scholarly journals Spectrum of opportunistic infections in relation to CD4 counts in HIV/AIDS patients admitted in the department of general medicine of a tertiary care hospital

2019 ◽  
Vol 6 (3) ◽  
pp. 845
Author(s):  
Deepak Pandharpurkar ◽  
Nagender Devulapally ◽  
B. Gouthami ◽  
Gudikandula Krishna
Keyword(s):  
Cell Count ◽  
Opportunistic Infections ◽  
Tertiary Care ◽  
Pneumocystis Carinii ◽  
Fatal Outcome ◽  
Care Hospital ◽  
Becton Dickinson ◽  
Cell Counts ◽  
Cd4 Cell ◽  
Hiv Aids

Background: HIV/AIDS was first recognized in USA in 1981 when centre for disease control (CDC) reported unexplained occurrence of Pneumocystis carinii pneumonia in 5 healthy homosexuals. Soon it was recognized in drug abusers and blood transfusion recipients. The present study has been taken up with an aim to know the incidence of various opportunistic infections in HIV positive patients and to correlate different opportunistic infections (OIs) with the CD4+cellcount.Methods: Sample of 132 cases admitted in Gandhi hospital during the study period were taken. CD4+ counting of blood samples was done by Flow cytometry as per manufacturer’s instructions (FACS Calibur, Becton- Dickinson, Immunocytometry system). Correlation of CD4 cell counts was done with the respective opportunistic infections.Results: TB (50%) is the most frequent OI followed by candidiasis (49%), pneumocystis (16%) and others. The mean CD4 cell count in TB was 110.80/mL and in candidiasis 97.84/mL. Low values were observed in CMV (27/mL) and in toxoplasmosis (61.66/mL).Conclusions: In most of the patient’s respiratory system was the most common system involved by OIs and had CD4 T cell count below 200/mL. Early diagnosis and prompt treatment of opportunistic infections is important. This study helps the clinicians in proper guidance to come up before development of severe immunodeficiency to prevent serious and fatal outcome.

scholarly journals CD4 T Cell Count in Newly diagnosed PTB Patients With Reference to their HIV Sero status

2017 ◽  
Vol 15 (2) ◽  
pp. 32-39
Author(s):  
Piyush Rajbhandari ◽  
Shyamal Kumar Bhattacharya ◽  
Rajendra Gurung ◽  
Nimesh Poudyal ◽  
Bickram Pradhan
Keyword(s):  
T Cells ◽  
Cell Count ◽  
Tertiary Care ◽  
Healthy Population ◽  
Care Hospital ◽  
National Guidelines ◽  
Infected Population ◽  
Cell Counts ◽  
The Mean ◽  
Cd4 Cell

Introduction: CD4 and CD8 T cells facilitate the containment of tuberculosis (TB) and has been postulated that there will be changes in their level in patients with TB. This study was carried out to analyze the CD4 cell counts in pulmonary tuberculosis (PTB) patients with reference to their HIV status.Methods: A cross-sectional study was conducted at the Department of Microbiology of a tertiary care hospital of eastern Nepal from May 2012 to April 2013. A total of 160 individuals, 40 each in the PTB, PTB/HIV, HIV and healthy population were included after obtaining informed consent. PTB and HIV diagnosis was made according to national guidelines. CD4 T cells were analyzed using a BD FACS Count Cytometer. Data were entered in Microsoft Excel 2007 and analyzed using SPSS version 11.7.Results: The mean absolute CD4 cells in PTB patient were 562.20 ± 197.3 cells/ul, which was a clear reduction (p < 0.001) when compared to the healthy population of this area (786.30 ± 239.17 cells/ul). There was significant decrease in the CD4 level among the HIV/TB patient (123.70 ± 99.4 cells/ul) as compared to PTB patient without HIV (p < 0.001). The study also noted that the mean CD4 cell level among HIV infected population (249.68 cells/ul) was higher compared to the HIV/TB co-infected population (p < 0.05).Conclusion: CD4 cell count can reflect the degree of immunosuppression in PTB patient irrespective of their HIV status but it cannot predict the disease severity in PTB patient.  

