scholarly journals Treatment outcome of antiretroviral treatment naive HIV infected patients initiated on antiretroviral therapy in a tertiary care hospital in South India

2018 ◽  
Vol 6 (5) ◽  
pp. 1704
Author(s):  
Rajendra Prasad S. ◽  
Subhash Chandra B. J.
Keyword(s):  
Side Effects ◽  
Antiretroviral Treatment ◽  
Opportunistic Infections ◽  
Tertiary Care ◽  
Cd4 Count ◽  
Clinical Profile ◽  
Hiv Positive ◽  
Care Hospital ◽  
Route Of Transmission ◽  
The Mean

Background: About 2.1 million people are infected with HIV in India. Clinical profile of patients has evolved over a period of time in the Antiretroviral treatment (ART) era. This study was done to document the clinical presentation of patients in a tertiary care in Mysuru in Karnataka. The aim of the study was to follow the patients who were initiated on ART over a period of time and to know its effect on the clinical outcome and overall morbidity and mortality of the patients.Methods: A prospective study of HIV positive patients who were initiated on ART was done regarding clinical profile and outcome over a period of one and a half to two years depending on when they were initiated on ART.Results: Totally 183 patients were registered during the period, out of which 114 patients (62.29%) were males and the rest were females (37.70%). The commonest route of transmission was heterosexual route seen in 97.3% (178). Most (56.8%) of the patients were asymptomatic. The mean basal CD4 count was 162.70. The mean age of patients was 39.07. The mean BMI was 20.29. A 23.5% (43) had one or other side effects. Anemia (44.2%) was the most common side effects seen. There were 18 deaths (12.2%). A 39.34% (72) patients had opportunistic infections (OI), the commonest being tuberculosis 45(%).Conclusions: It was concluded that patients with low CD4 count, low BMI were more prone for Opportunistic infections and death. Early initiation of ART can prevent such incidences and improve the quality of life of HIV positive patients.

scholarly journals A comparative evaluation of the effects of ZLN and TLE anti-retroviral regimens in HIV positive patients: A retrospective record-based study

2021 ◽  
Vol 64 ◽  
pp. 298-302
Author(s):  
Ritika Singla ◽  
Neetu Sharma
Keyword(s):  
Opportunistic Infections ◽  
Tertiary Care ◽  
Cd4 Count ◽  
Hiv Positive ◽  
Care Hospital ◽  
Immunodeficiency Virus ◽  
Group A ◽  
The Mean ◽  
The Difference ◽  
Group B

Objectives: Until 2012, zidovudine+lamivudine+nevirapine (ZLN) was the first line treatment for human immunodeficiency virus (HIV)-positive patients, whereas in 2013, tenofovir+lamivudine+efavirenz (TLE) was recommended as a preferred regimen due to less adverse drug reactions and better virological response. The present study was done to compare the change in CD4 count and emergence of opportunistic infections (OIs) in HIV-positive patients on ZLN and TLE regimens. Materials and Methods: This retrospective record-based study was conducted at anti-retroviral therapy (ART) center of a tertiary care hospital on 150 charts of patients on ZLN (Group A) and TLE (Group B) regimens each for 1 year. Data were analyzed using GraphPad Prism version 6. Results: The mean age of patients in Group A was 38.72 (±10.5) years and Group B 37.75 (±11.57) years (P = 0.4460). After 1 year of ART, the mean CD4 count (cells/mm3) increased in both groups (Group A: 223.51 [±111.21] to 415.37 [±218.16] [P = 0.0001] vs. Group B: 255.05 [±164.50] to 433.12 [±247.66] [P = 0.0001]). With the baseline counts being comparable (P = 0.0527), the difference in mean CD4 counts between the groups post-ART was not statistically significant (P = 0.5105). The incidence of OI was 45% in Group A as compared to 25% in Group B. Overall, the most prevalent OI was tuberculosis (TB) (13.33%). Conclusion: Both ZLN and TLE regimens are equally effective in improving the immunological status of HIV-positive patients. Patients on ZLN have higher incidence of OI than those on TLE. However, therapy should be individualized as per patient’s suitability.

