Opportunistic infection at the start of antiretroviral therapy and baseline CD4+ count less than 50 cells/mm3 are associated with poor immunological recovery

2019 ◽  
Vol 30 (2) ◽  
pp. 163-171
Author(s):  
Amod Tilak ◽  
Smita Shenoy ◽  
Muralidhar Varma ◽  
Asha Kamath ◽  
Amruta Tripathy ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Opportunistic Infection ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Hiv Positive ◽  
P Value ◽  
Care Hospital ◽  
Long Term Treatment ◽  
Immunological Recovery

AbstractIntroductionThere is a dearth of studies assessing the efficacy and immunological improvement in patients started on antiretroviral therapy (ART) in India. This study was undertaken to assess the 2-year treatment outcomes in HIV-positive patients initiated on ART in a tertiary-care hospital.MethodsAfter approval from the Institutional Ethics Committee, adult HIV-positive patients from a tertiary-care hospital, initiated on ART between January 2013 and February 2015, were included in the study. Data on clinical and immunological parameters were obtained from medical case records over a period of 2 years after initiation of therapy. Intention-to-treat analysis was done using a descriptive approach, using SPSS version 15 (SPSS Inc. Released 2006. SPSS for Windows, Version 15.0. Chicago, SPSS Inc.). A logistic regression analysis was done to assess the predictors for poor outcomes. A p-value <0.05 was considered statistically significant.ResultsART was initiated in 299 adult patients. At 1 and 2 years, the median (interquartile range) change in CD4+cell count was 65 (39, 98) cells/mm3and 160 (95, 245) cells/mm3. The change observed after 2 years of treatment initiation was statistically significant compared with that after 1 year. Three deaths occurred during the study period and 28 were lost to follow-up. Male sex, presence of at least one opportunistic infection at the start of therapy, and baseline CD4+count <50 cells/mm3were associated with poor immunological recovery.ConclusionsWith long-term treatment and regular follow-up, sustained clinical and immunological outcomes can be obtained in resource-limited settings.

scholarly journals Assessment of adherence to ATT among HIV-TB co-infected patients attending the ART centre of a tertiary care hospital of Jharkhand

2019 ◽  
Vol 6 (2) ◽  
pp. 619
Author(s):  
Abhishek Kumar ◽  
Vivek Kashyap
Keyword(s):  
Prospective Study ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Hiv Positive ◽  
Care Hospital ◽  
Medical Sciences ◽  
Cd4 Cell Count ◽  
Common Opportunistic Infection ◽  
Cd4 Cell

Background: Despite being preventable and curable, TB is the leading cause of HIV associated mortality. It is the most common opportunistic infection among HIV positive individuals with CD4 cell count <500/ mm3. Worldwide the number of people infected with both HIV & TB is rising. The objective of the study was to describe the socio-demographic profile of HIV-TB co-infected patients and to assess the adherence of HIV TB Co-infected patients to anti tubercular treatment (ATT) attending ART Centre, RIMS, Ranchi.Methods: It was a hospital based prospective study done at Rajendra Institute of Medical Sciences (RIMS), Ranchi. Duration of study was 14 months. A total of 117 patients were registered during the study period and were followed up for adherence to ATT.Results: Out of 117 patients 4 were excluded. Among 113 patients, mostly were male (74.3%) and from rural background (69.9%). Majority (94.7%) of the patients came for regular follow up and took medicines as advised. Adherence was significantly associated with education (p=0.025).Conclusions: In this study it was concluded that education significantly affected adherence to ATT among HIV-TB Co-infected patients of ART Centre of RIMS, Ranchi.

scholarly journals Outcomes of Squint Surgery in Terms of Motor Alignment within 10 Prism Diopters in a Tertiary Care Hospital: A Clinical Audit

2021 ◽  
Vol 37 (4) ◽  
Author(s):  
Shaukat Ali Chhipa ◽  
Sharmeen Akram ◽  
Asma Rahman
Keyword(s):  
Tertiary Care Hospital ◽  
Clinical Audit ◽  
Tertiary Care ◽  
University Hospital ◽  
P Value ◽  
Care Hospital ◽  
Age And Gender ◽  
Squint Surgery ◽  
And Gender

Purpose:  To determine the outcome of squint surgery in terms of motor ocular alignment within 10 prism diopters, in a tertiary care hospital. Study Design:  A clinical audit at a tertiary care hospital. Place and Duration of Study:  The study was conducted in Ophthalmology department, of Aga khan university hospital, Karachi between December 2016 and June 2017. Methods:  Medical records of all patients who underwent squint surgery were retrieved and included in the study. Patients with amblyopia, corneal or retinal pathologies and those who lost to follow-up or with incomplete records were excluded. All the available demographic and clinical data including pre-operative visual acuity, squint measurements, procedure performed and post-operative ocular alignment up to maximum of 6 months of follow-up was compiled. Results:  One hundred and nineteen patients fulfilled the inclusion criteria. There were 54.6% males and 45.4% were females. Squint was unilateral in 75.4% of patients and bilateral in 24.5%. Exotropia was present in 74 (62%) and Esotropia in 45 (38%) patients. The frequency of post-operative outcomes among the study participants were analyzed and it was reported that at six months follow-up central straight eye position or squint less than 10 prism diopters was seen among 75.5% of patients. The association of age and gender with primary outcome was obtained by applying independent sample T test. All the categories of age and gender showed statistically significant results i.e. p-value ? 0.05, except one week follow-up among different categories of gender showing insignificant results with p value = 0.740. Conclusion:  In present study 75.5% patients achieved the required result of ocular alignment within 10 prism diopters of orthotropia at the final follow-up visit. Key Words:  Squint, Esotropia, Exotropia, 10 prism Diopters.

