scholarly journals Investigating the risk factors for seroprevalence and the correlation between CD4+ T-cell count and humoral antibody responses to Toxoplasma gondii infection amongst HIV patients in the Bamenda Health District, Cameroon

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0256947
Author(s):  
Eugene Enah Fang ◽  
Raymond Babila Nyasa ◽  
Emmanuel Menang Ndi ◽  
Denis Zofou ◽  
Tebit Emmanuel Kwenti ◽  
...  
Keyword(s):  
Risk Factors ◽  
T Cell ◽  
Toxoplasma Gondii ◽  
Cell Count ◽  
Health District ◽  
Cd4 T Cell ◽  
Igg Antibody ◽  
Hiv Patients ◽  
Significant Difference ◽  
Cd4 T Cell Count

Background Toxoplasmosis is caused by an obligate intracellular tissue protozoan parasite, Toxoplasma gondii that infect humans and other warm-blooded animals. Transmission to humans is by eating raw or inadequately cooked infected meat or through ingestion of oocysts that cats have passed in faeces. Studies have shown life-threatening and substantial neurologic damage in immunocompromised patients; however, 80% of humans remain asymptomatic. The aim of this study was to determine the seroprevalence of Toxoplasma gondii infection in HIV positive patients and the risk factors associated with the infection, and to investigate the correlation between CD4+ T-cell count and toxoplasma specific antibodies as possible predictors of each other amongst HIV patients in the Bamenda Health District of the North West Region of Cameroon. Methods A cross-sectional study was conducted, in which 325 HIV patients were recruited for administration of questionnaire, serological diagnosis of T. gondii and measurement of CD4+ T-cell count. Bivariate and multivariate logistic regression was used to identify risk factors associated with T. gondii infection while the linear regression was used to investigate the relationship between CD4+ T-cell count and antibody levels against T. gondii. Results The findings showed that, majority (45.8%) of HIV patients suffered from chronic (IgG antibody) infection, and 6.5% from acute (IgM and IgM/IgG antibody) toxoplasma infection. The overall sero-prevalence of T. gondii infection amongst HIV patients was 50.5%. On the whole, 43 men (45.7%) and 127 women (55%) presented with anti- T. gondii antibodies; however, there was no significant difference amongst males and females who were positive to T. gondii infection (p = 0.131). Marital status (p = 0.0003), contact with garden soil (p = 0.0062), and garden ownership (p = 0.009), were factors that showed significant association with T. gondii infection. There was no significant difference (p = 0.909) between the mean CD4+ T-cell count of HIV patients negative for toxoplasma infection (502.7 cells/mL), chronically infected with T. gondii (517.7 cells/mL) and acutely infected with T. gondii (513.1 cells/mL). CD4+ T-cell count was neither a predictor of IgM antibody titer (r = 0.193, p = 0.401), nor IgG antibody titer (r = 0.149, p = 0.519) amongst HIV patients acutely infected with T. gondii. Conclusion The findings from this study underscore the need to implement preventive and control measures to fight against T. gondii infection amongst HIV patients in the Bamenda Health District.

scholarly journals Serological survey and risk factors associated with Toxoplasma gondii infection among HIV-infected pregnant women attending Abuja Tertiary Hospital, Nigeria

2020 ◽  
Vol 32 (3) ◽  
pp. 169-176
Author(s):  
Maryam Zakari
Keyword(s):  
Risk Factors ◽  
T Cell ◽  
Toxoplasma Gondii ◽  
Pregnant Women ◽  
Cell Count ◽  
Education Level ◽  
Cd4 T Cell ◽  
Toxoplasma Gondii Infection ◽  
Hiv Seropositive ◽  
Cd4 T Cell Count

