Pre-cART Inflammation, Microbial Translocation and Long-Term Probability of Clinical Progression in People Living With HIV 

2021 ◽  
Author(s):  
Esther Merlini ◽  
Alessandro Cozzi-Lepri ◽  
Antonella Castagna ◽  
Andrea Costantini ◽  
Sergio Lo Caputo ◽  
...  
Keyword(s):  
Cox Regression ◽  
Microbial Translocation ◽  
Study Cohort ◽  
People Living With Hiv ◽  
Continuous Variables ◽  
Clinical Progression ◽  
Cart Initiation ◽  
Kaplan Meier ◽  
Hs Crp ◽  
Living With Hiv

Abstract Background. We aimed to investigate the role of pre-cART inflammation and microbial translocation (MT) as predictors of clinical progression in HIV+ patients enrolled in the Icona Foundation Study Cohort.Methods. We included Icona patients with plasma stored within 6 months before cART initiation and at least one CD4 count after therapy available. Circulating biomarker: LPS, sCD14, EndoCab, hs-CRP. Kaplan-Meier curves and Cox regression models were used. We defined the endpoint of clinical progression as the occurrence of a new AIDS-defining condition, severe non-AIDS condition (SNAEs) or death whichever occurred first. Follow-up accrued from the data of starting cART and was censored at the time of last available clinical visit. Biomarkers were evaluated as both binary (above/below median) and continuous variables (logescale).Results. We studied 486 patients with 125 clinical events:10.8 (0.77-14.8)/1000 PYFU new AIDS, 18.3 (14.2-23.3)/1000 PYFU SNAEs, and 5.56 (3.40-8.57)/1000 PYFU deaths. Among morbidity events, the incidence of infectious-related events was 19.4 (15.2-24.5)/1000 PYFU. Hs-CRP seemed to be the only biomarker retaining some association with the endpoint of clinical progression (i.e. AIDS/SNAEs/death p=.056).Conclusions. Circulating pre-cART hs-CRP but not MT seems associated with the risk of disease progression after cART initiation, suggesting that pre-therapy HIV-driven pro-inflammatory milieu might overweight MT and its downstream immune-activation. This result should help guiding the design of interventional studies.

scholarly journals Inflammation and microbial translocation measured prior to combination antiretroviral therapy (cART) and long-term probability of clinical progression in people living with HIV

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Esther Merlini ◽  
Alessandro Cozzi-lepri ◽  
Antonella Castagna ◽  
Andrea Costantini ◽  
Sergio Lo Caputo ◽  
...  
Keyword(s):  
Cox Regression ◽  
Microbial Translocation ◽  
Study Cohort ◽  
People Living With Hiv ◽  
Clinical Progression ◽  
Cart Initiation ◽  
Increased Risk ◽  
Study Population ◽  
Hs Crp ◽  
Living With Hiv

Abstract Background Despite the effectiveness of cART, people living with HIV still experience an increased risk of serious non-AIDS events, as compared to the HIV negative population. Whether pre-cART microbial translocation (MT) and systemic inflammation might predict morbidity/mortality during suppressive cART, independently of other known risk factors, is still unclear. Thus, we aimed to investigate the role of pre-cART inflammation and MT as predictors of clinical progression in HIV+ patients enrolled in the Icona Foundation Study Cohort. Methods We included Icona patients with ≥2 vials of plasma stored within 6 months before cART initiation and at least one CD4 count after therapy available. Circulating biomarker: LPS, sCD14, EndoCab, hs-CRP. Kaplan-Meier curves and Cox regression models were used. We defined the endpoint of clinical progression as the occurrence of a new AIDS-defining condition, severe non-AIDS condition (SNAEs) or death whichever occurred first. Follow-up accrued from the data of starting cART and was censored at the time of last available clinical visit. Biomarkers were evaluated as both binary (above/below median) and continuous variables (logescale). Results We studied 486 patients with 125 clinical events: 39 (31%) AIDS, 66 (53%) SNAEs and 20 (16%) deaths. Among the analyzed MT and pro-inflammatory markers, hs-CRP seemed to be the only biomarker retaining some association with the endpoint of clinical progression (i.e. AIDS/SNAEs/death) after adjustment for confounders, both when the study population was stratified according to the median of the distribution (1.51 mg/L) and when the study population was stratified according to the 33% percentiles of the distribution (low 0.0–1.1 mg/L; intermediate 1.2–5.3 mg/L; high > 5.3 mg/L). In particular, the higher the hs-CRP values, the higher the risk of clinical progression (p = 0.056 for median-based model; p = 0.002 for 33% percentile-based model). Conclusions Our data carries evidence for an association between the risk of disease progression after cART initiation and circulating pre-cART hs-CRP levels but not with levels of MT. These results suggest that pre-therapy HIV-driven pro-inflammatory milieu might overweight MT and its downstream immune-activation.

