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.

scholarly journals Clinical characteristics and outcomes of people living with HIV hospitalized with COVID-19: a nationwide experience

2021 ◽  
Vol 32 (5) ◽  
pp. 435-443
Author(s):  
Maria Elena Ceballos ◽  
Patricio Ross ◽  
Martin Lasso ◽  
Isabel Dominguez ◽  
Marcela Puente ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
General Population ◽  
Clinical Characteristics ◽  
Cd4 Count ◽  
People Living With Hiv ◽  
Hiv Diagnosis ◽  
Hiv Viral Load ◽  
Risk Of Death ◽  
Living With Hiv

In this prospective, multicentric, observational study, we describe the clinical characteristics and outcomes of people living with HIV (PLHIV) requiring hospitalization due to COVID-19 in Chile and compare them with Chilean general population admitted with SARS-CoV-2. Consecutive PLHIV admitted with COVID-19 in 23 hospitals, between 16 April and 23 June 2020, were included. Data of a temporally matched-hospitalized general population were used to compare demography, comorbidities, COVID-19 symptoms, and major outcomes. In total, 36 PLHIV subjects were enrolled; 92% were male and mean age was 44 years. Most patients (83%) were on antiretroviral therapy; mean CD4 count was 557 cells/mm3. Suppressed HIV viremia was found in 68% and 56% had, at least, one comorbidity. Severe COVID-19 occurred in 44.4%, intensive care was required in 22.2%, and five patients died (13.9%). No differences were seen between recovered and deceased patients in CD4 count, HIV viral load, or time since HIV diagnosis. Hypertension and cardiovascular disease were associated with a higher risk of death ( p = 0.02 and 0.006, respectively). Compared with general population, the HIV cohort had significantly more men (OR 0.15; IC 95% 0.07–0.31) and younger age (OR 8.68; IC 95% 2.66–28.31). In PLHIV, we found more intensive care unit admission (OR 2.31; IC 95% 1.05–5.07) but no differences in the need for mechanical ventilation or death. In this cohort of PLHIV hospitalized with COVID-19, hypertension and cardiovascular comorbidities, but not current HIV viro-immunologic status, were the most important risk factors for mortality. No differences were found between PLHIV and general population in the need for mechanical ventilation and death.

scholarly journals Hepatitis B virus prevalence, immunization and immune response in people living with HIV/AIDS in Istanbul, Turkey: a 21-year data analysis

2021 ◽  
Vol 21 (4) ◽  
pp. 1621-8
Author(s):  
Esra Zerdali ◽  
Inci Yilmaz Nakir ◽  
Serkan Surme ◽  
Mustafa Yildirim
Keyword(s):  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Antibody Response ◽  
Control Measures ◽  
People Living With Hiv ◽  
Hiv Diagnosis ◽  
Keywords Hiv ◽  
B Virus ◽  
Living With Hiv ◽  
Hiv Aids

Objective: We aimed to determine Hepatitis B virus (HBV) prevalence, immune status, and the prevalence of antibody response in people living with HIV/AIDS (PLWHA) in Istanbul, Turkey. Methods: The study includes PLWHA aged 18 years and older who were followed-up for at least 6 months from 1997 to 2018. Results: Of the 653 patients with PLWHA, 99 (15.2%) were both antiHBc-IgG and antiHBs positive, 120 (18.3%) were antiHBc-IgG positive/antiHBs negative. HBsAg was positive in 40 (6.1%) patients. HBsAg positive coinfection (≤40 years 4.6% vs. >40 years 21.7%, p<0.001) and antiHBc-IgG positivity/antiHBs negativity (≤40 years 14.0% vs. >40 years 26.5, p<0.001) were higher in PLWHA older than 40 years. The prevalence of HIV/HBV coinfection reached a peak level of 22.2% in 2004, and it decreased to 3.3% in 2018. The prevalence of immunization before HIV diagnosis was low (15.6%). The prevalence of antibody response (anti-HBs>10 IU/L) after immunization for HBV was 50%. A higher protective response was associated with CD4+≥350 cell/mm3 (59.3%, p=0.014). Conclusion: HBV coexistence in PLWHA remains an imperatively important problem. The most conclusive methods in solving this problem are to prevent transmission by immunization and control measures. Also, HBV screening should in no manner be neglected in PLWHA. Keywords: HIV; Hepatitis B; prevalence.

scholarly journals Depression and its predictors among people living with HIV/AIDS on antiretroviral therapy

2019 ◽  
Vol 6 (10) ◽  
pp. 4557
Author(s):  
Rudramma J. ◽  
Jannatbi Iti
Keyword(s):  
Mental Illness ◽  
Antiretroviral Therapy ◽  
Severe Depression ◽  
People Living With Hiv ◽  
Mild Depression ◽  
Clinical Predictors ◽  
Hiv Diagnosis ◽  
Cross Sectional ◽  
Living With Hiv ◽  
Hiv Aids

