scholarly journals Phenotype and Treatment of Breast Cancer in HIV-Positive and -Negative Women in Cape Town, South Africa

2016 ◽  
Vol 2 (5) ◽  
pp. 284-291 ◽  
Author(s):  
Lizanne Langenhoven ◽  
Pieter Barnardt ◽  
Alfred I. Neugut ◽  
Judith S. Jacobson
Keyword(s):  
Breast Cancer ◽  
South Africa ◽  
Standard Deviation ◽  
Systemic Chemotherapy ◽  
Hiv Positive ◽  
Hiv Status ◽  
Cd4 Cell Count ◽  
The Mean ◽  
Cd4 Cell ◽  
Hiv Negative

Purpose An estimated 5.9 million people in South Africa are infected with HIV. Because antiretroviral therapy has made infection with HIV a treatable, chronic condition, HIV-infected individuals are now surviving to middle and older age. We investigated the implications of HIV status for breast cancer in South Africa. Methods We compared clinical and demographic characteristics of women newly diagnosed with a first primary breast cancer at Tygerberg Hospital, Cape Town, South Africa, from January 2010 to December 2011 by HIV status. We then compared HIV-positive patients with HIV-negative controls, matched 2:1 on age and ethnicity, with respect to chemotherapy regimens, toxicities, completion of systemic chemotherapy, and changes in CD4 cell count. Results Of 586 women with breast cancer, 31 (5.3%) were HIV positive, 420 (71.7%) were HIV negative, and 135 (23%) were untested for HIV. Women with HIV were younger than other women (P < .001). The groups did not differ in regard to stage at presentation, histologic subtype, tumor grade, nodal involvement, or hormone receptor positivity. More than 84% of patients who initiated systemic chemotherapy, regardless of HIV status, completed it without serious toxicity. Among HIV-positive patients receiving chemotherapy, the mean baseline CD4 cell count was 477 cells/µL (standard deviation, 160 cells/µL), and the mean nadir was 333 cells/µL (standard deviation, 166 cells/µL). Conclusion HIV-infected women were younger at breast cancer diagnosis than HIV-negative women but otherwise similar in phenotype and completion of chemotherapy. Longer term follow-up is needed to evaluate the effects of HIV, antiretroviral therapy, and chemotherapy on the survival and quality of life of patients with breast cancer.

scholarly journals Performance of verbal autopsy methods in estimating HIV-associated mortality among adults in South Africa

2018 ◽  
Vol 3 (4) ◽  
pp. e000833 ◽  
Author(s):  
Aaron S Karat ◽  
Noriah Maraba ◽  
Mpho Tlali ◽  
Salome Charalambous ◽  
Violet N Chihota ◽  
...  
Keyword(s):  
South Africa ◽  
Verbal Autopsy ◽  
Vital Statistics ◽  
Classification Systems ◽  
Hiv Positive ◽  
Hiv Status ◽  
Civil Registration ◽  
Art Initiation ◽  
Better Than ◽  
Hiv Negative

IntroductionVerbal autopsy (VA) can be integrated into civil registration and vital statistics systems, but its accuracy in determining HIV-associated causes of death (CoD) is uncertain. We assessed the sensitivity and specificity of VA questions in determining HIV status and antiretroviral therapy (ART) initiation and compared HIV-associated mortality fractions assigned by different VA interpretation methods.MethodsUsing the WHO 2012 instrument with added ART questions, VA was conducted for deaths among adults with known HIV status (356 HIV positive and 103 HIV negative) in South Africa. CoD were assigned using physician-certified VA (PCVA) and computer-coded VA (CCVA) methods and compared with documented HIV status.ResultsThe sensitivity of VA questions in detecting HIV status and ART initiation was 84.3% (95% CI 80 to 88) and 91.0% (95% CI 86 to 95); 283/356 (79.5%) HIV-positive individuals were assigned HIV-associated CoD by PCVA, 166 (46.6%) by InterVA-4.03, 201 (56.5%) by InterVA-5, and 80 (22.5%) and 289 (81.2%) by SmartVA-Analyze V.1.1.1 and V.1.2.1. Agreement between PCVA and older CCVA methods was poor (chance-corrected concordance [CCC] <0; cause-specific mortality fraction [CSMF] accuracy ≤56%) but better between PCVA and updated methods (CCC 0.21–0.75; CSMF accuracy 65%–98%). All methods were specific (specificity 87% to 96%) in assigning HIV-associated CoD.ConclusionAll CCVA interpretation methods underestimated the HIV-associated mortality fraction compared with PCVA; InterVA-5 and SmartVA-Analyze V.1.2.1 performed better than earlier versions. Changes to VA methods and classification systems are needed to track progress towards targets for reducing HIV-associated mortality,

scholarly journals Cancer in HIV-positive and HIV-negative adolescents and young adults in South Africa: a cross-sectional study

