scholarly journals Incidence and predictors of tuberculosis among HIV-positive adults on antiretroviral therapy at Debre Markos Referral Hospital, Northwest Ethiopia: A retrospective record review

2019 ◽  
Author(s):  
Belisty Temesgen ◽  
Getiye Dejenu Kibret ◽  
Nakachew Mekonnen Alamirew ◽  
Mamaru Wubale Melkamu ◽  
Yitbarek Tenaw Hibstie ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Opportunistic Infections ◽  
Preventive Therapy ◽  
Disease Stage ◽  
Hiv Positive ◽  
Immunodeficiency Virus ◽  
Hiv Positive Adults ◽  
Debre Markos ◽  
Record Review

Abstract Background: Tuberculosis is the leading cause of morbidity and mortality among people living with human immunodeficiency virus. Almost one-third of deaths among people living with human immunodeficiency virus are attributed to tuberculosis. Despite this evidence, in Ethiopia, there is a scarcity of information regarding the incidence and predictors of tuberculosis among people living with HIV. Thus, this study assessed the incidence and predictors of tuberculosis among HIV-positive adults on antiretroviral therapy. Methods: This study was a retrospective record review including 544 HIV-positive adults on antiretroviral therapy at Debre Markos Referral Hospital between January 1, 2012 and December 31, 2017. The study participants were selected using a simple random sampling technique. The data extraction format was adapted from antiretroviral intake and follow-up forms. Cox-proportional hazards regression model was fitted and Cox-Snell residual test was used to assess the goodness of fit. Tuberculosis free survival time was estimated using the Kaplan-Meier survival curve. Both the bi-variable and multivariable Cox-proportional hazard regression models were used to identify predictors of tuberculosis. Results: In the final analysis, a total of 492 HIV-positive adults were included, of whom, 83 (16.9%) developed tuberculosis at the time of follow-up. This study found that the incidence of tuberculosis was 6.5 (95% CI: 5.2, 8.0) per 100-person-years (PY) of observation. Advanced World Health Organization clinical disease stage (III and IV) (AHR: 2.1, 95% CI: 1.2, 3.2), being ambulatory and bedridden (AHR: 1.8, 95% CI: 1.1, 3.1), baseline opportunistic infections (AHR: 2.8, 95% CI: 1.7, 4.4), low hemoglobin level (AHR: 3.5, 95% CI: 2.1, 5.8), and not taking Isonized Preventive Therapy (AHR: 3.9, 95% CI: 1.9, 7.6) were found to be the predictors of tuberculosis. Conclusion: The study found that there was a high rate of tuberculosis occurrence as compared to previous studies. Baseline opportunistic infections, being ambulatory and bedridden, advanced disease stage, low hemoglobin level, and not taking Isonized Preventive Therapy were found to be the predictors of tuberculosis. Therefore, early detection and treatment of opportunistic infections like tuberculosis should get a special attention. Keywords: Debre Markos, HIV, Incidence, Predictors, tuberculosis

scholarly journals Incidence and predictors of tuberculosis among HIV-positive adults on antiretroviral therapy at Debre Markos referral hospital, Northwest Ethiopia: a retrospective record review

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Belisty Temesgen ◽  
Getiye Dejenu Kibret ◽  
Nakachew Mekonnen Alamirew ◽  
Mamaru Wubale Melkamu ◽  
Yitbarek Tenaw Hibstie ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Opportunistic Infections ◽  
Preventive Therapy ◽  
Hemoglobin Level ◽  
Disease Stage ◽  
Hiv Positive ◽  
Immunodeficiency Virus ◽  
Hiv Positive Adults ◽  
Record Review

