Tuberculosis Infection in Human Immunodeficiency Virus—Positive Adolescents and Young Adults: A New York City Cohort

PEDIATRICS ◽  
1996 ◽  
Vol 97 (2) ◽  
pp. 198-203
Author(s):  
Neal D. Hoffman ◽  
Colleen Kelly ◽  
Donna Futterman
Keyword(s):  
Human Immunodeficiency Virus ◽  
Substance Use ◽  
Young Adults ◽  
Hiv Infection ◽  
Skin Test ◽  
Tuberculosis Infection ◽  
Adolescents And Young Adults ◽  
Hiv Positive ◽  
Immunodeficiency Virus ◽  
Cd4 Cell

Objectives. Adolescents with human immunodeficiency virus (HIV) infection are at increased risk for tuberculosis (TB), underscoring the importance of early identification of TB infection. The goals of this study were to assess the factors associated with the completion of evaluations for TB in a cohort of HIV-positive adolescents and young adults and to describe the prevalence of Mycobacterium tuberculosis infection and adherence to antituberculous treatment regimens. Methods. A retrospective chart review was done for all HIV-positive adolescents and young adults, ages 13 to 21 years (n = 49), seen in a comprehensive care program from January 1991 through December 1992. Data collected included CD4 cell count, HIV clinical status, living situation, substance use history, and the completion of an annual evaluation for TB infection. The evaluation consisted of a tuberculin skin test (Mantoux test), using an intraepidermal injection of 0.1 mL of 5 tuberculin units of purified protein derivative (PPD) and a simultaneous Merieux multitest anergy panel. Chi-square analysis was used to assess the association between the completion of the evaluation for TB and both living status and substance use. Results. Thirty-one (63%) of 49 patients completed evaluations for TB. Of the 31 completed evaluations, 18 were assessed by clinic staff on site, and 13 were assessed by other medical or trained nonmedical observers through community networking efforts. Neither homelessness nor illicit substance use were factors in the completion of the evaluation. Six (19%) of the 31 patients had positive PPD skin test results. Three had medical histories and chest radiographs suggesting active TB, and all were hospitalized for at least 2 weeks. Two had positive cultures for M tuberculosis, although the third also responded clinically to antituberculous therapy. All three were otherwise asymptomatic for HIV infection, with only moderately depressed CD4 cell counts. All three were homeless and used crack cocaine. After the initial treatment as inpatients, none completed treatment within the prescribed time period. Conclusions. The completions of the evaluations for TB were greatly facilitated by community networking, but innovative strategies to enhance both screening and treatment programs, such as training youth service providers in the community to read PPD skin tests, expansion of directly observed therapy services, and youth-centered programs for housing and substance use, need further development. The high prevalence of TB in the cohort underscores the need for providers to increase efforts to identify cases of TB infection among adolescents and young adults and to incorporate HIV risk assessment, counseling, and testing into their practices routinely.

Abstract WP426: Subarachnoid Hemorrhage in patients infected with Human Immunodeficiency Virus

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Haralabos Zacharatos ◽  
Malik M Adil ◽  
Ameer E Hassan ◽  
Sarwat I Gilani ◽  
Adnan I Qureshi
Keyword(s):  
Human Immunodeficiency Virus ◽  
Subarachnoid Hemorrhage ◽  
Blood Transfusion ◽  
Hospital Mortality ◽  
Hiv Infection ◽  
The United States ◽  
Hiv Positive ◽  
Published Data ◽  
Immunodeficiency Virus ◽  
Hiv Negative