scholarly journals A pattern of Opportunistic Infections among HIV In patients on Antiretroviral Therapy in a Tertiary Care Hospital in Coastal Karnataka: A Retrospective Evaluation

2020 ◽  
Vol 11 (4) ◽  
pp. 6385-6390
Author(s):  
Guntur Aishwarya ◽  
Sunil Pai B ◽  
Priyanka Kamath ◽  
Rakesh K B ◽  
Priya Rathi ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Opportunistic Infections ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Hiv Positive ◽  
Care Hospital ◽  
Retrospective Case ◽  
Case Record ◽  
Resource Limited ◽  
Immunodeficiency Virus

Though the incidence of opportunistic infection (OI) is reducing with combination antiretroviral therapy. In this study we aimed to identify the pattern of the occurrence of opportunistic infections in HIV (Human Immunodeficiency Virus) patients. This was a retrospective, case-record based, time-bound study over a four year period (2013-2016) which included HIV positive in-patients aged >18 years of age, of either gender on Antiretroviral Therapy (ART). Demographic details, details of HIV infection including baseline and all available CD4 counts, details of the medications were recorded. Adverse drug reactions (ADR) were recorded by reviewing patient records. Among the files checked, 298 inpatients were on ART regimens recommended by the National AIDS Control Organization (NACO), and were included in the study. Among them, 70.8% of patients developed atleast one OI, 29.8% developed two OIs, and 6.71% developed three OIs. The most common OI was pulmonary tuberculosis (48.3%). The most common ART regimen was a combination of Zidovudine + Lamivudine + Nevirapine. In our study, 70.8% of patients developed at least one OI, which suggests that despite availability of combination ART, OIs continue being a significant issue in patients with HIV in resource-limited settings.

Sero-Prevalence of Parvovirus B 19 Infection Among HIV Positive Patients Attending Tertiary Care Hospital in Central India

2017 ◽  
Vol 01 (04) ◽  
pp. 127-132
Author(s):  
Bhushan Shrikhande ◽  
Meena Mishra ◽  
Mohiuddin Qazi ◽  
Arvind Kurhade ◽  
Chandrashekhar Unakal ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Central India ◽  
Hiv Positive ◽  
Care Hospital ◽  
Parvovirus B 19

Chemo-prophylaxis of COVID-19 with hydroxychloroquine: a study of health care workers attitude, adherence to regime and toxicities/side effects (Preprint)

2020 ◽  
Author(s):  
Debajyoti Bhattacharyya ◽  
Neeraj Raizada ◽  
Bharathnag Nagappa ◽  
Arvind Tomar ◽  
Prateek Maurya ◽  
...  
Keyword(s):  
Side Effects ◽  
Health Care Workers ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Perceived Threat ◽  
Care Hospital ◽  
Care Workers ◽  
Perceived Danger ◽  
Structured Questionnaire

BACKGROUND There are apprehensions among healthcare worker (HCWs) about COVID-19. The HCWs have been given hydroxychloroquine (HCQ) chemo-prophylaxis for seven weeks as per Government of India guidelines. OBJECTIVE To assess the apprehensions among HCWs about COVID-19 and to document accessibility, adherence and side effects related to HCQ prophylaxis in HCWs. METHODS A longitudinal follow up study was conducted in a tertiary care hospital. HCQ was given in the dose of 400 mg twice on day one, and then 400 mg weekly for seven weeks. 391 HCWs were interviewed using semi structured questionnaire. RESULTS 62.2% HCWs expressed perceived danger posted by COVID-19 infection. Doctors (54%) showed least acceptance and paramedics (88%) showed highest acceptance to chemo-prophylaxis. 17.5% participants developed at least one of the side effects to HCQ. Females and nursing profession were significantly associated with adverse effects. Common side effects were gastro-intestinal symptoms, headache and abnormal mood change. Most of these were mild, not requiring any intervention. Gender, professions and perceived threat of COVID-19 were significantly associated with acceptance and adherence to HCQ prophylaxis. CONCLUSIONS Two third of HCWs had perceived danger due to COVID-19. Three fourth of the HCWs accepted chemo-prophylaxis and four out of five who accepted had complete adherence to prophylaxis schedule. One out of five had developed at least one of side effects; however, most of these were mild not requiring any intervention.

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