scholarly journals Social characteristics associated with outcome of paediatric human immunodeficiency virus admissions

2019 ◽  
Vol 6 (4) ◽  
pp. 1620
Author(s):  
Olusola Adetunji Oyedeji ◽  
Olasunkanmi Oladapo Olubanjo ◽  
Gabriel Ademola Oyedeji
Keyword(s):  
Human Immunodeficiency Virus ◽  
Parental Education ◽  
Economic Status ◽  
Tertiary Hospital ◽  
Social Characteristics ◽  
Background Information ◽  
Female Ratio ◽  
Immunodeficiency Virus ◽  
The Status ◽  
The Mean

Background: Information on social characteristics in human immunodeficiency virus (HIV) infected Nigerian children is scarce. The association between social characteristics such as single parenthood, low socio-economic status, polygamy and lack of parental education on the outcome of paediatric HIV admissions has been under studied.Methods: Information was obtained from the case notes of HIV infected children between the year 2006 and 2012 at a Nigerian tertiary hospital. Details of the information extracted include socio-demographics, diagnoses and outcome of management. Data was analysed with the SPSS 18 software.Results: Fifty (1.73%) of the total 2897 paediatric admissions were due to HIV disease. The mean age of the children studied was 3.7±2.9years and the 50 children were made up by 27 boys and 23 girls, giving a male to female ratio of 1:0.9. The mean age of the mothers and fathers were 28.7 and 36.7 years respectively. Pneumonia, septicaemia and tuberculosis accounted for more than 60% of admissions. Five (10.0%) children were from the upper, 12 (24.0%) from the middle and 33 (766.0%) from the lower socioeconomic classes. Twenty-four parents (couples) were both sero-positive for HIV and 7 discordant. Nineteen (38.0%) could not be classified because the status of the father was unknown. Of the 7 sero-discordant parents, 3 sero-negative fathers neglected their families. Thirty-nine children were from monogamous homes, nine from polygamous and two were raised by single parents. There were two discharges against medical advice and eleven deaths. The average number of siblings of the children studied was 2.57±2.1. Mortalities on admission were significantly associated with, parental financial constraints and the admitted HIV infected child having more than one sibling (p<0.05).Conclusions: It was concluded that appropriate interventions to manage these associations will most likely improve the outcome of admissions. Strategies of improving disclosure and prevention of negative outcome of disclosures, such as family neglect in sero-discordant couples also need to be identified. 

Heparin Cofactor II Deficiency in Patients Infected with the Human Immunodeficiency Virus

1993 ◽  
Vol 70 (05) ◽  
pp. 730-735 ◽  
Author(s):  
P Toulon ◽  
M Lamine ◽  
I Ledjev ◽  
T Guez ◽  
M E Holleman ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Absolute Number ◽  
Thrombin Inhibitor ◽  
Unusual Complication ◽  
Healthy Individuals ◽  
Heparin Cofactor Ii ◽  
Immunodeficiency Virus ◽  
Coagulation Inhibitor ◽  
The Mean ◽  
Cd4 Lymphocytes

SummaryIn human plasma, heparin cofactor II (HCII) is a thrombin inhibitor, whose deficiency has been reported to be associated with recurrent thrombosis. The finding of two cases of low plasma HCII activity in two patients infected with the human immunodeficiency virus (HIV) led us to investigate this coagulation inhibitor in the plasma of a larger population of HIV-infected patients. The mean plasma HCII activity was significantly lower in 96 HIV-infected patients than in 96 age- and sex-matched healthy individuals (0.75 ± 0.24 vs 0.99 ± 0.17 U/ml, p <0.0001). HCII antigen concentration was decreased to the same extent as the activity. The proportion of subjects with HCII deficiency was significantly higher in the HIV-infected group than in healthy individuals (38.5% vs 2.1%). In addition, HCII was significantly lower in AIDS patients than in other HIV-infected patients, classified according to the Centers for Disease Control (CDC) on the basis of an absolute number of circulating CD4+ lymphocytes below 200 x 106/1. The link between HCII and immunodeficiency is further suggested by significant correlations between HCII activity and both the absolute number of CD4+ lymphocytes and the CD4+ to CD8+ lymphocyte ratio. Nevertheless, the mean HCII level was not different in the various groups of patients classified according to clinical criteria, except in CDC IVD patients in whom HCII levels were significantly lower. In addition, no correlation could be demonstrated between HCII and protein S activities, another coagulation inhibitor whose plasma level was also found to be decreased in HIV-infected patients. A similar prevalence of HCII deficiency was also found in a small series of 7 HIV-infected patients who developed thrombotic episodes, an unusual complication of the infection. This suggests that, in HIV-infected patients, HCII deficiency is not in itself the causative factor for the development of thrombosis.