scholarly journals The Burden of Anxiety During the COVID-19 Pandemic Among People Living with HIV (PLHIV) in Pune, India

2020 ◽  
Author(s):  
Ivan Marbaniang ◽  
Shashikala Sangle ◽  
Smita Nimkar ◽  
Kanta Zarekar ◽  
Sonali Salvi ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Thematic Analysis ◽  
Family Income ◽  
Screening Tools ◽  
Prior History ◽  
People Living With Hiv ◽  
Continuous Variables ◽  
Tertiary Healthcare ◽  
The Government ◽  
Living With Hiv

Abstract Introduction: There is a dearth of data on anxiety related to the COVID-19 pandemic from people living with HIV (PLHIV). This is a cause of concern as anxiety is associated with antiretroviral therapy (ART) nonadherence. Globally, India has the third largest population of PLHIV and third highest number of COVID-19 cases which are rapidly increasing. Therefore, it is crucial to understand the burden of anxiety and its sources among Asian Indian PLHIV during this pandemic.Methods: We used data from a telephonically delivered assessment among PLHIV engaged in care at a tertiary healthcare associated antiretroviral therapy (ART) center in Pune, India. Assessments were conducted between April 21 and May 28, 2020, one month into the government mandated lockdown. GAD-7 was used to assess for anxiety over two-preceding weeks. Significant sociodemographic and clinical differences between groups (GAD-7<10 and GAD-7≥10) were assessed using Fisher’s exact and Wilcoxson rank sum tests, for categorical and continuous variables, respectively. Thematic analysis was employed to analyze an open-ended question that asked about the most pressing cause(s) of concern. Results: Of 167 PLHIV contacted, median age was 44 years (IQR:40 – 50), 60% (n=100) were cisgender women and 81% (n=135) had a monthly family income<200 USD. Thirty-eight percent (n=64) had prior history of tuberculosis and 27% (n=45) were living with another comorbidity. A fourth (25%, n=41) had GAD-7 scores indicative of generalized anxiety. PLHIV who had fewer remaining doses of ART had significantly higher GAD-7 scores compared to those that had more doses (p=0.05). Thematic analysis indicated that concerns were both health related and unrelated, and stated temporally. Present concerns were often also projected as future concerns. Conclusions: In a group of socioeconomically disadvantaged PLHIV, a fourth were found to have anxiety, that appeared to be influenced by concerns about ART availability. Furthermore, the persistence of sources of anxiety and therefore an increase in anxiety for these PLHIV is anticipated as the pandemic worsens in India. We recommend the regular utilization of short screening tools for anxiety to monitor and triage PLHIV as an extension of current HIV-services.

scholarly journals Impact of Isoniazid Preventive Therapy on Tuberculosis incidence among people living with HIV: A secondary data analysis using Inverse Probability Weighting of individuals attending HIV care and treatment clinics in Tanzania

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254082
Author(s):  
Werner M. Maokola ◽  
Bernard J. Ngowi ◽  
Michael J. Mahande ◽  
Jim Todd ◽  
Masanja Robert ◽  
...  
Keyword(s):  
Observational Studies ◽  
Cox Regression ◽  
Preventive Therapy ◽  
Isoniazid Preventive Therapy ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Clinical Settings ◽  
Inverse Probability ◽  
Care And Treatment ◽  
Living With Hiv

