scholarly journals A study of bone mineral density among people living with HIV in India and its correlation with CD4 count

2017 ◽  
Vol 5 (2) ◽  
pp. 563 ◽  
Author(s):  
Kamal K. Sawlani ◽  
Sushrut Singh ◽  
Shyam C. Chaudhary ◽  
D. Himanshu Reddy ◽  
Kauser Usman ◽  
...  
Keyword(s):  
Cd4 Count ◽  
Hiv Positive ◽  
Control Group ◽  
People Living With Hiv ◽  
Care Hospital ◽  
Mineral Density ◽  
Hiv Patients ◽  
Negative Controls ◽  
Prevalence Of Osteoporosis ◽  
Hiv Negative

Background: Data on the prevalence of osteoporosis in HIV patients in Asian population is scarce this study was done to find out the prevalence of osteoporosis in HIV infected patients and its correlation with CD4 counts.Methods: This cross- sectional study was conducted in NACO- ART center of tertiary care hospital. Total 115 HIV patients were included in this study which were divided into ART naive (n= 69) and patients taking ART (n= 46). We analysed BMD by DEXA in 115 HIV positive patients and 78 HIV negative age and sex matched controls. Correlation of BMD with a CD4 count and ART regimen was studied.Results: BMD was found to be low in HIV positive patients. T score in HIV positive patients was significantly lower (p<0.05) as compared to the HIV negative control group. The prevalence of osteopenia and osteoporosis in HIV positive patients was 50.4% and 29.6% respectively, as compared to 23.1% and 2.6% in HIV negative controls. BMD showed relation with CD4 count. We did not find any statistical difference between any ART regimen and BMD.Conclusions: The prevalence of osteopenia and osteoporosis in HIV infected cases was higher as compared to HIV negative controls and higher in ART group as compared to ART naïve group. Low BMD levels show correlation with low CD4 count. We recommend that HIV positive patients especially with advanced stage of disease, low CD4 count should be screened for low BMD by DEXA scan for osteoporosis and managed accordingly

scholarly journals Electrocardiographic and echocardiographic abnormalities in urban African people living with HIV in South Africa

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0244742
Author(s):  
Geert V. T. Roozen ◽  
Ruchika Meel ◽  
Joyce Peper ◽  
William D. F. Venter ◽  
Roos E. Barth ◽  
...  
Keyword(s):  
South Africa ◽  
Viral Load ◽  
Left Ventricular Mass ◽  
Qt Interval ◽  
Left Ventricular ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Living With Hiv ◽  
Negative Controls ◽  
Hiv Negative

Background Studies from high income countries report that HIV-positive people have an impaired systolic and diastolic cardiac function compared to HIV-negative people. It is unclear if results can be translated directly to the Sub-Saharan Africa context. This study assesses electro- and echocardiographic characteristics in an urban African population, comparing HIV-positive people (treated and not yet treated) with HIV-negative controls. Methods We conducted a cross-sectional study in Johannesburg, South Africa. We enrolled HIV-positive participants from three randomized controlled trials that had recruited participants from routine HIV testing programs. HIV-negative controls were recruited from the community. Data were collected on demographics, cardiovascular risk factors, medical history and electrocardiographic and echocardiographic characteristics. Results In total, 394 HIV-positive participants and 153 controls were enrolled. The mean age of HIV-positive participants was 40±9 years (controls: 35±10 years), and 34% were male (controls: 50%). Of HIV-positive participants 36% were overweight or obese (controls: 44%), 23% had hypertension (controls: 28%) and 12% were current smoker (controls: 37%). Median time since HIV diagnosis was 6.0 years (IQR 2.3–10.0) and median treatment duration was 4.0 years (IQR 0.0–8.0), 50% had undetectable viral load. The frequency of anatomical cardiac abnormalities was low and did not differ between people with and without HIV. We observed no relation between HIV or anti-retroviral therapy (ART) and systolic or diastolic heart function. There was an association between ART use and corrected QT interval: +11.8 ms compared to HIV-negative controls (p<0.01) and +18.9 ms compared to ART-naïve participants (p = 0.01). We also observed a higher left ventricular mass index in participants on ART (+7.8 g/m2, p<0.01), but this association disappeared after adjusting for CD4 cell count, viral load and HIV-duration. Conclusion The low number of major cardiac abnormalities in this relatively young, well managed urban African HIV-positive population is reassuring. The increase in corrected QT interval and left ventricular mass may contribute to higher cardiac mortality and morbidity in people living with HIV in the long term.