2020 ◽  
Author(s):  
Tafadzwa G Dhokotera ◽  
Julia Bohlius ◽  
Matthias Egger ◽  
Adrian Spoerri ◽  
Jabulani Ncayiyana ◽  
...  
Keyword(s):  
South Africa ◽  
Cervical Cancer ◽  
Cross Sectional Study ◽  
Hiv Positive ◽  
Sectional Study ◽  
Hiv Status ◽  
Cross Sectional ◽  
Cancer Data ◽  
Living With Hiv ◽  
Hiv Negative

Objective: To determine the spectrum of cancers in AYAs living with HIV in South Africa compared to their HIV negative peers. Design: Cross sectional study with cancer data provided by the National Cancer Registry and HIV data from the National Health Laboratory Service. Setting and participants: The NHLS is the largest provider of pathology services in the South African public sector with an estimated coverage of 80%. The NCR is a division of the NHLS. We included AYAs (aged 10-24 years) diagnosed with cancer by public health sector laboratories between 2004 and 2014 (n=8 479). We included 3 672 in the complete case analysis. Primary and secondary outcomes: We used linked NCR and NHLS data to determine the spectrum of cancers by HIV status in AYAs. We also used multivariable logistic regression to describe the association of cancer in AYAs with HIV, adjusting for age, sex (as appropriate), ethnicity, and calendar period. Due to the large proportion of unknown HIV status we also imputed (post-hoc) the missing HIV status. Results: From 2004-2014, 8 479 AYAs were diagnosed with cancer, HIV status was known for only 45% (n=3812); of those whose status was known, about half were HIV positive (n=1853). AYAs living with HIV were more likely to have Kaposi's sarcoma (adjusted odds ratio (aOR) 218, 95% CI 89.9-530), cervical cancer (aOR 2.18, 95% CI 1.23-3.89), non-Hodgkin's lymphoma (aOR 2.12, 95% CI 1.69-2.66), and anogenital cancers other than cervix (aOR 2.73, 95% CI 1.27-5.86). About 44% (n=1 062) of AYAs with HIV related cancers had not been tested for HIV, though they were very likely to have the disease. Conclusions: Cancer burden in AYAs living with HIV in South Africa could be reduced by screening young women for cervical cancer and vaccinating them against human papilloma virus (HPV) infection.

The impact of HIV infection on overall survival among women with stage IV breast cancer in South Africa.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 6559-6559
Author(s):  
Yoanna S Pumpalova ◽  
Oluwatosin Ayeni ◽  
Wenlong Carl Chen ◽  
Daniel O'Neil ◽  
Sarah Nietz ◽  
...  
Keyword(s):  
Breast Cancer ◽  
South Africa ◽  
Overall Survival ◽  
Subgroup Analysis ◽  
Hormone Receptor ◽  
Stage Iv ◽  
Public Hospitals ◽  
Hiv Status ◽  
The Impact ◽  
Hiv Negative

6559 Background: Advanced stage at breast cancer (BC) diagnosis is common in sub-Saharan Africa. In public hospitals across South Africa (SA), 10-15% of women present with metastatic BC, compared to <5% in the U.S., and 20% of new BCs are diagnosed in women living with HIV (WLWH). We evaluated the impact of HIV on overall survival (OS) among women with stage IV BC, which is associated with a poor prognosis in SA. Methods: We conducted a prospective cohort study of women diagnosed with stage IV BC between February 2, 2015 and September 18, 2019 at six public hospitals in SA. Baseline characteristics were compared by HIV status and multivariate Cox regression models were used to estimate the effect of HIV on OS. Results: Among 550 eligible women, 147 (26.7%) were WLWH. Compared to HIV-negative BC patients, WLWH were younger (median age 45 vs. 60 years, p<0.001), predominantly black (95.9% vs. 77.9%, p<0.001), and more likely to have hormone receptor-negative BC (32.7% vs. 22.6%, p=0.016). HER2 tumor status did not differ by HIV status (25.3% HER2 positive overall), and Ki67 index was not increased among WLWH (57.1% Ki67 > 20 overall). Receipt of systemic anti-cancer therapy did not differ by HIV status (80.9% treated overall) and most women were treated with anthracycline (55.5%). HIV status was not associated with OS (Hazard Ratio (HR)=1.13, 95% confidence interval (CI)=0.89-1.44) (Table). In an exploratory subgroup analysis, WLWH and hormone receptor-negative BC had shorter OS compared to HIV-negative women (1-year OS: 27.1% vs. 48.8%, p=0.003; HR=1.94, 95% CI=1.27-2.94), which was not observed for hormone receptor-positive BC. Results were unchanged when analysis was restricted to black women only. Conclusions: HIV status was not associated with worse OS in women with stage IV BC in SA and cannot account for the poor survival in our cohort. Subgroup analysis revealed that WLWH with hormone receptor-negative BC had worse OS; this differential effect of HIV on BC survival by hormone receptor status is a novel finding that warrants further investigation.[Table: see text]