Abstract Background Tuberculosis is the leading cause of morbidity and mortality among people living with human immunodeficiency virus. Almost one-third of deaths among people living with human immunodeficiency virus are attributed to tuberculosis. Despite this evidence, in Ethiopia, there is a scarcity of information regarding the incidence and predictors of tuberculosis among people living with HIV. Thus, this study assessed the incidence and predictors of tuberculosis among HIV-positive adults on antiretroviral therapy. Methods This study was a retrospective record review including 544 HIV-positive adults on antiretroviral therapy at Debre Markos Referral Hospital between January 1, 2012 and December 31, 2017. The study participants were selected using a simple random sampling technique. The data extraction format was adapted from antiretroviral intake and follow-up forms. Cox-proportional hazards regression model was fitted and Cox-Snell residual test was used to assess the goodness of fit. Tuberculosis free survival time was estimated using the Kaplan-Meier survival curve. Both the bi-variable and multivariable Cox-proportional hazard regression models were used to identify predictors of tuberculosis. Results In the final analysis, a total of 492 HIV-positive adults were included, of whom, 83 (16.9%) developed tuberculosis at the time of follow-up. This study found that the incidence of tuberculosis was 6.5 (95% CI: 5.2, 8.0) per 100-person-years (PY) of observation. Advanced World Health Organization clinical disease stage (III and IV) (AHR: 2.1, 95% CI: 1.2, 3.2), being ambulatory and bedridden (AHR: 1.8, 95% CI: 1.1, 3.1), baseline opportunistic infections (AHR: 2.8, 95% CI: 1.7, 4.4), low hemoglobin level (AHR: 3.5, 95% CI: 2.1, 5.8), and not taking Isonized Preventive Therapy (AHR: 3.9, 95% CI: 1.9, 7.6) were found to be the predictors of tuberculosis. Conclusion The study found that there was a high rate of tuberculosis occurrence as compared to previous studies. Baseline opportunistic infections, being ambulatory and bedridden, advanced disease stage, low hemoglobin level, and not taking Isonized Preventive Therapy were found to be the predictors of tuberculosis. Therefore, early detection and treatment of opportunistic infections like tuberculosis should get a special attention.

scholarly journals Incidence and predictors of tuberculosis among HIV-positive adults on antiretroviral therapy at Debre Markos Referral Hospital, Northwest Ethiopia: A retrospective record review

2019 ◽  
Author(s):  
Belisty Temesgen ◽  
Getiye Dejenu Kibret ◽  
Nakachew Mekonnen Alamirew ◽  
Animut Alebel
Keyword(s):  
Opportunistic Infections ◽  
Hemoglobin Level ◽  
Disease Stage ◽  
Hiv Positive ◽  
Retrospective Record Review ◽  
Immunodeficiency Virus ◽  
Hiv Positive Adults ◽  
Debre Markos ◽  
Record Review

Abstract Background: Tuberculosis (TB) is the leading cause of morbidity and mortality among people living with human immunodeficiency virus. Almost one-third of deaths among people living with human immunodeficiency virus (PLHIV) are attributed to tuberculosis. Despite this fact, in Ethiopia, particularly in our study area there is a scarcity of information regarding the incidence and predictors of TB among people living with HIV. Thus, this study aimed to assess the incidence and predictors of tuberculosis among HIV-positive adults on antiretroviral therapy (ART). Methods: A retrospective record review was conducted among 544 HIV-positive adults on ART at Debre Markos Referral Hospital from January 1, 2012 to December 31, 2017. The study participants were selected using a simple random sampling technique. The data extraction format was adapted from ART intake and follow-up forms. Cox-proportional hazards regression model was fitted and Cox-Snell residual test was used to assess the goodness of fit. Model with the least value of Akaike’s information criteria was selected as the best model. Tuberculosis free survival time was estimated using the Kaplan-Meier survival curve. Both the bi-variable and multivariable Cox-proportional hazard regression models were used to identify predictors of TB. Results: Among 492 HIV-positive adults included in the final analysis, 16.9% developed TB at the time of follow-up. The incidence rate of TB was found to be 6.5 (95%CI: 5.2, 8.0) per 100-person-years of observation. Advanced WHO clinical disease stage (III and IV) (AHR: 2.1, 95% CI: 1.2, 3.2), being ambulatory and bedridden (AHR: 1.8, 95% CI: 1.1, 3.1), baseline opportunistic infections (AHR: 2.8, 95% CI: 1.7, 4.4), low hemoglobin level (AHR: 3.5, 95% CI: 2.1, 5.8), and not taking IPT (AHR: 3.9, 95% CI: 1.9, 7.6) were found to be the predictors of TB. Conclusion: The study found that there was a high rate of TB occurrence as compared to previous studies. Baseline opportunistic infections, being ambulatory and bedridden, advanced disease stage, low hemoglobin level, and not taking IPT were found to be the predictors of TB. Therefore, early detection and treatment of opportunistic infections like TB should get a special attention. Keywords: Debre Markos, HIV, Incidence, Predictors, TB

scholarly journals Incidence and predictors of tuberculosis among HIV-positive adults on antiretroviral therapy at Debre Markos Referral Hospital, Northwest Ethiopia: A retrospective record review

