scholarly journals Metabolic abnormalities among HIV-infected patients: The rational of national health security for people living with HIV

2020 ◽  
Vol 27 (3) ◽  
pp. e78-e87
Author(s):  
Duangjai Duangrithi ◽  
Khuntikun Polsracoo ◽  
Titiwut Bhuddhataweekul
Keyword(s):  
Blood Pressure ◽  
National Health ◽  
Highly Active Antiretroviral Therapy ◽  
Fasting Glucose ◽  
Density Lipoprotein ◽  
People Living With Hiv ◽  
Metabolic Abnormalities ◽  
Benefit Package ◽  
Health Security ◽  
Living With Hiv

In the era of highly active antiretroviral therapy (ART), traditional risk factors for metabolic syndrome are presented as increasing age. In low- and middle-income countries, the restricted benefit package of national health security for human immunodeficiency virus (HIV) does not facilitate the early detection of metabolic disorders. In order to assess the rational of national health security for metabolic abnormalities among people living with HIV (PLHIV), this retrospective study aims to determine the occurrence of metabolic abnormalities and its predicting factors. The study was approved by the hospital ethics committee and conducted at the internal medicine clinic, Pathum Thani Hospital, Thailand. Patients with HIV having had at least 1 year of first-line ART, and having their fasting glucose, fasting lipid profile, and blood pressure assessed before ART were recruited into the study. Those with any abnormal metabolic component prior to ART or absent history of ART were excluded. The metabolic abnormalities were defined as any of the following: elevated triglyceride, reduced high-density lipoprotein (HDL), elevated blood pressure, elevated fasting glucose, or on drug treatment for these metabolic abnormalities. The occurrence of metabolic abnormalities was found in 102 of 340 patients (30.0%). Hypertension (11.4%) was the most common abnormality. Age became the single predictor of metabolic abnormalities (odds ratio [OR] = 1.03, 95% confidence interval [CI] = 1.00–1.06). Aging patients with HIV should be the target group for monitoring and treating metabolic abnormalities. The revision of the benefit package on metabolic abnormalities is urgently needed to promote a better quality of life.

Association between obstructive sleep apnea and metabolic abnormalities in patients with hypertrophic cardiomyopathy

2021 ◽  
Author(s):  
Juan Wang ◽  
Haobo Xu ◽  
Jiansong Yuan ◽  
Chao Guo ◽  
Fenghuan Hu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Hypertrophic Cardiomyopathy ◽  
High Density Lipoprotein ◽  
Fasting Glucose ◽  
Density Lipoprotein ◽  
Metabolic Abnormalities ◽  
Obstructive Sleep

Abstract Objectives Metabolic abnormalities have been associated with long-term cardiac mortality in patients with hypertrophic cardiomyopathy (HCM). Obstructive sleep apnea (OSA) is a risk factor for metabolic abnormalities in general populations, but association between OSA and metabolic abnormalities in HCM is still undefined. This study aimed to investigate the relationship between OSA and metabolic dysfunction in a large series of patients with HCM. Methods A total of 587 patients with HCM who underwent sleep evaluations at Fuwai Hospital were included. Data from clinical characteristics, polysomnography studies and metabolic measurements were collected. Results OSA was present in 344 patients (58.6%). Patients with OSA were older, more often male and had more clinical comorbidities. Body mass index, blood pressure, fasting glucose and triglycerides all increased (all P<0.001) and high-density lipoprotein cholesterol decreased (P=0.046) with the severity of OSA. In multivariate analysis, moderate to severe OSA and Log (AHI[apnea-hypopnea index]+1) were independently associated with obesity (OR, 2.42; 95%CI [1.48–3.95] and OR, 1.60; 95%CI [1.31–1.95]), elevated blood pressure (OR, 1.99; 95%CI [1.42–3.26] and OR, 1.31; 95%CI [1.08–1.60]) and elevated triglycerides (OR, 1.71; 95%CI [1.05–2.78] and OR, 1.24; 95%CI [1.02–1.51] but not elevated fasting glucose (OR, 0.88; 95%CI [0.50–1.52] and OR, 1.02; 95%CI [0.82–1.28]) and reduced high-density lipoprotein cholesterol (OR, 1.30; 95%CI [0.83–2.04] and OR, 1.06; 95%CI [0.89–1.27]). Conclusions Severity of OSA is independently associated with some profiles of metabolic abnormalities. Clinical trials are required to determine whether OSA treatment improves metabolic abnormalities and long-term outcomes in patients with HCM.

