PREVALENCE RATE AND IMPACT OF ADDICTIVE DISORDERS ON THE COURSE OF HIV-INFECTION IN IN-PATIENTS

Aim of the study. To make an analysis of the prevalence rate and the impact of addictive disorders on the course of HIV-infection and evaluate the efficacy of the antiretroviral therapy. Methods and Materials. The retrospective analysis of medical records of HIV-positive patients, examined by the narcologist in the S.P. Botkin Clinical Infectious Diseases Hospital during the period of from September to November in 2014 and 2016. Results. Half of the patients (576 out of 1164 patients, 49.5%) treated in HIV-infection hospital required consultation of narcologist. In 2014 and 2016 men were more prevalent among such patients (73% and 76% accordingly), with a trend toward the involvement of older patients. Most prevalent narcological pathology among HIV-positive patients was opioid dependence (48% and 45% accordingly). Despite an increase of absolute numbers of narcologist’s consultations in 2016 the only group in which the relative gain from 17% to 26% was observed there was a group of patients suffered both opioid dependency and chronic alcoholism simultaneously. According to our data odds ratio for starting antiretroviral therapy in the hospital were higher in women and in patients with remission of chronic alcoholism. Percentage of patients who started antiretroviral therapy was insufficient - 30% among patients discharged after the complete in-hospital stay. Conclusion. The pattern of HIV epidemic among patients with addictive disorders does not differ from the general HIV-positive population. The gain in percentage of patients with comorbidity such as opioid dependency with alcohol abuse was observed. Patients manifested the alcohol abuse at the time of admission have lower chances to begin to receive ARVT comparing to those who were in remission.

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Exploring the impact of HIV infection and antiretroviral therapy on placenta morphology

Placenta ◽

10.1016/j.placenta.2020.12.004 ◽

2021 ◽

Vol 104 ◽

pp. 102-109

Author(s):

Michael Yampolsky ◽

Oleksandr Shlakhter ◽

Dianna Deng ◽

Smriti Kala ◽

Sharon L. Walmsley ◽

...

Keyword(s):

Antiretroviral Therapy ◽

Hiv Infection ◽

The Impact

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Human Immunodeficiency Virus–Associated Squamous Cell Cancer of the Anus: Epidemiology and Outcomes in the Highly Active Antiretroviral Therapy Era

Journal of Clinical Oncology ◽

10.1200/jco.2007.14.2810 ◽

2008 ◽

Vol 26 (3) ◽

pp. 474-479 ◽

Cited By ~ 83

Author(s):

Elizabeth Y. Chiao ◽

Thomas P. Giordano ◽

Peter Richardson ◽

Hashem B. El-Serag

Keyword(s):

Antiretroviral Therapy ◽

Hiv Infection ◽

Squamous Cell ◽

Highly Active Antiretroviral Therapy ◽

Cell Cancer ◽

Cox Proportional Hazards ◽

Administrative Databases ◽

Hiv Positive ◽

Highly Active ◽

Hiv Negative

Purpose To evaluate and determine predictors of squamous cell carcinoma of the anus (SCCA) outcomes in the highly active antiretroviral therapy (HAART) era for HIV-positive and -negative individuals using large national Veterans Affairs (VA) Administration databases. Patients and Methods We used the VA administrative databases to perform a retrospective cohort study in 1,184 veterans diagnosed with SCCA between 1998 and 2004. We calculated HIV infection rates and used logistic regression to identify epidemiologic factors that were associated with HIV infection. Kaplan-Meier curves and Cox proportional hazards models were calculated to compare survival between HIV-positive and HIV-negative veterans. Results In our cohort, 175 patients (15%) were HIV positive. The median age of the HIV-negative and -positive patients was 63 and 49 years, respectively (P < .001). Individuals with HIV were eight times more likely to be male (P = .01) and three times more likely to be African American (P < .001). There were no differences between HIV-positive and HIV-negative individuals in the receipt of treatment. The 2-year observed survival rates were 77% and 75% among HIV-positive and HIV-negative individuals, respectively. In multivariate Cox analysis, significant predictors of survival were age, sex, metastasis at diagnosis, and comorbidity score. HIV infection did not affect survival. Conclusion A noteworthy proportion of individuals with SCCA in the VA system are HIV positive. HIV-associated SCCA seems mainly to be a disease among younger men. Survival of SCCA is equivalent between HIV-positive and HIV-negative individuals in the HAART era. Treatment should not be withheld or deintensified based on HIV status.