2019 ◽  
Author(s):  
Belisty Temesgen ◽  
Getiye Dejenu Kibret ◽  
Nakachew Mekonnen Alamirew ◽  
Animut Alebel
Keyword(s):  
Opportunistic Infections ◽  
Hemoglobin Level ◽  
Disease Stage ◽  
Hiv Positive ◽  
Retrospective Record Review ◽  
Immunodeficiency Virus ◽  
Hiv Positive Adults ◽  
Debre Markos ◽  
Record Review

Abstract Background: Tuberculosis (TB) is the leading cause of morbidity and mortality among people living with human immunodeficiency virus. Almost one-third of deaths among people living with human immunodeficiency virus (PLHIV) are attributed to tuberculosis. Despite this fact, in Ethiopia, particularly in our study area there is a scarcity of information regarding the incidence and predictors of TB among people living with HIV. Thus, this study aimed to assess the incidence and predictors of tuberculosis among HIV-positive adults on antiretroviral therapy (ART). Methods: A retrospective record review was conducted among 544 HIV-positive adults on ART at Debre Markos Referral Hospital from January 1, 2012 to December 31, 2017. The study participants were selected using a simple random sampling technique. The data extraction format was adapted from ART intake and follow-up forms. Cox-proportional hazards regression model was fitted and Cox-Snell residual test was used to assess the goodness of fit. Model with the least value of Akaike’s information criteria was selected as the best model. Tuberculosis free survival time was estimated using the Kaplan-Meier survival curve. Both the bi-variable and multivariable Cox-proportional hazard regression models were used to identify predictors of TB. Results: Among 492 HIV-positive adults included in the final analysis, 16.9% developed TB at the time of follow-up. The incidence rate of TB was found to be 6.5 (95%CI: 5.2, 8.0) per 100-person-years of observation. Advanced WHO clinical disease stage (III and IV) (AHR: 2.1, 95% CI: 1.2, 3.2), being ambulatory and bedridden (AHR: 1.8, 95% CI: 1.1, 3.1), baseline opportunistic infections (AHR: 2.8, 95% CI: 1.7, 4.4), low hemoglobin level (AHR: 3.5, 95% CI: 2.1, 5.8), and not taking IPT (AHR: 3.9, 95% CI: 1.9, 7.6) were found to be the predictors of TB. Conclusion: The study found that there was a high rate of TB occurrence as compared to previous studies. Baseline opportunistic infections, being ambulatory and bedridden, advanced disease stage, low hemoglobin level, and not taking IPT were found to be the predictors of TB. Therefore, early detection and treatment of opportunistic infections like TB should get a special attention. Keywords: Debre Markos, HIV, Incidence, Predictors, TB

scholarly journals Incidence of tuberculosis among HIV-positive adults on antiretroviral therapy at Debre Markos Referral Hospital, Northwest Ethiopia: A retrospective record review

2019 ◽  
Author(s):  
Belisty Temesgen ◽  
Getiye Dejenu Kibret ◽  
Nakachew Mekonnen Alamirew ◽  
Animut Alebel
Keyword(s):  
Human Immunodeficiency Virus ◽  
Opportunistic Infections ◽  
Hemoglobin Level ◽  
Disease Stage ◽  
Hiv Positive ◽  
Retrospective Record Review ◽  
Immunodeficiency Virus ◽  
Hiv Positive Adults ◽  
Record Review

Abstract Background: Tuberculosis is the leading cause of morbidity and mortality among people living with human immunodeficiency virus. Almost one-third of deaths among people living with human immunodeficiency virus are attributed to tuberculosis. Despite this fact, in Ethiopia, particularly in our study area there is a scarcity of information regarding the incidence and predictors of TB among peoples living with HIV. Thus, this study aimed to assess the incidence and predictors of tuberculosis among HIV-positive adults on ART. Methods: A retrospective record review was conducted among 544 HIV-positive adults on ART at Debre Markos Referral Hospital from January 1, 2012 to December 31, 2017. The study participants were selected using a simple random sampling technique. The data extraction format was adapted from ART intake and follow-up forms. Data were entered using Epi-Data version 4.2 and analyzed using STATA Version 13. Tuberculosis free survival time was estimated using the Kaplan-Meier survival curve. Both the bi-variable and multivariable Cox-proportional hazard regression models were used to identify predictors of the time to develop TB. Results: Among 492 HIV-positive adults included in the final analysis, 16.9% developed TB at the time of follow up. The incidence rate of TB was found to be 6.5 (95%CI: 5.2, 8.0) per 100-person years of observation. Advanced WHO clinical disease stage (III and IV) (AHR: 2.1, 95% CI: 1.2, 3.2), being ambulatory and bedridden (AHR: 1.8, 95% CI: 1.1, 3.1), baseline opportunistic infections (AHR: 2.8, 95% CI: 1.7, 4.4), low hemoglobin level (AHR: 3.5, 95% CI: 2.1, 5.8), and not taking IPT (AHR: 3.9, 95% CI: 1.9, 7.6) were found to be the predictors of TB. Conclusion: In this study, a high incidence rate of TB was observed among HIV-positive adults. Advanced WHO clinical disease stage (III and IV), being ambulatory and bedridden, baseline opportunistic infections, low hemoglobin level, and not taking IPT were found to be the predictors of TB. Keywords: HIV, Incidence, Predictors, TB

