scholarly journals Pneumocystis pneumonia in patients with primary nephrotic syndrome: analysis of 18 cases

2020 ◽  
Author(s):  
Xiaohan You ◽  
Ji Zhang ◽  
Qiongxiu Zhou ◽  
Jianna Zhang
Keyword(s):  
Nephrotic Syndrome ◽  
Pneumocystis Pneumonia ◽  
Prednisone Dose ◽  
Primary Nephrotic Syndrome ◽  
Cd4 Cell Count ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
The Mean ◽  
Cd4 Cell ◽  
Syndrome Analysis

Abstract Background The aim of this study was to analysis the clinical features, risk factors and outcomes of patients with primary nephrotic syndrome (PNS) who developed pneumocystis pneumonia (PCP). Methods We systematically reviewed medical records from 18 PNS patients with PCP admitted to our hospital from April 2007 to April 2019. A total of 180 cases were randomly selected as controls from PNS inpatients without infection. Results In PCP patients, the mean age at presentation was 48.5 years, mean duration of prednisone treatment was 3.7 months and mean prednisone dose on admission was 31.3 mg/d, the most common clinical manifestation was fever (100%) and average PaO 2 on admission was 59.5 mmHg. Eight patients (44.4%) had coexisting infections, most often was cytomegalovirus (4 patients), 11 patients (61.1%) had ICU admission and 9 patients (50%) had mechanical ventilation. PCP patients had more prednisone, more immunosuppressive therapy, lower CD4+ cell counts and hemoglobin, and higher serum creatinine than those without infections (p<0.05). Logistic regression analysis showed that patients with prednisone usage and lower CD4+ cell counts were more likely to have PCP compared to controls (p<0.05). All patients survived after treatment. Conclusion PCP was not unusual in PNS patients, and the most important risk factor was a lower CD4+ cell count, but however, these patients had a good outcome after enough treatments.

scholarly journals Pneumocystis pneumonia in patients with primary nephrotic syndrome: analysis of 18 cases

2020 ◽  
Author(s):  
Xiaohan You ◽  
Ji Zhang ◽  
Qiongxiu Zhou ◽  
Jianna Zhang
Keyword(s):  
Nephrotic Syndrome ◽  
Pneumocystis Pneumonia ◽  
Prednisone Dose ◽  
Primary Nephrotic Syndrome ◽  
Cd4 Cell Count ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
The Mean ◽  
Cd4 Cell ◽  
Syndrome Analysis

Abstract Background: The aim of this study was to analysis the clinical features, risk factors and outcomes of patients with primary nephrotic syndrome (PNS) who developed pneumocystis pneumonia (PCP).Methods: We systematically reviewed medical records from 18 PNS patients with PCP admitted to our hospital from April 2007 to April 2019. A total of 180 cases were randomly selected as controls from PNS inpatients without infection.Results: In PCP patients, the mean age at presentation was 48.5 years, mean duration of prednisone treatment was 3.7 months and mean prednisone dose on admission was 31.3 mg/d, the most common clinical manifestation was fever (100%) and average PaO2 on admission was 59.5 mmHg. Eight patients (44.4%) had coexisting infections, most often was cytomegalovirus (4 patients), 11 patients (61.1%) had ICU admission and 9 patients (50%) had mechanical ventilation. PCP patients had more prednisone, more immunosuppressive therapy, lower CD4+ cell counts and hemoglobin, and higher serum creatinine than those without infections (p<0.05). Logistic regression analysis showed that patients with prednisone usage and lower CD4+ cell counts were more likely to have PCP compared to controls (p<0.05). All patients survived after treatment.Conclusion: PCP was not unusual in PNS patients, and the most important risk factor was a lower CD4+ cell count, but however, these patients had a good outcome after enough treatments.

scholarly journals Pneumocystis Pneumonia in Patients with Primary Nephrotic Syndrome: Analysis of 18 Cases

2020 ◽  
Author(s):  
Xiaohan You ◽  
Ji Zhang ◽  
Qiongxiu Zhou ◽  
Jianna Zhang
Keyword(s):  
Nephrotic Syndrome ◽  
Pneumocystis Pneumonia ◽  
Prednisone Dose ◽  
Primary Nephrotic Syndrome ◽  
Cd4 Cell Count ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
The Mean ◽  
Cd4 Cell ◽  
Syndrome Analysis

