scholarly journals HIV is associated with endothelial activation despite ART, in a sub-Saharan African setting

2018 ◽  
Vol 6 (2) ◽  
pp. e531 ◽  
Author(s):  
Joseph Kamtchum-Tatuene ◽  
Henry Mwandumba ◽  
Zaid Al-Bayati ◽  
Janet Flatley ◽  
Michael Griffiths ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Endothelial Activation ◽  
Sub Saharan Africa ◽  
Intercellular Adhesion Molecule ◽  
Hiv Positive ◽  
Plasminogen Activator Inhibitor 1 ◽  
Multivariable Logistic Regression Model ◽  
Cross Sectional ◽  
Sub Saharan ◽  
Pai 1

ObjectiveTo study the relationship between endothelial dysfunction, HIV infection, and stroke in Malawians.MethodsUsing a cross-sectional design, we measured plasma levels of intercellular adhesion molecule-1 (ICAM-1), plasminogen activator inhibitor-1 (PAI-1), vascular endothelial growth factor (VEGF), and soluble thrombomodulin (sTM) in stroke patients and controls, stratified by HIV status. These biomarkers were measured using ELISA. After dichotomization, each biomarker was used as the dependent variable in a multivariable logistic regression model. Primary independent variables included HIV and stroke status. Adjustment variables were age, sex, hypertension, diabetes mellitus, tobacco and alcohol consumption, personal/family history of stroke, antiretroviral therapy status, and hypercholesterolemia.ResultsSixty-one stroke cases (19 HIV+) and 168 controls (32 HIV+) were enrolled. The median age was 55 years (38.5–65.0) for controls and 52 years (38.0–73.0) for cases (p = 0.38). The median CD4+ T-cell count was 260.1 cells/mm3 (156.3–363.9) and 452 cells/mm3 (378.1–527.4) in HIV-infected cases and controls, respectively. HIV infection was independently associated with high levels of ICAM-1 (OR = 3.6, 95% CI: 1.3–10.6, p = 0.018) in controls but not in stroke cases even after excluding patients with a viral load >1,000 RNA copies/mL (OR = 4.1, 95% CI: 1.3–13.1, p = 0.017). There was no association between the clinical profiles of HIV-positive controls or HIV-positive stroke and high levels of PAI-1, VEGF, and sTM.ConclusionsHIV infection is associated with endothelial activation despite antiretroviral treatment. Our findings underscore the need for larger clinical cohorts to better understand the contribution of this perturbation of the endothelial function to the increasing burden of cardiovascular diseases in sub-Saharan Africa.

scholarly journals Mapping evidence on adolescents’ HIV-positive status disclosure in sub-Saharan Africa: a protocol for a scoping review

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Patience Adzordor ◽  
Clement Avoka ◽  
Vitalis Bawontuo ◽  
Silas Agbesi ◽  
Desmond Kuupiel
Keyword(s):  
Hiv Infection ◽  
Scoping Review ◽  
Keyword Search ◽  
Sub Saharan Africa ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Sub Saharan ◽  
Living With Hiv ◽  
Status Disclosure ◽  
Hiv Aids

Abstract Background Sub-Saharan Africa (SSA) homes most of the people living with HIV/AIDS in the world. Adolescents/young people are a vulnerable population and at high risk of HIV infection. Identifying and bridging the research gaps on the disclosure of HIV-positive status among adolescents, particularly to their sexual partners, is essential to inform appropriate policy planning and implementation towards preventing HIV transmission. This study will aim to explore literature and describe the evidence on HIV-positive status disclosure among adolescents in SSA. Methods The framework provided by Arksey and O’Malley’s framework and improved by Levac and colleagues will be used to conduct a scoping review. A keyword search for relevant literature presenting evidence on HIV-positive status disclosure among adolescents in SSA will be conducted in CINAHL, PubMed, Science Direct, Google Scholar, and SCOPUS. Date limitations will be removed, but Boolean terms “AND” and “OR” as well as Medical Subject Headings terms will be included where possible and syntax modified to suit the database during the search. Additional relevant articles will be sought from the reference lists of all included studies using a snowballing method. Two reviewers will independently screen the articles at the abstract and full-text screening phases in order to reduce bias and improve the reliability of this study’s findings. A tabular form will be developed using Microsoft Word and piloted for data extraction. Thematic content analysis will be conducted, and a narrative summary of all relevant outcomes reported. Quality appraisal of the included studies for this proposed study will be performed utilizing the recent mixed methods appraisal tool. Discussion The evidence produced by this review may help inform policy and strategies to reduce the incidence of HIV infection among adolescents and improve social support for adolescents living with HIV/AIDS in SSA. It may also reveal literature gaps to guide future researches to further inform HIV policies for adolescents in SSA. Platforms such as peer review journals, policy briefs, and conferences will be used to disseminate this study’s findings.