scholarly journals Incidence of tuberculosis among HIV-positive adults on antiretroviral therapy at Debre Markos Referral Hospital, Northwest Ethiopia: A retrospective cohort study

2019 ◽  
Author(s):  
Belisty Temesgen ◽  
Getiye Dejenu Kibret ◽  
Nakachew Mekonnen Alamirew ◽  
Animut Alebel
Keyword(s):  
Human Immunodeficiency Virus ◽  
Cohort Study ◽  
Retrospective Cohort ◽  
Opportunistic Infections ◽  
Hemoglobin Level ◽  
Disease Stage ◽  
Hiv Positive ◽  
Immunodeficiency Virus ◽  
Hiv Positive Adults

Abstract Background: Tuberculosis is the leading cause of morbidity and mortality among people living with human immunodeficiency virus. Almost one-third of deaths among people living with human immunodeficiency virus are attributed to tuberculosis. Despite this fact, in Ethiopia, particularly in our study area there is a scarcity of information regarding the incidence and predictors of TB among peoples living with HIV. Thus, this study aimed to assess the incidence and predictors of tuberculosis among HIV positive adults. Methods: An institution based retrospective cohort study was conducted among 544 HIV-positive adults on ART at Debre Markos Referral Hospital from January 1, 2012 to December 31, 2017. The study participants were selected using a simple random sampling technique. The data extraction format was adapted from ART intake and follow-up forms. Data were entered using Epi-Data version 4.2 and analyzed using STATA Version 13. Tuberculosis free survival time was estimated using the Kaplan-Meier survival curve. Both the bi-variable and multivariable Cox-proportional hazard regression models were used to identify predictors of the time to develop TB. Results: Among 492 HIV-positive adults included in the final analysis, 16.9% of them developed TB at the time of follow up. The incidence rate of TB was found to be 6.5 (95%CI: 5.2, 8.0) per 100-person years. Advanced WHO clinical disease stage (III and IV) (AHR: 2.1, 95% CI: 1.2, 3.2), being ambulatory and bedridden (AHR: 1.8, 95% CI: 1.1, 3.1), baseline opportunistic infections (AHR: 2.8, 95% CI: 1.7, 4.4), low hemoglobin level (AHR: 3.5, 95% CI: 2.1, 5.8), and not taking IPT (AHR: 3.9, 95% CI: 1.9, 7.6) were found to be predictors of the time to develop TB. Conclusion: In this study, a high incidence rate of TB was observed among HIV-positive adults. Advanced HIV disease stage (III and IV), being ambulatory and bedridden, having opportunistic infections, having a low hemoglobin level, and not taking IPT were found to be predictors of the time to develop TB. Keywords: HIV, Incidence, Predictors, TB

scholarly journals Urine Lipoarabinomannan Testing in Adults With Advanced Human Immunodeficiency Virus in a Trial of Empiric Tuberculosis Therapy

2021 ◽  
Author(s):  
Mitch M Matoga ◽  
Gregory P Bisson ◽  
Amita Gupta ◽  
Sachiko Miyahara ◽  
Xin Sun ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Clinical Symptoms ◽  
Preventive Therapy ◽  
Hiv Positive ◽  
Kaplan Meier ◽  
Immunodeficiency Virus ◽  
Hiv Positive Adults ◽  
Intent To Treat ◽  
Aids Clinical Trials ◽  
Tuberculosis Therapy