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A New Perspective on HIV Diagnostics: Reinterpretation in the Age of Early Treatment

Journal of Clinical Microbiology ◽

10.1128/jcm.00978-19 ◽

2019 ◽

Vol 57 (10) ◽

Author(s):

Sheila M. Keating

Keyword(s):

Antiretroviral Therapy ◽

Hiv Infection ◽

Viral Replication ◽

Early Treatment ◽

Clinical Microbiology ◽

Link Type ◽

New Perspective ◽

Hiv Diagnostics ◽

The Impact

ABSTRACT Early treatment of HIV infection with antiretroviral therapy in recently identified HIV-infected individuals reduces viral replication and decreases the risk of transmission. The screening and supplemental, confirmatory assays used to identify infection are influenced by early treatment and may obscure a clear diagnosis of HIV infection. In this issue of the Journal of Clinical Microbiology, Manak et al. demonstrate the impact of antiretroviral therapy on the evolution of biomarkers that have traditionally been used for identifying HIV infection (M. M. Manak, L. L. Jagodzinski, A. Shutt, J. A. Malia, et al., J Clin Microbiol 57:e00757-19, 2019, https://doi.org/10.1128/JCM.00757-19).

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Contribution of HIV Infection, AIDS, and Antiretroviral Therapy to Exocrine Pathogenesis in Salivary and Lacrimal Glands

International Journal of Molecular Sciences ◽

10.3390/ijms19092747 ◽

2018 ◽

Vol 19 (9) ◽

pp. 2747 ◽

Cited By ~ 1

Author(s):

Imran Nizamuddin ◽

Peter Koulen ◽

Carole McArthur

Keyword(s):

Antiretroviral Therapy ◽

Hiv Infection ◽

Immune Deficiency Syndrome ◽

Deficiency Syndrome ◽

Exocrine Function ◽

Lacrimal Glands ◽

Immunodeficiency Virus ◽

And Function ◽

The Impact

The structure and function of exocrine glands are negatively affected by human immunodeficiency virus (HIV) infection and its co-morbidities, including innate and adaptive immune responses. At the same time, exocrine function may also be influenced by pharmacotherapies directed at the infectious agents. Here, we briefly review the role of the salivary glands and lacrimal glands in normal physiology and exocrine pathogenesis within the context of HIV infection and acquired immune deficiency syndrome (AIDS), including the contribution of antiretroviral therapies on both. Subsequently, we discuss the impact of HIV infection and the types of antiretroviral therapy on disease management and therapy development efforts.

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Clinico-immunological profile and outcome of antiretroviral therapy in HIV-positive children

Public Health Nutrition ◽

10.1017/s1368980011003181 ◽

2012 ◽

Vol 15 (8) ◽

pp. 1442-1445 ◽

Cited By ~ 3

Author(s):

Nidhi Choudhary ◽

Sunil Gomber ◽

Manish Narang

Keyword(s):

Antiretroviral Therapy ◽

Nutritional Status ◽

Short Stature ◽

Clinical Status ◽

Hiv Positive ◽

Who Guidelines ◽

First Line ◽

Immunological Profile ◽

Control And Prevention ◽

The Impact

AbstractObjectivesTo study the clinico-immunological, nutritional and growth characteristics of HIV-infected children and the impact of antiretroviral therapy (ART) on these parameters.DesignRetrospective study.SettingOut-patient department of a paediatric ART centre, Delhi, India.SubjectsHIV-positive children registered at the paediatric ART centre of the hospital were enrolled (n 130). Anthropometric measurements were used to classify children into the type of malnutrition according to definitions of the WHO and US Centers for Disease Control and Prevention. Clinical and immunological status of the children was recorded as per WHO guidelines. First-line ART was started based on guidelines of the National AIDS Control Organization. Nutritional status and clinico-immunological characteristics were followed up annually in children receiving ART.ResultsOf children ≤5 years of age (n 54), stunting was noted in 42·5 % contrary to wasting seen in only 12·9 %. In children >5 years of age (n 76), short stature (40·7 %) and underweight (39·4 %) were seen in almost equal proportions. Asymptomatic presentation was noted in 60·0 %. Following ART, a reduction in wasting was noted in 75·0 % of children ≤5 years of age, whereas only 44·4 % of underweight children >5 years of age showed an improvement after therapy. Stunting and short stature continued to persist in all in children (≤5 years and >5 years, respectively). Clinico-immunologically, 67·5 % improved in clinical status and 62·5 % showed immunological improvement.ConclusionsART improves the acute parameters of nutritional status like wasting. It also improves the clinical outcome and restores the immune system. At present first-line ART is effective in HIV-positive children.

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B cells in early and chronic HIV infection: evidence for preservation of immune function associated with early initiation of antiretroviral therapy

Blood ◽

10.1182/blood-2010-05-285528 ◽

2010 ◽

Vol 116 (25) ◽

pp. 5571-5579 ◽

Cited By ~ 165

Author(s):

Susan Moir ◽

Clarisa M. Buckner ◽

Jason Ho ◽

Wei Wang ◽

Jenny Chen ◽

...

