scholarly journals Immunologic Biomarkers, Morbidity and Mortality Among HIV Patients Hospitalized in a Tertiary Care Hospital in the Brazilian Amazon

2020 ◽  
Author(s):  
Wellington Gama Mota ◽  
Taynná Vernalha Rocha Almeida ◽  
Daniel Silva dos Santos ◽  
Yury Oliveira Chaves ◽  
Danielle Furtado da Silva ◽  
...  
Keyword(s):  
Opportunistic Infections ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Brazilian Amazon ◽  
Morbidity And Mortality ◽  
People Living With Hiv ◽  
Care Hospital ◽  
Aids Patients ◽  
Laboratory Parameters ◽  
Hiv Aids

Abstract Background: While antiretroviral therapy (ART) has significantly improved survival rates of people living with HIV, some regions in Brazil still show a linear trend of growth in the opportunistic infections that cause HIV-associated mortality. We aimed to describe HIV-associated morbidity and mortality among hospitalized medical patients in a tertiary care hospital in Manaus, in the Brazilian Amazon, by investigating clinical data and immunologic biomarkers in order to assess predictive factors of mortality in this patient group. Methods: We prospectively measured concentrations of cytokines Th1/Th2/Th17 and soluble CD14 (sCD14) and reviewed the laboratory parameters and opportunistic infections in outcomes of either death or discharge of eighty-three HIV/AIDS patients who were admitted in 2017-2018 to the Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD) in Manaus. Results: The mortality in the sample studied was 20.5%. Tuberculosis (TB) showed a relative risk (RR) =1.86 (confidence interval (CI) 1.14 to 2.81: and p = 0.026), and weight loss was the symptom (RR=1.81; CI: 1.21 to 2.53 and p = 0.007) most highly associated with the death outcome in HIV/AIDS inpatients. Univariable analyses showed that the eosinophil count, platelet distribution width (PDW), and alanine aminotransferase were the only laboratory parameters that differed among patients who died. In relation to cytokines and sCD14 levels, no differences were found between those who died or were discharged. A multivariable logistic regression model was used to predict mortality and showed that individuals with no digestive syndrome (especially the absence of oropharyngeal candidiasis), nor TB are 63% to 76% less likely to die, respectively. In addition, increases in PDW values also decreased the probability of death. Curiously, patients who were discharged showed a trend towards a concomitant increase in PDW and mean platelet volume (MPV) in relation to those who died.Conclusions: Opportunistic infections continue to be major events in morbidity and mortality of HIV/AIDS patients, and the relationship between increased PDW and the likelihood of survival suggests the need for future studies on innate immune response of platelets in HIV/AIDS inpatients.

scholarly journals Immunologic biomarkers, morbidity and mortality among HIV patients hospitalised in a Tertiary Care Hospital in the Brazilian Amazon

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wellington Mota Gama ◽  
Carlos Henrique Michiles Frank ◽  
Taynná Vernalha Rocha Almeida ◽  
Daniel Silva dos Santos ◽  
Yury Oliveira Chaves ◽  
...  
Keyword(s):  
Platelet Activation ◽  
Opportunistic Infections ◽  
Tertiary Care ◽  
Enzyme Linked Immunosorbent Assay ◽  
People Living With Hiv ◽  
Care Hospital ◽  
Aids Patients ◽  
Distribution Width ◽  
Advanced Immunosuppression ◽  
Hiv Aids

Abstract Background The irregular use of antiretroviral therapy (ART) and late diagnosis still account for a large part of HIV-associated mortality in people living with HIV (PLHIV). Herein, we describe HIV-associated morbidity among hospitalised HIV/AIDS patients with advanced immunosuppression and assess the comorbidities, laboratory parameters, and immunological markers associated with mortality. Methods The cross-sectional study was conducted at the Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD) in Manaus, Brazil. In all, 83 participants aged between 12 and 70 years were enrolled by convenience within 72 h of their hospitalisation. Clinical and laboratory data were obtained from electronic medical records. We prospectively measured the cytokines Th1/Th2/Th17 and inflammatory cytokines IL-8, IL-1β, and IL-12 using cytometric bead array, and the soluble CD14 using in-house enzyme-linked immunosorbent assay. Results The HIV/AIDS inpatients presented a scenario of respiratory syndromes as the most prevalent comorbidity. Almost all patients had CD4 T counts below 350 cells/mL and the mortality rate was 20.5%. Pulmonary tuberculosis, neurotoxoplasmosis and oropharyngeal–esophageal candidiasis were the most prevalent opportunistic infections. TB and weight loss were more prevalent in HIV/AIDS inpatients who died. The Mann Whitney analysis showed that those who died had higher platelet distribution width (PDW) on admission, which is suggestive for platelet activation. The Poisson multivariate analysis showed the prevalence of TB, digestive syndrome and increases in IL-8 and lactate dehydrogenase (LDH) associated to death. Conclusions The advanced immunosuppression characterized by the opportunistic infections presented in these HIV/AIDS inpatients was the major factor of mortality. The role of platelet activation in worse outcomes of hospitalisation and the IL-8 associated with the context of advanced immunosuppression may be promising markers in the prediction of mortality in HIV/AIDS patients.