Background Toxoplasmosis in pregnancy could induce miscarriage, congenital anomalies in foetuses and encephalitis in HIV-infected people. Hence, there is a need to determine the prevalence of toxoplasmosis in HIV-infected pregnant women to inform clinicians about the significance of maternal toxoplasmosis in antenatal care.AimThis study aimed to determine the seroprevalence of Toxoplasma gondii infection, associated CD4+ T-cell profile and sociodemographic risk factors among pregnant women with or without HIV infection attending the University of Abuja Teaching Hospital, Abuja, Nigeria. MethodsThis hospital-based cross-sectional study involved blood samples collected from 160 HIV-infected and 160 HIV-seronegative pregnant women. These samples were analysed for anti-T. gondii (IgG and IgM) and CD4+ T-cell count using ELISA and flow cytometry, respectively. Sociodemographic variables of participants were collected using structured questionnaires. ResultsThe overall seroprevalence of anti-T. gondii IgG and IgM was 28.8% and 3.8%, respectively. The seroprevalence of anti-T. gondii IgG and IgM was 29.4% and 4.4%, respectively, among HIV-seropositive pregnant women and 28.1% and 3.1%, respectively, among HIV-seronegative women. There was no significant association between the seroprevalence of anti-T. gondii-IgG and anti-T. gondii-IgM with age, gestational age, education level, parity or place of residence of HIV-infected pregnant women (P > 0.05). However, there was significant association between the seroprevalence of anti-T. gondii-IgG (P = 0.03) and anti-T. gondii-IgM (P = 0.01) with education level. CD4+ T-cell count varied significantly between HIV-infected and HIV-uninfected pregnant women (P = 0.035). Conclusion In this study, the seroprevalence of anti-T. gondii IgG and IgM did not differ in HIV-seropositive or HIV-seronegative pregnant women. However, women with primary T. gondii and HIV coinfection had lower CD4+ T-cell count than those with toxoplasmosis monoinfection.

scholarly journals 321. Low Volumetric Bone Density at Proximal Femur in HIV-Infected Men and Its Risk Factors: Comparison with Community-Dwelling Non-Infected Men

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S170-S170
Author(s):  
Jung Ho Kim ◽  
Namki Hong ◽  
Woon Ji Lee ◽  
Hye Seong ◽  
Jin young Ahn ◽  
...  
Keyword(s):  
Risk Factors ◽  
T Cell ◽  
Hiv Infection ◽  
Protease Inhibitor ◽  
Cell Count ◽  
Community Dwelling ◽  
Cd4 T Cell ◽  
Total Hip ◽  
Tertiary Center ◽  
Cd4 T Cell Count

Abstract Background Individuals with HIV infection is at increased risk of low area bone mineral density (BMD) and fracture. However, data regarding volumetric BMD (vBMD) of central bone determined by quantitative computed tomography (QCT) which can distinguish the cortical and trabecular bone component are limited. Methods From November 2017 to October 2018, we measured spine and hip vBMD in HIV-infected men aged 30 years or older at the tertiary center. QCT data were compared with 1:2 matched control by age- and body mass index (BMI) sampled from a community-based healthy individual cohort. HIV-specific risk factors for low total hip vBMD as a primary outcome were identified using multivariate linear regression models. Results A total of 83 HIV-infected men and 166 control were analyzed (mean age 47.4 vs. 47.0 year; BMI 23.3 vs. 23.7 kg/m2; P > 0.05). In HIV-infected men, vBMD of trochanter, intertrochanter and total hip was significantly lower than that of non-infected men. (198 ± 31 vs. 213 ± 32; 339 ± 50 vs. 356 ± 47; 280 ± 41 vs. 296 ± 41 mg/cc; all P < 0.05) Association between HIV infection and lower total hip vBMD remained robust (Adjusted β -14.4; P = 0.013) after adjustment for age, diabetes, smoking, and vitamin D status. In HIV cohort, low CD4 T-cell count at initial diagnosis (< 200 vs. ≥200 cells/μL; Adjusted β = −6.7, P = 0.015) and use of protease inhibitor (vs. integrase inhibitor; Adjusted β = −29.9, P = 0.029) were negatively associated with total hip vBMD, after adjustment for age, BMI, and duration of HIV infection, whereas tenofovir disoproxil fumarate use was not. (Adjusted β −12.1, P = 0.280) In HIV-infected men with low tertile total hip vBMD, the levels of β-crosslaps (0.42 ± 0.23 vs. 0.30 ± 0.16 ng/mL; P = 0.012) and osteocalcin (22.10 ± 8.65 vs. 16.57 ± 6.04 ng/mL; P = 0.001) were higher than those with middle-upper tertile total hip vBMD. Conclusion HIV-infected men had lower hip vBMD compared with age- and BMI-matched non-infected men. Low baseline CD4 T-cell count and protease inhibitor use were independent risk factors for lower total hip vBMD. High born turnover was attributable to the negative effect on born health of HIV-infected men. Disclosures All authors: No reported disclosures.