scholarly journals Evaluation of upper gastro intestinal endoscopy among HIV positive and negative patients at a tertiary care hospital: a comparative study

2018 ◽  
Vol 5 (5) ◽  
pp. 1213
Author(s):  
Ramapriya Rengaswamy ◽  
Thayumanavan L.
Keyword(s):  
Helicobacter Pylori ◽  
Comparative Study ◽  
Tertiary Care ◽  
General Medicine ◽  
Hiv Positive ◽  
Control Group ◽  
Case Group ◽  
Care Hospital ◽  
Endoscopic Findings ◽  
Hiv Negative

Background: Endoscopy is the diagnostic test of choice for most HIV-associated GI diseases, as endoscopic and histopathologic evaluation can render diagnoses in patients with non-specific symptoms.  The objective of the present research was to study the gastrointestinal endoscopic findings among HIV positive patients and compare them with HIV negative patients.Methods: A comparative study was carried out in the department of General Medicine to study the gastrointestinal endoscopic findings among HIV positive patients and compare them with HIV negative patients for a period of two years. 101 cases who were HIV positive were compared with equal number of HIV negative subjects. The subjects in the case group as well as control group were chosen randomly.Results: There was a significant lower incidence of Helicobacter pylori positivity (38.6%) among HIV positive patients when compared to controls (73.6%). There were overall 63 patients with abnormal biopsy findings in HIV group and 75 patients with abnormal biopsy findings in the control group. Among HIV positive patients who were also RUT positive approximately 80% had abnormal histopathological findings. Similarly, among the RUT positive control 81% of the patients had abnormal biopsy findings. Incidence of normal biopsy findings was more in the control group (57.1%) compared to the study group (48.4%). But this difference was not found to be statistically significant.Conclusions: The histology of gastric mucosa was no different in Helicobacter pylori positive or negative subjects with HIV. But Helicobacter pylori incidence was significantly less in HIV positive persons compared to HIV negative.

scholarly journals Prevalence of osteoporosis and osteopenia in a cohort of HIV positive women with a history of treated neoplasms

2021 ◽  
Vol 9 ◽  
pp. 205031212110374
Author(s):  
Cecilia Rivera-Díaz ◽  
P Volkow-Fernández ◽  
José Luis Villalobos ◽  
P Cornejo-Juárez
Keyword(s):  
Femoral Neck ◽  
Lifestyle Changes ◽  
Hiv Positive ◽  
Mineral Density ◽  
Hiv Positive Women ◽  
History Of ◽  
Prevalence Of Osteoporosis ◽  
Cancer Clinic ◽  
History Of Cancer ◽  
Hiv Negative

Introduction: Higher prevalence of osteopenia and osteoporosis in HIV positive patients compared to non-infected population has been recognized. However, cancer patients have a higher risk of bone loss and fractures that is multifactorial. The aim of the study was to describe the prevalence of osteopenia and osteoporosis in HIV positive women with history of treated cancer. Methods: Between January 2018 and December 2019, women aged >40 years, HIV+ with a history of cancer diagnosis, who attended the AIDS Cancer Clinic at Instituto Nacional de Cancerología, Mexico City, and who had a dual X-ray absorptiometry performed during the study period were included. Two control groups (CG)—HIV negative women with history of cancer (CG1) and non-HIV, non-cancer women (CG2)—were matched by age 1:1. Results: Forty-eight patients in each group were included; the mean age was 51.1 ± 8.1 years. Osteopenia was found in femoral neck in 54.2% (HIV+), 37.5% (CG1), and 27.1% (CG2), p = 0.02; in spine was 35.7%, 47.9%, and 31.2%, respectively, p = 0.442. Osteoporosis in femoral neck was documented in 12.5%, 2.1%, and 0% in HIV+, CG1, and CG2 ( p = 0.03), and in the spine was 47.9%, 16.7%, and 14.6%, respectively ( p = 0.002). Conclusion: HIV patients with a history of treated cancer have a much higher prevalence of osteoporosis when compared with same-aged HIV-uninfected women with and without cancer. It is necessary to monitor Bone Mineral Density periodically, and all patients should be encouraged to make lifestyle changes, such as avoid tobacco and alcohol, and to increase exercising.

scholarly journals Comparative Study on Bone Mineral Densitometry in People Living with HIV with or without Highly Active Antiretroviral Therapy