scholarly journals Arterial stiffness is associated with oxidative stress and endothelial activation among persons with treated HIV in Zambia

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Theresa Chikopela ◽  
Fastone Goma ◽  
Longa Kaluba ◽  
Wilbroad Mutale ◽  
Chris Guure ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Arterial Stiffness ◽  
Endothelial Activation ◽  
Sub Saharan Africa ◽  
University Teaching ◽  
Stiffness Index ◽  
Intercellular Adhesion Molecule ◽  
Vascular Compliance ◽  
Sub Saharan ◽  
Hiv Negative

Background: Cardiovascular disease (CVD) prevalence is rising among persons with HIV (PLWH) in sub-Saharan Africa. Oxidative stress and endothelial activation, resulting in reduced vascular compliance, are contributors to CVD risk. However, there is a paucity of vascular health data in this population.Objectives: To assess the relationships of oxidative stress and endothelial activation with vascular stiffness among PLWH.Method: Fifty-four PLWH on antiretroviral therapy 5 years and 57 HIV-negative controls, all aged 18–45 years, were enrolled from the University Teaching Hospital, Lusaka, Zambia. Oxidative stress was measured by nitrotyrosine, a peroxynitrite biomarker, and endothelial activation by soluble intercellular adhesion molecule-1 (sICAM-1) plasma levels. Vascular compliance was measured using carotid-radial pulse wave velocity (crPWV) and arterial stiffness index (crASI).Results: PLWH had higher sICAM-1 levels (median 345 ng/mL) compared to controls (275 ng/mL, p 0.01), as well as higher nitrotyrosine levels (297 versus 182 nM; p = 0.02). Median crPWV was similar between the groups, but PLWH had higher crASI (2.4 versus 2.2 cm/ms; p 0.05). After adjusting for age, fat mass, and blood pressure, the estimated effect of a one unit increase in nitrotyrosine on crPWV were twofold higher in the PLWH, but neither reached significance. In a model pooling all participants, there were significant differences in the relationship of nitrotyrosine with crPWV and crASI by HIV status.Conclusion: PLWH in sub-Saharan Africa had significantly greater oxidative stress and endothelial activation compared to HIV-negative individuals. These factors may contribute to increased arterial stiffness and higher CVD prevalence in this population.

scholarly journals OPPORTUNISTIC INFECTIONS DIAGNOSED IN PATIENTS INFECTED WITH THE HUMAN IMMUNODEFICIENCY VIRUS (HIV) AT THE SERVICE OF INFECTIOUS DISEASES OF UHC (UNIVERSITY HOSPITAL CENTER) YALGADO OUÉDRAOGO, BURKINA FASO

2021 ◽  
pp. 1-2
Author(s):  
Savadogo M ◽  
Diallo I ◽  
Sondo K A
Keyword(s):  
Infectious Diseases ◽  
Hiv Infection ◽  
Opportunistic Infection ◽  
Antiretroviral Treatment ◽  
Opportunistic Infections ◽  
Sub Saharan Africa ◽  
University Hospital ◽  
Cross Sectional ◽  
Sub Saharan ◽  
Living With Hiv