scholarly journals Subcutaneous recombinant granulocyte-macrophage colony-stimulating factor used as a single agent and in an alternating regimen with azidothymidine in leukopenic patients with severe human immunodeficiency virus infection [see comments]

Blood ◽  
1990 ◽  
Vol 76 (3) ◽  
pp. 463-472 ◽  
Author(s):  
JM Pluda ◽  
R Yarchoan ◽  
PD Smith ◽  
N McAtee ◽  
LE Shay ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Geometric Mean ◽  
Hematologic Toxicity ◽  
Colony Stimulating Factor ◽  
Immunodeficiency Virus ◽  
P24 Antigen ◽  
Macrophage Colony Stimulating Factor ◽  
The Mean ◽  
Macrophage Colony ◽  
Stimulating Factor

We investigated the effects of recombinant human granulocyte-macrophage colony-stimulating factor (rGM-CSF) administered by the subcutaneous route, first alone and then alternating with azidothymidine (AZT), in leukopenic patients with severe human immunodeficiency virus (HIV) infection. Ten patients with acquired immunodeficiency syndrome (AIDS) or related disorders, five of whom could not tolerate conventional doses of AZT, were administered rGM-CSF subcutaneously for 12 days. They then were administered an alternating regimen using AZT for 1 week, followed by 5 days of subcutaneous rGM-CSF and 2 days without any medication. During the initial 12 days of GM-CSF administration, there was an increase in the mean white blood cell (WBC) value. In addition, rGM-CSF stimulated circulating monocytes as evidenced by an increase in superoxide anion production and expression of surface HLA-DR antigen. However, at the same time rGM-CSF increased the serum HIV p24 antigen in each of the six evaluable patients from 189 x/divided by 2.02 pg/mL (geometric mean x/divided by SEM) at entry to 375 x/divided by 2.11 pg/mL (P less than .05). During the subsequent period of alternating AZT and rGM-CSF treatment, serum HIV p24 antigen fell below the day 14 value in most patients, particularly after the weeks of AZT administration. The mean T4 cell value increased in patients who had not previously received AZT, but generally did not change in those who had prior AZT exposure. Hematologic toxicity appeared to be somewhat reduced compared with continuous full-dose AZT therapy, and two patients with previous AZT hematologic toxicity tolerated this alternating regimen for 25 weeks. Additional regimens simultaneously combining these two agents are worth exploring.

scholarly journals Knowledge, Attitudes and Practices of Male Transgenders in Transmission of Human Immunodeficiency Virus in Lahore, Pakistan

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Akash John ◽  
Muhammad Saleem Rana ◽  
Asif Hanif ◽  
Tallat Anwar Faridi ◽  
Sofia Noor ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Progressive Failure ◽  
Knowledge Score ◽  
Control Programme ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Attitudes And Practices ◽  
Immunodeficiency Virus ◽  
The Mean ◽  
Knowledge Attitudes And Practices

