scholarly journals Immunologic biomarkers, morbidity and mortality among HIV patients hospitalised in a Tertiary Care Hospital in the Brazilian Amazon

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wellington Mota Gama ◽  
Carlos Henrique Michiles Frank ◽  
Taynná Vernalha Rocha Almeida ◽  
Daniel Silva dos Santos ◽  
Yury Oliveira Chaves ◽  
...  
Keyword(s):  
Platelet Activation ◽  
Opportunistic Infections ◽  
Tertiary Care ◽  
Enzyme Linked Immunosorbent Assay ◽  
People Living With Hiv ◽  
Care Hospital ◽  
Aids Patients ◽  
Distribution Width ◽  
Advanced Immunosuppression ◽  
Hiv Aids

Abstract Background The irregular use of antiretroviral therapy (ART) and late diagnosis still account for a large part of HIV-associated mortality in people living with HIV (PLHIV). Herein, we describe HIV-associated morbidity among hospitalised HIV/AIDS patients with advanced immunosuppression and assess the comorbidities, laboratory parameters, and immunological markers associated with mortality. Methods The cross-sectional study was conducted at the Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD) in Manaus, Brazil. In all, 83 participants aged between 12 and 70 years were enrolled by convenience within 72 h of their hospitalisation. Clinical and laboratory data were obtained from electronic medical records. We prospectively measured the cytokines Th1/Th2/Th17 and inflammatory cytokines IL-8, IL-1β, and IL-12 using cytometric bead array, and the soluble CD14 using in-house enzyme-linked immunosorbent assay. Results The HIV/AIDS inpatients presented a scenario of respiratory syndromes as the most prevalent comorbidity. Almost all patients had CD4 T counts below 350 cells/mL and the mortality rate was 20.5%. Pulmonary tuberculosis, neurotoxoplasmosis and oropharyngeal–esophageal candidiasis were the most prevalent opportunistic infections. TB and weight loss were more prevalent in HIV/AIDS inpatients who died. The Mann Whitney analysis showed that those who died had higher platelet distribution width (PDW) on admission, which is suggestive for platelet activation. The Poisson multivariate analysis showed the prevalence of TB, digestive syndrome and increases in IL-8 and lactate dehydrogenase (LDH) associated to death. Conclusions The advanced immunosuppression characterized by the opportunistic infections presented in these HIV/AIDS inpatients was the major factor of mortality. The role of platelet activation in worse outcomes of hospitalisation and the IL-8 associated with the context of advanced immunosuppression may be promising markers in the prediction of mortality in HIV/AIDS patients.

scholarly journals Immunologic Biomarkers, Morbidity and Mortality Among HIV Patients Hospitalized in a Tertiary Care Hospital in the Brazilian Amazon

2020 ◽  
Author(s):  
Wellington Gama Mota ◽  
Taynná Vernalha Rocha Almeida ◽  
Daniel Silva dos Santos ◽  
Yury Oliveira Chaves ◽  
Danielle Furtado da Silva ◽  
...  
Keyword(s):  
Opportunistic Infections ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Brazilian Amazon ◽  
Morbidity And Mortality ◽  
People Living With Hiv ◽  
Care Hospital ◽  
Aids Patients ◽  
Laboratory Parameters ◽  
Hiv Aids

Abstract Background: While antiretroviral therapy (ART) has significantly improved survival rates of people living with HIV, some regions in Brazil still show a linear trend of growth in the opportunistic infections that cause HIV-associated mortality. We aimed to describe HIV-associated morbidity and mortality among hospitalized medical patients in a tertiary care hospital in Manaus, in the Brazilian Amazon, by investigating clinical data and immunologic biomarkers in order to assess predictive factors of mortality in this patient group. Methods: We prospectively measured concentrations of cytokines Th1/Th2/Th17 and soluble CD14 (sCD14) and reviewed the laboratory parameters and opportunistic infections in outcomes of either death or discharge of eighty-three HIV/AIDS patients who were admitted in 2017-2018 to the Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD) in Manaus. Results: The mortality in the sample studied was 20.5%. Tuberculosis (TB) showed a relative risk (RR) =1.86 (confidence interval (CI) 1.14 to 2.81: and p = 0.026), and weight loss was the symptom (RR=1.81; CI: 1.21 to 2.53 and p = 0.007) most highly associated with the death outcome in HIV/AIDS inpatients. Univariable analyses showed that the eosinophil count, platelet distribution width (PDW), and alanine aminotransferase were the only laboratory parameters that differed among patients who died. In relation to cytokines and sCD14 levels, no differences were found between those who died or were discharged. A multivariable logistic regression model was used to predict mortality and showed that individuals with no digestive syndrome (especially the absence of oropharyngeal candidiasis), nor TB are 63% to 76% less likely to die, respectively. In addition, increases in PDW values also decreased the probability of death. Curiously, patients who were discharged showed a trend towards a concomitant increase in PDW and mean platelet volume (MPV) in relation to those who died.Conclusions: Opportunistic infections continue to be major events in morbidity and mortality of HIV/AIDS patients, and the relationship between increased PDW and the likelihood of survival suggests the need for future studies on innate immune response of platelets in HIV/AIDS inpatients.