Background: HIV infection is one of the raising public health problems. HIV diagnosis is usually associated with stigma and often results in mental illness among the people infected. Depression is the most common mental illness in HIV patients as found by various studies. Hence the present study aimed to determine the proportion of depression and its socio-demographic and clinical predictors among people living with HIV/AIDS (PLHA).Methods: A hospital based cross sectional study was done among 322 PLHA on Antiretroviral therapy attending ART centre at GIMS Teaching Hospital, Gadag. After taking written informed consent from the patients, a predesigned proforma which included socio-demographic variables, clinical details, and CD-4 count, along with patient health questionnaire (PHQ) 9 was administered to assess depression in PLHA.Results: Out of the 322 people living with HIV/AIDS, 108 (33.5%) had depressed. According to PHQ 9 questionnaire, 19.9% had mild depression, 10.6% moderate depression and 3.1% had moderate severe depression. It was noted that 40.3% of females had depression compared to 24.8% of males. PHLA who were on ART for less than one year had higher proportion of depression (61.1%) compared to those with 5 years duration of ART (28.6%) and it was statistically significant.Conclusions: In the study 33.5% of PHLA had depression. Socio-economic status, gender, duration of ART had significant association with depression whereas age, education, place of residence, CD4 count were not associated with depression. Depression screening among PHLA can be done at regular follows ups at ART centres.

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 Risk of adverse COVID-19 outcomes for people living with HIV: a rapid review and meta-analysis

2020 ◽  
Author(s):  
Maya Mellor ◽  
Anne Bast ◽  
Nicholas Jones ◽  
Nia Roberts ◽  
Jose Ordonez-Mena ◽  
...  
Keyword(s):  
Viral Load ◽  
T Cell ◽  
Meta Analysis ◽  
Cd4 T Cell ◽  
Rapid Review ◽  
People Living With Hiv ◽  
Hiv Viral Load ◽  
Increased Risk ◽  
Living With Hiv ◽  
Cd4 T Cell Count

Objective: To assess whether people living with HIV (PLWH) are at increased risk of COVID-19 mortality or adverse outcomes, and whether antiretroviral therapy (ART) influences this risk. Design: Rapid review with meta-analysis and narrative synthesis. Methods: We searched databases including Embase, Medline, medRxiv, and Google Scholar up to 26th August 2020 for studies describing COVID-19 outcomes in PLWH and conducted a meta-analysis of higher quality studies. Results: We identified 1,908 studies and included 19 in the review. In a meta-analysis of five studies, PLWH had a higher risk of COVID-19 mortality (hazard ratio (HR) 1.93, 95% Confidence Interval (CI): 1.59-2.34) compared to people without HIV. Risk of death remained elevated for PLWH in a subgroup analysis of hospitalised cohorts (HR 1.54, 95% CI: 1.05-2.24) and studies of PLWH across all settings (HR 2.08, 95%CI: 1.69-2.56). Eight other studies assessed the association between HIV and COVID-19 outcomes, but provided inconclusive, lower-quality evidence due to potential confounding and selection bias. There were insufficient data on the effect of CD4+ T cell count and HIV viral load on COVID-19 outcomes. Eleven studies reported COVID-19 outcomes by ART-regimen. In the two largest studies, tenofovir-disoproxil-fumarate (TDF)-based regimens were associated with a lower risk of adverse COVID-19 outcomes, although these analyses are susceptible to confounding by comorbidities. Conclusion: Evidence is emerging that suggests a moderately increased risk of COVID-19 mortality amongst PLWH. Further investigation into the relationship between COVID-19 outcomes and CD4+ T cell count, HIV viral load, ART and the use of TDF is warranted.

scholarly journals Burden of Talaromyces marneffei infection in people living with HIV/AIDS in Asia during ART era: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Yuanyuan Qin ◽  
Xiaojie Huang ◽  
Hui Chen ◽  
Xinchao Liu ◽  
Yao Li ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Lower Latitude ◽  
People Living With Hiv ◽  
Dimorphic Fungus ◽  
Talaromyces Marneffei ◽  
Cell Counts ◽  
Pooled Prevalence ◽  
Increased Risk ◽  
Living With Hiv ◽  
Hiv Aids

