scholarly journals Homocysteine Levels in Patients with Human Immunodeficiency Virus and Acquired Immunodeficiency Syndrome in Ibadan

2020 ◽  
Vol 7 (02) ◽  
pp. 4739-4745
Author(s):  
TOLULASE OLUTOGUN ◽  
FOLUKE FASOLA ◽  
Kehinde Olufemi-Aworinde ◽  
YETUNDE AKEN'OVA
Keyword(s):  
Risk Factors ◽  
Full Blood Count ◽  
Hiv Positive ◽  
Control Group ◽  
College Hospital ◽  
Cell Counts ◽  
Increased Risk ◽  
Objective Evidence ◽  
Cd4 Cell ◽  
Hiv Negative

Introduction: Homocysteine is produced from the conversion of methionine to cysteine. Conditions resulting in hyper homocysteinemia leads to an increased risk of both arterial and venous thromboembolisms by about 2 fold. 20% of HIV infected patients with objective evidence of venous thromboembolism are found to be thrombophilic with higher homocysteine levels. We enquired into homocysteine levels prior to the development of a clinical evidence of a venous thrombus in both HAART naïve and those on HAART of HIV /AIDS population. We evaluated the association between homocysteine, CD4 lymphocyte count and ART use in order to identify possible risk factors for hyper homocysteinemia in HIV population. Method: Employing a cross sectional design; we compared mean plasma levels of homocysteine, full blood count parameters and CD4+ lymphocytes counts in HIV positive patients and HIV negative controls. One hundred and twenty patients with HIV infection attending the APIN clinic at the University College Hospital Ibadan and St Mary’s Catholic Hospital Eleta Ibadan and one hundred and twenty-six HIV negative healthy controls were compared in the study. Results:  Fifty-nine point one percent of the HIV positive patient had hyperhomocysteinemia i.e. homocysteine levels of >18µmol/l. The mean plasma homocysteine levels were significantly higher at 24.4µmol/l (SD=13.8) (CI -2 to -8; p=0.002) in the HIV positive group compared with 19.5µmol/L (SD=10.6) in the control group.  The use of Anti-retroviral drugs was not associated with higher homocysteine level in the seropositive group and neither were factors like age, gender or the use of combined oral contraceptive pills. There was no correlation between CD4 cell count and homocysteine levels (r= -0.01; p=0.9). Conclusion:  Homocysteine levels are elevated in HIV positive patients and hyperhomocysteinemia was found in a significant number of HIV positive patients. None of the patients investigated had features of thromboembolism or outright deep venous thrombosis. Neither CD4 cell counts nor traditional risk factors were associated with the higher homocysteine levels.

scholarly journals Toxoplasmosis Among HIV Patients and Healthy Volunteers in Port Harcourt, Rivers State, Nigeria

2020 ◽  
Vol 7 (2) ◽  
Author(s):  
Evelyn O Onosakponome ◽  
Austin E Abah ◽  
Michael Wogu
Keyword(s):  
Risk Factors ◽  
Healthy Volunteers ◽  
Hiv Positive ◽  
Hiv Patients ◽  
Aids Patients ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Port Harcourt ◽  
Cd4 Cell ◽  
Hiv Aids

Background: Toxoplasmosis is a serious infection, especially among the immune-compromised people such as HIV/AIDS patients. Objectives: This study assessed the seroprevalence and associated risk factors of toxoplasmosis among HIV patients and healthy volunteers or immuno-competent persons (IP) in Port Harcourt. Methods: A total of 400 (200 per group) randomly-selected sera were tested for IgG and IgM T. gondii antibodies using ELISA technique. CD4 cell counts were also determined. Demographic and risk factors were determined using a well-structured questionnaire. Results: Overall seroprevalence for HIV and IP using IgG and IgM toxoplasma antibodies was 36.0%, 21.5%, and 1.5%, 7.0%, respectively. The age group f 40 years and above had the highest seroprevalence of 25.3% among the HIV positive persons, while the age groups 25 - 29 years had the highest seroprevalence of 20.0% among the IP. Traders’ positive with HIV had the highest seroprevalence of 30.0% and 0.9% for IgG and IgM toxoplasma antibodies, respectively. HIV subjects with a secondary education showed the highest seroprevalence of 20.0%. More HIV positive females were infected with toxoplasmosis 18.5%. In all, 6.7% (P > 0.05) of the seropositive patients had CD4 cell counts of less than 200 cells/µL, indicating no correlation between seroprevalence and CD4 cell counts of HIV/AIDS patients. Risk factors in this study included the history of living with pets, farming and eating improperly-washed fruits and vegetables. Conclusions: Seroprevalence of Toxoplasmosis was high among HIV patients in Port Harcourt. It is suggested that the institutions included the Toxoplasmosis test as one of the routine tests for HIV patients.