Abstract Background: The aim of this study was to analysis the clinical features, risk factors and outcomes of patients with primary nephrotic syndrome (PNS) who developed pneumocystis pneumonia (PCP).Methods: We systematically reviewed medical records from 18 PNS patients with PCP admitted to our hospital from April 2007 to April 2019. A total of 180 cases were randomly selected as controls from PNS inpatients without infection. Results: In PCP patients, the mean age at presentation was 48.5 years, mean duration of prednisone treatment was 3.7 months and mean prednisone dose on admission was 31.3 mg/d, the most common clinical manifestation was fever (100%) and average PaO2 on admission was 59.5 mmHg. Eight patients (44.4%) had coexisting infections, most often was cytomegalovirus (4 patients), 11 patients (61.1%) had ICU admission and 9 patients (50%) had mechanical ventilation. PCP patients had more prednisone, more immunosuppressive therapy, lower CD4+ cell counts and hemoglobin, and higher serum creatinine than those without infections (p<0.05). Logistic regression analysis showed that patients with prednisone usage and lower CD4+ cell counts were more likely to have PCP compared to controls (p<0.05). All patients survived after treatment. Conclusion: PCP was not unusual in PNS patients, and the most important risk factor was a lower CD4+ cell count, but however, these patients had a good outcome after enough treatments.

scholarly journals Pneumocystis pneumonia in patients with primary nephrotic syndrome: analysis of 18 cases

2020 ◽  
Author(s):  
Xiaohan You ◽  
Ji Zhang ◽  
Qiongxiu Zhou ◽  
Jianna Zhang
Keyword(s):  
Risk Factors ◽  
Nephrotic Syndrome ◽  
Pneumocystis Pneumonia ◽  
Prednisone Dose ◽  
Primary Nephrotic Syndrome ◽  
Cd4 Cell Count ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Independent Risk Factors ◽  
Cd4 Cell

Abstract Background: The aim of this study was to analysis the clinical features, risk factors and outcomes of patients with primary nephrotic syndrome (PNS) who developed pneumocystis pneumonia (PCP).Methods: We systematically reviewed medical records from 18 PNS patients with PCP admitted to our hospital from April 2007 to April 2019. A total of 180 cases were randomly selected as controls from PNS inpatients without infection. Results: In PCP patients, the mean age at presentation was 48.5 years, mean duration of prednisone treatment was 3.7 months and mean prednisone dose on admission was 31.3 mg/d, the most common clinical manifestation was fever (100%) and average PaO2 on admission was 59.5 mmHg. Eight patients (44.4%) had coexisting infections, most often was cytomegalovirus (4 patients), 11 patients (61.1%) had ICU admission and 9 patients (50%) had mechanical ventilation. PCP patients had more prednisone, more immunosuppressive therapy, lower CD4+ cell counts and hemoglobin, and higher serum creatinine than those without infections (p<0.05). Logistic regression analysis showed that PNS patients with prednisone usage and lower CD4+ cell counts were independent risk factors of more likely to have PCP compared to controls (OR =3.39, p=0.002; OR =0.64, p=0.021p<0.05). All patients survived after treatment. Conclusion: PCP was not unusual in PNS patients, and the most important risk factors were prednisone usage and a lower CD4+ cell count, but however, these patients had a good outcome after enough treatments.

scholarly journals Linear Mixed Modeling of CD4 Cell Counts of HIV-Infected Children Treated with Antiretroviral Therapy

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Belay Belete Anjullo ◽  
Derbachew Asfaw Teni
Keyword(s):  
Cell Count ◽  
Stage Iv ◽  
Observation Time ◽  
Square Root ◽  
Cd4 Cell Count ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
History Of ◽  
The Mean ◽  
Cd4 Cell