scholarly journals Clinical profile of HIV positive patients attending ART centre of a tertiary care hospital

2018 ◽  
Vol 7 (8) ◽  
pp. 1542
Author(s):  
Tejas M. Doshi ◽  
Rusva A. Mistry ◽  
Manish N. Mehta
Keyword(s):  
Hiv Infection ◽  
Tertiary Care ◽  
Clinical Profile ◽  
Reproductive Age ◽  
Hiv Positive ◽  
Common Symptom ◽  
Care Hospital ◽  
Age Group ◽  
Route Of Transmission ◽  
Common Opportunistic Infection

Background: HIV infection/AIDS is a global pandemic greatly exceeds earlier prediction. With widespread availability and uses of Anti Retroviral Therapy (ART), HIV becomes a chronic manageable illness but immediate and long term side effects become a major problem. The objective of the study was to study clinical profile of HIV positive patients attending A.R.T. centre of a tertiary care hospital.Methods: Observational and prospective study was carried out over 100 HIV positive Patients attending ART centre of G.G.G Hospital, Jamnagar, Saurastra, Gujarat over a period of 12 months.Results: Out of 100 HIV positive studied patients, maximum cases (95%) were in the age group of 15-49 years, 75% were males. (58%) cases were from rural area and (56%) were illiterate. Maximum cases were having sexual (79%) route of transmission. Most common symptom among HIV positive patients was weight loss (62%) followed by fever (58%). Mycobacterium tuberculosis (65%) was the most common opportunistic infection. (84%) patients had CD4 count between 50-200/cub.mm, (66%) were in stage III. ART was well tolerated, ADRs were found in 43% of patients.Conclusions: HIV is more common in reproductive age group with males being more affected and major route of transmission of HIV infection remains heterosexual mode.

scholarly journals Treatment of HIV and Use of HAART in HIV Infected Patients with Acute Septic Shock

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S434-S434
Author(s):  
Christopher Polk ◽  
Samuel Webb ◽  
Nigel Rozario ◽  
Charity Moore ◽  
Michael Leonard
Keyword(s):  
Healthcare System ◽  
Opportunistic Infections ◽  
Tertiary Care ◽  
Hiv Positive ◽  
Virologic Suppression ◽  
Care Hospital ◽  
Research Support ◽  
Hiv Patients ◽  
Clinical Patient ◽  
The Impact

Abstract Background For HIV patients admitted with sepsis, ARVs are often stopped or held due to myriad concerns including drug interactions, acute renal failure, gastrointestinal dysfunction, or inability to administer crushed medications down feeding tubes. We seek to examine prescription patterns of HAART for HIV positive patients admitted for sepsis in our healthcare system and the impact of HAART prescription on patient outcomes. Methods We identified HIV positive patients from an institutional database of patients admitted for sepsis within our multi-hospital healthcare system and retrospectively extracted further clinical patient and laboratory information as well as information on HAART prescription by chart review. The impact of HAART prescription and immunologic and virologic parameters of HIV infection on mortality was examined. Results Inpatient mortality was 35% in HIV patients admitted for sepsis, compared with 17% for all patients with sepsis in our healthcare system. Opportunistic infections were identified in only 25% of patients while 56% had other infections identified. Only 55% of patients had HAART prescribed while inpatient. CD4 count, virologic suppression, APACHE score, presence of an opportunistic infection, admission to a tertiary care hospital, and inpatient prescription of HAART were all predictors of survival. Conclusion Immunologic and virologic status at time of admission predicted survival in HIV patients admitted for sepsis but prescription of HAART to HIV patients admitted for sepsis may increase survival. Disclosures C. Polk, Gilead Sciences: Investigator, Research support; Viiv Healthcare: Investigator, Research support

scholarly journals Clinical profile and geographical distribution of malaria patients attending a tertiary care centre in Mangaluru, South India