HPV types, cervical high-grade lesions and risk factors for oncogenic human papillomavirus infection among 3416 Tanzanian women

2020 ◽  
pp. sextrans-2019-054263 ◽  
Author(s):  
Bariki Lawrence Mchome ◽  
Susanne Krüger Kjaer ◽  
Rachel Manongi ◽  
Patricia Swai ◽  
Marianne Waldstroem ◽  
...  
Keyword(s):  
Risk Factors ◽  
Human Papillomavirus ◽  
Quadrivalent Vaccine ◽  
Hiv Positive ◽  
High Grade ◽  
Factors Associated ◽  
Hpv Prevalence ◽  
Hiv Positive Women ◽  
Increased Risk ◽  
Hiv Negative

ObjectiveThe objective of the present study was to assess the prevalence and type-specific distribution of cervical high-risk (HR) human papillomavirus (HPV) among women with normal and abnormal cytology, and to describe risk factors for HR HPV among HIV-positive and HIV-negative women in Tanzania.MethodologyA cross-sectional study was conducted in existing cervical cancer screening clinics in Kilimanjaro and Dar es Salaam. Cervical specimens were obtained from women aged 25–60 years. Samples were shipped to Denmark for cytological examination, and to Germany for HR HPV testing (using Hybrid Capture 2) and genotyping (using LiPaExtra). Risk factors associated with HPV were assessed by multivariable logistic regression analysis.ResultAltogether, 4080 women were recruited with 3416 women contributing data for the present paper, including 609 HIV-positive women and 2807 HIV-negative women. The overall HR HPV prevalence was 18.9%, whereas the HR HPV prevalence in women with high-grade squamous intraepithelial lesions (HSILs) was 92.7%. Among HPV-positive women with HSIL, HPV16 (32.5%) and HPV58 (19.3%) were the the most common types followed by HPV18 (16.7%) and HPV52 (16.7%). Factors associated with HR HPV included younger age, increasing number of partners and early age at first intercourse. Similar risk factors were found among HIV-positive and HIV-negative women. In addition, among HIV-positive women, those with CD4 counts <200 cells/mm3 had an increased risk of HR HPV (OR 2.2; 95% CI 1.2 to 4.8) compared with individuals with CD4 count ≥500 cells/mm3.ConclusionGiven the HPV distribution among Tanzanian women, the current HPV vaccination in Tanzania using quadrivalent vaccine may be considered replaced by the nonavalent vaccine in the future. In addition, appropriate antiretroviral treatment management including monitoring of viremia may decrease the burden of HR HPV in HIV-positive women.

A Study of Pap Smears in HIV-Positive and HIV-Negative Women from a Tertiary Care Center in South India

2019 ◽  
Vol 63 (1) ◽  
pp. 50-55
Author(s):  
Kritika Gupta ◽  
Cheryl Sarah Philipose ◽  
Sharada Rai ◽  
John Ramapuram ◽  
Gagandeep Kaur ◽  
...  
Keyword(s):  
Pap Smear ◽  
Negative Control Group ◽  
Negative Control ◽  
Hiv Positive ◽  
Control Group ◽  
Pap Smears ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Intraepithelial Lesion ◽  
Hiv Negative