Homelessness among an inpatient HIV-positive cohort at a tertiary care hospital in central London

2020 ◽  
Vol 31 (7) ◽  
pp. 705-707
Author(s):  
Venkateshwaran Sivaraj ◽  
Rudiger Pittrof ◽  
Olubanke Davies ◽  
Ranjababu Kulasegaram
Keyword(s):  
Bacterial Infections ◽  
Substance Misuse ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Hiv Positive ◽  
Care Hospital ◽  
Hiv Viral Load ◽  
Cd4 Cell Count ◽  
Cell Counts ◽  
Cd4 Cell

A cohort review was conducted at a central London tertiary care hospital trust on the prevalence of homelessness among human immunodeficiency virus (HIV)-positive inpatients over a year. Data were collected on the duration of inpatient stay, co-morbidities including acquired immune deficiency syndrome (AIDS)-defining illnesses, co-infections, initiation of antiretroviral therapy, CD4 cell count, HIV viral load and substance misuse. Homeless people were found to be at high risk for hepatitis C, mental health illness, substance misuse including injecting drug use, recurrent bacterial infections, AIDS-associated illnesses, lower CD4 cell counts and HIV viremia. They also had more missed HIV outpatient appointments. It was highlighted that a multidisciplinary approach in their care was necessary to address their needs and reduce the morbidity burden in this cohort.

Clinical features of HIV/AIDS patients presenting to an inner city clinic in Ho Chi Minh City, Vietnam

2007 ◽  
Vol 18 (7) ◽  
pp. 482-485 ◽  
Author(s):  
Stephen A Klotz ◽  
Hao Cong Nguyen ◽  
Tam Van Pham ◽  
Liem Thanh Nguyen ◽  
Dong Thi Anh Ngo ◽  
...  
Keyword(s):  
Cell Count ◽  
Opportunistic Infections ◽  
Extrapulmonary Tuberculosis ◽  
Pneumocystis Carinii ◽  
Population Data ◽  
World Health ◽  
Ho Chi Minh City ◽  
Cd4 Cell Count ◽  
To Come ◽  
Cd4 Cell

An outpatient HIV clinic was opened in March 2005 in Binh Thanh District, a poor section of Ho Chi Minh City, Vietnam. Over 1500 patients were seen in the first year. The average age of patients was 27 years. Men represented 77% of the clinic population, women, 23% and children under the age of 16 years of age, 5% of the population. The most common risk factor among men was being an injecting drug user (IDU), 76%, and among women, being married to an IDU HIV-positive man, 35%. Physical signs of disease were uncommon: lymphadenopathy in 24% and hepatomegaly and splenomegaly in 4% and 3%, respectively. Men and women were anaemic at presentation, with a mean haemoglobin of 11.9 g/dL and 11.1 g/dL, respectively. An overwhelming majority of patients had profound immunodeficiency. The mean CD4+ cell count was 164 cells/mL and the median was 69 cells/mL. No correlation was found between the World Health Organization's stage of disease and the CD4+ cell count. Thus, the former is a poor predictor of immunity in this population. Data regarding opportunistic infections diagnosed at the first visit were studied. Candidiasis of the oral pharynx, oesophagus or vagina was found in 34.5% of the patients, and pulmonary and extrapulmonary tuberculosis was found in 32% of the patients. Pneumocystis carinii pneumonia (PCP) was diagnosed in only 3% of the patients. Cotrimoxazole prophylaxis is advocated for HIV-infected Vietnamese, but the incidence of PCP is negligible and resources could be spent elsewhere. The various opportunistic infections seen in this resource-poor clinic setting is likely to be a pattern of presentation of HIV-infected Vietnamese for some time to come.

scholarly journals Immunologic biomarkers, morbidity and mortality among HIV patients hospitalised in a Tertiary Care Hospital in the Brazilian Amazon

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wellington Mota Gama ◽  
Carlos Henrique Michiles Frank ◽  
Taynná Vernalha Rocha Almeida ◽  
Daniel Silva dos Santos ◽  
Yury Oliveira Chaves ◽  
...  
Keyword(s):  
Platelet Activation ◽  
Opportunistic Infections ◽  
Tertiary Care ◽  
Enzyme Linked Immunosorbent Assay ◽  
People Living With Hiv ◽  
Care Hospital ◽  
Aids Patients ◽  
Distribution Width ◽  
Advanced Immunosuppression ◽  
Hiv Aids