Background Information on how well Isoniazid Preventive Therapy (IPT) works on reducing TB incidence among people living with HIV (PLHIV) in routine settings using robust statistical methods to establish causality in observational studies is scarce. Objectives To evaluate the effectiveness of IPT in routine clinical settings by comparing TB incidence between IPT and non-IPT groups. Methods We used data from PLHIV enrolled in 315 HIV care and treatment clinic from January 2012 to December 2016. We used Inverse Probability of Treatment Weighting to adjust for the probability of receiving IPT; balancing the baseline covariates between IPT and non-IPT groups. The effectiveness of IPT on TB incidence was estimated using Cox regression using the weighted sample. Results Of 171,743 PLHIV enrolled in the clinics over the five years, 10,326 (6.01%) were excluded leaving 161,417 available for the analysis. Of the 24,800 who received IPT, 1.00% developed TB disease whereas of the 136,617 who never received IPT 6,085 (4.98%) developed TB disease. In 278,545.90 person-years of follow up, a total 7,052 new TB cases were diagnosed. Using the weighted sample, the overall TB incidence was 11.57 (95% CI: 11.09–12.07) per 1,000 person-years. The TB incidence among PLHIV who received IPT was 10.49 (95% CI: 9.11–12.15) per 1,000 person-years and 12.00 (95% CI: 11.69–12.33) per 1,000 person-years in those who never received IPT. After adjusting for other covariates there was 52% lower risk of developing TB disease among those who received IPT compared to those who never received IPT: aHR = 0.48 (95% CI: 0.40–0.58, P<0.001). Conclusion IPT reduced TB incidence by 52% in PLHIV attending routine CTC in Tanzania. IPTW adjusted the groups for imbalances in the covariates associated with receiving IPT to achieve comparable groups of IPT and non-IPT. This study has added evidence on the effectiveness of IPT in routine clinical settings and on the use of IPTW to determine impact of interventions in observational studies.

scholarly journals The “Real R0”: A Resection Margin Smaller Than 0.1 cm is Associated with a Poor Prognosis After Oncologic Esophagectomy

2021 ◽  
Author(s):  
Penelope St-Amour ◽  
Michael Winiker ◽  
Christine Sempoux ◽  
François Fasquelle ◽  
Nicolas Demartines ◽  
...  
Keyword(s):  
Resection Margin ◽  
Cox Regression ◽  
Tumor Biology ◽  
Disease Free Survival ◽  
Recurrence Risk ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Chi Square ◽  
Kaplan Meier

Abstract Background Although resection margin (R) status is a widely used prognostic factor after esophagectomy, the definition of positive margins (R1) is not universal. The Royal College of Pathologists considers R1 resection to be a distance less than 0.1 cm, whereas the College of American Pathologists considers it to be a distance of 0.0 cm. This study assessed the predictive value of R status after oncologic esophagectomy, comparing survival and recurrence among patients with R0 resection (> 0.1-cm clearance), R0+ resection (≤ 0.1-cm clearance), and R1 resection (0.0-cm clearance). Methods The study enrolled all eligible patients undergoing curative oncologic esophagectomy between 2012 and 2018. Clinicopathologic features, survival, and recurrence were compared for R0, R0+, and R1 patients. Categorical variables were compared with the chi-square or Fisher’s test, and continuous variables were compared with the analysis of variance (ANOVA) test, whereas the Kaplan-Meier method and Cox regression were used for survival analysis. Results Among the 160 patients included in this study, 113 resections (70.6%) were R0, 34 (21.3%) were R0+, and 13 (8.1%) were R1. The R0 patients had a better overall survival (OS) and disease-free survival (DFS) than the R0+ and R1 patients. The R0+ resection offered a lower long-term recurrence risk than the R1 resection, and the R status was independently associated with DFS, but not OS, in the multivariate analysis. Both the R0+ and R1 patients had significantly more adverse histologic features (lymphovascular and perineural invasion) than the R0 patients and experienced more distant and locoregional recurrence. Conclusions Although R status is an independent predictor of DFS after oncologic esophagectomy, the < 0.1-cm definition for R1 resection seems more appropriate than the 0.0-cm definition as an indicator of poor tumor biology, long-term recurrence, and survival.

scholarly journals Consequences of the COVID-19 pandemic on the continuum of the care in a cohort of people living with HIV followed in a single center of Northern Italy

