TB and HIV/AIDS

2015 ◽  
Author(s):  
Christopher Dye
Keyword(s):  
Public Health ◽  
Risk Factor ◽  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Population Biology ◽  
Preventive Therapy ◽  
Control Measures ◽  
Isoniazid Preventive Therapy ◽  
Global Epidemiology ◽  
Hiv Aids

This chapter examines the dual epidemic of tuberculosis and HIV/AIDS. There have been some major successes in the control of both HIV/AIDS and TB. The discovery and widespread use of antiretroviral therapy (ART) is among the greatest advances in public health during the past thirty years. The rise of TB cases in Africa and elsewhere and on the discovery and implementation of control measures raise a series of questions about the population biology of TB linked to HIV/AIDS. The chapter first provides an overview of HIV infection as a risk factor for TB before discussing the global epidemiology of TB linked to HIV/AIDS. It then describes the anatomy of a TB-HIV epidemic, along with TB control in the presence of HIV. In particular, it considers ART and isoniazid preventive therapy. The chapter concludes with the argument that the DOTS strategy is necessary but not sufficient for TB–HIV control.

scholarly journals Low body mass index increases risk of anemia in patients with HIV-AIDS receiving antiretroviral therapy

2017 ◽  
Vol 36 (3) ◽  
pp. 221
Author(s):  
Mirna Widiyanti ◽  
Reynold Ubra ◽  
Eva Fitriana
Keyword(s):  
Body Mass Index ◽  
Logistic Regression ◽  
Risk Factor ◽  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Body Mass ◽  
Significant Risk ◽  
Severe Anemia ◽  
Low Body Mass Index ◽  
Hiv Aids

Background<br />In acquired immunodeficiency syndrome (AIDS) cases, cytopenias of all major blood cell lines were increasingly recognized in patients with HIV infection. Anemia commonly occurs during HIV infection and has been associated with increased progression to AIDS and decreased survival. The aim of this study was to determine the prevalence of anemia and associated risk factors in adults with HIV-AIDS receiving antiretroviral therapy (ART). <br /><br />Methods<br />A cross sectional study was conducted involving 90 adults with HIV-AIDS. Sociodemographic data were collected using a questionnaire. In all patients, CD4+ lymphocyte counts were performed by means of a PIMA analyzer, while hemoglobin was determined using a Sysmex hematology analyzer. The WHO cutoff value of hemoglobin was adjusted to altitude to define anemia. Mild to moderate anemia was defined as hemoglobin 8-13 g/dL for men and 8-12 g/dL for women. Severe anemia was defined as hemoglobin 8 g/dL. Data was analyzed by using logistic regression test.<br /><br />Results<br />There were 90 subjects with HIV-AIDS in this study. Anemia was found in 50 subjects (55.6%), consisting of 12.2% with mild anemia and 43.4% with moderate to severe anemia. Multiple logistic regression showed that an important risk factor for anemia was low body mass index (BMI) between &lt;17-18.5 (OR=4.20; 95% CI=1.23-14.36). However, the CD4 &lt;350 cells/mm3 was not a significant risk factor for anemia (OR=1.03; 95% CI=0.21-5.04).<br /><br />Conclusions<br />Low BMI increases the risk of anemia in subjects with HIV receiving ART. Better screening for anemia and infectious diseases, and modified harm reduction strategy for injection drug users are primary needs in HIV patients.

scholarly journals Undernutrition and associated factors among adult HIV/AIDS patients receiving antiretroviral therapy in eastern zone of Tigray, Northern Ethiopia: a cross-sectional study

2020 ◽  
Vol 78 (1) ◽  
Author(s):  
Tsegu Hailu Gebru ◽  
Haftea Hagos Mekonen ◽  
Kbrom Gemechu Kiros
Keyword(s):  
Antiretroviral Therapy ◽  
Associated Factors ◽  
Preventive Therapy ◽  
Cd4 Count ◽  
Clinical Staging ◽  
Northern Ethiopia ◽  
Aids Patients ◽  
Cross Sectional ◽  
Eastern Zone ◽  
Hiv Aids

