scholarly journals HAART THERAPY IN GHANA: COMPARATIVE ASSESSMENT OF THE EFFECTIVENESS OF DIFFERENT HAART COMBINATIONS AT KOMFO ANOKYE TEACHING HOSPITAL

2020 ◽  
pp. 89-93
Author(s):  
PAA KOFI TAWIAH ADU GYAMFI ◽  
KWESI BOADU MENSAH ◽  
STEPHEN MENSAH ARHIN ◽  
ALIU MOOMIN
Keyword(s):  
Teaching Hospital ◽  
Highly Active Antiretroviral Therapy ◽  
Cd4 Count ◽  
Highly Active ◽  
Significant Difference ◽  
Proven Efficacy ◽  
Major Teaching Hospital ◽  
Major Teaching ◽  
Study Population ◽  
Haart Therapy

Objective: Although all marketed antiretrovirals (ARVs) have proven efficacy, genetic differences can result in varied effectiveness. This study was conducted to determine the effectiveness of different Highly Active Antiretroviral Therapy (HAART) combinations among patients attending HIV clinic at a Major Teaching Hospital in Ghana. Methods: The study was a retrospective study involving 500 patients at an HIV clinic in the Ashanti Region of Ghana. Results: Twelve major antiretroviral combinations for HAART were prescribed at the study center. The most prescribed drug combinations were AZT+3TC+EFV and AZT+3TC+NVP. The study identified that HAART, irrespective of the kind of drug combination used, was effective at increasing CD4 count within the first 6 mo of therapy initiation in the study population. However, the magnitude of the increases differed from combination to combination. All HAART combinations with zidovudine as one of the drugs resulted in higher CD4 counts compared with combinations containing stavudine. HAART with nevirapine also resulted in a higher CD4 count than those with efavirenz. However, efavirenz-based combinations appeared to be more effective in critically ill patients and patients with mean CD4+T helper cells count below 100 cell/mm3. More importantly, efavirenz was common among all HAART combinations that resulted in treatment failure. Conclusion: There was significant variation in response to different HAART combination among Ghanaian HIV patients. However, there was no statistically significant difference in mean CD4 count between the two most predominately used HAART i. e AZT+3TC+EFV and AZT+3TC+NVP.

scholarly journals EFFECT OF ANTIRETROVIRAL TREATMENT REGIMENS ON LIVER ENZYMES IN HUMAN IMMUNODEFICIENCY VIRUS PATIENTS

2018 ◽  
Vol 11 (8) ◽  
pp. 95
Author(s):  
Adiga Sachidananda Mn ◽  
Adiga Usha S
Keyword(s):  
Human Immunodeficiency Virus ◽  
Highly Active Antiretroviral Therapy ◽  
Liver Enzymes ◽  
Cd4 Count ◽  
Treatment Regimens ◽  
Highly Active ◽  
Significant Difference ◽  
Immunodeficiency Virus ◽  
Slight Elevation ◽  
The Difference

Objective: Treatment of human immunodeficiency virus (HIV) with highly active antiretroviral therapy is complicated due to its effect on liver enzymes along with associated risk of opportunistic infection and its treatment. The objective of the study was to compare the effect of two zidovudine and lamivudine-based regimens on liver enzymes and to correlate them with age and CD4 count in HIV patients.Methods: In this retrospective study, patients who have received zidovudine+lamivudine+nevirapine (ZLN) or zidovudine+lamivudine+efavirenz (ZLE) at least for 1 year were included. Baseline, 6-month, and 1-year values of aspartate amino transferase (AST), alanine amino transferase (ALT), and CD4 count were collected. One-way analysis of variance and unpaired t-test were used to compare the difference in AST, ALT, and CD4 count value within basal, 6 months, and 1 year of two group and between the groups, respectively. Pearson’s correlation was used for correlation study.Results: Elevation of AST levels in patients who had received ZLN regimen at different interval was significant statistically. There was a statistically significant elevation of ALT level at 6 months. There was no significant change in AST and ALT values in patients who had received ZLE regimen. Between the two regimens, there was statistically significant difference in AST and ALT values at 6 months and 1 year. There was no correlation between age and CD4 count with liver enzymes.Conclusion: We conclude from the study that nevirapine containing zidovudine regimen showed a slight elevation in AST. The efavirenz regimen did not show a change in AST and ALT.

scholarly journals Hematological Profile of HIV-Infected Patients on First-Line Highly Active Antiretroviral Therapy and Its Correlation With CD4 Count

2021 ◽  
Author(s):  
John Jospeh Diamond Princy ◽  
Kshetrimayum Birendra Singh ◽  
Ningthoujam Biplab ◽  
Ningthoukhongjam Reema ◽  
Rajesh Boini ◽  
...  
Keyword(s):  
Platelet Count ◽  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Highly Active Antiretroviral Therapy ◽  
Cd4 Count ◽  
Total Leukocyte Count ◽  
Hiv Patients ◽  
Positive Correlation ◽  
Highly Active ◽  
The Mean

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.

scholarly journals Graves' Disease as a Manifestation of Immune Reconstitution in HIV-Infected Individuals after Initiation of Highly Active Antiretroviral Therapy