Abstract Background The urine lipoarabinomannan (LAM) antigen test is a tuberculosis (TB) diagnostic test with highest sensitivity in individuals with advanced human immunodeficiency virus (HIV). Its role in TB diagnostic algorithms for HIV-positive outpatients remains unclear. Methods The AIDS Clinical Trials Group (ACTG) A5274 trial demonstrated that empiric TB therapy did not improve 24-week survival compared to isoniazid preventive therapy (IPT) in TB screen–negative HIV-positive adults initiating antiretroviral therapy with CD4 counts <50 cells/µL. Retrospective LAM testing was performed on stored urine obtained at baseline. We determined the proportion of LAM-positive participants and conducted modified intent-to-treat analysis excluding LAM-positive participants to determine the effect on 24-week survival, TB incidence, and time to TB using Kaplan-Meier method. Results A5274 enrolled 850 participants; 53% were male and the median CD4 count was 18 (interquartile range, 9–32) cells/µL. Of the 850, 566 (67%) had LAM testing (283 per arm); 28 (5%) were positive (21 [7%] and 7 [2%] in the empiric and IPT arms, respectively). Of those LAM-positive, 1 participant in each arm died and 5 of 21 and 0 of 7 in empiric and IPT arms, respectively, developed TB. After excluding these 28 cases, there were 19 and 21 deaths in the empiric and IPT arms, respectively (P = .88). TB incidence remained higher (4.6% vs 2%, P = .04) and time to TB remained faster in the empiric arm (P = .04). Conclusions Among outpatients with advanced HIV who screened negative for TB by clinical symptoms, microscopy, and Xpert testing, LAM testing identified an additional 5% of individuals with TB. Positive LAM results did not change mortality or TB incidence.

scholarly journals Analysis of viral load change in Case of HIV/AIDS Patients under ART Follow-up in Arba Minch General Hospital

2021 ◽  
Author(s):  
Markos Erango ◽  
Kabtamu Gergiso ◽  
Sultan Hebo
Keyword(s):  
Human Immunodeficiency Virus ◽  
Viral Load ◽  
Antiretroviral Therapy ◽  
General Hospital ◽  
Preventive Therapy ◽  
Isoniazid Preventive Therapy ◽  
Adherence Level ◽  
Immunodeficiency Virus ◽  
Over Time

Abstract Background: Monitoring human immunodeficiency virus plasma viral load over time is critical to identify virologic treatment failure in patients taking antiretroviral therapy. The aim of this study was to determine whether the overtime viral load changes depends on patient characteristic measured at baseline of human immunodeficiency virus patients at Arba Minch General Hospital.Methods: This prospective follow up study was conducted using data obtained from medical records, patient interviews, and laboratory workup for six months. The study was employed among 152 adult patients that were selected by systematic random sampling. Longitudinal data analysis that accounts for the correlated nature of the data handled through linear mixed effect models were used to fit the data set in this study.Result: The mean viral load declines over time for each of the adherence level groups. The estimates of linear (p = 0.0006) and quadratic visit time (p=0.0256) effects and the baseline characteristics sex, age, adherence level, and Isoniazid preventive therapy had significant effects on change of viral load of patients over time. Conclusion: In order to improve the status of the patient’s viral load over time, considering the patients’ differences in adherence to antiretroviral therapy, sex, age, and Isoniazid preventive therapy are important.

Neurosurgery and human immunodeficiency virus in the era of combination antiretroviral therapy: a review

2017 ◽  
Vol 126 (3) ◽  
pp. 897-907 ◽  
Author(s):  
Duncan Henderson ◽  
Hugh P. Sims-Williams ◽  
Thomas Wilhelm ◽  
Helen Sims-Williams ◽  
Sanjay Bhagani ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Human Immunodeficiency Virus ◽  
Nervous System ◽  
Antiretroviral Therapy ◽  
Opportunistic Infections ◽  
Brain Lesions ◽  
Hiv Positive ◽  
Combination Antiretroviral Therapy ◽  
Immunodeficiency Virus ◽  
The Central Nervous System

Human immunodeficiency virus (HIV) is a global health problem. It renders the central nervous system susceptible to infectious and noninfectious diseases. HIV-positive individuals may present to neurosurgical services with brain lesions of unknown etiology. The differential diagnosis in these cases is broad, including opportunistic infections and malignancies, and investigation should be tailored accordingly. Opportunistic infections of the central nervous system can be complicated by hydrocephalus, and the management is pathogen dependent. Patients may also present to a neurosurgical service with conditions unrelated to their HIV status. This review outlines important conditions that cause brain lesions and hydrocephalus. It addresses the issues of diagnosis and intervention in HIV-positive patients in the era of combination antiretroviral therapy, while not ignoring the potential for opportunistic central nervous system infection in undiagnosed patients. The care of HIV-positive patients presenting to neurosurgical services requires a multidisciplinary approach, which is reflected in the authorship of this review, as well as in the guidance given.

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