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 Analysis of endometrial thickness measured by transvaginal ultrasonography in obese patients

2014 ◽  
Vol 12 (2) ◽  
pp. 164-167 ◽  
Author(s):  
Isabela Corrêa Barboza ◽  
Daniella de Batista Depes ◽  
Ilzo Vianna Júnior ◽  
Marisa Teresinha Patriarca ◽  
Raquel Martins Arruda ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Endometrial Thickness ◽  
Statistical Significance ◽  
Cross Sectional Study ◽  
The Body ◽  
Transvaginal Ultrasonography ◽  
Obese Patients ◽  
Cross Sectional ◽  
Endometrial Thickening

Objective To compare the endometrial echo values obtained by transvaginal ultrasonography with the body mass index of postmenopausal patients; to verify if there is higher prevalence of endometrial thickening in women with body mass index ≥30.Methods This is an analytical and cross-sectional study that evaluated 294 patients. Postmenopausal women were included, and those on hormone therapy were excluded. The variables evaluated were body mass index (considering obesity if >30), number of pregnancies, years since menopause, and age. These variables were correlated with endometrial echography.Results There was a statistically significant correlation between overweight and obese patients and increased endometrial thickness (p=0.0236). The correlation between age and endometrial echo was negative and statistically significant, that is, the older the woman, the lower the endometrial thickness (p=0.0478). Pregnancies and years since menopause showed no statistical significance in relation to endometrial echo, with p=0.0614 and p=0.115, respectively.Conclusion There was positive and significant correlation between body mass index ≥30 and endometrial thickeness.

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 Relationship between intake of artificial sweeteners and body mass index in young non-diabetic adults: a cross-sectional study

2017 ◽  
Vol 5 (4) ◽  
pp. 1208
Author(s):  
Geetika Gupta ◽  
Sabita Yograj ◽  
Anil K. Gupta ◽  
Bhavna Langer ◽  
Mumtaz Goni ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
English Language ◽  
Healthy Lifestyle ◽  
Statistical Significance ◽  
Cross Sectional Study ◽  
Artificial Sweeteners ◽  
Sectional Study ◽  
Cross Sectional ◽  
Significant Difference

Background: Artificial sweeteners have skyrocketed the market in the last decade and there are unlimited products available today that contain them. They are often projected as one of the easy and effortless method of cutting down calories and have gained importance in the community. They are being used as one of the dietary tools to control or prevent weight gain not only in diabetic adults but also in young healthy adults and children. There is a need to examine any possible contribution of these substances on body weight and BMI of an individual.Methods: A cross sectional study was conducted among randomly selected healthy non-diabetic subjects of both sexes in the age group 18-35 years. Those with history of intake of artificial sweeteners in the last one year (in the form of pellets or diet soda) were considered as study group and equal no of non-users were taken as comparison group for study purpose. A pretested semi structured questionnaire prepared in English language was used to collect information. Variables such as height, weight and body mass index were noted. Data was analyzed using SPSS (version 20.0).Results: There was a statistically significant difference between the two groups in terms of weight and BMI (p=0.003 and 0.002 respectively). The mean weight and BMI was more in those subjects who had consumed more than one serving of diet can per day. Sweeteners in pellet form failed to show any statistical significance association between frequency of use and BMI.Conclusions: The study suggested of a possible association between the use of artificial sweeteners and BMI. Young adults need to be sensitized about various safe weight management techniques and healthy lifestyle, rather than resorting to methods like intake of artificial sweeteners.

Etiology of Juandice and Associated Liver Diseases Among Hiv Patients

2021 ◽  
Vol 15 (10) ◽  
pp. 3366-3369
Author(s):  
Syed Shah Gul ◽  
Muhammad Abdul Quddus ◽  
Jahangir Zaib ◽  
Tahir Iqbal ◽  
Wajid Hussain ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Liver Disease ◽  
Cross Sectional Study ◽  
Drug Induced ◽  
Abdominal Ultrasonography ◽  
Cross Sectional ◽  
Term Survival ◽  
Immunodeficiency Virus ◽  
Fundamental Cause ◽  
Immunodeficiency Syndrome

Background and Aim: Jaundice and associated liver disease are frequently diagnosed in patients with acquired immunodeficiency syndrome (AIDS). The assessment of jaundice causes, etiology, and outcomes in human immunodeficiency virus (HIV)-infected patients with liver disease have not been addressed. The present study aimed to evaluate jaundice and associated liver disease in human immunodeficiency virus (HIV)-infected patients. Materials and Methods: This cross-sectional study was conducted on 272 human immunodeficiency virus(HIV)-infected patients with liver disease at the Department of Gastroenterology AK CMH/ Sheikh Khalifa bin Zayad Al Nahyan Hospital Rawalakot, Medicine Medical Unit A, Hayatabad Medical Complex, Peshawar and department of Medicine, Fauji Foundation Hospital Rawalpindi for duration between 5th January 2020 and 5th December 2020. Jaundice was defined as a serum bilirubin concentration of 3 mg/dL or higher. The etiology of jaundice was determined using a pattern of liver disease biochemistry test, radiographic studies, liver biopsy and clinical follow-up. Results: About 272 HIV-infected patients were evaluated liver disease; the prevalence of jaundice was 46 (16.9%). Drug-induced hepatitis was the more prevalent cause in Jaundice 19 (41.3%) followed by neoplasms in 14 (30.4%) patients. Out of 14 neoplasms, the extrahepatic and intrahepatic disease was present in 8 and 6 patients respectively. Alcoholic liver disease was present in 5 (10.9%). Various potential causes were present in three patients. The use of abdominal ultrasonography and CT was beneficial in determining the fundamental cause of the infection. five of these patients died as a result of liver disease. Conclusion: Jaundice is rare and can be caused by a number of opportunistic and non-opportunistic etiologies in AIDS. The most common cause is drug-induced hepatitis, which can be fatal. Long-term survival was dismal. Keywords: Jaundice, Liver Disease, Human immunodeficiency virus (HIV)

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

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