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Samad Rasul ◽  
Robert Delapenha ◽  
Faria Farhat ◽  
Jhansi Gajjala ◽  
Syeda Mehreen Zahra
Keyword(s):  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Immune Reconstitution ◽  
Immunological Response ◽  
Signs And Symptoms ◽  
Graves Disease ◽  
Typically Develop ◽  
Highly Active ◽  
Inflammatory Syndrome ◽  
Haart Therapy

Graves' disease after the initiation of highly active antiretroviral therapy (HAART) in certain HIV-1-infected individuals has been described as an immune reconstitution inflammatory syndrome (IRIS). This phenomenon should be suspected in individuals who present with clinical deterioration and a presentation suggestive of hyperthyroidism despite good virological and immunological response to HAART. Signs and symptoms of hyperthyroidism may be discrete or overt and typically develop 8–33 months after initiating therapy. One to two percent of HIV-infected patients can present with overt thyroid disease. Relatively few cases of Graves' IRIS have been reported in the literature to date. We describe four cases of Graves' IRIS in HIV-infected patients who were started on HAART therapy.

scholarly journals Examination of Haematotoxicity of Fixed-Dose Highly Active Antiretroviral Drug in Albino Wistar Rats

2012 ◽  
Vol 2012 ◽  
pp. 1-6
Author(s):  
Thomas Nubila ◽  
Ernest O. Ukaejiofo ◽  
Nkoyo I. Nubila ◽  
Godfrey I. Okorie
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
Wistar Rats ◽  
Venous Blood ◽  
Haemoglobin Concentration ◽  
Test Group ◽  
Mean Value ◽  
Fixed Dose ◽  
Control Group ◽  
Highly Active ◽  
Significant Difference

Highly active antiretroviral therapy (HAART) is considered toxic and has other life-threatening side effects. Our aim was to evaluate the haematotoxic effects of lamivudine, zidovudine, and nevirapine fixed-dose combinations in Albino Wistar rats. Fifty (50) three (3) months old male Albino Wistar rats weighing between 200 and 250 g were randomly assigned to five (5) groups (A, B, C, D, and E). Group A served as control. Two (2 mLs) of venous blood was aseptically collected on Days 5, 10, 15, 20, and 25 of treatment. Red blood cell (RBC) mean value recorded statistically significant increase () in groups B and C when compared with the control group on Day 5. However, there was a statistically significant decrease () in RBC, haemoglobin concentration (Hb), packed cell volume (PCV), and some red cell indices on Day 10. In addition there was no statistically significant difference () in all the parameters evaluated when the test group was compared with the control on Day 25. Furthermore, there was a time-related statistically significant increase () in the two major blood cells—RBC and platelet counts. From the result of this present study, it can be concluded that HAART when administered in fixed-dose combinations have no subacute haematotoxic effects.

scholarly journals Excisional lipectomy versus liposuction in HIV-associated lipodystrophy

2021 ◽  
Vol 48 (6) ◽  
pp. 685-690
Author(s):  
Natalie Barton ◽  
Ryan Moore ◽  
Karthik Prasad ◽  
Gregory Evans
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
Primary Treatment ◽  
Highly Active ◽  
Number Of Patients ◽  
Immunodeficiency Virus ◽  
Fat Redistribution ◽  
Successful Removal ◽  
Male Patients ◽  
Haart Therapy

Background Human immunodeficiency virus (HIV)-associated lipodystrophy is a known consequence of long-term highly active antiretroviral therapy (HAART). However, a significant number of patients on HAART therapy were left with the stigmata of complications, including fat redistribution. Few studies have described the successful removal of focal areas of lipohypertrophy with successful outcomes. This manuscript reviews the outcomes of excisional lipectomy versus liposuction for HIV-associated cervicodorsal lipodystrophy.Methods We performed a 15-year retrospective review of HIV-positive patients with lipodystrophy. Patients were identified by query of secure operative logs. Data collected included demographics, medications, comorbidities, duration of HIV, surgical intervention type, pertinent laboratory values, and the amount of tissue removed.Results Nine male patients with HIV-associated lipodystrophy underwent a total of 17 procedures. Of the patients who underwent liposuction initially (n=5), 60% (n=3) experienced a recurrence. There were a total of three cases of primary liposuction followed by excisional lipectomy. One hundred percent of these cases were noted to have a recurrence postoperatively, and there was one case of seroma formation. Of the subjects who underwent excisional lipectomy (n=4), there were no documented recurrences; however, one patient’s postoperative course was complicated by seroma formation.Conclusions HIV-associated lipodystrophy is a disfiguring complication of HAART therapy with significant morbidity. Given the limitations of liposuction alone as the primary intervention, excisional lipectomy is recommended as the primary treatment. Liposuction may be used for better contouring and for subsequent procedures. While there is a slightly higher risk for complications, adjunctive techniques such as quilting sutures and placement of drains may be used in conjunction with excisional lipectomy.

scholarly journals Depression and suicidal ideation among HIV seropositive patients attending the special treatment clinic of the University of Calabar Teaching Hospital, Calabar, Nigeria

