scholarly journals Echocardiographic Assessment of Asymptomatic US Air Force Members with Early HIV Infection

2019 ◽  
Author(s):  
Gadiel Rafael Alvarado ◽  
Courtney Usry ◽  
Rosco Gore ◽  
James Watts ◽  
Jason Okulicz
Keyword(s):  
Hiv Infection ◽  
Air Force ◽  
Global Longitudinal Strain ◽  
People Living With Hiv ◽  
Hiv Diagnosis ◽  
Cvd Risk ◽  
Us Air Force ◽  
Increased Risk ◽  
Hiv Acquisition ◽  
Living With Hiv

Abstract Objective People living with HIV (PLHIV) are at increased risk for cardiovascular disease (CVD) and development of subclinical echocardiographic abnormalities. The pathogenicity of HIV induced cardiotoxicity has been described however the time to development of echocardiographic abnormalities after HIV acquisition remains unclear. In this study we describe the echocardiographic evaluations of asymptomatic US Air Force members who were diagnosed with HIV infection. Results Patients (n=50) were predominantly male (96%), mostly black (60%), with a mean age of 28 years. At HIV diagnosis, the mean viral load was 112,585 copies/mL and CD4 count was 551 cells/uL; 2 patients were diagnosed with AIDS. All were found to have normal systolic ejection fraction (EF) and global longitudinal strain (GLS) however evidence of right ventricular dilatation and cardiac remodeling was observed in 7 (14%) and 13 (26%) patients, respectively. Subgroup analyses showed no significant differences in echocardiographic findings by HIV disease severity or CVD risk factors (p >0.05 for all). This study suggests that untreated HIV may have a low impact on the development of echocardiographic abnormalities shortly after seroconversion. Longitudinal studies are warranted to determine the optimal CVD risk assessment strategies for PLHIV.

scholarly journals Echocardiographic Assessment of Asymptomatic US Air Force Members with Early HIV Infection

2019 ◽  
Author(s):  
Gadiel Rafael Alvarado ◽  
Courtney Usry ◽  
Rosco Gore ◽  
James Watts ◽  
Jason Okulicz
Keyword(s):  
Hiv Infection ◽  
Air Force ◽  
Ventricular Remodeling ◽  
Medical Center ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
People Living With Hiv ◽  
Cvd Risk ◽  
Us Air Force ◽  
Increased Risk

Abstract Objective People living with HIV (PLHIV) are at increased risk for cardiovascular disease (CVD) and development of subclinical echocardiographic abnormalities. However, there is scant evidence of the echocardiographic changes that occur shortly after seroconversion. In this study we describe the echocardiographic evaluations of asymptomatic US Air Force members who were diagnosed with HIV infection and evaluated at the San Antonio Military Medical Center between September 1, 2015 and September 30, 2016. Results Patients (n=50) were predominantly male (96%), mostly African American (60%), with a mean age of 28 years. At HIV diagnosis, the mean viral load was 112,585 copies/mL and CD4 count was 551 cells/uL. All were found to have normal left ventricular systolic ejection fraction (EF) and global longitudinal strain (GLS) however evidence of right ventricular dilatation and left ventricular remodeling was observed in 7 (14%) and 13 (26%) patients, respectively. Subgroup analyses showed no significant differences in echocardiographic findings by HIV disease severity or CVD risk factors (p >0.05 for all).This study suggests that untreated HIV may have a low impact on the development of echocardiographic abnormalities shortly after seroconversion. Longitudinal studies are warranted to determine the optimal CVD risk assessment strategies for PLHIV.

scholarly journals Echocardiographic assessment of asymptomatic US Air Force members with early HIV infection

2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Gadiel R. Alvarado ◽  
Courtney R. Usry ◽  
Rosco S. Gore ◽  
James A. Watts ◽  
Jason F. Okulicz
Keyword(s):  
Hiv Infection ◽  
Air Force ◽  
Ventricular Remodeling ◽  
Medical Center ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
People Living With Hiv ◽  
Cvd Risk ◽  
Us Air Force ◽  
Increased Risk