2020 ◽  
Author(s):  
Eugenia Quiros-Roldan ◽  
Paola Magro ◽  
Canio Carriero ◽  
Annacarla Chiesa ◽  
Issa El Hamad ◽  
...  
Keyword(s):  
Antiretroviral Drugs ◽  
Hiv Care ◽  
Categorical Variables ◽  
People Living With Hiv ◽  
Continuous Variables ◽  
Hiv Diagnosis ◽  
Missed Visits ◽  
Hiv Continuum Of Care ◽  
Living With Hiv ◽  
The Continuum

Abstract Introduction: During the COVID-19 pandemic, hospitals faced increasing pressure, where people living with HIV risked to either acquire SARS-CoV-2 and to interrupt the HIV continuum of care.Methods: this is a retrospective, observational study. We compared the numbers of medical visits performed, antiretroviral drugs dispensed and the number of new HIV diagnosis and of hospitalizations in a cohort of people living with HIV (PLWH) followed by the Spedali Civili of Brescia between the bimester of the COVID-19 pandemic peak and the bimester of October-November 2019. Data were retrieved from administrative files and from paper and electronic clinical charts. Categorical variables were described using frequencies and percentages, while continuous variables were described using mean, median, and interquartile range (IQR) values. Means for continuous variables were compared using Student’s t-tests and the Mann-Whitney test. Proportions for categorical variables were compared using the χ2 test.Results: As of December 31st, 2019, a total of 3875 PLWH were followed in our clinic. Mean age was 51,4 ±13 years old, where 28% were females and 18.8% non-Italian. Overall, 98.9% were on ART (n=3834), 93% were viro-suppressed. A total of 1217 and 1162 patients had their visit scheduled at our out-patient HIV clinic during the two bimesters of 2019 and 2020, respectively. Comparing the two periods, we observed a raise of missed visits from 5% to 8% (p<0.01), a reduction in the number of new HIV diagnosis from 6.4 in 2019 to 2.5 per month in 2020 (p=0.01), a drop in ART dispensation and an increase of hospitalized HIV patients due to COVID-19. ART regimens including protease inhibitors (PIs) had a smaller average drop than ART not including PIs (16,6% vs 21,6%, p<0.05). Whether this may be due to the perception of a possible efficacy of PIs on COVID19 is not known. Conclusions: Our experience highlights the importance of a resilient healthcare system and the need to implement new strategies in order to guarantee the continuum of HIV care even in the context of emergency.

scholarly journals 110. Bone Mineral Density Screening in Veterans Living with HIV

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S184-S184
Author(s):  
Naveed Khanjee ◽  
Christie G Turin ◽  
Katharine Breaux ◽  
Reina Armamento-Villareal ◽  
Maria Rodriguez- Barradas ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Medical Center ◽  
T Test ◽  
Study Cohort ◽  
People Living With Hiv ◽  
Mineral Density ◽  
Hiv Viral Load ◽  
Glucocorticoid Treatment ◽  
Living With Hiv

Abstract Background Low bone mineral density (BMD) is more prevalent in people living with HIV (PLWH) than in the general population. Although no consensus exists regarding when to start screening for BMD loss in PLWH, the Infectious Diseases Society of America (IDSA) recommends dual x-ray absorptiometry (DXA) for men aged ≥50 years, postmenopausal women, and patients with a history of fragility fracture, chronic glucocorticoid treatment, or at high fall risk. The objective of this study is to evaluate how well this guideline is being carried out in a population of veterans living with HIV (VLWH). Methods We retrospectively identified VLWH seen at the Veterans Affairs Medical Center (VAMC) in Houston, TX, between 2014–2018 via the VAMC HIV Registry. We extracted demographic, laboratory, and clinical variables, as well as DXA results via this registry database and subsequent chart review. Results We identified 1,306 VLWH who received care between 2014–2018; 197 turned 50 years old during this time period. Of those, only 32 (16.2%) underwent DXA (2 women, 30 men). DXA revealed normal BMD in 17 (53.1%), osteopenia in 12 (37.5%), and osteoporosis in 3 (9.4%), as defined by traditional DXA T-score cutoffs. Average CD4 count at time of DXA was 698 cells/mm3 (n=30) (average CD4 for those with normal DXA was 654 [n=16] and for those with osteopenia/osteoporosis it was 749 [n=14]; t-test p = 0.47). Thirty had HIV viral load (VL) &lt; 100 copies/mL; the remaining 2 had VLs of 11,200 and 2,980, both with normal DXAs. Vitamin D (VD) levels were available for 1,005 (77%) VLWH in the study cohort. Of those, 278 (27.7%) were VD deficient (25-hydroxy VD level of &lt; 20 ng/mL). VD levels were available for 31 of the 32 VLWH who had DXA after turning 50 years old; the average VD level was 22.76 (24.61 [n=16] for those with normal BMD and 20.78 [n=15] for those with osteoporosis/osteopenia; t-test p = 0.30). Conclusion Our results indicate that adherence to IDSA BMD screening guidelines in VLWH can be improved. Given that nearly half of the screened patients showed evidence of BMD loss on their initial DXA, efforts should be made to increase awareness and screening in this vulnerable population. Prevention, earlier diagnosis, and treatment of BMD loss in VLWH would likely lead to decreased morbidity associated with fractures due to low BMD in this population. Disclosures All Authors: No reported disclosures