Introduction: Sub-Saharan Africa remains one of the regions most affected by HIV infection with severe lethality.Most deaths of patients living with HIV are caused by opportunistic infections. Objective: to determine the prevalence of opportunistic infections among patients living with HIV in hospital serving infectious diseases of UHC YO of Ouagadougou. Patients and Methods:This is a cross-sectional descriptive study covering a 14-month period from 1 January 2017 to 28 February 2018. Included were all HIV-positive patients, hospitalized at the service of Infectious Diseases, in which an opportunistic infection was diagnosed on the basis of clinical and/or para-clinical arguments. Results: During the study period a total of 55 patients living with HIV were hospitalized in the infectious disease unit,35 of whom had at least one opportunistic infection or 63.6% of the patients.The average age of patients was 37 years with extremes of 18 and 66 years.Twenty-two patients were female versus 13 male, a sex ratio = 0.59. HIV1 was involved in 97% of patients.The mean TCD4 lymphocyte rate was 156 cell/mm3 with extremes of 7 and 718 cell/mm3.Tuberculosis and digestive mycosis were the most frequently diagnosed opportunistic infections. Opportunistic infection was the circumstance for HIV testing in two patients.She revealed immune restoration syndrome in two other patients.Nineteen patients were already on antiretroviral treatment upon admission to the service.Half of the patients on treatment were in therapeutic failure.The evolution was marked by 26.5% lethality. Conclusion:The frequency of opportunistic infections is high in patients living with HIV.Their prevention requires early detection of HIV infection and antiretroviral treatment.

scholarly journals Distinct lung microbiota associate with HIV-associated chronic lung disease in children

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Sudha Bhadriraju ◽  
Douglas W. Fadrosh ◽  
Meera K. Shenoy ◽  
Din L. Lin ◽  
Kole V. Lynch ◽  
...  
Keyword(s):  
Lung Disease ◽  
Chronic Lung Disease ◽  
Cross Sectional Study ◽  
Sub Saharan Africa ◽  
Hiv Positive ◽  
Cross Sectional ◽  
Pathogenic Potential ◽  
Co Morbidity ◽  
Sub Saharan

Abstract Chronic lung disease (CLD) is a common co-morbidity for HIV-positive children and adolescents on antiretroviral therapy (ART) in sub-Saharan Africa. In this population, distinct airway microbiota may differentially confer risk of CLD. In a cross-sectional study of 202 HIV-infected children aged 6–16 years in Harare, Zimbabwe, we determined the association of sputum microbiota composition (using 16S ribosomal RNA V4 gene region sequencing) with CLD defined using clinical, spirometric, or radiographic criteria. Forty-two percent of children were determined to have CLD according to our definition. Dirichlet multinomial mixtures identified four compositionally distinct sputum microbiota structures. Patients whose sputum microbiota was dominated by Haemophilus, Moraxella or Neisseria (HMN) were at 1.5 times higher risk of CLD than those with Streptococcus or Prevotella (SP)-dominated microbiota (RR = 1.48, p = 0.035). Cell-free products of HMN sputum microbiota induced features of epithelial disruption and inflammatory gene expression in vitro, indicating enhanced pathogenic potential of these CLD-associated microbiota. Thus, HIV-positive children harbor distinct sputum microbiota, with those dominated by Haemophilus, Moraxella or Neisseria associated with enhanced pathogenesis in vitro and clinical CLD.

scholarly journals Severe Skin Forms of Psoriasis in Black Africans: Epidemiological, Clinical, and Histological Aspects Related to 56 Cases

2013 ◽  
Vol 2013 ◽  
pp. 1-4
Author(s):  
Komenan Kassi ◽  
Oussou Armel Mienwoley ◽  
Mohamed Kouyate ◽  
Sylvanus Koui ◽  
Kouame A. Kouassi
Keyword(s):  
Sex Ratio ◽  
Psoriasis Vulgaris ◽  
Sub Saharan Africa ◽  
Hiv Positive ◽  
Cross Sectional ◽  
Black Africans ◽  
Histological Features ◽  
Erythrodermic Psoriasis ◽  
Sub Saharan ◽  
General Signs

Bacground. Psoriasis is an erythematosquamous dermatosis of chronic development. In sub-Saharan Africa, few studies have been focused on complicated forms of psoriasis.Objective. The aim is to describe epidemiological, clinical, and histological features of severe skin forms of psoriasis in Cote d’Ivoire.Material and Methods. The study was both cross-sectional and descriptive, that focused on patient admitted to the dermatology unit for complicated psoriasis, from January 1st, 1986, to December 31th, 2007.Results. Fifty-six patients admitted to hospital for severe skin forms of psoriasis were recorded and included in our study over 7.503 patients hospitalized during the study period. They represented 0.75% of cases. The average age was 39.6 ± 3.3 years. There were 49 male (87.5%) and 7 female patients (12.5%) with a sex ratio of 7. At socioprofessional level, 48 patients (87.5%) were from category 1. Patients’ history was dominated by the psoriasis vulgaris. Physical and general signs were dominated by itching (58.9%). The three severe skin forms were observed with predominant erythrodermic psoriasis (60.7%). Fifteen patients (34.9%) were HIV positive.Conclusion. Severe skin forms of psoriasis are rare in our setting. But in the quarter of HIV-positive patients, they are dominated by the erythrodermic psoriasis.