Human immunodeficiency virus (HIV) is a subgroup of retrovirus causing HIV infection which if prolongs turns into a progressive failure of the immune system called as acquired immunodeficiency syndrome. It is commonly prevalent in Male Transgenders who are born male and disobeys the cultural defined social norms and identify themselves as a female. The objective was to assess knowledge, Attitudes and Practices of Transgender Community regarding Transmission of Human Immunodeficiency Virus in Lahore, Pakistan. A Descriptive Cross-sectional Survey was conducted in Nine Towns of Lahore. A sample size of 79 was calculated and data was collected in duration of 9 months. A self-administered survey-based questionnaire was developed using WHO and National AIDS control Programme guidelines followed and pilot tested. Data was collected after Informed consent.The mean age of Respondents was 29.56 ± 8.27 years with minimum and maximum age as 19 and 50. In this study the mean knowledge score of the transgender about HIV Transmission was 2.804±0.32, the mean score of attitudes of transgender were 3.25±0.19 and the mean practice score was 2.931±0.28.Majority of the transgender have insufficient knowledge, and bad attitude towards their health. They have unsafe sexual practice and Drug Interventions playing a significant role in HIV epidemic. Majority of them are uneducated, unemployed and found sex selling and dancing an easiest way of earning. Their knowledge about HIV screening, transmission, and antiretroviral therapy is low.

scholarly journals Clinical Signs and Laboratory Parameters as Predictors of Mortality among Hospitalized Human Immunodeficiency Virus-Infected Adult Patients at Tertiary Hospital in Surabaya

2021 ◽  
Vol 9 (B) ◽  
pp. 497-502
Author(s):  
Rentha Monica Simamora ◽  
Muhammad Vitanata Arfijanto ◽  
Musofa Rusli ◽  
Budi Utomo ◽  
Cennikon Pakpahan ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Multivariate Analysis ◽  
Platelet Count ◽  
Liver Enzymes ◽  
Clinical Signs ◽  
Tertiary Hospital ◽  
Bivariate Analysis ◽  
Elevated Liver Enzymes ◽  
Immunodeficiency Virus ◽  
Hiv Aids

BACKGROUND: The morbidity and mortality rates due to human immunodeficiency virus (HIV) infection are still high despite various and advanced efforts in the management given for HIV/AIDS patients. AIM: This study proposed that clinical signs and laboratory parameters could be expected to predict the patient’s mortality. METHODS: This retrospective study was done by collecting 408 medical records of adult HIV/AIDS inpatients at a tertiary hospital in Surabaya from January 1, 2017, to December 31, 2019. Bivariate analysis using Chi-square test was carried out on nine variables, which were Glasgow Coma Scale (GCS) <15, hypotension, PaO2/FiO2 <400 mmHg, elevated liver enzymes, hemoglobin levels <10 mg/dl, platelet count <150,000/mm3, eGFR <60 ml/min/1.73 m2, albumin levels <3.5 mg/dl, and body mass index (BMI) <18.5 kg/m2. Variables which met the criteria would be included in the multivariate analysis using logistic regression. RESULTS: Based on bivariate analysis, mortality was found to be significantly associated with GCS <15, hypotension, PaO2/FiO2, elevated liver enzymes, platelet count <100,000 mm3, eGFR <60 ml/1.73kg/m2, albumin levels <3.5 mgdl, and BMI <18.5 kg/m2. However, based on multivariate analysis, there were five variables which were found to be able to independently predict the patients’ mortality, those were GCS <15 (OR 11.625), hypotension (OR 6.062), PaO2/FiO2< 400 mmHg (OR 7.794), eGFR <60 ml/min/1.73 m2 (OR 2.646), and albumin levels <3.5 mg/dl (OR 4.091). CONCLUSION: GCS <15, hypotension, PaO2/FiO2 <400 mmHg, eGFR <60 ml/1.73g/m2, and albumin levels <3.5 mg/dl were found as the independent risk factors which could predict the hospitalized HIV/AIDS patients’ mortality.