2020 ◽  
Vol 6 (01) ◽  
pp. 18-23
Author(s):  
Tutan Das ◽  
Bhagyabati Devi ◽  
Ningthoukhongjam Reema ◽  
Thangjam Gautam Singh
Keyword(s):  
Antiretroviral Therapy ◽  
Bone Loss ◽  
Hiv Infection ◽  
Bone Mineral ◽  
The Body ◽  
Cd4 Count ◽  
People Living With Hiv ◽  
Mineral Density ◽  
Hiv Patients ◽  
Living With Hiv

Abstract Introduction Human immunodeficiency virus (HIV) is a disease that affects millions of people globally and affects almost all the body systems including bone metabolism. Derangement of bone mineral density (BMD) in HIV patients is well established in international literature but least studied in India. Therefore, this study aims to determine the association between BMD change and HIV infection with or without antiretroviral therapy (ART) and compare the different regimens of ART. Materials and Methods The cross-sectional study was conducted at the Department of Medicine and ART Center of Regional Institute of Medical Sciences, Imphal, India. A total of 50 HIV patients were screened by a central dual-energy X-ray absorptiometry (DEXA) examination for measuring BMD. Correlation of BMD with a CD4 count, and different ART regimens were also studied. Results In our study, majority of the patients (29 [58%]) had low BMD. Of the 29 patients, 18 (36%) had osteopenia and 11 (22%) had osteoporosis. Of the ART naïve patients, 81.8% have reduced BMD. Among different ART regimens, tenofovir-based regimes were mostly associated with low BMD (52.4%). A statistically significant association between low CD4 count and low BMD was found. Conclusion Our study concluded that HIV infection is associated with bone loss and low BMD in people living with HIV (PLHIV) irrespective of its treatment with ART. PLHIV are at a greater risk of bone loss secondary to decreased BMD. Among the ART regimens, tenofovir-based regimens are mostly associated with low BMD. Therefore, all HIV patients should be screened by DEXA scan for BMD status, and timely intervention should be started.

scholarly journals Prevalence of tuberculosis in newly diagnosed HIV patients and its relationship with cluster of differentiation 4 count in a tertiary care hospital

2019 ◽  
Vol 6 (6) ◽  
pp. 1849
Author(s):  
Archana B. ◽  
Vivek K. U.
Keyword(s):  
Extrapulmonary Tuberculosis ◽  
Tertiary Care ◽  
Cd4 Count ◽  
Hiv Positive ◽  
Clear Correlation ◽  
Pulmonary Medicine ◽  
Care Hospital ◽  
Newly Diagnosed ◽  
Hiv Patients ◽  
Pulmonary Tb

Background: Tuberculosis (TB) is the commonest opportunistic infection among Human Immunodeficiency Virus (HIV) positive patients in India and HIV/TB co-infection poses a major public health challenge in developing countries. It is estimated that 60-70% of HIV positive patients will develop tuberculosis in their lifetime. The aim of the present study is to record the clinical, radiological profile of pulmonary and Extrapulmonary Tuberculosis (EPTB) in HIV positive patients.Methods: This was a prospective study conducted in the department of Pulmonary medicine, Kempegowda institute of medical sciences. All newly diagnosed HIV patients during the study period were included and screened for tuberculosis irrespective of whether they had signs and symptoms.Results: Among 44(15.94%) patients among 276 HIV positive patients were diagnosed to have tuberculosis. Males (72.72%) were affected more than females (27.27%). Most common affected age group was 31-40 years with a mean age of 38.08 years. Unprotected heterosexual contact was the most common mode of HIV transmission. Fever, weight loss and cough were the commonest symptoms at presentation. Pulmonary TB was diagnosed in 10(22.7%) patients, EPTB in 30(68.3%) and disseminated TB in 4(9%) patients. All the pulmonary TB patients had CD4 count below 250, EPTB below 150 and disseminated TB patients below 50.6(13.63%) patients had pleural effusion, 5(11.36%) had abdominal TB, 5(11.36%) had tubercular meningitis, 4(9%) had intra thoracic lymphadenopathy and one (2.27%) patient had pericardial effusion. Low CD4 count (<150) had statically significant association with HIV/TB co-infection.Conclusions: The prevalence of HIV-TB co-infection was high. Moreover, HIV positive patients need early diagnosis and treatment of active TB. The study has shown clear correlation between clinical data and the laboratory parameter of immunodeficiency (CD4 count) and the temporal development of TB.