Abstract Objective People living with HIV (PLHIV) are at increased risk for cardiovascular disease (CVD) and development of subclinical echocardiographic abnormalities. However, there is scant evidence of the echocardiographic changes that occur shortly after seroconversion. In this study we describe the echocardiographic evaluations of asymptomatic US Air Force members who were diagnosed with HIV infection and evaluated at the San Antonio Military Medical Center between September 1, 2015 and September 30, 2016. Results Patients (n = 50) were predominantly male (96%), mostly African American (60%), with a mean age of 28 years. At HIV diagnosis, the mean viral load was 112,585 copies/mL and CD4 count was 551 cells/μL. All were found to have normal left ventricular systolic ejection fraction (EF) and global longitudinal strain (GLS) however evidence of right ventricular dilatation and left ventricular remodeling was observed in 7 (14%) and 13 (26%) patients, respectively. Subgroup analyses showed no significant differences in echocardiographic findings by HIV disease severity or CVD risk factors (p > 0.05 for all).This study suggests that untreated HIV may have a low impact on the development of echocardiographic abnormalities shortly after seroconversion. Longitudinal studies are warranted to determine the optimal CVD risk assessment strategies for PLHIV.

scholarly journals Echocardiographic Assessment of Asymptomatic US Air Force Members with Early HIV Infection

2019 ◽  
Author(s):  
Gadiel Rafael Alvarado ◽  
Courtney Usry ◽  
Rosco Gore ◽  
James Watts ◽  
Jason Okulicz
Keyword(s):  
Hiv Infection ◽  
Air Force ◽  
Ventricular Remodeling ◽  
Medical Center ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
People Living With Hiv ◽  
Cvd Risk ◽  
Us Air Force ◽  
Increased Risk

Abstract Objective People living with HIV (PLHIV) are at increased risk for cardiovascular disease (CVD) and development of subclinical echocardiographic abnormalities. In this study we describe the echocardiographic evaluations of asymptomatic US Air Force members who were diagnosed with HIV infection and evaluated at the San Antonio Military Medical Center between September 1, 2015 and September 30, 2016. Results Patients (n=50) were predominantly male (96%), mostly black (60%), with a mean age of 28 years. At HIV diagnosis, the mean viral load was 112,585 copies/mL and CD4 count was 551 cells/uL. All were found to have normal left ventricular systolic ejection fraction (EF) and global longitudinal strain (GLS) however evidence of right ventricular dilatation and left ventricular remodeling was observed in 7 (14%) and 13 (26%) patients, respectively. Subgroup analyses showed no significant differences in echocardiographic findings by HIV disease severity or CVD risk factors (p >0.05 for all).This study suggests that untreated HIV may have a low impact on the development of echocardiographic abnormalities shortly after seroconversion. Longitudinal studies are warranted to determine the optimal CVD risk assessment strategies for PLHIV.

scholarly journals Community‐Acquired Pneumonia and Risk of Cardiovascular Events in People Living With HIV

2020 ◽  
Vol 9 (23) ◽  
Author(s):  
Jerry S. Zifodya ◽  
Meredith S. Duncan ◽  
Kaku A. So‐Armah ◽  
Engi F. Attia ◽  
Kathleen M. Akgün ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hiv Infection ◽  
Cox Regression ◽  
Community Acquired Pneumonia ◽  
People Living With Hiv ◽  
Hiv Status ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Increased Risk ◽  
Living With Hiv

Background Hospitalization with community‐acquired pneumonia (CAP) is associated with an increased risk of cardiovascular disease (CVD) events in patients uninfected with HIV. We evaluated whether people living with HIV (PLWH) have a higher risk of CVD or mortality than individuals uninfected with HIV following hospitalization with CAP. Methods and Results We analyzed data from the Veterans Aging Cohort Study on US veterans admitted with their first episode of CAP from April 2003 through December 2014. We used Cox regression analyses to determine whether HIV status was associated with incident CVD events and mortality from date of admission through 30 days after discharge (30‐day mortality), adjusting for known CVD risk factors. We included 4384 patients (67% [n=2951] PLWH). PLWH admitted with CAP were younger, had less severe CAP, and had fewer CVD risk factors than patients with CAP who were uninfected with HIV. In multivariable‐adjusted analyses, CVD risk was similar in PLWH compared with HIV‐uninfected (hazard ratio [HR], 0.89; 95% CI, 0.70–1.12), but HIV infection was associated with higher mortality risk (HR, 1.49; 95% CI, 1.16–1.90). In models stratified by HIV status, CAP severity was significantly associated with incident CVD and 30‐day mortality in PLWH and patients uninfected with HIV. Conclusions In this study, the risk of CVD events during or after hospitalization for CAP was similar in PLWH and patients uninfected with HIV, after adjusting for known CVD risk factors and CAP severity. HIV infection, however, was associated with increased 30‐day mortality after CAP hospitalization in multivariable‐adjusted models. PLWH should be included in future studies evaluating mechanisms and prevention of CVD events after CAP.