scholarly journals 13 Isolated exercise-induced pulmonary hypertension is associated with clinical worsening and poor immunological control in HIV patients

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Rosalinda Madonna ◽  
Silvia Fabiani ◽  
Riccardo Morganti ◽  
Arianna Forniti ◽  
Matteo Mazzola ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
T Cell ◽  
Cell Count ◽  
Clinical Status ◽  
Cd4 T Cell ◽  
Hiv Diagnosis ◽  
Hiv Patients ◽  
Pulmonary Arterial ◽  
Exercise Induced ◽  
Cd4 T Cell Count

Abstract Aims Exercise-induced pulmonary hypertension (Ex-PH) may represent the earliest sign of pulmonary arterial hypertension (PAH) in human immunodeficiency virus (HIV) patients. We investigated its association with clinical and immunological status, virologic control, and response to antiviral therapy. Methods and results In 32 consecutive HIV patients with either low (n = 29) or intermediate probability (n = 3) of PH at rest, we evaluated the association of isolated Ex-PH with: time to HIV diagnosis; CD4+ T-cell count; clinical progression to acquired immunodeficiency syndrome (AIDS); development of resistance to antiretroviral therapy (ART); HIV RNA levels; time to beginning of ART; current use of protease inhibitors; combination of ART with boosters (ritonavir or cobicistat); immuno-virologic response to ART; and ART discontinuation. Isolated Ex-PH at stress echocardiography (ESE) was defined as absence of PH at rest and systolic pulmonary arterial pressure (sPAP) &gt;45 mmHg or a &gt; 20 mmHg increase during low-intensity exercise cardiac output (&lt;10 l/min). In our cohort, 22% (n = 7) of the enrolled population developed Ex-PH which was inversely related to CD4+ T-cell count (P = 0.047), time to HIV diagnosis (P = 0.014) and time to onset of ART (P = 0.041). Patients with Ex-PH had a worse functional class than patients without Ex-PH (P &lt; 0.001). Ex-PH and AIDS showed a trend (P = 0.093) to a direct relationship. AIDS patients had a higher pulmonary vascular resistance compared to patients without Ex-PH (P = 0.020) at rest echocardiography. Conclusions The presence of isolated Ex-PH associates with a worse clinical status and poor immunological control in HIV patients. Assessment of Ex-PH by ESE may help identify subgroups of HIV patients with a propensity to develop subclinical impairment of pulmonary circulation following poor control of HIV infection.

scholarly journals Vγ9Vδ2 T-Cell Polyfunctionality Is Differently Modulated in HAART-Treated HIV Patients according to CD4 T-Cell Count

PLoS ONE ◽  
2015 ◽  
Vol 10 (7) ◽  
pp. e0132291 ◽  
Author(s):  
Rita Casetti ◽  
Gabriele De Simone ◽  
Alessandra Sacchi ◽  
Alessandra Rinaldi ◽  
Domenico Viola ◽  
...  
Keyword(s):  
T Cell ◽  
Cell Count ◽  
Cd4 T Cell ◽  
Hiv Patients ◽  
Cd4 T Cell Count

scholarly journals Clinical characteristics and risk factors of severe infections in hospitalized adult patients with primary nephrotic syndrome

2017 ◽  
Vol 45 (6) ◽  
pp. 2139-2145 ◽  
Author(s):  
Jie Li ◽  
Qiankun Zhang ◽  
Bofeng Su
Keyword(s):  
Risk Factors ◽  
Nephrotic Syndrome ◽  
T Cell ◽  
Cell Count ◽  
Severe Infection ◽  
Adult Patients ◽  
Cd4 T Cell ◽  
Infection Group ◽  
Severe Infections ◽  
Cd4 T Cell Count

Objective Infection is a common condition in patients with nephrotic syndrome. The objective of the present study is to investigate the clinical characteristics and risk factors of infections in adult patients with primary nephrotic syndrome (PNS). Methods Medical charts of 138 consecutive patients with PNS and infections who were admitted to hospital from April 2013 to April 2016 were systematically reviewed. Results Patients were divided into three groups according to the degree of infections: mild infection group (n = 45), moderate infection group (n = 60), and severe infection group (n = 33). In the severe infection group, most patients (96.9%) had pulmonary infections with opportunistic pathogens. There were significant differences in cumulative prednisone dose, immunosuppressor use, and CD4+ T cell count among the three groups. A lower CD4+ T cell count (<300 cells/mm3) (odds ratio = 4.25 [95% confidence interval 1.680–10.98]) and higher cumulative dose of prednisone (odds ratio = 1.38 [95% confidence interval 1.05–3.26]) were risk factors for severe infections in adult patients with PNS. Conclusions CD4+ T cell count (<300 cells/mm3) and a higher cumulative dose of prednisone are important risk factors for severe infections in adult patients with PNS.