Objectives: The aim of this work was to study the spectrum of epithelial abnormalities on Pap smears of HIV-positive women categorized as per the Bethesda System of Reporting Cervical Cytology, to correlate them with CD4 lymphocyte counts, and to compare them with the spectrum of abnormalities seen in a HIV-negative control group. Study Design and Methodology: The present study was a 6-year retrospective study conducted in the Department of Pathology at Kasturba Medical College, Mangalore, which included 150 Pap smears from HIV-positive and HIV-negative women, respectively. The Pap-stained slides of the cases were retrieved and studied. The data collected were tabulated and analyzed. A statistical study was performed using SPSS software. The χ2 test was used to analyze the data and a p value < 0.05 was considered to be significant. Results: Pap smear abnormalities were twice as high in HIV-infected women (12%) as compared with HIV-negative women (6%; p = 0.006, RR = 2). Negative for intraepithelial lesion/malignancy was the most common finding (88%), which was further subdivided into inflammatory, atrophic smear, non-specific, candidiasis, and bacterial vaginitis groups. The percentage of epithelial abnormalities was 12%, including: atypical squamous cells of undetermined significance, 5.55%; atypical squamous cells, cannot exclude HSIL, 16.66%; low-grade squamous intraepithelial lesion, 5.55%; high-grade squamous intraepithelial lesion (HSIL), 61.11%, and squamous cell carcinoma, 11.11%. The highest incidence of intraepithelial lesions in HIV-positive females was in the age group of 34–49 years. CD4 cell counts fell in the range of 200–500 cells/mm3 in most of the HIV-positive patients (68.75%), but was not found to be statistically significant. Conclusion: Routine Pap smear examination is advocated in women with HIV as the prevalence of epithelial cell abnormalities was found to be 12%, which was twice as high as compared to the HIV-negative control group. Although there was no correlation of epithelial cell abnormalities with CD4 counts, a higher rate of the cases with epithelial abnormalities were observed to have CD4 cell counts of 200–500 cells/mm3.

scholarly journals Cardiovascular Diseases Associated Inflammatory Biomarker Levels in a Small Cohort of HIV-1 Infected Patients Deintensificated from Abacavir/Lamivudine/ Dolutegravir to Lamivudine Plus Dolutegravir Running Head: Risk of Cardiovascular Diseases and Abacavir Use

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Be G ◽  
◽  
Lattuada E ◽  
Gibellini D ◽  
Diani E ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Diseases ◽  
Hiv Infection ◽  
Hiv Positive ◽  
Biological Mechanism ◽  
Cvd Risk ◽  
Increased Risk ◽  
Small Cohort ◽  
Hiv 1 ◽  
Hiv Negative

Following the successful introduction of combined Antiretroviral Therapy (cART), a dramatic decrease in viral burden and opportunistic infections along with a consistent increase in life expectancy has been observed in Human Immunodeficiency Virus (HIV) infected patients [1]. This deep change in the HIV disease evolution has determined that HIV positive subjects were effectively monitored for several alterations of many tissue and organs due to HIV chronic disease and antiretroviral treatment for example, cardiovascular system, bone, adipose tissues, kidney and central nervous system represent the major target of these structural and functional damages during HIV infection. In particular, Cardiovascular Diseases (CVD) were considered important clinical complications in the HIV patient and represent a leading cause of death among HIV-positive patients, accounting for approximately 11% of the total deaths in this population [2]; the risk of CVD is higher in HIV positive individuals compared with HIV negative people, and particularly the reported Myocardial Infarction (MI) incidence in cohort study ranges from 3 to 11 cases per 1000 patients a year in HIV- positive individuals against 2 to 7 cases per 1000 patients-years in HIV-negative population [3,4]. Although initial studies indicated a higher prevalence of traditional CVD risk factors in HIV infected population [5,6] as a possible cause, the molecular mechanisms of increased CVD risk in HIV still remain incompletely defined and should be probably attributable to a combination of multiple factors, including both direct and indirect effects of HIV infection on metabolism. Evidence from experimental and observational studies [7,8] in recent years suggested a more important role of HIV itself in contributing to CVD. Endothelial dysfunction due to gp120, Tat and Nef proteins have been identified as a critical link between infection, inflammation, immune activation, atherosclerosis and cardiovascular system. Moreover, ART may play a role in the exacerbation of risk factors for CVD [9]; since the presentation of findings from the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study in 2008 demonstrating a 90% increased risk of MI in HIV- positive individuals receiving ART regimens including Abacavir (ABC), subsequent studies, conducted by FDA [10], GlaxoSmithKline [11] and independent researchers [12], to investigate this risk have yielded conflicting results. Although more recent studies have shown an effective increased risk of CVD associated with use of ABC, many results did not reach statistical significance [13-17]. The absence of a demonstrated underlying biological mechanism for such a risk added interest and confusion about the question, as well as the higher prevalence of risk factors for CVD, such as renal impairment and substance abuse among abacavir recipients; in addition, a recent meta analysis suggests that Relative Risk (RR) for MI is increased within a 6 months exposure to ABC (RR=1.61; 95% confidence interval: 1.48–1.75) and in cART-naive population [18]. While the published evidence remains conflicting and a plausible biological mechanism for this potential association has not yet been identified, in the following study we have tried to verify whether, after introduction of ABC and its discontinuation in the contest of HAART deintensification, common metabolic markers CVD related such as glucose, LDL, HDL, total cholesterol and triglycerides and inflammatory biomarkers such as IL-6 and D-dimer could change in a small cohort of HIV-1 infected patients.