scholarly journals KNOWLEDGE, ATTITUDE AND PRACTICES AMONG NURSES TOWARDS HIV/ AIDS PATIENTS IN TERTIARY CARE HOSPITAL, AMROHA

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Atul Agrawal ◽  
Ankita Agrawal
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
People Living With Hiv ◽  
Care Hospital ◽  
Aids Patients ◽  
Attitudes And Practices ◽  
Positive Attitudes ◽  
High Level ◽  
Living With Hiv ◽  
Hiv Aids

Background: Human Immunodeficiency Virus (HIV) has become one of the most serious challenges to public health due to its high morbidity, mortality and economic impacts. Good Knowledge, positive attitudes and practices are important aspects of providing nursing care for people living with HIV/AIDS. Aim: This study aimed to assess knowledge, attitudes and practices of nurses working with HIV/AIDS patients. Methods: This study was descriptive, performed on 200 nurses working with HIV/AIDS patients at a tertiary care Hospital, Amroha. Data was collected using pretested, validated, self administered questionnaire consisting of knowledge, attitude and practice based questions related to HIV/Aids and infected patients along with demographic variables of nursing staff under study.  Results: The result of this study showed that majority of nurses (81%) working with HIV/AIDS patients possess adequate level of knowledge. Most of the nurses under study showed high level of empathic attitude toward people living with HIV/AIDS (above 80%) but at the same time high level of avoidance was observed among some nurses. Practice of nurses working with HIV/AIDS patients was found good. Conclusions: There was satisfactory knowledge, positive attitudes and good practice level among nurses under study. Recommendations: Training should focus on Preventive methods and modes of HIV transmission, care and support of all patients no matter what the disease, emphasizing confidentiality as a patient right that should not be ignored and should train nurses and monitor nursing skills. Keywords: Public health, Nurses, HIV, Knowledge, Attitude, Practices

scholarly journals Clinical and Socio demographic profile of attendees at ART centre in a tertiary care hospital in Mangalore, India

2015 ◽  
Vol 6 (5) ◽  
pp. 61-65
Author(s):  
U.B. Nayak ◽  
S. Lenka ◽  
B. Achappa
Keyword(s):  
Opportunistic Infections ◽  
Oral Candidiasis ◽  
Tertiary Care ◽  
Local Context ◽  
People Living With Hiv ◽  
Care Hospital ◽  
Heterosexual Contact ◽  
Presenting Symptoms ◽  
Number Of Patients ◽  
Hiv Aids

Introduction: India has the third largest number of people living with HIV/AIDS. There is a need to study the profile of patients who come to ART centers and link their clinical and socio-demographic variables in the management. Moreover, it is important to understand the presentation of HIV disease in the local context and culture. The present study is aimed at identifying the socio-demographic characteristics, clinical presentations of HIV/AIDS patients, opportunistic infections and the possible risk factors for acquiring HIV infection at an ART centre of Government Wenlock hospital, situated in Karnataka state of India. Materials and Methods: In this study 102 HIV patients attending the HIV clinic were enrolled and they were followed for a period of one year with relevant investigations.Results: Of 102 patients 69 were males and 33 were females.The mean age of the study subjects at the time of diagnosis was 38.06. Heterosexual contact was the commonest mode of transmission in96 (94.12%) patients. History suggestive of a risk factor for HIV transmission could not be elicited in 4 (3.92%) patients. Fever (71.5%), weight loss (62.74%), cough (51.96%) and chronic diarrhea (43.9%) were the common presenting symptoms. The most common opportunistic infection was oral candidiasis (66.67%) followed bytuberculosis (22.54%) and pneumocystis pneumonia (13.72%). Significant number of patients (30.37%) developed Zidovudine induced anemia and females were more prone for Zidovudine induced anemia as compared to males. CD4 counts of the patients were significantly inversely correlated with the number of symptoms and the number of opportunistic infections. Conclusion: Majority of patients were of low socioeconomic status and in productive age group with heterosexual contact being commonest mode of transmission.Significant number of patients developed Zidovudine induced anemia and females were more prone. DOI: http://dx.doi.org/10.3126/ajms.v6i5.11622Asian Journal of Medical Sciences Vol.6(5) 2015 61-65