Background. Human immunodeficiency virus (HIV) is a major health problem in the world, and failure to implement prevention programs results in an increased number of infections among newborns. The goal of this study was to investigate the evolution and determinants of cluster of differentiation four (CD4) cell count among HIV-infected children who were under antiretroviral therapy (ART). Methods. We follow up a cohort of 201 children aged under fifteen years from October 2013 to March 2017 at Adama Hospital in Ethiopia. To get insight into the data, exploratory data analysis was performed on the change in the longitudinal CD4 cell count. Results. At the baseline, the average number of CD4 cell counts was 468.5 cells/mm3 of blood with a standard deviation of 319.11 cells/mm3. Here, we employed the random intercept and the random slope linear mixed-effects model to analyze the data. Among predictor variables, observation time, baseline age, WHO clinical stage, the history of tuberculosis (TB), and functional status were determinant factors for the mean change in the square root of the CD4 cell count. Conclusions. The finding revealed that the change in the square root of the CD4 cell count increases with an increment of age at diagnosis. Regarding WHO clinical stages of patients, those who were in stage III and stage IV of the HIV/AIDs disease stages relatively had lower CD4 cell counts than stage I patients. This shows the change in the square root of CD4 cell counts of stage III and stage IV patients was 6.43 and 9.28 times lower than stage I patients, respectively. Similarly, we noticed that observation time, the history of TB, and functional status were significantly associated with the mean change in the square root of the CD4 cell count.

scholarly journals Clinical analysis of 207 patients with coronavirus disease 2019 (COVID-19) in Shanghai, China

2020 ◽  
Author(s):  
Lin Wang ◽  
Yuan Zhang ◽  
Fei Shan ◽  
Renyin Zhang ◽  
Nannan Shi ◽  
...  
Keyword(s):  
Laboratory Data ◽  
Clinical Analysis ◽  
Chest Ct ◽  
Cd4 Cell Count ◽  
Prognostic Effect ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Slow Decline ◽  
The Mean ◽  
Cd4 Cell

Abstract Objectives: To investigate clinical features and the chest computed tomography (CT) findings in patients with confirmed cases of coronavirus disease 2019 (COVID-19) in Shanghai. Materials and Methods: Two hundred seven patients (102 men and 105 women, 15-84 years old) with COVID-19 from 23 January 2020 to 8 February 2020 were retrospectively reviewed. The imaging findings, clinical and laboratory data of the patients were evaluated and analyzed. The CT score was determined by totaling the lobes of lungs affected ranging from 0-25. Results: The median time from onset of symptoms to first hospital admission was 5.3±3.9 days.After being tested positive, the hospital stay of patients with onset of symptoms within one week is longer than that of patients with onset of symptoms over one week (15.7 vs. 11.5 respectively, p<0.01). The initial lung findings of patients with COVID-19 on chest CT were small subpleural ground glass opacities (GGO) that grew larger with crazy-paving pattern and consolidation with or without interstitial opacity. The mean CT scores peaked at 8-10 days of illness, with a slow decline thereafter and substantial scores after the 10 days. Both age and CD4+ cell counts had a remarkable prognostic effect on imaging outcomes (p<0.05). Conclusion: For patients in mild-to-moderatecondition, the disease began to improve after 10 days from the initiation of the symptoms. Both age and baseline CD4+ cell count were pivotal predictor of the outcome of imaging of the patients with COVID-19.

HIV-1 Plasma RNA level and CD4 cell count in a large urban HIV-1-infected patient population from 1997 to 2000

2003 ◽  
Vol 14 (11) ◽  
pp. 740-744 ◽  
Author(s):  
Hua Shan ◽  
Estelle Piwowar-Manning ◽  
Richard E Thompson ◽  
J Brooks Jackson
Keyword(s):  
Cell Count ◽  
Infected Patient ◽  
Laboratory Findings ◽  
Cd4 Cell Count ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
The Mean ◽  
Cd4 Cell ◽  
Plasma Rna ◽  
Hiv 1

We evaluated the change in plasma HIV-1 RNA level and CD4 cell counts in an HIV-1-infected population between 1997 and 2000. Both the mean and the median values of plasma HIV-1 RNA level decreased with time with the exception of 1998. The mean and medians for CD4 cell count appear to be fairly stable. While the percentage of patients with plasma HIV-1 RNA level <400 copies/mL increased from 29.12% in 1997 to 41.31% in 2000, the percentage of patients with plasma HIV-1 RNA level >100,000 copies/mL remained fairly constant. The availability of HAART had impacted the level of plasma HIV-1 RNA, although many patients still have plasma HIV-1 RNA level >100,000 copies/mL. Most patients with plasma HIV-1 RNA level >400 copies/mL in 1997 still have plasma HIV-1 RNA level >400 copies/mL in 2000. These laboratory findings, however, do not necessarily mean that there had been a lack of clinical benefit.