Keyword(s):

B Cells ◽

Antiretroviral Therapy ◽

Hiv Infection ◽

B Cell ◽

Immune Cell ◽

Memory B Cells ◽

Early Initiation ◽

Cell Counts ◽

The Impact ◽

Chronic Hiv Infection

Abstract Characterization of lymphocytes including B cells during early versus chronic HIV infection is important for understanding the impact of chronic viremia on immune cell function. In this setting, we investigated B cells before and after reduction of HIV plasma viremia by antiretroviral therapy (ART). At baseline, peripheral blood B-cell counts were significantly lower in both early and chronic HIV-infected individuals compared with uninfected controls. Similar to CD4+ but not CD8+ T cells, B-cell numbers in both groups increased significantly after ART. At baseline, B cells of early HIV-infected individuals were composed of a higher percentage of plasmablasts and resting memory B cells compared with chronic HIV-infected individuals whose B cells were composed of a higher percentage of immature/transitional and exhausted B cells compared with their early infection counterparts. At 1 year after ART, the percentage of resting memory B cells remained higher in early compared with chronic HIV-infected individuals. This difference translated into a better functional profile in that memory B-cell responses to HIV and non-HIV antigens were superior in early- compared with chronic-treated HIV infected individuals. These findings provide new insights on B cells in HIV infection and how early initiation of ART may prevent irreversible immune system damage.

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Etiology and Outcome of Patients with HIV Infection and Respiratory Failure Admitted to the Intensive Care Unit

Interdisciplinary Perspectives on Infectious Diseases ◽

10.1155/2013/732421 ◽

2013 ◽

Vol 2013 ◽

pp. 1-5 ◽

Cited By ~ 4

Author(s):

Jose Orsini ◽

Noeen Ahmad ◽

Ashvin Butala ◽

Rosemarie Flores ◽

Truc Tran ◽

...

Keyword(s):

Mechanical Ventilation ◽

Respiratory Failure ◽

Hiv Infection ◽

Cell Count ◽

Hiv Viral Load ◽

Viral Loads ◽

Cell Counts ◽

Time Of Admission ◽

The Impact

Background. Although access to HAART has prolonged survival and improved quality of life, HIV-infected patients with severe immunosuppression or comorbidities may develop complications that require critical care support. Our objective is to evaluate the etiology of respiratory failure in patients with HIV infection admitted to the ICU, its relationship with the T-lymphocytes cell count as well as the use of HAART, and its impact on outcome.Methods. A single-center, prospective, and observational study among all patients with HIV-infection and respiratory failure admitted to the ICU from December 1, 2011, to February 28, 2013, was conducted.Results. A total of 42 patients were admitted during the study period. Their median CD4cell count was 123 cells/μL (mean 205.7, range 2.0–694.0), with a median HIV viral load of 203.5 copies/mL (mean 58,676, range <20–367,649). At the time of admission, 23 patients (54.8%) were receiving HAART. Use of antiretroviral therapy at ICU admission was not associated with survival, but it was associated with higher CD4cell counts and lower HIV viral loads. Twenty-five patients (59.5%) had respiratory failure secondary to non-HIV-related diseases. Mechanical ventilation was required in 36 patients (85.1%). Thirteen patients (31.0%) died.Conclusions. Noninfectious etiologies of respiratory failure account for majority of HIV-infected patients admitted to ICU. Increased mortality was observed among patients with sepsis as etiology of respiratory failure (HIV related and non-AIDS related), in those receiving mechanical ventilation, and in patients with decreased CD4cell count. Survival was not associated with the use of HAART. Complementary studies are warranted to address the impact of HAART on outcomes of HIV-infected patients with respiratory failure admitted to ICU.

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Mood disorders in HIV infection

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.569 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S482-S482

Author(s):

L. Martínez ◽

E. Boix ◽

L. González ◽

R. Esteban ◽

E. Davi ◽

...

Keyword(s):

Case Report ◽

Antiretroviral Therapy ◽

Hiv Infection ◽

Mood Disorders ◽

Depressive Disorders ◽

Significant Risk ◽

Poor Adherence ◽

Hiv Positive ◽

Strict Adherence ◽

First Case

IntroductionPsychiatric disorders, particularly mood disorders, have a profound effect on the use of and adherence to highly active antiretroviral therapy (HAART) among patients with human immunodeficiency virus (HIV) infection.HIV infection and mood disorders have features in common, and each is a significant risk factor for the other.ObjectiveThe objective is to highlight the clinicians on the importance of screening and treating affective disorders among patients with HIV infection.MethodsTwo cases of HIV infected patients with comorbid mood disorder and torpid evolutions by poor adherence to treatment are reported.A brief literature review on this subject is done.ResultsMajor depression has been shown to alter the function of killer lymphocytes in HIV-infected patients and may be associated with the progression of HIV disease.HIV-positive patients with mental disorders are less likely to receive and adherence to antiretroviral therapy.First case-report: a man 52 years old, HIV-positive since 1985 with a comorbid bipolar disorder, with recurrent depressions and poor adherence to both treatment with a rapidly exitus laetalis.Second case-report: man 45 years old, HIV-positive since 1992 with a comorbid depressive disorder, non-adhered to both therapy and HIV-associated dementia.ConclusionsDepressive disorders are common in HIV infection. Antiretroviral regimens for HIV-infected patients require strict adherence. Untreated depression has been associated with medication nonadherence. Understanding the contribution of depression and its subsequent treatment on antiretroviral therapy adherence might direct clinicians toward earlier identification and more aggressive treatment among this population.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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