Abstract Background The irregular use of antiretroviral therapy (ART) and late diagnosis still account for a large part of HIV-associated mortality in people living with HIV (PLHIV). Herein, we describe HIV-associated morbidity among hospitalised HIV/AIDS patients with advanced immunosuppression and assess the comorbidities, laboratory parameters, and immunological markers associated with mortality. Methods The cross-sectional study was conducted at the Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD) in Manaus, Brazil. In all, 83 participants aged between 12 and 70 years were enrolled by convenience within 72 h of their hospitalisation. Clinical and laboratory data were obtained from electronic medical records. We prospectively measured the cytokines Th1/Th2/Th17 and inflammatory cytokines IL-8, IL-1β, and IL-12 using cytometric bead array, and the soluble CD14 using in-house enzyme-linked immunosorbent assay. Results The HIV/AIDS inpatients presented a scenario of respiratory syndromes as the most prevalent comorbidity. Almost all patients had CD4 T counts below 350 cells/mL and the mortality rate was 20.5%. Pulmonary tuberculosis, neurotoxoplasmosis and oropharyngeal–esophageal candidiasis were the most prevalent opportunistic infections. TB and weight loss were more prevalent in HIV/AIDS inpatients who died. The Mann Whitney analysis showed that those who died had higher platelet distribution width (PDW) on admission, which is suggestive for platelet activation. The Poisson multivariate analysis showed the prevalence of TB, digestive syndrome and increases in IL-8 and lactate dehydrogenase (LDH) associated to death. Conclusions The advanced immunosuppression characterized by the opportunistic infections presented in these HIV/AIDS inpatients was the major factor of mortality. The role of platelet activation in worse outcomes of hospitalisation and the IL-8 associated with the context of advanced immunosuppression may be promising markers in the prediction of mortality in HIV/AIDS patients.

scholarly journals Spectrum of Opportunistic Fungal Infections in HIV/AIDS Patients in Tertiary Care Hospital in India

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Ravinder Kaur ◽  
Megh S. Dhakad ◽  
Ritu Goyal ◽  
Preena Bhalla ◽  
Richa Dewan
Keyword(s):  
Fungal Infections ◽  
Tertiary Care ◽  
North India ◽  
Clinical Samples ◽  
Fungal Culture ◽  
Care Hospital ◽  
Aids Patients ◽  
Cell Counts ◽  
Fungal Isolates ◽  
Hiv Aids

HIV related opportunistic fungal infections (OFIs) continue to cause morbidity and mortality in HIV infected patients. The objective for this prospective study is to elucidate the prevalence and spectrum of common OFIs in HIV/AIDS patients in north India. Relevant clinical samples were collected from symptomatic HIV positive patients (n=280) of all age groups and both sexes and subjected to direct microscopy and fungal culture. Identification as well as speciation of the fungal isolates was done as per the standard recommended methods. CD4+T cell counts were determined by flow cytometry using Fluorescent Activated Cell Sorter Count system. 215 fungal isolates were isolated with the isolation rate of 41.1%.Candidaspecies (86.5%) were the commonest followed byAspergillus(6.5%),Cryptococcus(3.3%),Penicillium(1.9%), andAlternariaandRhodotorulaspp. (0.9% each). AmongCandidaspecies,Candida albicans(75.8%) was the most prevalent species followed byC. tropicalis(9.7%),C. krusei(6.4%),C. glabrata(4.3%),C. parapsilosis(2.7%), andC. kefyr(1.1%). Study demonstrates that the oropharyngeal candidiasis is the commonest among different OFIs and would help to increase the awareness of clinicians in diagnosis and early treatment of these infections helping in the proper management of the patients especially in resource limited countries like ours.