scholarly journals Driving Force of Covid-19 Among People Living With HIV/AIDS in Wuhan, China

2020 ◽  
Author(s):  
Wei Guo ◽  
Fangzhao Ming ◽  
Yu Dong ◽  
Qian Zhang ◽  
Lian Liu ◽  
...  
Keyword(s):  
T Lymphocyte ◽  
Lymphocyte Count ◽  
Driving Force ◽  
Driving Forces ◽  
People Living With Hiv ◽  
Hiv Diagnosis ◽  
Hiv Viral Load ◽  
Increased Risk ◽  
Living With Hiv ◽  
Hiv Aids

Abstract Background: Even people living with HIV/AIDS (PLWHA) were considered to be at increased risk of SARS-CoV-2 infection, the driving force among this group of individuals is still not clear. Methods: We investigated 1,701 PLWHA through a telephone interview and found 11 COVID-19 patients in four districts of Wuhan, China. The demographic features and major clinical characteristics of these patients were retrieved from the information management systems for COVID-19 patients of four districts’ CDC. Statistical analysis was performed to find out the driving force of COVID-19 among PLWHA.Results: The incidence proportion of COVID-19 in PLWHA is 0.6% (95% CI: 0.2% - 1.0%), which is comparable to the overall population incidence rate in Wuhan city (0.6%). Nine out of the 11 COVID-19/AIDS patients had relatively high CD4+ T lymphocyte count (>200/μl) and undetectable HIV viral load (＜20 copies/ml), and ten of them were on antiretroviral therapy. PLWHA who were old, had low CD4+ T lymphocyte count, infected HIV through homosexual activity, and had been diagnosed for HIV for a long time, were more likely to develop COVID-19.Conclusions: PLWHA has comparable COVID-19 morbidity rates as the general population, and older age, low CD4 count, long length since HIV diagnosis, and treatment-naive were potential driving forces of COVID-19 occurrence among PLWHA. Strategies in preventing SARS-CoV-2 infection among PLWHA with worse immune responses are needed. Article Summary Line: As COVID-19 continues to spread around the world, people living with HIV/AIDS (PLWHA) are also at risk of infection with SARS-CoV-2. We investigated the factors associated with SARS-CoV-2 infection among PLWHA in Wuhan, China.

Tracking missed opportunities for an early HIV diagnosis in a population of people living with HIV with known time of infection

2021 ◽  
pp. sextrans-2020-054697
Author(s):  
Dimitrios Basoulis ◽  
Evangelia Georgia Kostaki ◽  
Dimitrios Paraskevis ◽  
Angelos Hatzakis ◽  
Mina Psichogiou
Keyword(s):  
Late Presentation ◽  
People Living With Hiv ◽  
Hiv Diagnosis ◽  
Missed Opportunities ◽  
Delay In Diagnosis ◽  
Group 4 ◽  
Targeted Testing ◽  
Hiv Acquisition ◽  
Living With Hiv ◽  
Low Coverage