Nonlinear Resistance Training Enhances the Lipid Profile and Reduces Inflammation Marker in People Living With HIV: A Randomized Clinical Trial

2016 ◽  
Vol 13 (7) ◽  
pp. 765-770 ◽  
Author(s):  
Hugo Ribeiro Zanetti ◽  
Lucas Gonçalves da Cruz ◽  
Camilo Luís Monteiro Lourenço ◽  
Giovana Castilho Ribeiro ◽  
Marco Aurélio Ferreira de Jesus Leite ◽  
...  
Keyword(s):  
Body Composition ◽  
Resistance Training ◽  
Lipid Profile ◽  
Body Fat ◽  
Highly Active Antiretroviral Therapy ◽  
Density Lipoprotein ◽  
The Body ◽  
People Living With Hiv ◽  
Living With Hiv ◽  
Nonlinear Resistance

Background:Highly active antiretroviral therapy (HAART) is associated with high total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), triglyceride (TG), and C-reactive protein (CRP) levels. The natural course of the HIV infection reduces the high-density lipoprotein level (HDL-c). Thus, physical exercise plays a key role in reducing the effects of HAART and HIV.Methods:Thirty people living with HIV (PLHIV) were randomized to the nonlinear resistance training (NLRT) and control (CON) groups. The NLRT group underwent 12 weeks of resistance training, whereas the CON group maintained usual daily activities. All volunteers underwent anthropometric, body composition, and biochemical assessments at the beginning and end of 12 weeks.Results:After 12 weeks, the NLRT group had increased lean body mass (P < .0001), and a reduction in body fat mass (P < .0001) and body fat percentage (P < .0001). The levels of TC (P < .0001), LDL-c (P = .049), TG (P < .0001), and CRP (P = .004) were reduced, and the HDL-c level increased (P < .0001).ConclusionTwelve weeks of NLRT causes beneficial changes in the body composition, lipid profile, and inflammation markers in PLHIV, and it can be used in this patient population.

scholarly journals Weight and height of people living with HIV/AIDS attended by the Brazilian National Health System

2013 ◽  
Vol 16 (3) ◽  
pp. 622-632
Author(s):  
Katia Cristina Bassichetto ◽  
Denise Pimentel Bergamaschi ◽  
Deivis Elton Schlickmann Frainer ◽  
Vania Regina Salles Garcia ◽  
Edina Aparecida Tramarin Trovões
Keyword(s):  
Health Status ◽  
Health System ◽  
National Health ◽  
National Health System ◽  
Reference Population ◽  
Average Weight ◽  
People Living With Hiv ◽  
Cross Sectional ◽  
Living With Hiv ◽  
Hiv Aids

The nutritional status of people living with HIV/AIDS (PLWHA) is related to morbidity and mortality and its monitoring is important in the maintenance of the health status. This is a cross-sectional study carried out in Brazilian National Health System in the Municipality of São Paulo. It describes anthropometrical characteristics: weight and height; indices of weight for height (W/H), height for age (H/A), body mass index for age (BMI/A) and Z score for height and weight. The study includes 772 participants from all ages: children, adolescents, adults and elderly. The graphical analysis shows that in under-5s and in the 5 to 19 years old group, the W/H, the H/A and the BMI/A curves are similar to the reference population with an exception in the H/A for 5 to 19 years old group which is left-shifted (mean Z = -0.66). In the case of adults, graphics for the study population show median weight apparently lower than in the reference population for most age groups in the case of men, and when age is greater in women. The proportion of people over 20 years old with AIDS on anti-retroviral therapy is lower when coinfection is present (p < 0.001). The findings of the study showed that, for children and adolescents with HIV/AIDS, the average weight and height are lower than the values for non infected population. For adults and elderly, the weight average is lower than the reference population with a worsening among coinfected patients. This underscores the need to direct more effort in nutritional actions thus helping enhance the health status of this group.

scholarly journals Clinical and biological profiles of older adults aged 50 and over compared to those under 50 in people living with HIV attending Kinshasa University Teaching Hospital (DR Congo)