scholarly journals Seroprevalence of IgM and IgG Antibodies to Toxoplasma infection in healthy and HIV-positive adults from Northern Nigeria

2013 ◽  
Vol 7 (05) ◽  
pp. 398-403 ◽  
Author(s):  
Dimie Ogoina ◽  
Geoffrey C Onyemelukwe ◽  
Bolanle O Musa ◽  
Reginald O Obiako
Keyword(s):  
Healthy Adults ◽  
Clinical Staging ◽  
Hiv Positive ◽  
Northern Nigeria ◽  
Toxoplasma Infection ◽  
Cross Sectional ◽  
Cd4 Cell Count ◽  
Cell Counts ◽  
Cd4 Cell ◽  
Hiv Negative

Introduction: We examined the seroprevalence of toxoplasma infection in HIV-negative and -positive adults from Zaria, Northern Nigeria, and assessed its relationship with demographic, clinical, and immunological findings. Methodology: In a six-month cross-sectional study undertaken in 2008, sera of 219 adults, including 111 consecutive HIV-infected adults and 108 healthy HIV-negative adult volunteers from Zaria, Northern Nigeria, were examined for IgG and IgM antibodies to toxoplasma by ELISA.  Clinical characteristics of the HIV-infected patients were documented. Differences in toxoplasma seropositivity between HIV-positive and negative adults were sought. The relationship between toxoplasma seropositivity and variables such as age, sex and antiretroviral (ART) status, as well as HIV clinical staging and CD4 cell counts were also determined. P<0.05 was considered significant. Results: The seroprevalence of toxoplasma infection (IgG positive and or IgM positive) was 32.4% in HIV-negative healthy adults and 38.7% in HIV-infected adults (P>0.05).  The rate of IgM seropositivity was 4.6% in healthy adults and 1.8% in HIV-infected patients, while the rate of IgG seropositivity (without IgM seropositivity) was 28.7% in healthy adults and 37.8% in HIV-infected patients (p>0.05).  Toxoplasma seropositivity was not associated with age, sex, ART status, CD4 cell count or HIV clinical staging. Seventy-four percent of the toxoplasma seropositive HIV-infected patients were asymptomatic and no cases of toxoplasma encephalitis were identified. Conclusion: Toxoplasmosis is equally prevalent in HIV-infected patients and healthy adults from similar environments in Northern Nigeria. It is imperative to develop public health policies to prevent toxoplasmosis in Nigeria, especially in HIV-infected patients.

scholarly journals Risk Factors and Seroprevalence of Hepatitis C among Patients Hospitalized at Mulago Hospital, Uganda

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
J. I. O'Reilly ◽  
P. Ocama ◽  
C. K. Opio ◽  
A. Alfred ◽  
E. Paintsil ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatitis C ◽  
Hcv Infection ◽  
Antibody Detection ◽  
Hiv Positive ◽  
Mulago Hospital ◽  
Hcv Rna ◽  
Increased Risk ◽  
Hcv Antibody ◽  
Hiv Negative