scholarly journals Seroreactivity of HIV among patients attending a tertiary care hospital in North India: a retrospective analysis

2019 ◽  
Vol 8 (1) ◽  
pp. 177
Author(s):  
Akanksha Singh ◽  
Deepak Chopra ◽  
Sarver Jahan ◽  
Razia Khatoon
Keyword(s):  
Rural Areas ◽  
Hiv Transmission ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Intervention Strategy ◽  
North India ◽  
People Living With Hiv ◽  
Care Hospital ◽  
Immunodeficiency Syndrome ◽  
Hiv Aids

Background: HIV (Human Immunodeficiency Virus) is the causative agent of AIDS (Acquired Immunodeficiency Syndrome). It belongs to the lentivirus subgroup of the family Retroviridae. The HIV/AIDS is spreading worldwide at an alarming rate. India has the third largest number of estimated people living with HIV/AIDS. Most common mode of HIV transmission is through heterosexual contact, blood transfusion, percutaneous, mucosal and perinatal mode. The present study was done to evaluate the seroreactivity of HIV among patients attending Integrated Counselling and Testing Centre (ICTC) of our Tertiary care hospital.  Methods: This retrospective study was conducted on data of patients who had attended ICTC and undergone HIV testing from January 2017 to January 2019. A total of 4519 patients were included in the study who gave their consent followed by pre-test and post-test counseling and were screened for HIV antibody by using rapid kit Comb-Aids.Results: Out of 4519 samples tested, 23 were reactive to HIV screening test, hence sero-reactivity of HIV was found to be 0.50%. Higher seroreactivity was seen among males (56.5%, 13/23), and patients aged 31-40 years (39.1%, 9/23). Maximum seroreactivity was found among patients of rural areas (73.9%, 17/23), indoor patients (91.3%, 21/23) and married patients (73.9%, 17/23).Conclusions: In this study the seroreactivity of HIV was found to be low among patients attending ICTC but still HIV continues to be a major contributor to the global burden of disease. ICTC data can be used as an important tool for planning and improving the national HIV/AIDS intervention strategy.

Postmortem findings in HIV/AIDS patients in a tertiary care hospital in rural South Africa

2010 ◽  
Vol 40 (2) ◽  
pp. 81-84 ◽  
Author(s):  
Mirta Garcia-Jardon ◽  
Vivek G Bhat ◽  
E Blanco-Blanco ◽  
Andrez Stepian
Keyword(s):  
South Africa ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Pneumocystis Pneumonia ◽  
People Living With Hiv ◽  
Care Hospital ◽  
Opportunistic Fungi ◽  
Post Mortem Findings ◽  
Living With Hiv ◽  
Hiv Aids

South Africa has the largest number of people living with HIV/AIDS, and various associated infectious and noninfectious conditions contribute towards mortality. The objective of this study was to determine the important post-mortem findings in HIV-infected individuals in a high HIV burden rural area in South Africa. The patient population included HIV patients who died at the tertiary care hospital, from 2000–2008. Autopsies were performed according to standard protocols and diagnoses were made with additional laboratory investigations wherever required. A total of 86 patients were autopsied (30 males, 56 females). The major postmortem findings were related to infections, with 38% of the patients having had some form of tuberculosis, followed by pyogenic infections – pneumonias (21.5%), meningitis (10.1%) and septicemias (5.1%). Other important infections included opportunistic fungi like cryptococcosis (7.6%) and pneumocystis pneumonia (8.9%). Among the noninfectious conditions, the findings seen were predominantly related to liver (10.1%) and cardiac involvement (10.1%).

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