scholarly journals Linear Mixed Modeling of CD4 Cell Counts of HIV Infected Children Treated with Antiretroviral Therapy

2020 ◽  
Author(s):  
Belay Belete Anjullo ◽  
Derbachew Asfaw Teni
Keyword(s):  
Cell Count ◽  
Stage Iv ◽  
Observation Time ◽  
Square Root ◽  
Cd4 Cell Count ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
History Of ◽  
The Mean ◽  
Cd4 Cell

Abstract Background: HIV is a major health problem in the world and failure to implement prevention programs result in an increased number of infections among newborns.The goal of this study was to investigate the evolution and determinants of CD4 cell count among HIV-infected children who were under ART. Methods: We follow-up a cohort of 201 children aged under fifteen years from Oct. 2013-to-Mar. 2017 at Adama Hospital in Ethiopia. To get insight into the data, exploratory data analysis was performed on the change in the longitudinal CD4 cell count. Results: At the baseline the average number of CD4 cell counts was 468.5 cells/mm3 of blood with a standard deviation of 319.11 cells/mm3. Here we employed the random intercept and the random slope linear mixed-effects model to analyze the data. Among predictor variables, observation time, baseline age, WHO clinical stage, history of TB and functional status were determinant factors for the mean change in the square root of CD4 cell count.Conclusions: The finding revealed that; the change in the square root of CD4 cell count increases with an increment of age at diagnosis. Regarding WHO clinical stages of patients, those who were in stage III and stage IV of the HIV/AIDs disease stages relatively had lower CD4 cell counts than stage I patients. This shows the change in the square root of CD4 cell counts of stage III and stage IV patients were 6.43 and 9.28 times lower than stage I patients respectively. Similarly, we noticed observation time, history of TB, and functional status had significantly associated with the mean change in the square root of CD4 cell count.

Factors associated with late presentation of HIV infection in Catalonia, Spain

2012 ◽  
Vol 23 (7) ◽  
pp. 475-480 ◽  
Author(s):  
N Vives ◽  
D Carnicer-Pont ◽  
P Garcia De Olalla ◽  
N Camps ◽  
A Esteve ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Late Presentation ◽  
Late Diagnosis ◽  
Cd4 Cell Count ◽  
Hiv Surveillance ◽  
Factors Associated ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Populations At Risk ◽  
Cd4 Cell

We sought to describe the prevalence, trends and factors associated with late diagnosis of HIV infection between 2001 and 2008 in Catalonia, Spain. Adults over 13 years of age with available CD4 cell counts, who were notified to the Catalonia Voluntary HIV Surveillance System between January 2001 and December 2008, were included in the study. Late presentation for HIV infection was defined as a CD4 cell count <350 cells/μL or with an AIDS-defining condition at presentation. Multivariable logistic regression was used to identify factors independently associated with late diagnosis of HIV. Of the 4651 newly diagnosed HIV-infected individuals with available CD4 counts, 2598 (55.9%) were diagnosed late. The proportion of people with a late diagnosis decreased from 60.4% in 2001 to 50% in 2008, a significant trend ( P < 0.001). Older age, male gender, foreign birth, heterosexuality and injecting drug use were independent risk factors for late diagnosis. Strategies to actively promote HIV testing to populations at risk of late diagnosis of HIV or those never attending health systems should be implemented.

scholarly journals The outcome predictors and therapeutic strategy of pneumocystis pneumonia in North China: a double-center retrospective study

2019 ◽  
Author(s):  
Wei Hua ◽  
Yang Yang ◽  
Zheng Zhang ◽  
Wei Zhang ◽  
Jing Zeng ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Side Effect ◽  
Therapeutic Strategy ◽  
North China ◽  
Pneumocystis Pneumonia ◽  
Parameter Distribution ◽  
Glucocorticoid Treatment ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Cd4 Cell