Background: There is limited data regarding the unique attributes of ischemic stroke among patients infected with human immunodeficiency virus (HIV). There is no published data regarding the occurrence and outcomes of subarachnoid hemorrhage (SAH) among HIV infected persons. Methods: The largest all-payer Nationwide Inpatient Sample (NIS 2002-2010) data was used to identify and analyze all patients presenting with the primary diagnosis of SAH in the United States. Among this cohort, we identified the patients who were not HIV positive and those who were HIV positive. Patient demographics, medical co-morbidities, in-hospital complications, in-hospital procedures, and discharge disposition were compared between the two groups. The association between HIV infection and outcomes was evaluated in multivariate analysis after adjusting for potential confounders. Results: Of the 351,491 patients admitted with SAH, 1367 (0.39%) were infected with HIV. HIV infected patients were younger, mean age [±SD] of 45 ±14.2 years versus those who were not 58±19 years, (p<0.0001). The rate of blood transfusion [27,286 (7.8%) versus 245.6 (18%), p=0.0003], mechanical ventilation [51,199 (14.6%) versus 316.1(23.1%), p=0.008], and sepsis [14,644 (4.2%) versus 236.1 (17.3%), p<0.0001] was significantly higher among HIV infected patients. After adjusting for age, gender, hypertension, coagulopathy, atrial fibrillation, renal failure, and dyslipidemia, HIV negative patients had a significantly higher rate of discharge to home (odds ratio [OR] 1.9, 95% CI: 1.4-2.6, p<0.0001) and lower in-patient mortality (OR 0.4, 95% CI: 0.3-0.5, p<0.001). Further adjustment for blood transfusion and sepsis reduced the odds of discharge to home for the HIV negative patients, from 1.9 to 1.7 but did not affect in-hospital mortality. Conclusion: The in-hospital mortality in HIV infected patients with SAH is higher despite these patients being younger than non-HIV infected patients. We believe that this study provides a nationwide perspective which may have some important implications for early recognition and diagnosis of HIV-infection in SAH patients.

scholarly journals Levels of Macrophage Inflammatory Protein 1α (MIP-1α) and MIP-1β in Intervillous Blood Plasma Samples from Women with Placental Malaria and Human Immunodeficiency Virus Infection

2003 ◽  
Vol 10 (4) ◽  
pp. 631-636 ◽  
Author(s):  
Sujittra Chaisavaneeyakorn ◽  
Julie M. Moore ◽  
Lisa Mirel ◽  
Caroline Othoro ◽  
Juliana Otieno ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
Blood Plasma ◽  
Plasma Levels ◽  
Placental Malaria ◽  
Hiv Positive ◽  
Inflammatory Protein ◽  
Immunodeficiency Virus ◽  
Macrophage Inflammatory Protein ◽  
Hiv Negative

ABSTRACT Macrophage inflammatory protein-1α (MIP-1α) and MIP-1β play an important role in modulating immune responses. To understand their importance in immunity to placental malaria (PM) and in human immunodeficiency virus (HIV)-PM coinfection, we investigated levels of these chemokines in the placental intervillous blood plasma (IVB plasma) and cord blood plasma of HIV-negative PM-negative, HIV-negative PM-positive, HIV-positive PM-negative, and HIV-positive PM-positive women. Compared to HIV-negative PM-negative women, the MIP-1β concentration in IVB plasma was significantly elevated in HIV-negative PM-positive women and HIV-positive PM-positive women, but it was unaltered in HIV-positive PM-negative women. Also, PM-infected women, irrespective of their HIV status, had significantly higher levels of MIP-1β than HIV-positive PM-negative women. The MIP-1α level was not altered in association with either infection. The IVB plasma levels of MIP-1α and MIP-1β positively correlated with the cord blood plasma levels of these chemokines. As with IVB plasma, only cord plasma from PM-infected mothers had significantly elevated levels of MIP-1β compared to PM-negative mothers, irrespective of their HIV infection status. MIP-1β and MIP-1α levels in PM-positive women were positively associated with parasite density and malaria pigment levels. Regardless of HIV serostatus, the IVB MIP-1β level was significantly lower in women with PM-associated anemia. In summary, an elevated level of MIP-1β was associated with PM. HIV infection did not significantly alter these two chemokine levels in IVB plasma.

scholarly journals Tuberculin Skin Test Conversion and Reactivity Rates among Adults with and without Human Immunodeficiency Virus in Urban Settings in Ethiopia