scholarly journals Association Between HIV Infection and Cancer Stage at Presentation at the Uganda Cancer Institute

2018 ◽  
pp. 1-9 ◽  
Author(s):  
Manoj P. Menon ◽  
Anna Coghill ◽  
Innocent O. Mutyaba ◽  
Warren T. Phipps ◽  
Fred M. Okuku ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Hodgkin Lymphoma ◽  
Advanced Cancer ◽  
Clinical Care ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
Hiv Positive ◽  
Advanced Stage ◽  
Duration Of Symptoms ◽  
Sub Saharan

Purpose The HIV epidemic has contributed to the increasing incidence of cancer in sub-Saharan Africa, where most patients with cancer present at an advanced stage. However, improved access to HIV care and treatment centers in sub-Saharan Africa may facilitate earlier diagnosis of cancer among patients who are HIV positive. To test this hypothesis, we characterized the stage of cancer and evaluated the factors associated with advanced stage at presentation among patients in Uganda. Methods We conducted a retrospective analysis of adult patients with any of four specific cancers who presented for care in Kampala, Uganda, between 2003 and 2010. Demographic, clinical, and laboratory data were abstracted from the medical record, together with the outcome measure of advanced stage of disease (clinical stage III or IV). We identified measures for inclusion in a multivariate logistic regression model. Results We analyzed 731 patients with both AIDS-defining cancers (cervical [43.1%], and non-Hodgkin lymphoma [18.3%]), and non–AIDS-defining cancers (breast [30.0%] and Hodgkin lymphoma [8.6%]). Nearly 80% of all patients presented at an advanced stage and 37% had HIV infection. More than 90% of patients were symptomatic and the median duration of symptoms before presentation was 5 months. In the multivariate model, HIV-positive patients were less likely to present at an advanced stage as were patients with higher hemoglobin and fewer symptoms. Conclusion Patients with limited access to primary care may present with advanced cancer because of a delay in diagnosis. However, patients with HIV now have better access to clinical care. Use of this growing infrastructure to increase cancer screening and referral is promising and deserves continued support, because the prognosis of HIV-positive patients with advanced cancer is characterized by poor survival globally.

Adolescent Suicidality as Seen in Rural Northeastern Uganda

Crisis ◽  
2011 ◽  
Vol 32 (1) ◽  
pp. 43-51 ◽  
Author(s):  
Eugene Kinyanda ◽  
Ruth Kizza ◽  
Jonathan Levin ◽  
Sheila Ndyanabangi ◽  
Catherine Abbo
Keyword(s):  
Low Socioeconomic Status ◽  
Sub Saharan Africa ◽  
Psychosocial Risk ◽  
Psychiatric Nurses ◽  
Health Concern ◽  
Cross Sectional ◽  
Childhood Experiences ◽  
Low Socioeconomic ◽  
Dsm Iv ◽  
Sub Saharan

Background: Suicidal behavior in adolescence is a public health concern and has serious consequences for adolescents and their families. There is, however, a paucity of data on this subject from sub-Saharan Africa, hence the need for this study. Aims: A cross-sectional multistage survey to investigate adolescent suicidality among other things was undertaken in rural northeastern Uganda. Methods: A structured protocol administered by trained psychiatric nurses collected information on sociodemographics, mental disorders (DSM-IV criteria), and psychological and psychosocial risk factors for children aged 3–19 years (N = 1492). For the purposes of this paper, an analysis of a subsample of adolescents (aged 10–19 years; n = 897) was undertaken. Results: Lifetime suicidality in this study was 6.1% (95% CI, 4.6%–7.9%). Conclusions: Factors significantly associated with suicidality included mental disorder, the ecological factor district of residence, factors suggestive of low socioeconomic status, and disadvantaged childhood experiences.

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