HIV and the dual burden of malnutrition in Senegal, 1994–2012

2018 ◽  
Vol 29 (12) ◽  
pp. 1165-1173
Author(s):  
Noelle A Benzekri ◽  
Moussa Seydi ◽  
Ibrahima NDoye ◽  
Macoumba Toure ◽  
Nancy B Kiviat ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Cell Count ◽  
Multinomial Logistic Regression ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Nutrition Interventions ◽  
Commercial Sex Work ◽  
Cd4 Cell Count ◽  
Cd4 Cell ◽  
Hiv Negative

The aims of this study were to determine the nutritional status of HIV-positive versus HIV-negative adults in Senegal and to identify predictors of nutritional status among people living with HIV (PLHIV). We conducted a retrospective study using data from individuals enrolled in previous studies in Senegal. Undernutrition was defined as body mass index (BMI) <18.5 and overnutrition was defined as BMI ≥25.0. Subcategories of overnutrition were overweight (defined as BMI 25.0–29.9) and obesity (BMI ≥30.0). Predictors of nutritional status were identified using multinomial logistic regression. Data from 2448 adults were included; 1471 (60%) were HIV positive. Among HIV-negative individuals, the prevalence of undernutrition decreased from 23% in 1994–1999 to 5% in 2006–2012, while the prevalence of overnutrition increased from 19 to 55%. Among PLHIV, undernutrition decreased from 52 to 37% and overnutrition increased from 10 to 15%. Women had greater odds of obesity (odds ratio [OR] 11.4; p < 0.01). Among HIV-positive women, undernutrition was associated with WHO stage 3 or 4 and CD4 cell count <200; antiretroviral therapy (ART) and education were protective. Obesity was associated with age > 35 years, commercial sex work, and alcohol use. Among HIV-positive men, WHO stage 3 or 4 and CD4 cell count <200 were predictive of undernutrition; ART was protective. Our study highlights the need for the integration of nutrition interventions into HIV programs in Senegal and suggests that for nutrition programs to be most effective, strategies may need to differ when targeting men versus women. Furthermore, improving access to education and focusing on women for nutrition interventions could be of particularly high impact at the household level.

Clinical manifestations of influenza in HIV-infected individuals

2001 ◽  
Vol 12 (10) ◽  
pp. 646-650 ◽  
Author(s):  
Daniel J Skiest ◽  
Peter Kaplan ◽  
Timothy Machala ◽  
Linda Boney ◽  
James Luby
Keyword(s):  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Pulmonary Complications ◽  
Hiv Viral Load ◽  
Cd4 Cell Count ◽  
Viral Loads ◽  
The Mean ◽  
Cd4 Cell ◽  
The Relationship ◽  
Hiv Negative

Although influenza vaccination is recommended for individuals with HIV infection, there are no data indicating an increased incidence or severity of influenza in this population. We sought to describe the clinical manifestations and morbidity of influenza in HIV-infected patients. All cases of influenza occurring in HIV-infected individuals over 3 years at a large county hospital were reviewed. Forty-three cases of influenza were diagnosed. Most patients presented with typical signs and symptoms of influenza, including cough (90%), myalgias (64%), and fever (52%). Sore throat and headache occurred in less than half of patients. The mean CD4 cell count and HIV viral load in patients with influenza was 340 cells/mm3 and 3.34 log copies/ml, respectively. No significant differences in CD4 counts or viral loads were noted in patients with pneumonia ( n=7) compared with patients without pneumonia ( n=36), P>0.5. Six patients were hospitalized. One patient each had encephalitis and renal failure, although the relationship to influenza was not clear. No new or unusual clinical manifestations were observed. The rate of pulmonary complications was similar to other studies in HIV-negative patients; however, the hospitalization rate was higher than commonly seen in HIV-negative individuals.