2006 ◽  
Vol 13 (7) ◽  
pp. 784-789 ◽  
Author(s):  
Belete Tegbaru ◽  
Dawit Wolday ◽  
Tsehaynesh Messele ◽  
Mengistu Legesse ◽  
Yared Mekonnen ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
T Cell ◽  
Tuberculin Skin Test ◽  
Skin Test ◽  
Hiv Positive ◽  
Screening Methods ◽  
Lower Sensitivity ◽  
Urban Settings ◽  
Cell Counts ◽  
Immunodeficiency Virus

ABSTRACT To investigate whether low CD4+ T-cell counts in healthy and human immunodeficiency virus (HIV)-infected Ethiopians influence tuberculosis (TB) immunological memory, tuberculin skin test (TST) conversion and reactivity rates were investigated among adults with and without HIV infection in urban settings in Ethiopia. Reaction to the TST was analyzed with purified protein derivative by the Mantoux technique. A total of 1,286 individuals with TST results of ≥5-mm (n = 851) and ≤4-mm (n = 435) induration diameters were included. Individuals with ≤4-mm induration sizes were followed up for 21.4 ± 9.5 months (mean ± standard deviation) to observe skin test conversion. The overall TST reactivity (≥5-mm induration diameter) was 66.2% (n = 851). Reactivity was significantly lower among HIV-positive persons (40.5%) than among HIV-negative persons (68.7%) (P < 0.001). Of the above persons, 32 incident TB patients were checked for their TST status 13.05 ± 11.1 months before diagnosis and reactivity was found among 22 (68.7%) of them. Of the TST-negative persons with 0- to 4-mm indurations who were followed up for 3 years, the conversion rate to positivity was 17.9/100 person-years of observation (PYO) (14.4/100 PYO and 18.3/100 PYO in HIV-positive and -negative persons, respectively). Despite lower absolute CD4+ T-cell numbers in Ethiopians, higher TST conversion and reactivity rates show the presence of a higher rate of latent TB infection and/or transmission. The lower TST positivity rate before a diagnosis of TB disease showed the lower sensitivity of the test. This indicates the need for other sensitive and specific diagnostic and screening methods to detect TB infection, particularly among HIV-positive persons, so that they can be given prophylactic isoniazid therapy.

scholarly journals Seroprevalence of HIV in blood donors at tertiary care center, M.Y.H. Indore, India

2018 ◽  
Vol 7 (1) ◽  
pp. 183
Author(s):  
Priyanka Solanki ◽  
Ashok Yadav ◽  
Khushboo Likhar
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
Blood Donors ◽  
Care Center ◽  
Tertiary Care ◽  
Blood Bank ◽  
Hiv Positive ◽  
Screening Programs ◽  
Immunodeficiency Virus ◽  
Voluntary Donor

Background: Transfusion of blood has become an important mode of transmission of infections such as human immunodeficiency virus and hepatitis B to the recipients. Blood transfusion is a boon in medical era if properly screened. The aim of study was to determine the seroprevalence of HIV donors in blood bank at M.Y.H. Indore.Methods: The study was conducted in the blood bank, M.Y.H. Hospital, Indore. Total 115775 donors attending blood bank were included in the study. All the donor samples were screened for detection of antibodies for human immunodeficiency virus by microwell Enzyme Linked Immunosorption Assay (ELISA) method. The seroprevalence of HIV infection among the donors was determined over a period of five years since January 2013 to December 2017.Results: Total 115775 blood donors were recorded. Out of total 115775 blood donors included in the study, replacement donor were 10766 (9.29%) while voluntary donor were 105009 (90.70%). In the duration of five-year study period, total 80 cases (0.06%) were reactive to HIV. Out of total 115775 blood donors included in the study, maximum cases i.e. 22 (0.08%) cases were found to be positive for HIV infection in year 2017. Out of 10766 replacement donors included in the study, 64 cases (0.59%) were reactive to HIV infection. While out of 105009 voluntary donors, 16 cases (0.01%) were found to be reactive to HIV infection. Voluntary donors are more as compared to the replacement donors. Number of HIV positive patients were found to more in replacement donor as compared to the voluntary donors.Conclusions: The seroprevalence of HIV is low in this study and hence it is concluded that the more the number of voluntary donors, the less the number of HIV positive cases. Voluntary donors can be motivated by proper health education and high quality screening programs.