scholarly journals Cerebral Toxoplasmosis, CMV and Bacterial Pneumonia with Decreasing CD4+ T-Cell Count as Results of Antiretroviral Therapy Discontinuation—A Case Report

Pathogens ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 497
Author(s):  
Marta Piwowarek ◽  
Katarzyna Siennicka ◽  
Tomasz Mikuła ◽  
Alicja Wiercińska-Drapało
Keyword(s):  
Viral Load ◽  
T Cell ◽  
Antiretroviral Therapy ◽  
Toxoplasma Gondii ◽  
Cell Count ◽  
Bacterial Pneumonia ◽  
Cd4 T Cell ◽  
Cerebral Toxoplasmosis ◽  
Therapy Discontinuation ◽  
Cd4 T Cell Count

Cerebral toxoplasmosis occurs mainly in immunocompromised hosts as a reactivation of latent Toxoplasma gondii infection. In the diagnostic process, magnetic resonance imaging (MRI), serum testing, and biopsy are used. We describe a case of a 43-year-old HIV-positive patient presenting with altered levels of consciousness, aphasia, and hemiparesis. The patient had a history of antiretroviral therapy discontinuation for about 3 years. MRI revealed lesions, suggesting cerebral toxoplasmosis and subacute hemorrhage, serum tests for Toxoplasma gondii were positive. Antiparasitics and glycocorticosteroids were administered. A decline in viral load and clinical improvement were observed, however CD4+ T-cell count continued to decrease. The patient’s state worsened, he developed CMV and bacterial pneumonia, which led to his death. What is crucial in the management of an HIV-infected patient is effective and continuous antiretroviral therapy. Discontinuation of the treatment may result in AIDS and lead to poor recovery of the CD4+ T-cell population, even after reimplementation of antiretroviral therapy and a decrease in viral load.

scholarly journals Gradual increases in dyslipidemia among male patients with human immunodeficiency virus primarily treated with tenofovir plus lamivudine plus efavirenz: a 3-year follow-up study

2021 ◽  
Author(s):  
dafeng liu ◽  
Xingyi ZHANG ◽  
Jun Kang ◽  
Fengjiao Gao ◽  
Yinsheng He ◽  
...  
Keyword(s):  
Lipid Metabolism ◽  
T Cell ◽  
Cell Count ◽  
Cd4 T Cell ◽  
Anthropometric Parameters ◽  
Significant Difference ◽  
Male Patients ◽  
Cd4 T Cell Count

Abstract Introduction: Since the development of antiretroviral therapy (ART) with TDF plus 3TC plus EFV, this specific regimen has not been studied enough with long-term lipid and uric monitoring.Methods: A prospective follow-up cohort study was performed. Sixty-one treatment-naive male patients with HIV were divided into three groups based on their baseline CD4+ T cell count (26, 12, and 23 patients in the <200, 200 to 350, and >350 groups, respectively). The lipid and purine metabolism parameters of the patients over 144 weeks were analyzed.Result: TG, TC, LDL-c and HDL-c levels all gradually increased over 144 weeks, but the increases in TC levels and HDL-c levels were significant (P=0.001, 0.000, respectively). Moreover, the percentages of hypercholesterolemia, hyper LDL cholesterolemia and hypertriglyceridemia all showed gradual and nonsignificant increases; the percentage of low HDL cholesterolemia showed a gradual and significant decrease (P=0.0007). Furthermore, the lower the baseline CD4+ T lymphocyte counts were, the higher the TG levels were and the lower the TC, LDL-c and HDL-c levels were. However, only baseline LDL-c levels differed significantly between the three groups (P=0.0457). Although the UA level and the percentages of hyperuricemia gradually increased over 144 weeks, there was no significant difference between the different follow-up time point groups or between the three CD4+ T cell count groups (all P>0.05). Further analyses revealed that the main factors contributing to lipid metabolism were age, anthropometric parameters and follow-up weeks, and virus load was the main factor contributing to uric acid levels.Conclusions: These findings provide a reference for clinicians to monitor lipid metabolism parameters closely during long-term ART with the TDF plus 3TC plus EFV regimen.