scholarly journals Host blood transcriptomic biomarkers of tuberculosis disease in people living with HIV: a systematic review protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e048623
Author(s):  
Simon C Mendelsohn ◽  
Humphrey Mulenga ◽  
Stanley Kimbung Mbandi ◽  
Fatoumatta Darboe ◽  
Mary Shelton ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Extrapulmonary Tuberculosis ◽  
Preventive Therapy ◽  
Study Cohort ◽  
People Living With Hiv ◽  
Test Accuracy ◽  
Cochrane Central Register ◽  
Cross Sectional ◽  
Living With Hiv

IntroductionCurrent tuberculosis triage and predictive tools offer poor accuracy and are ineffective for detecting asymptomatic disease in people living with HIV (PLHIV). Host tuberculosis transcriptomic biomarkers hold promise for diagnosing prevalent and predicting progression to incident tuberculosis and guiding further investigation, preventive therapy and follow-up. We aim to conduct a systematic review of performance of transcriptomic signatures of tuberculosis in PLHIV.Methods and analysisWe will search MEDLINE (PubMed), WOS Core Collection, Biological Abstracts, and SciELO Citation Index (Web of Science), Africa-Wide Information and General Science Abstracts (EBSCOhost), Scopus, and Cochrane Central Register of Controlled Trials databases for articles published in English between 1990 and 2020. Case–control, cross-sectional, cohort and randomised controlled studies evaluating performance of diagnostic and prognostic host-response transcriptomic signatures in PLHIV of all ages and settings will be included. Eligible studies will include PLHIV in signature test or validation cohorts, and use microbiological, clinical, or composite reference standards for pulmonary or extrapulmonary tuberculosis diagnosis. Study quality will be evaluated using the ‘Quality Assessment of Diagnostic Accuracy Studies-2’ tool and cumulative review evidence assessed using the ‘Grading of Recommendations Assessment, Development and Evaluation’ approach. Study selection, quality appraisal and data extraction will be performed independently by two reviewers. Study, cohort and signature characteristics of included studies will be tabulated, and a narrative synthesis of findings presented. Primary outcomes of interest, biomarker sensitivity and specificity with estimate precision, will be summarised in forest plots. Expected heterogeneity in signature characteristics, study settings, and study designs precludes meta-analysis and pooling of results. Review reporting will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses of Diagnostic Test Accuracy Studies guidelines.Ethics and disseminationFormal ethics approval is not required as primary human participant data will not be collected. Results will be disseminated through peer-reviewed publication and conference presentation.PROSPERO registration numberCRD42021224155.

scholarly journals Time to Develop and Predictors for Incidence of Tuberculosis among Children Receiving Antiretroviral Therapy

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Fassikaw Kebede ◽  
Tsehay Kebede ◽  
Birhanu Kebede ◽  
Abebe Abate ◽  
Dube Jara ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Cox Regression ◽  
Survival Curve ◽  
Final Analysis ◽  
Preventive Therapy ◽  
Public Hospitals ◽  
People Living With Hiv ◽  
Human Immune Deficiency Virus ◽  
North West ◽  
Living With Hiv