scholarly journals Seroprevalence of IgM and IgG Antibodies to Toxoplasma infection in healthy and HIV-positive adults from Northern Nigeria

2013 ◽  
Vol 7 (05) ◽  
pp. 398-403 ◽  
Author(s):  
Dimie Ogoina ◽  
Geoffrey C Onyemelukwe ◽  
Bolanle O Musa ◽  
Reginald O Obiako
Keyword(s):  
Healthy Adults ◽  
Clinical Staging ◽  
Hiv Positive ◽  
Northern Nigeria ◽  
Toxoplasma Infection ◽  
Cross Sectional ◽  
Cd4 Cell Count ◽  
Cell Counts ◽  
Cd4 Cell ◽  
Hiv Negative

Introduction: We examined the seroprevalence of toxoplasma infection in HIV-negative and -positive adults from Zaria, Northern Nigeria, and assessed its relationship with demographic, clinical, and immunological findings. Methodology: In a six-month cross-sectional study undertaken in 2008, sera of 219 adults, including 111 consecutive HIV-infected adults and 108 healthy HIV-negative adult volunteers from Zaria, Northern Nigeria, were examined for IgG and IgM antibodies to toxoplasma by ELISA.  Clinical characteristics of the HIV-infected patients were documented. Differences in toxoplasma seropositivity between HIV-positive and negative adults were sought. The relationship between toxoplasma seropositivity and variables such as age, sex and antiretroviral (ART) status, as well as HIV clinical staging and CD4 cell counts were also determined. P<0.05 was considered significant. Results: The seroprevalence of toxoplasma infection (IgG positive and or IgM positive) was 32.4% in HIV-negative healthy adults and 38.7% in HIV-infected adults (P>0.05).  The rate of IgM seropositivity was 4.6% in healthy adults and 1.8% in HIV-infected patients, while the rate of IgG seropositivity (without IgM seropositivity) was 28.7% in healthy adults and 37.8% in HIV-infected patients (p>0.05).  Toxoplasma seropositivity was not associated with age, sex, ART status, CD4 cell count or HIV clinical staging. Seventy-four percent of the toxoplasma seropositive HIV-infected patients were asymptomatic and no cases of toxoplasma encephalitis were identified. Conclusion: Toxoplasmosis is equally prevalent in HIV-infected patients and healthy adults from similar environments in Northern Nigeria. It is imperative to develop public health policies to prevent toxoplasmosis in Nigeria, especially in HIV-infected patients.

HIV-related mortality at a district hospital in Botswana

2016 ◽  
Vol 28 (3) ◽  
pp. 277-283 ◽  
Author(s):  
Melissa EO Perry ◽  
Kitenge Kalenga ◽  
Louise Francois Watkins ◽  
Japheth E Mukaya ◽  
Kathleen M Powis ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Testing ◽  
Tertiary Hospital ◽  
Mortality Data ◽  
Hiv Positive ◽  
Hiv Status ◽  
Surveillance Period ◽  
Hospital System ◽  
Cd4 Cell Count ◽  
Hiv Negative

We reviewed mortality data among medical inpatients at a tertiary hospital in Botswana to identify risk factors for adverse inpatient outcomes. This review was a prospective analysis of inpatient admissions. All medical admissions to male and female medical wards were recorded over a six-month period between 1 November 2011 and 30 April 2012. Data collected included patient demographics, HIV status (positive, negative, unknown), HIV testing history, HIV related treatment and serological history, admission and discharge diagnoses, and mortality status at final discharge or transfer. Of 972 patients admitted during the surveillance period, 427 (43.9%) were known to be HIV-positive on admission, 144 (14.8%) were known to be HIV-negative, and 401 (41.3%) had an unknown HIV status. Of those with unknown status, 131 (32.7%) were tested for HIV during admission and among these 35 (27.5%) were HIV-positive. Including patients with known mortality status following transfer, 172 (17.9%) patients died during the hospitalization. Death occurred in 105 (23%) of known HIV-positive patients, compared with 31 (13%) of known HIV-negative patients (p = 0.002, HR = 1.56 in adjusted analyses). Among HIV-positive patients who died, a low CD4 cell count (<200 cells/mm3) was associated with death. Overall, patients who died had significantly more neurological and respiratory-related presenting complaints than patients who survived. In conclusion, we identified higher overall mortality among HIV-positive patients at a tertiary hospital in Botswana, and low rates of in-hospital HIV testing and antiretroviral therapy initiation. These data demonstrate that despite available antiretroviral therapy in the population for over a decade, HIV continues to add excess burden to the hospital system and adds to inpatient mortality in Botswana.