PurposeThe goal of 90-90-90 first requires the expansion of access to HIV testing. Our aim was to record frequencies of HIV indicator conditions (ICs) and identify missed opportunities for an early HIV diagnosis.MethodsWe retrospectively identified ICs in a population of 231 people living with HIV with known infection dates who attended our clinic. The study population was divided into four groups: (1) those self-tested pre-emptively (47/231, 20.3%), (2) those offered targeted testing based on risk factors (67/231, 29%), (3) those tested after an IC (73/231, 31.6%) and (4) those who were not offered testing after an IC (44/231, 19%). HIV acquisition dates were estimated by molecular clock analysis.ResultsA total of 169 healthcare contacts (HCCs) were recorded. The most frequent HCC was mononucleosis-like syndrome (20.1%), unexplained weight loss (10.7%) and STIs (10.1%). AIDS-defining conditions were detected in 11.8%. Only 62.4% (73/117) of those with an IC were offered testing after their first HCC. Patients in group 4 had statistically significant delay in diagnosis compared with group 3 (109.1 weeks (IQR 56.4–238.6) vs 71.6 weeks (IQR 32.3–124.6)). The proportion of patients diagnosed as late presenters in each group was: (1) 16/47 (34%), (2) 37/67 (55.2%), (3) 43/73 (58.9%) and (4) 27/44 (61.4%) (p=0.027).ConclusionsOur study uses a combination of molecular and clinical data and shows evidence that late presentation occurs in a high proportion of patients even in the presence of an IC. Given that risk-based targeted testing has low coverage, IC-guided testing provides a reasonable alternative to facilitate earlier HIV diagnosis and to improve late diagnosis across Europe and globally.

scholarly journals “That same stigma...that same hatred and negativity:” a qualitative study to understand stigma and medical mistrust experienced by people living with HIV diagnosed with COVID-19

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Andre Hall ◽  
Olivier Joseph ◽  
Samantha Devlin ◽  
Jared Kerman ◽  
Jessica Schmitt ◽  
...  
Keyword(s):  
Qualitative Interviews ◽  
Vulnerable Groups ◽  
Vaccine Hesitancy ◽  
People Living With Hiv ◽  
Medical Mistrust ◽  
Hiv Diagnosis ◽  
Future Health ◽  
Increased Risk ◽  
Related Stigma ◽  
Living With Hiv

Abstract Background The COVID-19 and HIV epidemics have exacerbated existing inequities among vulnerable groups and severely impacted communities of color. People living with HIV (PLWH), who may already face stigma or discrimination, are at risk of experiencing further stigma as a result of COVID-19, which can result in medical mistrust. Methods We performed qualitative interviews between June and August 2020 among 32 PLWH, including 10 individuals diagnosed with COVID-19. A majority of participants perceived themselves as having an increased risk of contracting COVID-19 due to their HIV status. Results Of those who tested positive for COVID-19, the majority regarded their HIV diagnosis as having a more profound impact on their lives but found similarities between COVID-19 stigma and HIV-related stigma. Many participants also expressed mistrust. Conclusions These results can be used to better understand the perspectives of PLWH during the COVID-19 pandemic and have important implications for potential COVID-19 vaccine hesitancy and future health crises.

Psychological aspects and sexual problems

2019 ◽  
pp. 429-442
Keyword(s):  
Mental Illness ◽  
Sexual Dysfunction ◽  
People Living With Hiv ◽  
Psychological Issues ◽  
People With Mental Illness ◽  
Increased Risk ◽  
High Prevalence ◽  
Hiv Acquisition ◽  
Risk Of Hiv Acquisition ◽  
Living With Hiv

Psychological issues are commonly encountered within sexual health. They may be as a result of embarrassment or anxiety regarding the consultation/examination/procedure or due to being given a diagnosis, suffering a chronic or recurrent problem, or concern about a possible diagnosis. Mental illness can contribute to sexual dysfunction and vice versa. This chapter discusses psychosexual problems and sexual dysfunction in men and women, and how best to manage them. People living with HIV have a high prevalence of mental illness and people with mental illness are at increased risk of HIV acquisition. Stigma and isolation are commonly experienced amongst people with HIV and a multidisciplinary approach with psychology, social work, peer support is important for providing holistic care.

scholarly journals Risk of myocardial infarction among people living with HIV: an updated systematic review and meta-analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e025874 ◽  
Author(s):  
Oghenowede Eyawo ◽  
Gwenyth Brockman ◽  
Charles H Goldsmith ◽  
Mark W Hull ◽  
Scott A Lear ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Systematic Review ◽  
Hiv Infection ◽  
Meta Analysis ◽  
Cumulative Exposure ◽  
People Living With Hiv ◽  
Cochrane Central Register ◽  
Cvd Risk ◽  
Eligibility Criteria ◽  
Increased Risk