2021 ◽  
Vol 5 (2) ◽  
pp. 087-095
Author(s):  
Mbula MMK ◽  
Longo-Mbenza B ◽  
Situakibanza HNT ◽  
Mananga GL ◽  
Makulo JRR ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Teaching Hospital ◽  
University Teaching ◽  
People Living With Hiv ◽  
Chi Square ◽  
Stage 4 ◽  
History Of ◽  
Student’S T ◽  
Living With Hiv ◽  
Student’S T Test

Background: The survival of people living with HIV (PLWHIVs) is increased and Health systems will have to deal with the early-aging-associated medical conditions. Objective: The objective of this study is to compare the clinical and biological profiles of PLWHIVs aged 50 and over and those aged less than 50 years. Material and methods: This study conducted at Kinshasa University Teaching Hospital (KUTH) covers 6 years. The clinical and biological characteristics of PLWHIVs aged 50 and over were compared with those under 50. Statistical analysis used the means ± SD, the calculation of frequencies, Student’s t-test and Chi-square. Results: PLWHIVs aged 50 or over represented 35.1%. Their average age was 58.0 ± 4.8 years. Women predominate among those under 50 and men among those 50 and over. Married people were more numerous (54% among those under 50). There were more unemployed (50% of PLHIV under 50). Patients 50 years and older were significantly classified as WHO stage 4 with a high frequency of history of tuberculosis, genital herpes, high blood pressure, smoking, vomiting, hepatomegaly, moderate elevation of diastolic blood pressure (DBP) and sytolic blood pressure (SBP), tuberculosis and anemia. Those under 50 had a significantly increased frequency of shingles, hepatitis B-hepatitis C, headaches and more survivals. The mean of Hb, HDL-C, and CD4s+ were significantly lower in patients 50 years and older, and urea, LDL-C, and ALAT levels were significantly higher. Conclusion: The average age was higher from 50 years old. These PLWHIVs were more frequently in WHO stage 4 with more common TB and anemia. Their Hb, HDL-C, and CD4s+ levels were lower while their urea, LDL-C and ALAT levels were significantly elevated.

scholarly journals Adherence to Highly Active Antiretroviral Therapy and Its Association with Serostatus Disclosure among People Living with HIV in Ethiopia:  A Systematic Review and Meta-Analysis.

2020 ◽  
Author(s):  
Abere Woretaw Azagew ◽  
Chilot Kassa Mekonnen ◽  
Abebaw Jember Ferede ◽  
Kassahun Gebeyehu Yazew ◽  
Zewdu Baye Tezera
Keyword(s):  
Systematic Review ◽  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Assessment Tool ◽  
Meta Analysis ◽  
People Living With Hiv ◽  
Serostatus Disclosure ◽  
Highly Active ◽  
Pooled Prevalence ◽  
Living With Hiv

Abstract Background: Adherence to highly active antiretroviral therapy (HAART) is a public health challenge worldwide. Non-adherence to HAART leads to treatment, immunologic, and virological failure. Despite different interventions made, adherence to HAART among adult people living with HIV (PLWHIV) is still inconsistent across studies, and the effect of serostatus disclosure on adherence to HAART was not studied in Ethiopia. Therefore, the study is aimed to determine the pooled prevalence of adherence to HAART and its relationship with serostatus disclosure among adult PLWHIV in Ethiopia.Methods: We searched 3247 original articles, both published and unpublished on Ethiopia dated from January 2016 to November 2019 by using different search engines. Data were extracted using Microsoft excel. New Castle Ottawa Scale quality assessment tool was used. STATA software version 11 was used for analysis. A random-effects model for meta-analysis was computed. Cochran Q statistics and I2 were used to estimate heterogeneity. Egger’s and Begg’s test was used to assess the publication bias.Results: A total of fifteen articles for systematic review and four articles for meta-analysis were used. The pooled prevalence of adherence to HAART is found to be 81.19% (80.1, 82.3). In the subgroup analysis, the pooled prevalence of adherence to HAART was 79.82% (73.19, 86.45) in the Oromia region, 82.51 %( 73.14, 91.87) in the Amhara region, and 72.7% (63.78, 81.61) in the Southern Nations Nationalities and Peoples’ Region (SNNPR). The serostatus disclosure improves adherence to HAART by nearly three times compared to non-serostatus disclosed PLWHIV (AOR=2.99, 95 %CI: 1.88, 4.77).Conclusions: The pooled prevalence of adherence to HAART among adult PLWHIV in Ethiopia was found to be low compared to WHO antiretroviral treatment recommendations. Having serostatus disclosure improved adherence to HAART.

