scholarly journals Cardiac Disease and HIV in Africa: A Case for Physical Exercise

2015 ◽  
Vol 9 (1) ◽  
pp. 62-65 ◽  
Author(s):  
Ana Olga Mocumbi

AIDS-related deaths and new HIV infections have declined globally, but continue to be a major problem in Africa. Prior to the advent of antiretroviral treatment (ART) HIV patients died of immunodeficiency and associated opportunistic infections; Highly Active Antiretroviral Therapy (HAART) has resulted in increased survival of these patients and has transformed this illness into a chronic condition. Cardiovascular, respiratory, neurological and muscular problems interfere with exercise in HIV-infected patients. Particularly cardiovascular disease may be associated with direct damage by the virus, by antiretroviral therapy and by malnutrition and chronic lung disease, resulting in physical and psychological impairment. Recent studies have shown the benefits of exercise training to improvement of physiologic and functional parameters, with the gains being specific to the type of exercise performed. Exercise should be recommended to all HIV patients as an effective prevention and treatment for metabolic and cardiovascular syndromes associated with HIV and HAART exposure in sub-Saharan Africa.

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e015123 ◽  
Author(s):  
Sonia Menon ◽  
Rodolfo Rossi ◽  
Natasha Zdraveska ◽  
Mbabazi Kariisa ◽  
Sushama D Acharya ◽  
...  

ObjectivesIn sub-Saharan Africa, substantial international funding along with evidence-based clinical practice have resulted in an unparalleled scale-up of access to antiretroviral treatment at a higher CD4 count. The role and timing of highly active antiretroviral therapy (HAART) in mediating cervical disease remains unclear. The aim of this article is to systematically review all evidence pertaining to Africa and identify research gaps regarding the epidemiological association between HAART use and the presence of premalignant/malignant cervical lesions.MethodFive databases were searched until January 2017 to retrieve relevant literature from sub-Saharan Africa. Publications were included if they addressed prevalence, incidence or clearance of human papillomavirus (HPV) infection in women undergoing HAART as well as cytological or histological neoplastic abnormalities.Results22 studies were included, of which seven were prospective studies. Women receiving HAART are less likely to develop squamous intraepithelial lesions (SILs). There is evidence that duration of HAART along with the CD4 count may reduce the prevalence of high-risk HPV (HR-HPV), suggesting that without HAART, severe immunosuppression increases the risk of becoming or remaining infected with HR-HPV. Furthermore, according to existent literature, the CD4 count, rather than HAART coverage or its duration, plays a central role in the prevalence of cervical intraepithelial neoplasia (CIN) 2 and CIN 3.ConclusionOur findings suggest a positive impact of HAART duration, in conjunction and interaction with CD4 count, on reducing the prevalence of HR-HPV. The greatest treatment effect might be seen among women starting at the lowest CD4 count, which may have a more instrumental role in cervical oncogenesis than either HAART use or the treatment duration on the prevalence of CIN 2 and CIN 3. There is still insufficient evidence to show a clear association between HAART coverage and the incidence of invasive cervical cancer. Enhanced surveillance on the impact of HAART treatment is crucial.


AIDS ◽  
2004 ◽  
Vol 18 (8) ◽  
pp. 1159-1168 ◽  
Author(s):  
Motasim Badri ◽  
Linda-Gail Bekker ◽  
Catherine Orrell ◽  
Jennifer Pitt ◽  
François Cilliers ◽  
...  

Author(s):  
Chijioke Patrick Amadi ◽  
Grace Michael Ikon ◽  
Udoinyang Clement Inyang

Background: Malaria and HIV remain two leading causes of morbidity and mortality to patients in developing African countries. Both infectious diseases have been documented to account for an enormous morbidity and mortality in Sub-Saharan Africa. The geographical overlap in sub-Saharan Africa and South America has led to similarities in co-infection with Plasmodium and HIV, this has resulted in the quick progression and severity of both diseases particularly among the poor, and contributes to the poverty of sub-Saharan African nations by taking a toll on young people who contribute greatly to the workforce of the economy. The present study was conducted to determine the prevalence of malarial infection in HIV patients receiving high active antiretroviral therapy in university Uyo teaching hospital, Uyo Nigeria.Methods: A predesigned structured questionnaire was administered to collect bio data and socio-demographic characteristics from the participants consisting 35 HIV infected adult patients and 32 non HIV infected adults as controls. All HIV patients were receiving HAART during this study. The HAART regimens used by HIV infected patients consist of zidovudine, lamivudine, efavirenze, and nevirapine.Results: About 5 (14.2%) HIV patients on HAART had falciparum malaria. No falciparum malaria was detected in HIV negative participants. Of the five positive malaria cases detected in HIV patients, 8.5% were females and 5.7% were males.Conclusions: There was no significant difference of malaria parasite infection by gender (P = 0.88), age group (P = 0.17), and CD4+ count (O.R:1.0, P = 0.81).


Author(s):  
John Jospeh Diamond Princy ◽  
Kshetrimayum Birendra Singh ◽  
Ningthoujam Biplab ◽  
Ningthoukhongjam Reema ◽  
Rajesh Boini ◽  
...  

Abstract Introduction Human immunodeficiency virus (HIV) infection is a state of profound immunodeficiency. Disorders of hematopoietic system are a common but often overlooked complication of HIV infection. This can manifest at any stage of the disease but more commonly in the advanced stage with low CD4 count. Anemia is the most common hematological abnormality in HIV patients and prevalence ranges from 1.3 to 95%. As HIV disease progresses, the prevalence and severity of anemia also increase. Hence, this study was undertaken to assess the hematological parameters of HIV-infected patients on highly active antiretroviral therapy (HAART) at different treatment durations with the hope to improve the HAART outcome in HIV patients and its correlation with CD4 count. Methods This prospective longitudinal study enrolled 134 HIV-infected patients admitted to or attending the OPD in the Department of Medicine or Antiretroviral Therapy (ART) Center (Center of Excellence), Regional Institute of Medical Sciences (RIMS), Imphal, Manipur, from 2018 to 2020. Complete hemogram, CD4 count, and other related-blood investigations were studied. Results The mean age of the study population was 39.9 ± 11.04 years. Of the 134 patients, 75 (56%) were males and 59 (44%) were females. Twelve (9%) patients had a history of injecting drug use (IDU). TLE (tenofovir, lamivudine, efavirenz) regimen was started on 112 (83.6%) patients and the majority of them (69/134 [51.5%]) had a CD4 count of 200 to 499 cells/mm3, which increased significantly 6 months after HAART to 99 to 1,149 cells/mm3, with a mean of 445 ± 217 cells/mm3. There were significant improvements in hemoglobin (Hb) levels, total leukocyte count (TLC), absolute neutrophil count (ANC), and absolute lymphocyte count (ALC) after HAART indicating a positive correlation with CD4 count (p < 0.05). Thrombocytopenia was observed higher after HAART when compared to baseline. There was a positive correlation between platelet count and CD4 count. However, the mean corpuscular volume (MCV) and erythrocyte sedimentation rate (ESR) had a negative correlation with CD4 count. Conclusion The study inferred a strong positive correlation between CD4 and Hb levels, TLC, ANC, ALC, and platelet count after HAART with improvement in these values as CD4 count increases. Specific treatment intervention based on the changes in the immunohematological profile trends can help prevent most of the adverse effects on HIV patients in our community.


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