Abstract Background： Talaromyces marneffei (TM) is a dimorphic fungus mainly prevalent in Southeast Asian countries, which often causes disseminated life-threatening infection. TM infection often occurs in HIV/AIDS patients even in the antiretroviral therapy (ART) era. However, there has as yet, not been a systematic analysis of the prevalence of TM infection in HIV-infected populations in AsiaMethods：In this study, we searched Pubmed, Embase, Web of Science, CNKI, and WanFang from inception to 21 November 2018 for studies reporting TM infection in people living with HIV/AIDS (PLWHA). Our meta-analysis included studies investigating the prevalence of TM infection in PLWHA. Reviews, duplicate studies, and animal studies were excluded. A random effects model was used to estimate pooled prevalence, and meta-regression analysis was conducted to explore potential factors for heterogeneity.Results： 159,064 patients with HIV infection in 33 eligible studies were included in our meta-analysis. The pooled prevalence of TM infection in PLWHA was 3.6%. Vietnam had the highest prevalence (6.4%), followed by Thailand (3.9%), China (3.3%), India (3.2%) and Malaysia (2.1%). In China, TM infection was most prevalent in South China (15.0%), while the burden in Southwest China was not very heavy (0.3%). CD4+ T-cell counts below 200cells/mm3 contributed to the increased risk of TM infection in PLWHA (OR 12.68, 95%CI: 9.58-16.77). However, access to ART did not significantly decrease the risk of TM infection in PLWHA.Conclusions： The burden of TM infection in Asia is heavy, and varies from region to region. PLWHA in lower latitude areas are more likely to suffer from TM infection. Optimization of diagnostic tools and universal screening for TM in vulnerable people to ensure early case detection and prompt antifungal treatment should be considered.

HIV/AIDS Politics and Policy in Europe

2020 ◽  
Author(s):  
Paul DeBell
Keyword(s):  
Human Rights ◽  
People Living With Hiv ◽  
Health Crisis ◽  
Marginalized Communities ◽  
Leadership Challenges ◽  
Treatment And Prevention ◽  
Increased Risk ◽  
Living With Hiv ◽  
Universal Treatment ◽  
Hiv Aids

HIV/AIDS in Europe highlights the centrality of politics at local, state, and international levels to the successes and failures in fighting transnational, global threats. Though several European states have led the international struggle against HIV/AIDS and have made great strides in treatment and prevention, others host the fastest-growing epidemics in the world. Even in states with long histories of treatment, specific subpopulations, including many LGBTQ communities, face growing epidemics. This variation matches trends in public policy, the actions of political leaders, and social structures of inequity and marginalization toward affected populations. Where leaders stigmatize people living with HIV (PLHIV) and associated groups, the virus spreads as punitive policies place everyone at increased risk of infection. Thus, this epidemic links the health of the general public to the health of the most marginalized communities. Mounting evidence shows that a human rights approach to HIV/AIDS prevention involving universal treatment of all vulnerable communities is essential to combating the spread of the virus. This approach has taken hold in much of Europe, and many European states have worked together as a political force to shape a global human rights HIV/AIDS treatment and prevention regime. Despite this leadership, challenges remain across the region. In some Eastern European states, tragic epidemics are spreading beyond vulnerable populations and rates of transmission continue to rise. The Russian case in particular shows how a punitive state response paired with the stigmatization of PLHIV can lead to a health crisis for the entire country. While scholars have shed light upon the strategies of political legitimization likely driving the scapegoating and stigmatization of PLHIV and related groups, there is an immediate need for greater research in transnational social mobilization to pressure for policies that combat these backward political steps. As financial austerity and defiant illiberalism spread across Europe, key values of universal treatment and inclusion have come into the crosshairs along with the European project more generally. Researchers and policymakers must therefore be vigilant as continued progress in the region is anything but certain. With biomedical advances and the advent of the “age of treatment,” widespread alleviation from the suffering of HIV/AIDS is a real possibility. Realizing this potential will, however, require addressing widespread political, social, and economic challenges. This in turn calls for continued interdisciplinary, intersectional research and advocacy.

scholarly journals Response to First-Line Antiretroviral Therapy Among PLHIV from a High-Risk, Low-Prevalence Setting

2019 ◽  
Vol 18 ◽  
pp. 232595821986732
Author(s):  
Shahria Mohammad Rashed Ul Islam ◽  
Munira Jahan ◽  
Afzalun Nessa ◽  
Shahina Tabassum
Keyword(s):  
Antiretroviral Therapy ◽  
T Lymphocyte ◽  
Lymphocyte Count ◽  
Study Groups ◽  
People Living With Hiv ◽  
First Line ◽  
Cd8 T Lymphocyte ◽  
The Mean ◽  
Low Prevalence ◽  
Living With Hiv

The study reports the response of first-line antiretroviral therapy (ART) by assessing CD4 and CD8 T-lymphocyte and viral load (VL) among Bangladeshi people living with HIV (PLHIV). This observational approach was conducted on 100 PLHIVs, grouped into therapy naive (n = 33), therapy initiators with CD4 T-cell count of <350 cells/µL (n = 33), and therapy receivers for >1 year prior to the study period (n = 34). Therapy initiators who continued the study (n = 20) were followed up after 12 and 24 weeks of therapy initiation. The CD4 and CD8 T-lymphocyte count estimation and (VL) were quantified. The mean CD4 T-lymphocyte count was significantly reduced among the therapy initiators in comparison to therapy naive and therapy receivers. Similar findings were observed for CD8 T-lymphocyte count among the study groups. The mean HIV-1 RNA VL among therapy initiators showed a significant decrease after 12 and 24 weeks, and 85% patients in this group obtained undetectable VL status indicating the good therapeutic outcome.

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