Perioperative outcomes in human immunodeficiency virus-infected patients – the PRO HIV study

2018 ◽  
Vol 29 (10) ◽  
pp. 968-973 ◽  
Author(s):  
Divyashree Shanthamurthy ◽  
Abi Manesh ◽  
Naveena GP Zacchaeus ◽  
Lisa R Roy ◽  
Priscilla Rupali
Keyword(s):  
Surgical Procedures ◽  
Median Duration ◽  
Surgical Outcomes ◽  
Surgical Outcome ◽  
Tertiary Care ◽  
Perioperative Outcomes ◽  
Care Hospital ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Cd4 Cell

It is estimated that a quarter of patients with HIV/AIDS undergo at least one surgical procedure in their life time. Surgical outcomes in these patients from developing countries are poorly characterized and surgeons are often concerned about poor surgical outcomes, especially when their CD4 cell counts are less than 200 cells/µl. This study evaluated the surgical outcomes of HIV-infected patients undergoing various surgical procedures over a six-year period in a large tertiary care hospital from South India. Two hundred and ninety-three patients underwent 374 surgical procedures during the study period. The median duration of HIV prior to surgery was 1.9 years (range 0–18.8 years). Two-thirds (58%) were on highly active antiretroviral therapy (HAART) at the time of surgery with the median duration of this treatment being 38 months (n = 194). About one-third (35%) of surgical procedures were performed as an emergency. Abdomino-pelvic surgeries were the most common (225, 60%). Adverse surgical outcome defined as death or post-operative infection was seen in 25 (6.6%). The post-operative infection rate was 5% (20/374). The most common of these was surgical site infection observed in nine (60%) followed by pneumonia in five patients (33%) and urinary tract infection in one patient. Day 30 mortality was 2% (n = 8) and a quarter of these were reported to be related to post-operative infectious complications. On multivariate analysis, only preoperative haemoglobin of less than 10 g/dl was significantly associated with a poor surgical outcome. HIV-related parameters such as CD4 cell counts, duration of HIV infection and HAART regimen did not seem to contribute towards an adverse surgical outcome.

scholarly journals Immunologic Biomarkers, Morbidity and Mortality Among HIV Patients Hospitalized in a Tertiary Care Hospital in the Brazilian Amazon

2020 ◽  
Author(s):  
Wellington Gama Mota ◽  
Taynná Vernalha Rocha Almeida ◽  
Daniel Silva dos Santos ◽  
Yury Oliveira Chaves ◽  
Danielle Furtado da Silva ◽  
...  
Keyword(s):  
Opportunistic Infections ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Brazilian Amazon ◽  
Morbidity And Mortality ◽  
People Living With Hiv ◽  
Care Hospital ◽  
Aids Patients ◽  
Laboratory Parameters ◽  
Hiv Aids

Abstract Background: While antiretroviral therapy (ART) has significantly improved survival rates of people living with HIV, some regions in Brazil still show a linear trend of growth in the opportunistic infections that cause HIV-associated mortality. We aimed to describe HIV-associated morbidity and mortality among hospitalized medical patients in a tertiary care hospital in Manaus, in the Brazilian Amazon, by investigating clinical data and immunologic biomarkers in order to assess predictive factors of mortality in this patient group. Methods: We prospectively measured concentrations of cytokines Th1/Th2/Th17 and soluble CD14 (sCD14) and reviewed the laboratory parameters and opportunistic infections in outcomes of either death or discharge of eighty-three HIV/AIDS patients who were admitted in 2017-2018 to the Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD) in Manaus. Results: The mortality in the sample studied was 20.5%. Tuberculosis (TB) showed a relative risk (RR) =1.86 (confidence interval (CI) 1.14 to 2.81: and p = 0.026), and weight loss was the symptom (RR=1.81; CI: 1.21 to 2.53 and p = 0.007) most highly associated with the death outcome in HIV/AIDS inpatients. Univariable analyses showed that the eosinophil count, platelet distribution width (PDW), and alanine aminotransferase were the only laboratory parameters that differed among patients who died. In relation to cytokines and sCD14 levels, no differences were found between those who died or were discharged. A multivariable logistic regression model was used to predict mortality and showed that individuals with no digestive syndrome (especially the absence of oropharyngeal candidiasis), nor TB are 63% to 76% less likely to die, respectively. In addition, increases in PDW values also decreased the probability of death. Curiously, patients who were discharged showed a trend towards a concomitant increase in PDW and mean platelet volume (MPV) in relation to those who died.Conclusions: Opportunistic infections continue to be major events in morbidity and mortality of HIV/AIDS patients, and the relationship between increased PDW and the likelihood of survival suggests the need for future studies on innate immune response of platelets in HIV/AIDS inpatients.