Abstract Background Undernutrition and HIV/AIDS are highly prevalent in sub-Saharan Africa, Ethiopia inclusive as linked in a vicious cycle. Thus, several studies have documented that undernutrition among HIV/AIDS patients increases the risk of mortality, decrease survival rates, affect the overall clinical outcome and quality of life. Despite this fact, information about the burden of undernutrition and associated factors among adults receiving antiretroviral therapy is lacking in the particular study area. Hence, this study aimed to examine the prevalence of undernutrition and associated factors among adult HIV/AIADS patients receiving antiretroviral therapy patients in Eastern Zone of Tigray, Northern Ethiopia. Methods A cross-sectional research design was adopted in data collection while systematic sampling technique was employed to sample and select the study subjects. A structured questionnaire was used to collect information from 394 study subjects through face to face method. Also, data on demographics, laboratory and anthropometric variables were collected from each selected patients sampled. The data collected were entered and analyzed using SPSS version 22.. Bivariate and multivariable logistic regression analysis with 95% confidence interval were used to find factors associated with undernutrition. The adjusted odds ratio was calculated to show the strength of the association. Variables with p-value of < 0.05 were considered statically significant. Results The mean age of the respondents was 41 (± 10). Out of 394 study respondents, about 42.9% of them were undernourished (95% CI: 37.8–47.7). Respondents who had CD4+ count less than 200 cells/μl (AOR = 1.84; 95% CI: 1–3.36), being advanced clinical staging (AOR = 3.6; 95% CI: 2.11–6.18), and not taking co-trimoxazole preventive therapy (AOR = 2.38; 95% CI: 1.21–4.6) were independently associated with undernutrition. Conclusion The result of this study indicated that the prevalence of undernutrition was high. Respondents with advanced clinical stage of CD4+ count less than 200 cells/ul and those that were not taking co-trimoxazole preventive therapy was found to be positively associated with undernutrition. Therefore, the implementation of nutritional programs is very crucial to improve the nutritional status of HIV/AIDS patients in the particular study.

scholarly journals Projected population-wide impact of antiretroviral therapy-linked isoniazid preventive therapy in a high-burden setting

AIDS ◽  
2019 ◽  
Vol 33 (3) ◽  
pp. 525-536 ◽  
Author(s):  
Emily A. Kendall ◽  
Andrew S. Azman ◽  
Gary Maartens ◽  
Andrew Boulle ◽  
Robert J. Wilkinson ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Preventive Therapy ◽  
Isoniazid Preventive Therapy ◽  
High Burden

scholarly journals Differences in demographic characteristics, risky behavior and HIV status of men and women who were voluntarily and confidentially counseled and tested at the Counseling Center for HIV/AIDS of the Institute of Public Health in Belgrade

2021 ◽  
Vol 50 (2) ◽  
pp. 13-28
Author(s):  
Vesna Stijović ◽  
Pavle Piperac ◽  
Biljana Begović ◽  
Sandra Grujičić
Keyword(s):  
Public Health ◽  
Hiv Infection ◽  
Risky Behavior ◽  
Counseling Center ◽  
Demographic Characteristics ◽  
Hiv Status ◽  
Heterosexual Contact ◽  
Men And Women ◽  
Counseling And Testing ◽  
Hiv Aids

Introduction/Aim: Voluntary and confidential counseling and testing (VCCT) means getting information about HIV, ways of transmission, recognizing, reducing or avoiding risks for HIV infection, about safe sexual relations, the place where people can be tested, and what they should do depending on the test results in order to protect themselves and other people. The aim of this study was to examine differences in demographic characteristics, risky behavior and HIV status between men and women who were voluntarily and confidentially counseled and tested at the Counseling Center for HIV/AIDS of the Institute of Public Health in Belgrade. Methods: This research was conducted as a cross-sectional study and it included 3,480 persons (43.2% of women and 56.8% of men), who were counseled and tested at the Counseling Center for HIV/AIDS of the Institute of Public Health in Belgrade from 2017 to 2019. ch2 or Fisher's test was used for the statistical analysis of data. Results: The majority of women (42.1%) and men (42.5%) who were counseled and tested were in the age group 21-30 years. Men used DPST services significantly more often than women. HIV positive status was significantly more frequent in men (2.5%) than in women (0.3%). Women came significantly more often to voluntary counseling and testing due to the possible exposure to HIV infection by heterosexual contact (84.9%), accident (11.1%) and raping (1.0%), while men were counseled and tested due to heterosexual contact (59.3%), homosexual and bisexual contact (33.6%) and intravenous drug abuse (1.1%). Men used condoms always or often (40.1%) and had two or more partners (53.2%) more frequently during the last 12 months in comparison to women (24.2% and 20.6%). Conclusion: Voluntary and confidential counseling and testing is necessary in the fight against HIV infection, especially from the perspective of early discovering of people with this infection and education of HIV negative persons about risky sexual behavior and possible prevention measures.

scholarly journals Trend analysis of tuberculosis case notifications with scale-up of antiretroviral therapy and roll-out of isoniazid preventive therapy in Zimbabwe, 2000–2018