2019 ◽  
Vol 6 (11) ◽  
pp. 4743
Author(s):  
Pavithra H. ◽  
Imaad Mohammed Ismail ◽  
Ayisha Kahar ◽  
Sai Bhargav ◽  
Samanth Bharadhwaj M. G. ◽  
...  
Keyword(s):  
Geographical Distribution ◽  
Blood Smear ◽  
Preventive Measures ◽  
Tertiary Care ◽  
Clinical Profile ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Male Preponderance ◽  
The Mean ◽  
Common Infection

Background: Around 0.84 million people contracted malaria in India in the year 2017 and it resulted in 194 deaths. This study was conducted to describe the demographic and clinical profile as well as the geographical distribution of malaria patients attending a tertiary care hospital in Mangaluru.Methods: It was a record based descriptive study. All the malaria cases which were admitted from 1st May 2017 till 30th April 2018 were included in the study. QGIS software was used to plot the cases geographically.Results: A total of 97 malaria cases were present, of which 74.2% were males. The mean age of the participants was 33.4 years. Fever and chills were the most common presenting complaints (94.8% and 85.6% respectively) and thrombocytopenia was the foremost complication. Diagnosis was done using blood smear in 45 cases and rapid diagnostic kit in 59 cases. 8 patients were detected positive by both the tests. Plasmodium vivax (69%) was the most common infection. QGIS plotting of address showed that 61.4% were from Mangaluru block. Rest of the cases were from other parts of Karnataka, Kerala and Bihar.Conclusions: Malaria has a male preponderance and usually affects the economically productive age group. Thrombocytopenia was a common complication, thus necessitating close vigilance on platelet counts in malaria patients. Thick and thin blood smear is recommended to be performed to every case irrespective of their rapid diagnostic kit results. Mangaluru block accounted for 60 cases out of 97 cases which necessitates intensification of preventive measures in the block.

scholarly journals Cd4 count at the time of presentation in newly diagnosed HIV patients in a tertiary care hospital in south India: implications for the programme

2019 ◽  
Vol 7 (2) ◽  
pp. 512
Author(s):  
Krishna Rajesh Kilaru ◽  
Likhita Punuru ◽  
Venkateswara Rao Garimella ◽  
Sindhu Kande
Keyword(s):  
Negative Impact ◽  
Tertiary Care ◽  
Cd4 Count ◽  
Care Hospital ◽  
Newly Diagnosed ◽  
National Guidelines ◽  
Hiv Diagnosis ◽  
Hiv Patients ◽  
Counseling And Testing ◽  
The Mean

Background: Lower CD4 count at initiation of antiretroviral therapy (ART) can have a significant negative impact on subsequent disease progression and mortality among HIV patients. Hence, author assessed the status of the CD4 count at the time of diagnosis and factors associated with lower CD4 count among newly diagnosed HIV cases.Methods: A prospective observational study was conducted in a single integrated counseling and testing center, affiliated with a Medical College and Hospital, Andhra Pradesh. All newly diagnosed HIV cases in the setting between January to December 2017 were included. The CD4 count was assessed as per national guidelines for enumeration of CD4 2015.Results: The final analysis included 125 participants. The mean CD4 count at diagnosis was 276.51±228.37. Only 19 (15.20%) people had CD4 count >500, 47 (37.60%) had between 200-500 and 59 (47.20%) had CD4 count <200. Only 20% had appropriate knowledge of treatment. Among the study population, 43 (34.70%) had symptomatic conditions attributed to HIV infection, 44 (35.50%) participants had an AIDS-defining illness at the time of diagnosis. Only 3 (2.40%) had voluntary counseling and testing. Even though male gender, poor educational status, having more sexual partners, poor knowledge related to HIV diagnosis and treatment was associated with higher odds of low CD4 count (<200), none of the associations were statistically significant.Conclusions: The mean CD4 count was low and almost half of newly diagnosed cases had low CD4 count (<200) at the time of diagnosis. There is a strong need to intensify the efforts to fill the gaps in the screening for the early diagnosis to maximize the benefits of HAART and to stop the spread of the infection.