scholarly journals Clinical and Socio demographic profile of attendees at ART centre in a tertiary care hospital in Mangalore, India

2015 ◽  
Vol 6 (5) ◽  
pp. 61-65
Author(s):  
U.B. Nayak ◽  
S. Lenka ◽  
B. Achappa
Keyword(s):  
Opportunistic Infections ◽  
Oral Candidiasis ◽  
Tertiary Care ◽  
Local Context ◽  
People Living With Hiv ◽  
Care Hospital ◽  
Heterosexual Contact ◽  
Presenting Symptoms ◽  
Number Of Patients ◽  
Hiv Aids

Introduction: India has the third largest number of people living with HIV/AIDS. There is a need to study the profile of patients who come to ART centers and link their clinical and socio-demographic variables in the management. Moreover, it is important to understand the presentation of HIV disease in the local context and culture. The present study is aimed at identifying the socio-demographic characteristics, clinical presentations of HIV/AIDS patients, opportunistic infections and the possible risk factors for acquiring HIV infection at an ART centre of Government Wenlock hospital, situated in Karnataka state of India. Materials and Methods: In this study 102 HIV patients attending the HIV clinic were enrolled and they were followed for a period of one year with relevant investigations.Results: Of 102 patients 69 were males and 33 were females.The mean age of the study subjects at the time of diagnosis was 38.06. Heterosexual contact was the commonest mode of transmission in96 (94.12%) patients. History suggestive of a risk factor for HIV transmission could not be elicited in 4 (3.92%) patients. Fever (71.5%), weight loss (62.74%), cough (51.96%) and chronic diarrhea (43.9%) were the common presenting symptoms. The most common opportunistic infection was oral candidiasis (66.67%) followed bytuberculosis (22.54%) and pneumocystis pneumonia (13.72%). Significant number of patients (30.37%) developed Zidovudine induced anemia and females were more prone for Zidovudine induced anemia as compared to males. CD4 counts of the patients were significantly inversely correlated with the number of symptoms and the number of opportunistic infections. Conclusion: Majority of patients were of low socioeconomic status and in productive age group with heterosexual contact being commonest mode of transmission.Significant number of patients developed Zidovudine induced anemia and females were more prone. DOI: http://dx.doi.org/10.3126/ajms.v6i5.11622Asian Journal of Medical Sciences Vol.6(5) 2015 61-65

scholarly journals Protein Status and CD4+ Cell Count in HIV Patients on Highly Active Anti-Retroviral Therapy

2019 ◽  
pp. 10-14
Keyword(s):  
Cell Count ◽  
Total Protein ◽  
Opportunistic Infections ◽  
Hiv Patients ◽  
Cd4 Cell Count ◽  
Highly Active ◽  
Protein Status ◽  
Cell Counts ◽  
Cd4 Cell

Background of Study: Malnutrition is associated with repeated opportunistic infections, rapid disease progression, and an increase in the incidence of human immunodeficiency virus (HIV) related mortality. The ability of anti-retroviral therapy (ART) in boosting the immune system depends on the nutritional status of the HIV patient. Aim: The study aimed at investigating the protein status and CD4+ cell counts in HIV patients taking highly active ART. Materials and Methods: The case-control study comprising of a total of 80 participants, compared the protein status and CD4+ cell count among baseline (ART-naïve n=20), switch (ART-resistant n=20), ART follow-up (n=20) patients, and apparently healthy controls (n=20). Results: The total protein of baseline patients was significantly (P<0.01) higher than that of the switch, follow-up, and controls. The CD4+ cell count of baseline patients was significantly (P=0.000) low compared to follow-up patients and controls. Total protein level and CD4+ cell count of switch patients were significantly (P=0.000) lower than that of follow-up patients and controls. Total protein of follow-up patients was significantly (P<0.02) higher than that of controls, while the CD4+ cell count of follow-up patients was significantly (P=0.000) lower than that of controls. Conclusion: The present study observed low protein along with low CD4+ cell count in switch patients, while a good outcome was observed in follow up patients.

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