The emergence of hepatitis C virus (HCV) and its associated sequelae in Africa is a cause for significant concern. Human immunodeficiency virus (HIV) positive patients are at an increased risk of contracting HCV infection due to similar risk factors and modes of transmission. We investigated the seroprevalence of hepatitis C in hospitalized HIV-positive and HIV-negative patients in Mulago Hospital, an academic hospital in Uganda. Blood samples were first tested for HCV antibodies, and positive tests were confirmed with HCV RNA PCR. We enrolled five hundred patients, half HIV-positive and half HIV negative. Overall, 13/500 patients (2.6%) tested positive for HCV antibodies. There was no difference in HCV antibody detection among HIV-positive and HIV-negative patients. Out of all risk factors examined, only an age greater than 50 years was associated with HCV infection. Traditional risk factors for concurrent HIV and HCV transmission, such as intravenous drug use, were exceedingly rare in Uganda. Only 3 of 13 patients with detectable HCV antibodies were confirmed by HCV RNA detection. This result concurs with recent studies noting poor performance of HCV antibody testing when using African sera. These tests should be validated in the local population before implementation.

scholarly journals Should the management of high grade cervical squamous intraepithelial lesion (HSIL) be different in HIV-positive women?

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Christine Gilles ◽  
Maude Velghe-lenelle ◽  
Yannick Manigart ◽  
Déborah Konopnicki ◽  
Serge Rozenberg
Keyword(s):  
Risk Factors ◽  
Viral Load ◽  
Treatment Failure ◽  
Hiv Positive ◽  
High Grade ◽  
Ablative Therapy ◽  
Hiv Positive Women ◽  
Increased Risk ◽  
Risk Of Treatment ◽  
Hiv Negative

Abstract Background This study compares the management and outcome of high grade squamous intraepithelial lesions (HSIL) in HIV-positive and -negative women and identifies risk factors for treatment failure. Methods This retrospective, controlled study includes 146 HIV-positive women, matched for HSIL, age and year of diagnosis, with 146 HIV-negative women. Differences were analysed using parametric and non-parametric tests and Kaplan–Meier survival curves. A binary logistic regression was used to assess risk factors for treatment failure. Results Persistence of cervical disease was observed most frequently in HIV-positive women (42 versus 17%) (p  <  0.001) and the cone biopsy margins were more often invaded in HIV-positive-women than in HIV-negative ones. (37 versus 16%; p  <  0.05). HIV-positive women, with successful cervical treatment had better HIV disease control: with significantly longer periods of undetectable HIV viral loads (VL) (19 versus 5 months; p  <  0.001) and higher CD4 counts (491 versus 320 cells/mm3; p  <  0.001). HIV-positive women with detectable VL at the time of dysplasia had 3.5 times (95% IC: 1.5–8.3) increased risk of treatment failure. Being treated through ablative therapy was associated with a 7.4, four-fold (95% IC: 3.2–17.3) increased risk of treatment failure compared to conization Conclusion HIV-positive women have a higher risk of treatment failure of HSIL than do HIV-negative women, especially when ablative therapy is used and in women with poor control of their HIV infection. The management and the follow- up of HSIL’s guidelines in this high-risk population should be adapted consequently: for HIV-positive women with uncontrolled viral load, excisional treatment should be the preferred therapy, whereas for women with undetectable viral load, CD4  +  lymphocytes higher than 500 cells/mm3 and with a desire of pregnancy, ablative therapy may be considered.

Sexual violence and associated factors among women in HIV discordant and concordant relationships in Uganda

2012 ◽  
Vol 24 (2) ◽  
Author(s):  
Faisal M.B. Shuaib ◽  
John E. Ehiri ◽  
Pauline Jolly ◽  
Qionghui Zhang ◽  
Donath Emusu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Sexual Violence ◽  
Partner Violence ◽  
Sexual Debut ◽  
Hiv Positive ◽  
Sexual Intimacy ◽  
Hiv Positive Women ◽  
Increased Risk ◽  
Hiv Serostatus ◽  
Hiv Negative