2021 ◽  
Vol 4 ◽  
pp. 64-70
Author(s):  
Elvis Mbu Bisong ◽  
Chidi John Okafor ◽  
Agam Ebaji Ayuk ◽  
Udeme Essien Asibong ◽  
Henry Ohem Okpa
Keyword(s):  
Viral Load ◽  
Suicidal Ideation ◽  
Highly Active Antiretroviral Therapy ◽  
Cd4 Count ◽  
Special Treatment ◽  
Prevalence Rates ◽  
Highly Active ◽  
Study Participants ◽  
Hiv Seropositive ◽  
Hiv Aids

Objectives: The introduction of highly active antiretroviral therapy and innovations in healthcare has contributed in improving the lives of persons living with human immunodeficiency virus (HIV)/AID. Patients infected with HIV are more susceptible to develop psychiatric illnesses. Depression is common among patients suffering from chronic illness such as HIV/AIDS and can exacerbate these illnesses. Depression has been observed to be twice as common in HIV seropositive individuals than in the general population. Undiagnosed and untreated depression in patients suffering from HIV/AIDS could lead to poor adherence to medications and lower quality of life. Depression is associated with rapid HIV disease progression. The diagnosis of HIV infection may be associated with feelings of anger, denial, sadness, guilt feelings, loss of self-esteem among others. These negative feelings could lead to suicidal ideation and attempted suicide or suicide. We sought to determine the prevalence rates, sociodemographics and predictors, of depression and suicidal ideation among study participants. Material and methods: Two hundred and two adult participants who met the inclusion criteria were recruited into the study. Mini International Neuropsychiatric Interview English version 6.0.0 was employed to diagnose depression and suicidal ideation. Data were analyzed using Statistical Package for the Social Sciences version 20.0. Significant levels were set at P < 0.05. Results: This study revealed prevalence rates of 11.4% for depression and 7.9% for suicidal ideation among study participants. Majority of the participants were females in the young age group category of 30–40 years (45%) with mostly secondary education (47.8%), most had a higher CD4 count greater than 200 cells/µL (82.6%) and were mainly on zidovudine/lamivudine/nevirapine combination therapy (56.5%). Mean age, CD4 count, and viral load levels were lower in HIV patients with depression but were not statistically significant (P > 0.05). CD4 count and viral load were not significantly associated with suicidal ideation. Lower age (30–40 years) was significantly associated with suicidal ideation (P < 0.05). Suicidal ideation is a predictor of depression in the same way depression is a predictor of suicidal ideation (P < 0.05). Conclusion: Routine screening for depression and suicidal ideation especially among younger HIV/AIDS patients is recommended in the clinic setting.

scholarly journals Resistant thrombocytopenia in an HIV and hepatitis C patient: treatment response with novel agent eltrombopag

2011 ◽  
Vol 1 (1) ◽  
pp. 5 ◽  
Author(s):  
Rajakrishnan Vijayakrishnan ◽  
Sourbha Dani ◽  
Aparna Ramasubramanian ◽  
Rekha Nair ◽  
Tony M. Samaha
Keyword(s):  
Hepatitis C ◽  
Antiretroviral Therapy ◽  
Treatment Response ◽  
Highly Active Antiretroviral Therapy ◽  
Standard Therapy ◽  
Receptor Agonist ◽  
Patient Treatment ◽  
Highly Active ◽  
Novel Agent ◽  
Haart Therapy

HIV-associated thrombocytopenia is a dis- ease which can be recurrent to standard therapy which includes highly active antiretroviral therapy (HAART) therapy, steroids and immunoglobulin. We report a patient with HIV and hepatitis C who presented with resistant thrombocytopenia. Treatment with Eltrombopag – a thrombopoeitin receptor agonist showed initial good response with recurrence of thrombocytopenia. This novel agent could be considered as a treatment option prior to splenectomy and may be useful as a tempo- rizing measure.

WOAD

2012 ◽  
pp. 127-147
Author(s):  
Federico Cabitza ◽  
Carla Simone
Keyword(s):  
Teaching Hospital ◽  
Electronic Document ◽  
High Level Architecture ◽  
Formal Expression ◽  
Major Teaching Hospital ◽  
Major Teaching ◽  
High Level ◽  
Event Based ◽  
User Friendly

In this article, we present WOAD, a framework that was inspired and partly validated within a 2-year observational case study at a major teaching hospital. We present the WOAD framework by stating its main and motivating rationales, outlining its high-level architecture and then introducing its denotational language, LWOAD. We propose LWOAD to support users of an electronic document system in declaratively expressing, specifying and implementing content- and event-based mechanisms that fulfill coordinative requirements and make users aware of relevant conditions. Our focus addresses (a) the user-friendly and yet formal expression of local coordinative practices based on the work context; (b) the promotion of awareness of both these conventions and the context to enable actors to quickly respond; (c) the full deployment of coordination-oriented and context-aware functionalities into legacy electronic document systems. We give examples of LWOAD mechanisms taken from the case study and discuss their impact from the EUD perspective.

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