Study of the Factors that Influence Low-Level Viremias in Human Immunodeficiency Virus Patients in a Tertiary Hospital

2021 ◽  
Vol 30 (1) ◽  
Author(s):  
Andrea Pinilla Rello ◽  
Herminia Navarro Aznárez ◽  
Arantxa Magallón Martínez ◽  
Lucía Cazorla Poderoso ◽  
María Pérez Moreno ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Tertiary Hospital ◽  
Low Level ◽  
Immunodeficiency Virus

Low-Dose Zidovudine in Children With an Human Immunodeficiency Virus Type 1 Infection Acquired in the Perinatal Period

PEDIATRICS ◽  
1991 ◽  
Vol 88 (2) ◽  
pp. 364-370
Author(s):  
Stephane Blanche ◽  
Anne-Marie Duliege ◽  
Marianne Debré ◽  
Claude Griscelli ◽  
Maria Soledad Navarette ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Human Immunodeficiency Virus Type ◽  
Virus Type ◽  
Low Dose ◽  
Initial Therapy ◽  
Full Dose ◽  
Dose Therapy ◽  
Immunodeficiency Virus ◽  
The Mean

This report describes the one-year results of a noncomparative study designed to assess the safety and tolerance of low-dose zidovudine (azidothymidine) given orally to 60 human immunodeficiency virus type 1-infected infants and children. At baseline, the mean age was 1.9 years (±1.4), and all were symptomatic: 43% were P2A and 57% were P2B to F according to the Centers for Disease Control classification. All the patients received zidovudine for at least 6 months, and 52 of them (87%) completed a full year of therapy. The mean duration of follow-up was 346 days (±42) (range, 183 to 366 days). The initial therapy consisted of four daily doses of 100 mg/m2 (400 mg/m2 per day, equivalent to 20 mg/kg per day). However, this treatment was modified when neutropenia or anemia was observed. Twenty-nine children (48%) remained at the initial therapy for the entire study. Zidovudine dosage was adjusted 92 times in the other 31 children (52%), mostly due to neutropenia (83%). Altogether, the time under full-dose therapy represented 81% of the total duration of the protocol for all patients. Children with mild symptoms, P2A at study entry, were more likely to remain under full-dose therapy than children with severe symptoms, P2B to F: the time under full-dose therapy represented 91% of the duration of the protocol for the former group and only 74% for the latter one (P &lt; .02). No clinical adverse experiences were attributed directly to zidovudine. Thirty-seven children were prescribed trimethoprim-sulfametoxazole as a prophylaxis for Pneumocystis carinii pneumonia. In a multivariate analysis, this comedication had no influence on the hematologic tolerance of zidovudine.

scholarly journals Pharmacokinetics of zidovudine after rectal administration in human immunodeficiency virus-infected patients.

1997 ◽  
Vol 41 (5) ◽  
pp. 1143-1145 ◽  
Author(s):  
U Wintergerst ◽  
B Rolinski ◽  
J R Bogner ◽  
G Notheis ◽  
F D Goebel ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Oral Intake ◽  
Pharmacokinetic Profile ◽  
Rectal Administration ◽  
Beta Phase ◽  
Time Curve ◽  
Concentration Time ◽  
Release Device ◽  
Immunodeficiency Virus ◽  
The Mean

We evaluated the pharmacokinetics of rectally administered zidovudine (ZDV) in 10 human immunodeficiency virus-infected adults. After rectal administration of an aqueous ZDV solution (250 mg of ZDV), mean peak ZDV levels were 1.3 +/- 0.7 micromol/liter (mean +/- standard deviation) versus 5.0 +/- 2.2 micromol/liter (P < 0.0001) after oral intake of a 250-mg ZDV capsule. The half-life at beta phase was 87.8 +/- 39.6 min for rectally administered ZDV versus 55.8 +/- 20.1 min (P = 0.035) for orally administered ZDV. The mean area under the concentration-time curve from 0 min to infinity was 232 +/- 181 micromol/liter x min after rectal administration versus 362 +/- 110 micromol/liter x min after oral intake. Although the two routes were not bioequivalent, ZDV was absorbed considerably after rectal administration, with a pharmacokinetic profile resembling that of a sustained-release device.

scholarly journals Steady-State Pharmacokinetics of Amprenavir Coadministered with Ritonavir in Human Immunodeficiency Virus Type 1-Infected Patients