ObjectiveCardiovascular disease (CVD) is one of the leading non-AIDS-defining causes of death among HIV-positive (HIV+) individuals. However, the evidence surrounding specific components of CVD risk remains inconclusive. We conducted a systematic review and meta-analysis to synthesise the available evidence and establish the risk of myocardial infarction (MI) among HIV+ compared with uninfected individuals. We also examined MI risk within subgroups of HIV+ individuals according to exposure to combination antiretroviral therapy (ART), ART class/regimen, CD4 cell count and plasma viral load (pVL) levels.DesignSystematic review and meta-analysis.Data sourcesWe searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews until 18 July 2018. Furthermore, we scanned recent HIV conference abstracts (CROI, IAS/AIDS) and bibliographies of relevant articles.Eligibility criteriaOriginal studies published after December 1999 and reporting comparative data relating to the rate of MI among HIV+ individuals were included.Data extraction and synthesisTwo reviewers working in duplicate, independently extracted data. Data were pooled using random-effects meta-analysis and reported as relative risk (RR) with 95% CI.ResultsThirty-two of the 8130 identified records were included in the review. The pooled RR suggests that HIV+ individuals have a greater risk of MI compared with uninfected individuals (RR: 1.73; 95% CI 1.44 to 2.08). Depending on risk stratification, there was moderate variation according to ART uptake (RR, ART-treated=1.80; 95% CI 1.17 to 2.77; ART-untreated HIV+ individuals: 1.25; 95% CI 0.93 to 1.67, both relative to uninfected individuals). We found low CD4 count, high pVL and certain ART characteristics including cumulative ART exposure, any/cumulative use of protease inhibitors as a class, and exposure to specific ART drugs (eg, abacavir) to be importantly associated with a greater MI risk.ConclusionsOur results indicate that HIV infection, low CD4, high pVL, cumulative ART use in general including certain exposure to specific ART class/regimen are associated with increased risk of MI. The association with cumulative ART may be an index of the duration of HIV infection with its attendant inflammation, and not entirely the effect of cumulative exposure to ART per se.PROSPERO registration numberCRD42014012977.

scholarly journals Global and regional prevalence and outcomes of COVID-19 in people living with HIV: A systematic review and meta-analysis

2021 ◽  
Author(s):  
Reynie Purnama Raya ◽  
Ami Kamila ◽  
Jaber S Alqahtani ◽  
Ahmed M Hjazi ◽  
Amy Li ◽  
...  
Keyword(s):  
Relative Risk ◽  
Hiv Infection ◽  
Random Effect ◽  
Random Effect Model ◽  
Sub Saharan Africa ◽  
People Living With Hiv ◽  
Global Risk ◽  
Risk Of Death ◽  
Increased Risk ◽  
Living With Hiv

Background The relationship between HIV infection and COVID-19 clinical outcome is unclear with conflicting data and hypotheses. We aimed to assess the prevalence and risk of severe COVID-19 and death in people living with HIV (PLWH) on the global and continental level. Methods Electronic databases were systematically searched in July 2021. Studies were screened and then extracted following the Preferred Reporting Items for Systematic Reviews and Meta analyses guidelines. Narratives were synthesised and data pooled for global and continental prevalence and relative risk of severity and mortality in HIV-infected COVID-19 patients using random effect model. Risk of bias was assessed using the Newcastle-Ottawa score, Egger,s test and presented as funnel plots. Results A total of 46 studies were included involving 18,034,947 COVID-19 cases of which 31,269 were PLWH. The global prevalence of PLWH with SARS-CoV-2 infection was 1% (95% CI = 0.9% - 1.1%) with the highest prevalence observed in sub-Saharan Africa. The relative risk (RR) of COVID-19 severity was significant only in Africa (RR, 95% CI = 1.14, 1.08 - 1.24) while risk of COVID-19 mortality was 1.53% (95% CI = 1.45 - 2.03) globally. The prevalence of PLWH in COVID-19 cases was significantly low, and the calculated global risk ratio show that HIV infection may be linked with increased COVID-19 death. The between-studies heterogeneity was significantly high while risk of publication bias was not significant. Conclusion There is low prevalence HIV-SARS-CoV-2 coinfection. HIV infection was linked with severe COVID-19 in the Africa and increased risk of death globally.

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