Group B Streptococcus Rectovaginal Colonization and Resistance Patterns in HIV-Positive Compared to HIV-Negative Pregnant Patients

2021 ◽  
Author(s):  
John A. Morgan ◽  
Miriam E. Hankins ◽  
Nicholas A. Callais ◽  
Charles W. Albritton ◽  
John A. Vanchiere ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Group B Streptococcus ◽  
Hiv Positive ◽  
Control Group ◽  
Hiv Viral Load ◽  
Significant Difference ◽  
Resistance Patterns ◽  
Group B ◽  
Negative Controls ◽  
Hiv Negative

Objective The objective of our study is to determine if human immunodeficiency virus (HIV)-positive pregnant patients have a higher rate of group B streptococcus (GBS) rectovaginal colonization compared with HIV-negative pregnant patients. Methods Our study is a multi-site retrospective study performed at Ochsner Louisiana State University-Health Shreveport and Monroe campuses including patients who delivered between December 2011and June 2019. Rates of GBS rectovaginal colonization between HIV-positive pregnant patients were compared with a control group of HIV-negative patients. The control group was age and race matched in a 2:1 fashion. The primary outcome was to investigate rates of GBS rectovaginal colonization. Secondary outcomes included GBS culture antibiotic sensitivities, presence of GBS urinary tract infection, GBS positivity based on HIV viral load, and GBS positivity based on new vs established diagnosis of HIV. Continuous data were analyzed using an unpaired t-test, and categorical data were analyzed using a Chi-squared test. The probability level of <0.05 was set as statistically significant. Results A total of 225 patients were included in the final analysis, 75 HIV-positive and 150 HIV-negative controls. Demographic differences were noted. HIV-positive patients were more likely to deliver preterm and were more likely to deliver via cesarean section. Our primary outcome showed no significant differences in incidence of GBS colonization between HIV-positive patients and control group (n = 31, 41.3% vs n = 46, 30.6%, p = 0.136). Antibiotic resistance patterns showed no significant difference between the two groups. There were no significant differences in GBS positivity based on HIV viral load. Conclusion Our study does not show a statistically significant difference in the incidence of GBS colonization between HIV-positive patients and HIV-negative controls. Key Points

scholarly journals Immune correlates of Mycobacterium Tuberculosis patients in Zambia stratified by HIV serostatus and level of immunity-a cross-sectional analytical laboratory based study

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262454
Author(s):  
Patrick Lungu ◽  
Evarist Njelesani ◽  
Thomas Sukwa ◽  
Owen Ngalamika ◽  
Sody Munsaka ◽  
...  
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Cd4 Count ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Pairwise Correlation ◽  
Immune Correlates ◽  
Tnf Α ◽  
Ifn Γ ◽  
Hiv Seropositive ◽  
Hiv Negative

Background People living with HIV (PLHIV) co-infected with tuberculosis (TB) have a distinct clinical presentation and poorer treatment outcomes compared to HIV-seronegative TB patients. Excluding low CD4 count, innate immune factors associated with TB are not fully elucidated. We, therefore, characterised and compared the expression of IL-6, TNF-α, IFN-γ, and IL-10 in whole blood of treatment naïve TB patients stimulated with heat-killed Mycobacterium tuberculosis stratified by HIV status and the level of CD4 count. Results We recruited 39 HIV seropositive and 31 HIV seronegative TB patients. Median (IQR) age was 35(28–42) years and 31(25–36) years respectively, and a majority had pulmonary tuberculosis i.e. 38(95%) and 30(97%), respectively. The two groups were significantly different in the distribution of CD4 count, 563 [465–702.5 cells/mm3] vs 345 [157–483 cell/mm3] in HIV negative vs HIV positive respectively p = <0.001. Post stimulation, the expression of IL-6 in HIV negative TB patients was significantly higher than in the HIV positive 16,757366 [8,827–23,686 pg/ml] vs. 9,508 [5,514–15,008 pg/ml], respectively; p = 0.0360. TNF-α and IFN-γ were highly expressed in HIV negative TB patients compared to the HIV positive though not statistically significant. We only observed higher expression of IL-6 in HIV negative patients in comparison to the HIV positive when stratified by level of CD4 counts as < 500 and ≥ 500 cell/mm3 for both cohorts. 21,953 [8,990–24,206 pg/ml] vs 9,505 [5,400–15,313 pg/ml], p value = 0.0585 in patients with CD4 count < 500 cell/mm3 and 13,168 [7,087–22,584 pg/ml] vs 10,413 [7,397–14,806 pg/ml], p value = 0.3744 for patients with CD4 count of ≥ 500 cell/mm3 respectively. We found a positive pairwise correlation between TNF-α -alpha and IL-6 in both HIV positive and HIV negative patients, r = 0.61 (95% CI 0.36–0.72; p < 0.0001) and r = 0.48 (95% CI 0.15–0.68; p = 0.005) respectively. The IFNγ/IL-10 ratio was higher in HIV negative when compared to HIV positive individuals, 0.052 [0.0–0.28] vs 0.007 [0–0.32] respectively; p = 0.05759. IL-6 independently reduced the probability of TB/HIV, Adjusted odds ratio 0.99, p value 0.007. Conclusions This study suggests that HIV seronegative TB patients have a higher pro-inflammatory response to MTB than HIV seropositive TB patients. Further, it also shows that the level of CD4 influences immunomodulation. The findings suggest that the difference in cytokine expression may be responsible for the distinct patterns of TB presentation between HIV positive and HIV negative patient.