Baseline CD4+ T-cell count and cardiovascular risk factors predict the evolution of cognitive performance during 2 years follow-up in HIV-infected patients

2014 ◽  
Vol 20 (4) ◽  
pp. 433-440 ◽  
Author(s):  
Nicoletta Ciccarelli ◽  
Pierfrancesco Grima ◽  
Massimiliano Fabbiani ◽  
Eleonora Baldonero ◽  
Alberto Borghetti ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
T Cell ◽  
Cardiovascular Risk Factors ◽  
Cell Count ◽  
Cognitive Performance ◽  
Cd4 T Cell ◽  
Cd4 T Cell Count

scholarly journals Intestinal Parasitosis in Relation to Anti-Retroviral Therapy, CD4+ T-cell Count and Diarrhea in HIV Patients

2015 ◽  
Vol 53 (6) ◽  
pp. 705-712 ◽  
Author(s):  
Shehla Khalil ◽  
Bijay Ranjan Mirdha ◽  
Sanjeev Sinha ◽  
Ashutosh Panda ◽  
Yogita Singh ◽  
...  
Keyword(s):  
T Cell ◽  
Cell Count ◽  
Cd4 T Cell ◽  
Hiv Patients ◽  
Intestinal Parasitosis ◽  
Cd4 T Cell Count

CD4+ T-cell count eligibility by HIV status among participants receiving immunotherapy for cancer diagnoses.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 12104-12104
Author(s):  
Thomas A Odeny ◽  
Matthew Harry Rosenthal ◽  
Kathryn Anne Lurain ◽  
Julius Strauss ◽  
Thomas S. Uldrick ◽  
...  
Keyword(s):  
T Cell ◽  
Cell Count ◽  
Checkpoint Inhibitors ◽  
Survival Rates ◽  
Cd4 T Cell ◽  
Cancer Therapies ◽  
Hiv Status ◽  
Significant Difference ◽  
Cd4 T Cell Count ◽  
Hiv Negative

12104 Background: The Food and Drug Administration recommends that patients living with HIV (PLWH) with a CD4+ T cell count (CD4) ≥350 cells/µL should generally be eligible for any cancer clinical trial, but there has been a reluctance to enter patients with lower CD4 counts. Patients with relapsed or refractory cancers may also have low CD4 due to initial cancer therapies, irrespective of HIV status. Immune checkpoint inhibitors (ICI) are safe among PLWH with advanced cancer receiving antiretroviral therapy and CD4 >100 cells/µL. We examined the outcomes of immunotherapy trials by HIV and CD4 status among patients receiving ICI for relapsed/refractory cancers. Methods: We conducted a retrospective cohort study of participants who received ICI for relapsed/refractory cancers in 2 trials (1 specifically in PLWH with CD4 >100 only) from the National Cancer Institute. Primary outcomes were to assess relationship between HIV status and baseline CD4 (<350 vs ≥350 cells/µL) and other characteristics. We stratified 3-year survival by CD4 in PLWH and HIV-negative participants with HPV-related cancers. The Kaplan-Meier method was used to estimate survival rates. Results: Eighty-three participants were included: 26 (31.3%) were HIV-positive and received pembrolizumab and 57 (68.7%) were HIV-negative and received bintrafusp alfa. HIV-negative participants had relapsed HPV related malignancies (cervix, anal, head and neck) whereas participants with HIV had both viral and non-viral associated cancers (Table). While the median screening CD4 was significantly lower among PLWH than HIV-negative participants, there was no difference in the proportion with CD4 <350 (p=0.1). When restricted to HPV related malignancies, 3-year survival rates were 32.2% for CD4 <350 and 21.2% for CD4 ≥350 (p=0.7). Conclusions: In this retrospective study of ICI clinical trials in relapsed and refractory malignancies, there was no significant difference in baseline CD4 (<350 vs ≥350 cells/µL) by HIV status; 50% of HIV-negative participants had CD4<350 cells/µL. Patients with HIV should be included in ICI studies, and CD4 thresholds lower than 350 cells/µL should be considered as to not unfairly exclude PLWH with cancer.[Table: see text]

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