2003 ◽  
Vol 47 (1) ◽  
pp. 118-123 ◽  
Author(s):  
Cecile Goujard ◽  
Isabelle Vincent ◽  
Jean-Luc Meynard ◽  
Nathalie Choudet ◽  
Diane Bollens ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Steady State ◽  
Human Immunodeficiency Virus Type ◽  
Virus Type ◽  
Time Curve ◽  
Concentration Time ◽  
Immunodeficiency Virus ◽  
The Mean ◽  
Hiv 1

ABSTRACT The protease inhibitor (PI) ritonavir is used as a strong inhibitor of cytochrome P450 3A4, which boosts the activities of coadministered PIs, resulting in augmented plasma PI levels, simplification of the dosage regimen, and better efficacy against resistant viruses. The objectives of the present open-label, multiple-dose study were to determine the steady-state pharmacokinetics of amprenavir administered at 600 mg twice daily (BID) and ritonavir administered at 100 mg BID in human immunodeficiency virus type 1 (HIV-1)-infected adults treated with different antiretroviral combinations including or not including a nonnucleoside reverse transcriptase inhibitor (NNRTI). Nineteen patients completed the study. The steady-state mean minimum plasma amprenavir concentration (C min,ss) was 1.92 μg/ml for patients who received amprenavir and ritonavir without an NNRTI and 1.36 μg/ml for patients who received amprenavir and ritonavir plus efavirenz. For patients who received amprenavir-ritonavir without an NNRTI, the steady-state mean peak plasma amprenavir concentration (C max,ss) was 7.12 μg/ml, the area under the concentration-time curve from 0 to 10 h (AUC0-10) was 32.06 μg · h/ml, and the area under the concentration-time curve over a dosing interval (12 h) at steady-state (AUCss) was 35.74 μg · h/ml. Decreases in the mean values of C min,ss (29%), C max,ss (42%), AUC0-10 (42%), and AUCss (40%) for amprenavir occurred when efavirenz was coadministered with amprenavir-ritonavir. No unexpected side effects were observed. As expected, coadministration of amprenavir with ritonavir resulted in an amprenavir C min,ss markedly higher than those previously reported for the marketed dose of amprenavir. When amprenavir-ritonavir was coadministered with efavirenz, amprenavir-ritonavir maintained a mean amprenavir C min,ss above the mean 50% inhibitory concentration of amprenavir previously determined for both wild-type HIV-1 isolates and HIV-1 strains isolated from PI-experienced patients. These data support the use of low-dose ritonavir to enhance the level of exposure to amprenavir and increase the efficacy of amprenavir.

scholarly journals Renal Echogenicity as a Predictor of Human Immunodeficiency Virus–Associated Nephropathy: A Cross-Sectional Study at a Tertiary Hospital in Lagos, Southwest Nigeria

2018 ◽  
Vol 34 (4) ◽  
pp. 261-272
Author(s):  
Cletus Uche Eze ◽  
Charles Ugwoke Eze ◽  
Adekunle A. O. Adeyomoye
Keyword(s):  
Human Immunodeficiency Virus ◽  
Serum Creatinine ◽  
Area Under The Curve ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Cd4 Count ◽  
Cross Sectional ◽  
Immunodeficiency Virus ◽  
Southwest Nigeria ◽  
Grade 3

The objective of this study was to determine the accuracy of sonography in a human immunodeficiency virus–associated nephropathy (HIVAN) diagnosis. A sample of 340 HIVAN patients underwent laboratory CD4+ count, serum creatinine/glomerular filtration rate (GFR) estimation, and sonographic echogenicity grading. The accuracy of sonography in predicting an HIVAN diagnosis was calculated. Mean CD4+ count, serum creatinine, and GFR for male and female HIVAN patients was 153.1 ± 103.2 cells/mm3 and 121.9 ± 91.0 cells/mm3, 218.4 ± 147.4 mmol/L and 222.0 ± 150.4 mmol/L, and 50.1 ± 23.6 mL/min/1.73 m2 and 39.3 ± 20.6 mL/min/1.73 m2, respectively; 56.9% of patients had echogenicity grade 3. On the basis of CD4+ count, serum creatinine, and GFR, the area under the curve was 0.76 and ≈ 1, respectively; the area under the curve was 0.63, 0.79, 0.70, 0.79 and 0.91, 0.99, 1, 1 for grades 0, 1, 2, and 3 echogenicity, respectively. With a high level of apathy to voluntary HIV/AIDS screening and late patient presentation, sonography (grade 3 renal echogenicity) can assist in predicting an HIVAN diagnosis.