BMJ Open ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. e034721
Author(s):  
Kudakwashe C Takarinda ◽  
Anthony D Harries ◽  
Tsitsi Mutasa-Apollo ◽  
Charles Sandy ◽  
Regis C Choto ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Scale Up ◽  
Population Level ◽  
Preventive Therapy ◽  
Isoniazid Preventive Therapy ◽  
People Living With Hiv ◽  
National Data ◽  
Tuberculosis Case ◽  
Case Notification ◽  
Roll Out

ObjectivesAntiretroviral therapy (ART) and isoniazid preventive therapy (IPT) are known to have a tuberculosis (TB) protective effect at the individual level among people living with HIV (PLHIV). In Zimbabwe where TB is driven by HIV infection, we have assessed whether there is a population-level association between IPT and ART scale-up and annual TB case notification rates (CNRs) from 2000 to 2018.DesignEcological study using aggregate national data.SettingAnnual aggregate national data on TB case notification rates (stratified by TB category and type of disease), numbers (and proportions) of PLHIV in ART care and of these, numbers (and proportions) ever commenced on IPT.ResultsART coverage in the public sector increased from <1% (8400 PLHIV) in 2004 to ~88% (>1.1 million PLHIV patients) by December 2018, while IPT coverage among PLHIV in ART care increased from <1% (98 PLHIV) in 2012 to ~33% (373 917 PLHIV) by December 2018. These HIV-related interventions were associated with significant declines in TB CNRs: between the highest CNR prior to national roll-out of ART (in 2004) to the lowest recorded CNR after national IPT roll-out from 2012, these were (1) for all TB case (510 to 173 cases/100 000 population; 66% decline, p<0.001); (2) for those with new TB (501 to 159 cases/100 000 population; 68% decline, p<0.001) and (3) for those with new clinically diagnosed PTB (284 to 63 cases/100 000 population; 77.8% decline, p<0.001).ConclusionsThis study shows the population-level impact of the continued scale-up of ART among PLHIV and the national roll-out of IPT among those in ART care in reducing TB, particularly clinically diagnosed TB which is largely associated with HIV. There are further opportunities for continued mitigation of TB with increasing coverage of ART and in particular IPT which still has a low coverage.

scholarly journals Safety and Effectiveness of Isoniazid Preventive Therapy in Pregnant Women Living with Human Immunodeficiency Virus on Antiretroviral Therapy: An Observational Study Using Linked Population Data

2020 ◽  
Vol 71 (8) ◽  
pp. e351-e358 ◽  
Author(s):  
Emma Kalk ◽  
Alexa Heekes ◽  
Ushma Mehta ◽  
Renee de Waal ◽  
Nisha Jacob ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Antiretroviral Therapy ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Absolute Risk ◽  
First Trimester ◽  
Preventive Therapy ◽  
Cd4 Count ◽  
Isoniazid Preventive Therapy ◽  
Immunodeficiency Virus

Abstract Background Isoniazid preventive therapy (IPT) is widely used to protect against tuberculosis (TB) in people living with human immunodeficiency virus (HIV). Data on the safety and efficacy of IPT in pregnant women living with HIV (PWLHIV) are mixed. We used an individual-level, population-wide health database to examine associations between antenatal IPT exposure and adverse pregnancy outcomes, maternal TB, all-cause mortality, and liver injury during pregnancy through 12 months postpartum. Methods We used linked routine electronic health data generated in the public sector of the Western Cape, South Africa, to define a cohort of PWLHIV on antiretroviral therapy. Pregnancy outcomes were assessed using logistic regression; for maternal outcomes we applied a proportional hazards model with time-updated IPT exposure. Results Of 43 971 PWLHIV, 16.6% received IPT. Women who received IPT were less likely to experience poor pregnancy outcomes (adjusted odds ratio [aOR], 0.83 [95% confidence interval {CI}, .78–.87]); this association strengthened with IPT started after the first trimester compared with none (aOR, 0.71 [95% CI, .65–.79]) or with first-trimester exposure (aOR, 0.64 [95% CI, .55–.75]). IPT reduced the risk of TB by approximately 30% (aHR, 0.71 [95% CI, .63–.81]; absolute risk difference, 1518/100 000 women). The effect was modified by CD4 cell count with protection conferred if CD4 count was ≤350 cells/μL (aHR, 0.51 [95% CI, .41–.63]) vs 0.93 [95% CI, .76–1.13] for CD4 count &gt;350 cells/µL). Conclusions This analysis of programmatic data is reassuring regarding the safety of antenatal IPT, with the greatest benefits against TB disease observed in women with CD4 count ≤350 cells/μL.

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