scholarly journals KNOWLEDGE, ATTITUDE AND PRACTICES AMONG NURSES TOWARDS HIV/ AIDS PATIENTS IN TERTIARY CARE HOSPITAL, AMROHA

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Atul Agrawal ◽  
Ankita Agrawal
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
People Living With Hiv ◽  
Care Hospital ◽  
Aids Patients ◽  
Attitudes And Practices ◽  
Positive Attitudes ◽  
High Level ◽  
Living With Hiv ◽  
Hiv Aids

Background: Human Immunodeficiency Virus (HIV) has become one of the most serious challenges to public health due to its high morbidity, mortality and economic impacts. Good Knowledge, positive attitudes and practices are important aspects of providing nursing care for people living with HIV/AIDS. Aim: This study aimed to assess knowledge, attitudes and practices of nurses working with HIV/AIDS patients. Methods: This study was descriptive, performed on 200 nurses working with HIV/AIDS patients at a tertiary care Hospital, Amroha. Data was collected using pretested, validated, self administered questionnaire consisting of knowledge, attitude and practice based questions related to HIV/Aids and infected patients along with demographic variables of nursing staff under study.  Results: The result of this study showed that majority of nurses (81%) working with HIV/AIDS patients possess adequate level of knowledge. Most of the nurses under study showed high level of empathic attitude toward people living with HIV/AIDS (above 80%) but at the same time high level of avoidance was observed among some nurses. Practice of nurses working with HIV/AIDS patients was found good. Conclusions: There was satisfactory knowledge, positive attitudes and good practice level among nurses under study. Recommendations: Training should focus on Preventive methods and modes of HIV transmission, care and support of all patients no matter what the disease, emphasizing confidentiality as a patient right that should not be ignored and should train nurses and monitor nursing skills. Keywords: Public health, Nurses, HIV, Knowledge, Attitude, Practices

scholarly journals Clinical and Socio demographic profile of attendees at ART centre in a tertiary care hospital in Mangalore, India

2015 ◽  
Vol 6 (5) ◽  
pp. 61-65
Author(s):  
U.B. Nayak ◽  
S. Lenka ◽  
B. Achappa
Keyword(s):  
Opportunistic Infections ◽  
Oral Candidiasis ◽  
Tertiary Care ◽  
Local Context ◽  
People Living With Hiv ◽  
Care Hospital ◽  
Heterosexual Contact ◽  
Presenting Symptoms ◽  
Number Of Patients ◽  
Hiv Aids

Introduction: India has the third largest number of people living with HIV/AIDS. There is a need to study the profile of patients who come to ART centers and link their clinical and socio-demographic variables in the management. Moreover, it is important to understand the presentation of HIV disease in the local context and culture. The present study is aimed at identifying the socio-demographic characteristics, clinical presentations of HIV/AIDS patients, opportunistic infections and the possible risk factors for acquiring HIV infection at an ART centre of Government Wenlock hospital, situated in Karnataka state of India. Materials and Methods: In this study 102 HIV patients attending the HIV clinic were enrolled and they were followed for a period of one year with relevant investigations.Results: Of 102 patients 69 were males and 33 were females.The mean age of the study subjects at the time of diagnosis was 38.06. Heterosexual contact was the commonest mode of transmission in96 (94.12%) patients. History suggestive of a risk factor for HIV transmission could not be elicited in 4 (3.92%) patients. Fever (71.5%), weight loss (62.74%), cough (51.96%) and chronic diarrhea (43.9%) were the common presenting symptoms. The most common opportunistic infection was oral candidiasis (66.67%) followed bytuberculosis (22.54%) and pneumocystis pneumonia (13.72%). Significant number of patients (30.37%) developed Zidovudine induced anemia and females were more prone for Zidovudine induced anemia as compared to males. CD4 counts of the patients were significantly inversely correlated with the number of symptoms and the number of opportunistic infections. Conclusion: Majority of patients were of low socioeconomic status and in productive age group with heterosexual contact being commonest mode of transmission.Significant number of patients developed Zidovudine induced anemia and females were more prone. DOI: http://dx.doi.org/10.3126/ajms.v6i5.11622Asian Journal of Medical Sciences Vol.6(5) 2015 61-65