Evaluation of Salivary Vitamin C and Catalase in HIV Positive and Healthy HIV Negative Control Group

2017 ◽  
Vol 17 (2) ◽  
Author(s):  
Fatemeh Ahmadi-Motamayel ◽  
Samaneh Vaziri-Amjad ◽  
Mohammad Taghi Goodarzi ◽  
Jalal Poorolajal
Keyword(s):  
Vitamin C ◽  
Negative Control Group ◽  
Negative Control ◽  
Hiv Positive ◽  
Control Group ◽  
Hiv Negative

scholarly journals Excess burden of age-associated comorbidities among people living with HIV in British Columbia, Canada: a population-based cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e041734
Author(s):  
Ni Gusti Ayu Nanditha ◽  
Adrianna Paiero ◽  
Hiwot M Tafessu ◽  
Martin St-Jean ◽  
Taylor McLinden ◽  
...  
Keyword(s):  
British Columbia ◽  
Cohort Study ◽  
Population Based ◽  
Age At Diagnosis ◽  
Secondary Outcome ◽  
People Living With Hiv ◽  
Prevalence Trends ◽  
Living With Hiv ◽  
Negative Controls ◽  
Hiv Negative

ObjectivesAs people living with HIV (PLWH) live longer, morbidity and mortality from non-AIDS comorbidities have emerged as major concerns. Our objective was to compare prevalence trends and age at diagnosis of nine chronic age-associated comorbidities between individuals living with and without HIV.Design and settingThis population-based cohort study used longitudinal cohort data from all diagnosed antiretroviral-treated PLWH and 1:4 age-sex-matched HIV-negative individuals in British Columbia, Canada.ParticipantsThe study included 8031 antiretroviral-treated PLWH and 32 124 HIV-negative controls (median age 40 years, 82% men). Eligible participants were ≥19 years old and followed for ≥1 year during 2000 to 2012.Primary and secondary outcome measuresThe presence of non-AIDS-defining cancers, diabetes, osteoarthritis, hypertension, Alzheimer’s and/or non-HIV-related dementia, cardiovascular, kidney, liver and lung diseases were identified from provincial administrative databases. Beta regression assessed annual age-sex-standardised prevalence trends and Kruskal-Wallis tests compared the age at diagnosis of comorbidities stratified by rate of healthcare encounters.ResultsAcross study period, the prevalence of all chronic age-associated comorbidities, except hypertension, were higher among PLWH compared with their community-based HIV-negative counterparts; as much as 10 times higher for liver diseases (25.3% vs 2.1%, p value<0.0001). On stratification by healthcare encounter rates, PLWH experienced most chronic age-associated significantly earlier than HIV-negative controls, as early as 21 years earlier for Alzheimer’s and/or dementia.ConclusionsPLWH experienced higher prevalence and earlier age at diagnosis of non-AIDS comorbidities than their HIV-negative controls. These results stress the need for optimised screening for comorbidities at earlier ages among PLWH, and a comprehensive HIV care model that integrates prevention and treatment of chronic age-associated conditions. Additionally, the robust methodology developed in this study, which addresses concerns on the use of administrative health data to measure prevalence and incidence, is reproducible to other settings.

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