Gestational trophoblastic syndrome and human immunodeficiency virus (HIV) infection: A retrospective analysis

2003 ◽  
Vol 13 (6) ◽  
pp. 875-878 ◽  
Author(s):  
M. Moodley ◽  
J. Moodley
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
Case Reports ◽  
Hiv Positive ◽  
Risk Category ◽  
Immunodeficiency Virus ◽  
The Subject ◽  
The Mean ◽  
Sub Saharan

The appropriate management of gynecological malignancies in association with human immunodeficiency virus (HIV) infection is not established. To date the reported literature on the subject consists mainly of case reports. Due to the increasing prevalence of HIV infection, especially in sub-Saharan countries, the chances of finding both conditions in the same patient has produced management and ethical dilemmas. This retrospective study describes the management of 12 HIV-infected patients and compares their outcome with 29 non HIV-infected patients. The mean age of the non HIV-infected patients was 30 years (range 16–56 years), while the mean age of the HIV-infected patients was 32 years (range 20–47 years). In terms of risk factors, there were 72% of non HIV-infected women in the high-risk category compared to 50% of HIV-infected women (P = 0.468). All patients who received treatment had CD4 counts greater than 200 cells/μl. Two HIV-infected women who did not receive any form of chemotherapy due to low CD4 counts (41 cells/μl and 84 cells/μl) demised of their disease. The majority of women (86% non HIV-infected & 90% HIV-infected) received lfewer than 10 cycles of chemotherapy to attain cure. Most side effects were minor. None of the HIV-infected patients who received chemotherapy demised of their disease. In total, irrespective of risk category, there were 38 patients (93%) who were cured of their disease by chemotherapy including 10 HIV-positive patients. All patients were alive and free of disease at their last follow-up visit. Although the numbers are small, it is proposed that HIV-infected patients with choriocarcinoma and a reasonable degree of CD4 counts (>200cells/μl) should receive standard therapy.

Adolescents and Human Immunodeficiency Virus Infection: The Role of the Pediatrician in Prevention and Intervention

PEDIATRICS ◽  
1993 ◽  
Vol 92 (4) ◽  
pp. 626-630
Author(s):  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Young Adults ◽  
Hiv Infection ◽  
Military Service ◽  
Latency Period ◽  
Cross Sectional ◽  
Long Latency ◽  
Immunodeficiency Virus ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome

The incidence of human immunodeficiency virus (HIV) infection among adolescents is both significant and rising, and concern about this disease is increasingly evident among adolescents, their parents, and health professionals. Such concern evolves from multiple factors including not only the number of adolescents who have been reported to have the acquired immunodeficiency syndrome (AIDS), but also the uncertainty as to how many youths have been infected with the virus but remain asymptomatic; the risk of becoming infected through either heterosexual behavior, homosexual behavior, or substance abuse; and the need to implement effective preventive strategies. EPIDEMIOLOGY By the end of December 1992, a total of 946 cases of AIDS in persons aged 13 through 19 had been reported to the Centers for Disease Control. Although adolescents account for less than 1% of the total reported cases of AIDS, 20% of total cases occur in young adults aged 20 through 29. The long latency period between infection with HIV and the emergence of clinical AIDS, often in excess of 5 years, suggests that many of these young adults were first infected during their adolescence. For others, who become infected as young adults, the sexual or drug use behaviors that placed them at risk for infection had their onset during adolescence. Although national cross-sectional seroprevalence studies have not been conducted, data from selected populations of adolescents provide some information about the rate of infection among segments of the adolescent population. Since October 1985, the Department of Defense has tested applicants for military service for HIV infection. The Prevalance rate for 17- to 19-years-old screened between October 1985 and March 1989 was 0.34 per 1000.

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