Postmortem findings in HIV/AIDS patients in a tertiary care hospital in rural South Africa

2010 ◽  
Vol 40 (2) ◽  
pp. 81-84 ◽  
Author(s):  
Mirta Garcia-Jardon ◽  
Vivek G Bhat ◽  
E Blanco-Blanco ◽  
Andrez Stepian

South Africa has the largest number of people living with HIV/AIDS, and various associated infectious and noninfectious conditions contribute towards mortality. The objective of this study was to determine the important post-mortem findings in HIV-infected individuals in a high HIV burden rural area in South Africa. The patient population included HIV patients who died at the tertiary care hospital, from 2000–2008. Autopsies were performed according to standard protocols and diagnoses were made with additional laboratory investigations wherever required. A total of 86 patients were autopsied (30 males, 56 females). The major postmortem findings were related to infections, with 38% of the patients having had some form of tuberculosis, followed by pyogenic infections – pneumonias (21.5%), meningitis (10.1%) and septicemias (5.1%). Other important infections included opportunistic fungi like cryptococcosis (7.6%) and pneumocystis pneumonia (8.9%). Among the noninfectious conditions, the findings seen were predominantly related to liver (10.1%) and cardiac involvement (10.1%).

Author(s):  
Atul Agrawal ◽  
Ankita Agrawal

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


Author(s):  
Rushali Rajan Lilare ◽  
Uday Wasudeorao Narlawar ◽  
Ganpat Mirdude

Background: The present study was retrospective record based, conducted with the aim of assessing the functional status and CD4 count of patients living with HIV/AIDS attending the ART Centre in special reference to gender difference at tertiary care hospital of central India.Methods: Study subjects were people living with HIV/AIDS registered at ART centre at tertiary care hospital of central India in the past three years (1 Jan. 2011 to 31 Dec. 2013). The study duration was from September 2013 to January 2015. This study was conducted on 2042 PLHIV subjects whose records were available for study.Results: In our study there were 58.37% males, 42.4% female and 0.15% transgender. Majority of male 42.45% were between 35-44 years of age group whereas 36.95% females were between 25-34years of age group. Majority of males 22.16% were non agricultural labourer whereas females 78.32% were homemaker. Majority of males 37.41% were in the WHO clinical stage 3 whereas majority of females 36.70% were in stage 1 at the start of ART treatment. About 84.30% females and 76.9% male were working at the start of ART. Majority of males 31.12% and 38.79% had CD4 count between 51-150 at the time of ART registration and at the time of ART treatment respectively. Majority of males 42.62% and 29.34% had CD4 count >350 and between151-250 respectively. About 16.53 % males and 8.97% female were died at the time of data collection.Conclusions: In the study there were male preponderance with 75.26% males and 57.39% females were having CD4 count less than350/cumm at the time of registration respectively. Majority of our study subjects were working at the time of start of ART. The deaths among males were significantly more as compared to females.


Author(s):  
Sumit Lathwal ◽  
Saurabh Mahajan ◽  
Arun K. Yadav

Background: Disclosure is a planned and selective behavior that responds to the balance of potential risks and benefits of secrecy and disclosure of the person living with HIV. The disclosure of HIV status to sexual partners, family or friends, has been shown to be a potent stressor, as persons living with HIV/AIDS might fear negative reactions such as blame, rejection or violence. This study was carried out with an aim to study the patterns of HIV status disclosure and the problems related with it among the HIV positive patients admitted in a tertiary care hospital in Western Maharashtra.Methods: A cross-sectional descriptive, hospital based study carried out in a tertiary care hospital of Western Maharashtra from 01 October 2008 to 30 September 2010. A total of 92 consenting respondents admitted in the hospital were administered a pre tested semi-structured questionnaire to collect the data. The results were analysed using SPSS Ver 16.0.Results: Out of 74 married HIV positive individuals who had a chance to disclose their sero-status to spouse, 64 (86.5%, 95% CI-78.7% to 94.29%) voluntarily disclosed their HIV status to spouse while a small number i.e. 10 (13.5%, 95% CI- 05.71% to 21.29%) did not disclose their HIV status to spouse.Conclusions: This exploratory analysis suggests the need for tailoring interventions for improving disclosure decisions making and outcomes. Institutionalized measures need to be enforced judiciously to assist the HIV positive individuals to reveal their status to their wife and other members of their social group.


Author(s):  
S. Cynthia Subhaprada ◽  
Shasank R. V. S. S. ◽  
T. Sivakala ◽  
S. Madhusai

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.


2020 ◽  
Author(s):  
Wellington Gama Mota ◽  
Taynná Vernalha Rocha Almeida ◽  
Daniel Silva dos Santos ◽  
Yury Oliveira Chaves ◽  
Danielle Furtado da Silva ◽  
...  

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.


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