scholarly journals Prevalence and determinants of anemia amongst HIV positive pregnant women in a tertiary Hospital in Nigeria

2020 ◽  
Vol 9 (12) ◽  
pp. 4825
Author(s):  
Innocent O. Eze ◽  
Clara U. Innoeze ◽  
Malachy E. Ayogu ◽  
Stephen C. Eze
Keyword(s):  
Pregnant Women ◽  
Cd4 Count ◽  
Hiv Positive ◽  
Hiv Status ◽  
Cross Sectional ◽  
Positive Group ◽  
Increased Risk ◽  
The Mean ◽  
Prevalence Of Anemia ◽  
Hiv Negative

Background: In pregnancy, anemia is associated with increased risk of both maternal and fetal morbidity and mortality especially in HIV situation. To determine the prevalence and determinants of anemia in HIV positive compared to HIV negative women.Methods: This was a cross sectional study carried out from June 2016 to December 2017 amongst pregnant women who presented to the antenatal clinic. Information on socio-demographic variables and laboratory test to determine the hemoglobin levels and CD4 count (for the HIV positive women) were carried out. A total of 350 subjects with equal number of HIV positive and HIV negative pregnant women were recruited. Variables were compared between the two groups using software package for social sciences version 20. P values<0.05 at 95% confidence interval are considered statistically significant.Results: The mean age for HIV positive and negative were 31.54 ±4.1 and 29.03 respectively while, mean gestational age at booking for HIV positive and negative were 20.41±8.61 and 22.37±7.4 weeks respectively. The HIV positive group had a mean parity of 2.02±1.5, and 2.56±1.2 was that of the HIV negative group. The mean hemoglobin statuses at booking were 9.92±1.8 g/dl and 10.6±1.1 g/df HIV positive and HIV negative women respectively. The mean CD4+ at booking for HIV positive group was 478±251 per microliter. The overall prevalence of anemia irrespective of HIV status was 36.6%. The prevalence of anemia in HIV positive and negative women were 44.6% and 28.6% respectively. There was statistically significant relationship between anemia and HIV status (p=0.002).Conclusions: There was inverse relationship between CD4+ count and anemia. Low CD4+ count and non-use of HAART at booking were important determinants of anemia among the HIV.

scholarly journals Efficacy of Once Daily Darunavir/Ritonavir in PI-Naïve, NNRTI-Experienced Patients in the ODIN Trial

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Anna Maria Geretti ◽  
Mathe Moeketsi ◽  
Ralph Demasi ◽  
Yvon van Delft ◽  
Perry Mohammed
Keyword(s):  
South Africa ◽  
Cell Count ◽  
Virological Suppression ◽  
Phase Iii ◽  
Once Daily ◽  
Cd4 Cell Count ◽  
The Mean ◽  
Cd4 Cell ◽  
Hiv 1

Background. An exploratory subanalysis of the ODIN trial was performed to evaluate the efficacy of darunavir/ritonavir (DRV/r) 800/100 mg OD versus 600/100 mg BID in patients who were NNRTI-experienced but PI-naïve.Methods. ODIN was a phase III, 48-week study comparing DRV/r OD versus BID in 590 treatment-experienced patients with no DRV resistance-associated mutations (RAMs) at screening. Patients received DRV/r 800/100 mg OD or DRV/r 600/100 mg BID plus ≥2 NRTIs. Of the 590 patients randomized, 272 (46%) were NNRTI-experienced but PI-naïve.Results. Overall, 272 patients received DRV/r ODn=135or BIDn=137plus ≥2 optimised NRTIs. The mean age was 39 years; 35% were female; 27% were Black, 24% Caucasian, 26% Oriental/Asian, and 23% other races; 17% were recruited in South Africa; and 48% had non-B HIV-1 subtypes. Mean baseline plasma HIV-1 RNA load was4.10 log10⁡copies/mL; median CD4 cell count was 258 cells/μL. At week 48, 111/135 (82%) of DRV/r OD and 109/137 (80%) of DRV/r BID patients achieved an HIV-1 RNA load <50 copies/mL. No patient developed primary PI RAMs.Conclusion. DRV/r 800/100 mg OD in combination with ≥2 optimised NRTIs led to virological suppression <50 copies/mL in 82% of NNRTI-experienced, PI-naïve patients by week 48.

Sign in / Sign up

Export Citation Format

Share Document