Abstract Background: Pneumocystis pneumonia (PCP) is common in HIV/AIDS patients with advanced immunosuppression. Trimethoprim/sulfamethoxazole (TMP/SMX) is recommended as the first-line anti-pneumocystis agent as soon as PCP is suspected based on its typical feature. However, the clinical characteristic and therapeutic strategy of Chinese PCP were not well-known. Methods: We retrospectively investigated 473 HIV associated PCPs in North China from double centers, Beijing You An Hospital during 2010 to 2017 and the Infectious Disease Hospital in Harbin during 2015 to 2017. HIV associated PCP were diagnosed as the guideline recommended by CDC, NIH and HIV Medicine Association of IDSA. Demographic and clinic data were collected and statistically analysed as the parameter distribution feature. Results: Among 473 HIV associated PCPs, we found that men were over-represented in PCP due to the high incidence of HIV infection among male homosexuality, and over one-third of them were aware of their HIV infection ago but did not maintain effective antiretroviral therapy. A history of smoking and multi-organism infection or system infection were common among them. In the multivariate analysis, we found lactate dehydrogenase (LDH) (OR 1.020, 95% CI 1.006-1.033, P=0.005), alveolar-arterial O2 difference ([A-a] DO2) and neutrophils counts (OR 1.051, 95% CI 1.005-1.099, P=0.030) were unfavourable predictors and CD4 cell counts (OR 0.900, 95% CI 0.813-0.996, P=0.041) were favourable predictor of PCP outcome. Trimethoprim/sulfamethozole (TMP/SMZ) but not TMP/SMX was used to anti-pneumocystis therapy in these patients with a low side-effect incidence which mainly forcused on epispasis, fever, liver injury and myelosuppression. Caspofungin was the only alternative medicine for those presented poor efficacy or could not tolerate the side-effects of TMP-SMZ and near 30 percent of moderate/severe PCP received glucocorticoid treatment. Conclusion: The present data suggest that high levels of serum-LDH, [A-a] DO2 and neutrophils counts and low CD4 cell counts predict poor outcome of PCP. TMP/SMZ can cure most PCPs with a low side-effect incidence and caspofungin is an effective alternation. A larger prospective study is needed to obtain better estimates of PCP in China.

scholarly journals The correlation of tuberculosis smear results and immuno-suppression with CD4+ counts as a surrogate marker among HIV infected patients.

2021 ◽  
Author(s):  
Kingsley Kamvuma ◽  
Yusuf ademola ◽  
Warren Chanda ◽  
Christopher Newton Phiri ◽  
Sam Bezza Phiri ◽  
...  
Keyword(s):  
Cell Count ◽  
Surrogate Marker ◽  
Hiv Positive ◽  
Sputum Smear ◽  
Cd4 Cell Count ◽  
Cd4 Counts ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Study Participants ◽  
Cd4 Cell

Abstract Background: Human immunodeficiency virus (HIV) and M.tuberculosis are two intracellular pathogens that interact at the cellular, clinical and population levels. Since the recognition of AIDS in 1981, the number of reported cases of TB in the has increased substantially, especially in regions with high incidence of AIDS. The main aim of this study was to establish weather there is a relationship between sputum smear positives and low CD4 cell counts among HIV infected patients.Materials and methods: This was a retrospective study involving 473 participants. The patients recruited in this study were those who tested HIV positive and smear positive for TB. Their HIV status was determined by performing an HIV blood test, if they were HIV positive their CD4 cell count were then made.Results: This study examined the relation between smear positivity and low CD4 (below 200cells/µl) together with CD8 and CD3 markers as a measure of immune function among patients infected with HIV. The study participants’ constituted males 67% and females 33%. The overall mean age was 33.2 (SD 6.9) with the youngest and oldest participants being 18 and 60 respectively. It was found that smear positive results negatively (r=-0.13; p=0.021) correlated with CD4+ below 200 cells/µl. No correlation was observed between smear positives and CD8+ or CD3+ since the calculated correlation coefficient was not significant 0.007 (p=0.9) and 0.03 (p=0.6) respectively. There are more 3+ smear results below 200 cells/µl than the others while above 200 cells/µl 1+ was the most commonly reported smear result. The scanty smear positives were the least commonly reported result in the low and high CD4 counts. Conclusion: The smear positive result negatively correlated with a low CD4+ (r=-0.13; p=0.021) but no correlation with low CD+8 and CD+3 results was observed. The long held theory that low bacillary counts in patients with low CD4+ counts needs to be revisited. The reduction of CD4+ cell count parallels' that of the total lymphocyte count and is more marked in patients with high bacillary counts. Further, studies are required to confirm these findings

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