scholarly journals Clinical profile of amoebic liver abscess patients admitted in a tertiary care hospital

2016 ◽  
Vol 48 (1-2) ◽  
pp. 20-23 ◽  
Author(s):  
Bishnupada Paik ◽  
Swapan Kumar Sarkar ◽  
Poritosh Kumar Chowdhury ◽  
Saad Ahmed
Keyword(s):  
Clinical Features ◽  
Liver Abscess ◽  
Tertiary Care ◽  
Needle Aspiration ◽  
Clinical Profile ◽  
Amoebic Liver Abscess ◽  
Care Hospital ◽  
College Hospital ◽  
Female Ratio ◽  
The Mean

Amoebic liver abscess is an important cause of space occupying lesions of the liver, especially in tropical and sub tropical regions. It is the most frequent complication of invasive amebiasis. It may be found in all age groups but relatively rare in children. The signs and symptoms vary according to the severity of illness. The present study was done to evaluate the clinical profile of patients with amoebic liver abscess for age, gender, clinical features, site of abscess, number of abscess, treatment modality by intravenous metronidazole along with percutaneous needle aspiration and prognosis. A prospective study of 86 admitted patients of amoebic liver abscess were included in this study which was carried out in the medicine department of Khulna Medical College Hospital over a period of 2 years from July 2010 to June 2012. Mean age of patients was 45 years. Male female ratio was 7:1. The mean duration of fever was 17.9 days and the mean duration of pain was 14.1 days. The duration of fever for more than 2 weeks was seen in 38 cases. Regarding clinical features, the major symptoms of fever, pain abdomen and dysentery were seen in 81, 78 and 10 cases respectively. The major signs as determined by clinical and radio imaging studies were hepatomegaly in 76, right lobe abscess in 60, left lobe abscess in 12, multiple abscesses in both lobes in 18, ascites in 5 and right sided pleural effusion in 12 cases respectively. All the cases underwent percutaneous needle aspiration. 5 cases died out of 86 patients.Bang Med J (Khulna) 2015; 48 : 20-23

scholarly journals Clinical Profile of Dengue Fever in Children: A Study from Southern Odisha, India

Scientifica ◽  
2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Shubhankar Mishra ◽  
Ramya Ramanathan ◽  
Sunil Kumar Agarwalla
Keyword(s):  
Dengue Fever ◽  
Viral Infections ◽  
Dengue Infection ◽  
Tertiary Care ◽  
Case Fatality ◽  
Clinical Profile ◽  
Severe Dengue ◽  
High Morbidity ◽  
Care Hospital ◽  
The Mean

Background. In India, dengue epidemics are becoming more frequent (WHO, 2008). The majority of dengue viral infections are self-limiting, but complications may cause high morbidity and mortality.Objectives. To assess the clinical profile of the dengue infection in children less than 14 years of age and to evaluate the outcomes of dengue fever from September 2013 to August 2015 at the Pediatric Department of Maharaja Krishna Chandra Gajapati Medical College, the largest tertiary care hospital of southern Odisha.Results. A total of 97 cases were classified into 84 (86.59%) nonsevere and 13 (13.40%) severe dengue cases. The most common age of presentation was above 11 yrs. The mean age of admission was 8.7 yrs. The most common presenting symptom was fever seen in 100% and hepatomegaly (43.8%), the most common physical finding. Gastrointestinal bleeding was markedly seen in severe dengue (76.9%). Elevation in aspartate transaminase (SGOT) was found in 47.42% and thrombocytopenia in 27.5%. The correlation between hepatomegaly and elevated SGOT was significant (Pvalue 0.0346). Case fatality rate (CFR) was 1.03%. The mean duration of hospitalisation was 3.8 days.Conclusion. In children, if symptoms like fever, pain, rashes, and vomiting are associated with hepatomegaly and elevated SGOT in context of low TPC, a strong possibility of dengue fever is present, especially in an epidemic setting. Early suspicion and effective management can reduce the severity.

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