Infection by the human immune deficiency virus (HIV) is the strongest risk factor for latent or new infection of tuberculosis (TB) through reduction of CD4 T-lymphocytes and cellular immune function. Almost one-third of deaths among people living with HIV are attributed to tuberculosis. Despite this evidence, in Ethiopia, there is a scarcity of information regarding the incidence of tuberculosis for children living with HIV. Thus, this study assessed time to develop and predictors for incidence of tuberculosis in children attending HIV/AIDS care in public hospitals: North West Ethiopia 2021. Methods. A facility-based retrospective cohort study was conducted among 421 seropositive children on antiretroviral therapy in two hospitals between January 1, 2011 and December 31, 2020. EPI-DATA version 3.2 and STATA/14 software were used for data entry and analysis, respectively. Tuberculosis-free survival time was estimated using the Kaplan-Meier survival curve. Bivariate and multivariable Cox regression model was fitted to identify predictors at a P value <0.05 within 95% CI. Results. In the final analysis, a total of 421 seropositive children were included, of whom, 64 (15.2%) developed tuberculosis at the time of follow-up. The mean (±SD) age of the children was 10.62 ± 3.32 years, with a median (IQR) time to develop TB that was 23.5 ( IQR = ± 19 ) months. This study found that the incidence of tuberculosis was 5.9 (95% CI: 4.7; 7.6) per 100 person-years (PY) risk of observation. Cases at baseline not taking cotrimoxazol preventive therapy (CPT) ( AHR = 2.5 ; 95% CI, 1.4-4.7, P < 0.021 ), being severely stunted ( AHR = 2.9 : 95% CI, 1.2-7.8, P < 0.03 ), and having low hemoglobin level ( AHR = 4.0 ; 95% CI, 2.1-8.1, P < 0.001 ) were found to be predictors of tuberculosis. Conclusion. A higher rate of tuberculosis incidence was reported in our study as compared with previous studies in Ethiopia. Cases at baseline not taking cotrimoxazol preventive therapy (CPT), being severely stunted, and having low hemoglobin (≤10 mg/dl) levels were found to be at higher risk to developed TB incidence.

scholarly journals CLINICAL AND IMMUNOLOGICAL CHARACTERISTICS OF HIV-INFECTION IN DYNAMICS AGAINST THE BACKGROUND OF ANTIRETROVIRAL THERAPY AMONG PATIENTS IN POLTAVA REGION

2019 ◽  
Vol 23 (5-6) ◽  
pp. 20-24
Author(s):  
O.H. Marchenko ◽  
T.I. Koval ◽  
L.M. Syzova ◽  
S.S. Rudenko ◽  
N.P. Lymarenko
Keyword(s):  
T Lymphocytes ◽  
Hiv Infection ◽  
Opportunistic Infections ◽  
Initial Level ◽  
People Living With Hiv ◽  
Clinical Progression ◽  
Relevant Issue ◽  
Control Center ◽  
Living With Hiv ◽  
And Control

HIV-infection is a relevant issue of the modern healthcare system due to socio-medical and demographic significance. The problem of correlation between clinico-laboratory characteristics and immunological indexes in people living with HIV-infection and obtain ART remains relevant, and the solution may help to expand the knowledge about predictors of the disease in the future. The aim of our research was to analyze the clinical and immunological characteristics of HIV-infection in dynamics against the background of ART considering the initial level of CD4+ T-lymphocytes. Patients and methods. We conducted a cohort study of 181 people living with HIV-infection – 127 male and 54 female patients, aged from 21 to 55 years (the average age 34.6±0.6 years), who underwent dispensary observation at Poltava Regional HIV/AIDS Prevention and Control Center during 2003-2017, for the purpose of evaluation of clinical and immunological characteristics of HIV-infection in dynamics against the background of ART. Results of the research and their discussion. We found that among people living with HIV, young people (90.0%) predominated; among them – males (70.2%); patients who injected drugs at the time of referral to medical care (49.2%); with bad habits (smoking – 49.2%, alcohol abuse – 14.4%) and had experience of incarceration (26.5%). They were diagnosed with opportunistic infections inherent to III and IV clinical stages of HIV-infection, including bacterial (37.0%), fungal (44.2%), viral (35.4%) and parasitic (6.6%) infections. Moreover, 24 (13.3%) patients developed the CD4+ T lymphocytes level ≥350 cells/µl. Examination of HIV-infected patients in dynamics showed that there was a clinical progression of HIV-infection against the background of ART background in 72 (39.8%) out of 181 patients, 21 of them (30%) with CD4+ T lymphocytes ≥350 cells/μl.

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