal Ideation ◽  
Highly Active Antiretroviral Therapy ◽  
Cd4 Count ◽  
Special Treatment ◽  
Prevalence Rates ◽  
Highly Active ◽  
Study Participants ◽  
Hiv Seropositive ◽  
Hiv Aids

Objectives: The introduction of highly active antiretroviral therapy and innovations in healthcare has contributed in improving the lives of persons living with human immunodeficiency virus (HIV)/AID. Patients infected with HIV are more susceptible to develop psychiatric illnesses. Depression is common among patients suffering from chronic illness such as HIV/AIDS and can exacerbate these illnesses. Depression has been observed to be twice as common in HIV seropositive individuals than in the general population. Undiagnosed and untreated depression in patients suffering from HIV/AIDS could lead to poor adherence to medications and lower quality of life. Depression is associated with rapid HIV disease progression. The diagnosis of HIV infection may be associated with feelings of anger, denial, sadness, guilt feelings, loss of self-esteem among others. These negative feelings could lead to suicidal ideation and attempted suicide or suicide. We sought to determine the prevalence rates, sociodemographics and predictors, of depression and suicidal ideation among study participants. Material and methods: Two hundred and two adult participants who met the inclusion criteria were recruited into the study. Mini International Neuropsychiatric Interview English version 6.0.0 was employed to diagnose depression and suicidal ideation. Data were analyzed using Statistical Package for the Social Sciences version 20.0. Significant levels were set at P < 0.05. Results: This study revealed prevalence rates of 11.4% for depression and 7.9% for suicidal ideation among study participants. Majority of the participants were females in the young age group category of 30–40 years (45%) with mostly secondary education (47.8%), most had a higher CD4 count greater than 200 cells/µL (82.6%) and were mainly on zidovudine/lamivudine/nevirapine combination therapy (56.5%). Mean age, CD4 count, and viral load levels were lower in HIV patients with depression but were not statistically significant (P > 0.05). CD4 count and viral load were not significantly associated with suicidal ideation. Lower age (30–40 years) was significantly associated with suicidal ideation (P < 0.05). Suicidal ideation is a predictor of depression in the same way depression is a predictor of suicidal ideation (P < 0.05). Conclusion: Routine screening for depression and suicidal ideation especially among younger HIV/AIDS patients is recommended in the clinic setting.

scholarly journals Adherence to Highly Active Antiretroviral Therapy and Its Association with Serostatus Disclosure among People Living with HIV in Ethiopia:  A Systematic Review and Meta-Analysis.

2020 ◽  
Author(s):  
Abere Woretaw Azagew ◽  
Chilot Kassa Mekonnen ◽  
Abebaw Jember Ferede ◽  
Kassahun Gebeyehu Yazew ◽  
Zewdu Baye Tezera
Keyword(s):  
Systematic Review ◽  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Assessment Tool ◽  
Meta Analysis ◽  
People Living With Hiv ◽  
Serostatus Disclosure ◽  
Highly Active ◽  
Pooled Prevalence ◽  
Living With Hiv

Abstract Background: Adherence to highly active antiretroviral therapy (HAART) is a public health challenge worldwide. Non-adherence to HAART leads to treatment, immunologic, and virological failure. Despite different interventions made, adherence to HAART among adult people living with HIV (PLWHIV) is still inconsistent across studies, and the effect of serostatus disclosure on adherence to HAART was not studied in Ethiopia. Therefore, the study is aimed to determine the pooled prevalence of adherence to HAART and its relationship with serostatus disclosure among adult PLWHIV in Ethiopia.Methods: We searched 3247 original articles, both published and unpublished on Ethiopia dated from January 2016 to November 2019 by using different search engines. Data were extracted using Microsoft excel. New Castle Ottawa Scale quality assessment tool was used. STATA software version 11 was used for analysis. A random-effects model for meta-analysis was computed. Cochran Q statistics and I2 were used to estimate heterogeneity. Egger’s and Begg’s test was used to assess the publication bias.Results: A total of fifteen articles for systematic review and four articles for meta-analysis were used. The pooled prevalence of adherence to HAART is found to be 81.19% (80.1, 82.3). In the subgroup analysis, the pooled prevalence of adherence to HAART was 79.82% (73.19, 86.45) in the Oromia region, 82.51 %( 73.14, 91.87) in the Amhara region, and 72.7% (63.78, 81.61) in the Southern Nations Nationalities and Peoples’ Region (SNNPR). The serostatus disclosure improves adherence to HAART by nearly three times compared to non-serostatus disclosed PLWHIV (AOR=2.99, 95 %CI: 1.88, 4.77).Conclusions: The pooled prevalence of adherence to HAART among adult PLWHIV in Ethiopia was found to be low compared to WHO antiretroviral treatment recommendations. Having serostatus disclosure improved adherence to HAART.

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