scholarly journals Single-Dose Pharmacokinetics and Safety of Abacavir (1592U89), Zidovudine, and Lamivudine Administered Alone and in Combination in Adults with Human Immunodeficiency Virus Infection

1999 ◽  
Vol 43 (7) ◽  
pp. 1708-1715 ◽  
Author(s):  
Laurene H. Wang ◽  
Gregory E. Chittick ◽  
James A. McDowell
Keyword(s):  
Human Immunodeficiency Virus ◽  
Adverse Events ◽  
Nucleoside Analogs ◽  
Neck Stiffness ◽  
Time Curve ◽  
Pharmacokinetic Interactions ◽  
Immunodeficiency Virus ◽  
The Mean ◽  
Clinically Significant ◽  
Hiv 1

ABSTRACT Abacavir (1592U89), a nucleoside reverse transcriptase inhibitor with in vitro activity against human immunodeficiency virus type-1 (HIV-1), has been evaluated for efficacy and safety in combination regimens with other nucleoside analogs, including zidovudine (ZDV) and lamivudine (3TC). To evaluate the potential pharmacokinetic interactions between these agents, 15 HIV-1-infected adults with a median CD4+ cell count of 347 cells/mm3 (range, 238 to 570 cells/mm3) were enrolled in a randomized, seven-period crossover study. The pharmacokinetics and safety of single doses of abacavir (600 mg), ZDV (300 mg), and 3TC (150 mg) were evaluated when each drug was given alone or when any two or three drugs were given concurrently. The concentrations of all drugs in plasma and the concentrations of ZDV and its 5′-glucuronide metabolite, GZDV, in urine were measured for up to 24 h postdosing, and pharmacokinetic parameter values were calculated by noncompartmental methods. The maximum drug concentration (C max), the area under the concentration-time curve from time zero to infinity (AUC0–∞), time to C max(T max), and apparent elimination half-life (t 1/2) of abacavir in plasma were unaffected by coadministration with ZDV and/or 3TC. Coadministration of abacavir with ZDV (with or without 3TC) decreased the meanC max of ZDV by approximately 20% (from 1.5 to 1.2 μg/ml), delayed the median T max for ZDV by 0.5 h, increased the mean AUC0–∞ for GZDV by up to 40% (from 11.8 to 16.5 μg · h/ml), and delayed the medianT max for GZDV by approximately 0.5 h. Coadministration of abacavir with 3TC (with or without ZDV) decreased the mean AUC0–∞ for 3TC by approximately 15% (from 5.1 to 4.3 μg · h/ml), decreased the meanC max by approximately 35% (from 1.4 to 0.9 μg/ml), and delayed the median T max by approximately 1 h. While these changes were statistically significant, they are similar to the effect of food intake (for ZDV) or affect an inactive metabolite (for GZDV) or are relatively minor (for 3TC) and are therefore not considered to be clinically significant. No significant differences were found in the urinary recoveries of ZDV or GZDV when ZDV was coadministered with abacavir. There was no pharmacokinetic interaction between ZDV and 3TC. Mild to moderate headache, nausea, lymphadenopathy, hematuria, musculoskeletal chest pain, neck stiffness, and fever were the most common adverse events reported by those who received abacavir. Coadministration of ZDV or 3TC with abacavir did not alter this adverse event profile. The three-drug regimen was primarily associated with gastrointestinal events. In conclusion, no clinically significant pharmacokinetic interactions occurred between abacavir, ZDV, and 3TC in HIV-1-infected adults. Coadministration of abacavir with ZDV or 3TC produced mild changes in the absorption and possibly the urinary excretion characteristics of ZDV-GZDV and 3TC that were not considered to be clinically significant. Coadministration of abacavir with ZDV and/or 3TC was generally well tolerated and did not produce unexpected adverse events.

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