scholarly journals An evaluation of health-related quality of life and its determinants among people living with HIV/AIDS attending tertiary care hospital of Kurnool, India

2019 ◽  
Vol 6 (10) ◽  
pp. 4470
Author(s):  
S. Cynthia Subhaprada ◽  
Shasank R. V. S. S. ◽  
T. Sivakala ◽  
S. Madhusai
Keyword(s):  
Quality Of Life ◽  
Tertiary Care ◽  
People Living With Hiv ◽  
Care Hospital ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Living With Hiv ◽  
Hiv Aids

Background: HIV/AIDS is known to affect an individual not only physically but also mentally, socially, and financially. It is a syndrome that builds a vacuum in a person affecting his/her life as a whole. Combined with ART, Quality of life (QoL) is an important component in the evaluation of the wellbeing of people living with HIV/AIDS (PLHIV). The objective of this study is to assess health related quality of life of HIV/AIDS patients attending ART clinic Tertiary care hospital, GGH, Kurnool and to determine the association of socio-demographic and disease related variables with health related quality of life.Methods: A cross-sectional study was conducted from April 2019 to June 2019 involving 400 purposively selected HIV-positive patients of age >18 years, who were taking highly active anti-retroviral therapy for the past 6months from the ART center, GGH, Kurnool. After obtaining IEC clearance and informed consent, WHOQOL-BREF instrument was used for data collection. Data analysis was performed using IBM SPSS version 26.0.Results: Out of the 400 participants, 60% were males. The mean age of the participants was 38.5±10.54 years. Overall quality of life had a mean score of 69.71. Physical (82.57) and level of independence (78.78) domains showed higher mean score when compared to psychological (63.82), environmental (61.49) and Social (60.26) domains.Conclusions: Among study subjects 15.5% had excellent QoL (≥80), nearly 69.75% had good QoL (60-79) and 14.75% had poor QoL (<60). Low QoL scores were seen in the social domain, suggesting that more social interventions are required in this population.

scholarly journals Spectrum of Opportunistic Fungal Infections in HIV/AIDS Patients in Tertiary Care Hospital in India

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Ravinder Kaur ◽  
Megh S. Dhakad ◽  
Ritu Goyal ◽  
Preena Bhalla ◽  
Richa Dewan
Keyword(s):  
Fungal Infections ◽  
Tertiary Care ◽  
North India ◽  
Clinical Samples ◽  
Fungal Culture ◽  
Care Hospital ◽  
Aids Patients ◽  
Cell Counts ◽  
Fungal Isolates ◽  
Hiv Aids

HIV related opportunistic fungal infections (OFIs) continue to cause morbidity and mortality in HIV infected patients. The objective for this prospective study is to elucidate the prevalence and spectrum of common OFIs in HIV/AIDS patients in north India. Relevant clinical samples were collected from symptomatic HIV positive patients (n=280) of all age groups and both sexes and subjected to direct microscopy and fungal culture. Identification as well as speciation of the fungal isolates was done as per the standard recommended methods. CD4+T cell counts were determined by flow cytometry using Fluorescent Activated Cell Sorter Count system. 215 fungal isolates were isolated with the isolation rate of 41.1%.Candidaspecies (86.5%) were the commonest followed byAspergillus(6.5%),Cryptococcus(3.3%),Penicillium(1.9%), andAlternariaandRhodotorulaspp. (0.9% each). AmongCandidaspecies,Candida albicans(75.8%) was the most prevalent species followed byC. tropicalis(9.7%),C. krusei(6.4%),C. glabrata(4.3%),C. parapsilosis(2.7%), andC. kefyr(1.1%). Study demonstrates that the oropharyngeal candidiasis is the commonest among different OFIs and would help to increase the awareness of clinicians in diagnosis and early treatment of these infections helping in the proper management of the patients especially in resource limited countries like ours.

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