Abstract HIV serodiscordance is a sexual partnership in which one partner is infected with HIV while the other is not. Managing emotional and sexual intimacy in HIV serodiscordant unions can be difficult due to concerns about HIV transmission and the challenge of initiating and maintaining safe sex. In situations where couples are jointly aware of their HIV status, women in serodiscordant unions may face increased risk of partner violence. We conducted an investigation to assess risk factors for HIV serodiscordance and determine if HIV serodiscordance is associated with incident sexual violence among a cohort of women attending HIV post-test club services at three AIDS Information Centers (AICs) in Uganda. Using a prospective study of 250 women, we elicited information about sexual violence using structured face-to-face interviews. Sexual violence and risk factors were assessed and compared among HIV positive women in HIV discordant unions, HIV negative women in discordant unions, and HIV negative women in negative concordant unions. Multivariable logistic regression was used to assess the association between participants’ serostatus and sexual violence. HIV negative women in serodiscordant relationships (36.1±11.1 years, range: 19–65 years) were significantly older than either HIV positive women in serodiscordant relationships (32.2±9.0 years, range: 18–56 years), or HIV negative women in concordant relationships (32.3±11.0 years, range: 18–62), (p=0.033). Early age at sexual debut was associated with a 2.4-fold increased risk of experiencing sexual violence (OR 2.4, 95% CI 1.27–4.65). Based on unadjusted analysis, HIV positive women in discordant relationship were at highest risk for sexual violence compared to HIV negative women in discordant unions, and HIV negative women in negative concordant unions. HIV negative women in discordant relationships and those in concordant negative relationships showed no increased risk for sexual violence. However, couples’ HIV serostatus was not significant related to incident sexual violence after controlling for potential confounding covariates. Nevertheless, the results were able to elucidate the sexual violence risk factor profile of participants based on couples’ HIV serostatus. Couple counseling protocols at HIV voluntary counseling and testing centers in Uganda should identify those at risk for sexual violence and develop interventions to reduce its incidence.

scholarly journals HIV RNA, CD4+ Percentage, and Risk of Hepatocellular Carcinoma by Cirrhosis Status

2019 ◽  
Vol 112 (7) ◽  
pp. 747-755 ◽  
Author(s):  
Jessie Torgersen ◽  
Michael J Kallan ◽  
Dena M Carbonari ◽  
Lesley S Park ◽  
Rajni L Mehta ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Cohort Study ◽  
Health Administration ◽  
Hiv Rna ◽  
Cell Percentage ◽  
Cell Counts ◽  
Increased Risk ◽  
Cd4 Percentage ◽  
Cd4 Cell

Abstract Background Despite increasing incidence of hepatocellular carcinoma (HCC) among HIV-infected patients, it remains unclear if HIV-related factors contribute to development of HCC. We examined if higher or prolonged HIV viremia and lower CD4+ cell percentage were associated with HCC. Methods We conducted a cohort study of HIV-infected individuals who had HIV RNA, CD4+, and CD8+ cell counts and percentages assessed in the Veterans Aging Cohort Study (1999–2015). HCC was ascertained using Veterans Health Administration cancer registries and electronic records. Cox regression was used to determine hazard ratios (HR, 95% confidence interval [CI]) of HCC associated with higher current HIV RNA, longer duration of detectable HIV viremia (≥500 copies/mL), and current CD4+ cell percentage less than 14%, adjusting for traditional HCC risk factors. Analyses were stratified by previously validated diagnoses of cirrhosis prior to start of follow-up. Results Among 35 659 HIV-infected patients, 302 (0.8%) developed HCC over 281 441 person-years (incidence rate = 107.3 per 100 000 person-years). Among patients without baseline cirrhosis, higher HIV RNA (HR = 1.25, 95% CI = 1.12 to 1.40, per 1.0 log10 copies/mL) and 12 or more months of detectable HIV (HR = 1.47, 95% CI = 1.02 to 2.11) were independently associated with higher risk of HCC. CD4+ percentage less than 14% was not associated with HCC in any model. Hepatitis C coinfection was a statistically significant predictor of HCC regardless of baseline cirrhosis status. Conclusion Among HIV-infected patients without baseline cirrhosis, higher HIV RNA and longer duration of HIV viremia increased risk of HCC, independent of traditional HCC risk factors. This is the strongest evidence to date that HIV viremia contributes to risk of HCC in this group.

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