scholarly journals Seroprevalence and molecular diversity of Human Herpesvirus 8 among people living with HIV in Brazzaville, Congo

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Gervillien Arnold Malonga ◽  
Aude Jary ◽  
Valentin Leducq ◽  
Dimitry Moudiongui Mboungou Malanda ◽  
Anicet Luc Magloire Boumba ◽  
...  
Keyword(s):  
Whole Blood ◽  
Highly Active Antiretroviral Therapy ◽  
Horizontal Transmission ◽  
Human Herpesvirus ◽  
Human Herpesvirus 8 ◽  
Nuclear Antigen ◽  
People Living With Hiv ◽  
Subtype C ◽  
Herpesvirus 8 ◽  
Living With Hiv

AbstractHuman herpesvirus 8 (HHV8) is endemic in Africa, although studies of this infection are rare in Congo. We evaluated seroprevalence and HHV-8 diversity among people living with HIV. We included 353 patients receiving highly active antiretroviral therapy. Antibodies against HHV-8 latency-associated nuclear antigen were detected by indirect immunofluorescence. In HHV-8 positive patients, we performed HHV-8 quantification in blood and saliva by real-time PCR and typing by Sanger sequencing of K1 open reading frame. HHV-8 seroprevalence was 19%, being male (odd ratio [OR] = 1.741, [95% Confidence interval {CI}, 0.97–3.07]; p = 0.0581) and having multiple sex partners before HIV diagnosis (OR = 1.682, [CI 95%, 0.97–2.92]; p = 0.0629) tended to be associated with HHV-8 seropositivity. Of the 64 HHV-8 seropositive patients, HHV-8 DNA was detected in 10 (16%) in saliva, 6 (9%) in whole-blood and in 2 (3%) in both whole-blood and saliva. Three out of 6 HHV-8 strains were subtypes A5, 2 subtype B1 and 1 subtype C. HHV-8 seroprevalence was relatively low with more frequent carriage in men, associated with asymptomatic oral excretion and a predominance of subtype A5. These data tend to support the hypothesis of horizontal transmission in people living with HIV in Brazzaville.

scholarly journals Late Onset of Antiretroviral Therapy in Adults Living with HIV in an Urban Area in Brazil: Prevalence and Risk Factors

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Priscila Ribeiro Guimarães Pacheco ◽  
Ana Laura Sene Amâncio Zara ◽  
Luiz Carlos Silva e Souza ◽  
Marília Dalva Turchi
Keyword(s):  
Viral Load ◽  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Perceived Risk ◽  
Opportunistic Infections ◽  
Late Onset ◽  
Baseline Viral Load ◽  
People Living With Hiv ◽  
Late Initiation ◽  
Living With Hiv

Introduction. Highly active antiretroviral therapy has been available since 1996. Early initiation of antiretroviral therapy (ART) leads to improved therapeutic response and reduced HIV transmission. However, a significant number of people living with HIV (PLHIV) still start treatment late. Objective. This study aimed to analyze characteristics and factors associated with late initiation of ART among HIV-infected treatment-naïve patients. Methods. This cross-sectional study included PLHIV older than 17 years who initiated ART at two public health facilities from 2009 to 2012, in a city located in Midwestern Brazil. Pregnant women were excluded. Data were collected from medical records, antiviral dispensing forms, and the Logistics Control of Medications System (SICLOM) of the Brazilian Ministry of Health. Late initiation of ART was defined as CD4+ cell count < 200 cells/mm3 or presence of AIDS-defining illness. Uni- and multivariate analysis were performed to evaluate associated factors for late ARV using SPSS®, version 21. The significance level was set at p<0.05. Results. 1,141 individuals were included, with a median age of 41 years, and 69.1% were male. The prevalence of late initiation of ART was 55.8% (95%CI: 52.9-58.7). The more common opportunistic infections at ART initiation were pneumocystosis, cerebral toxoplasmosis, tuberculosis, and histoplasmosis. Overall, 38.8% of patients had HIV viral load equal to or greater than 100,000 copies/mL. Late onset of ART was associated with higher mortality. After logistic regression, factors shown to be associated with late initiation of ARV were low education level, sexual orientation, high baseline viral load, place of residence outside metropolitan area, and concomitant infection with hepatitis B virus. Conclusion. These results revealed the need to increase early treatment of HIV infection, focusing especially on groups of people who are more socially vulnerable or have lower self-perceived risk.

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