scholarly journals Difference in Markers of Microbial Translocation and Cell Apoptosis in HIV Monoinfected and HIV/HCV Coinfected Patients

2019 ◽  
Vol 73 (4) ◽  
pp. 304-311
Author(s):  
Monta Madelāne ◽  
Angelika Krūmiņa ◽  
Raimonds Sīmanis ◽  
Ģirts Šķenders ◽  
Andrejs Ivanovs ◽  
...  
Keyword(s):  
Cell Count ◽  
Immune Activation ◽  
Cell Apoptosis ◽  
Microbial Translocation ◽  
University Hospital ◽  
Cd4 Cell Count ◽  
Significant Difference ◽  
Cyt C ◽  
Apoptosis Markers ◽  
Cd4 Cell

Abstract Immune activation in human immunodeficiency virus (HIV) infection is driven by microbial translocation and in HIV patients is one of the contributors to faster progression of liver disease along with increased cell apoptosis. The aim of the study was to compare microbial translocation and apoptosis markers in HIV monoinfected and HIV/hepatitis C virus (HCV) coinfected patients, depending on HIV immune status and antiretroviral treatment (ART). We analysed data for 78 HIV monoinfected and 105 HIV/HCV coinfected patients from the Rīga East University Hospital. Lipopolysaccharide (LPS), endotoxin core antibodies (EndoCAb), cytokeratin 18 (CK18) and cyto-chrome c (Cyt-c) levels were measured. No significant difference in LPS, EndoCAb, Cyt-c levels between HIV and HIV/HCV patients was found. The CK18 level was higher in the HIV/HCV group. Correlation between CD4+ cell count and EndoCAb antibodies was found in HCV positive patients. There was a significant effect of ART on markers for EndoCAb IgA and EndoCAb IgM antibodies in the HIV monoinfected group. Correlation between CD4+ cell count and EndoCAb antibodies and LPS was found in HIV/HCV patients on ART. Coinfection with HCV can lead to more pronounced response in EndoCAb antibody production and higher levels of cell apoptosis markers, despite similar LPS levels. ART has a positive effect on immune activation.

scholarly journals Effectiveness of tipranavir versus darunavir as a salvage therapy in HIV-1 treatment-experienced patients

2016 ◽  
Vol 10 (09) ◽  
pp. 982-987 ◽  
Author(s):  
Juan Carlos Domínguez-Hermosillo ◽  
José Antonio Mata-Marin ◽  
Norma Estela Herrera-González ◽  
Marcelino Chávez-García ◽  
Gloria Huerta-García ◽  
...  
Keyword(s):  
Viral Load ◽  
Cell Count ◽  
Salvage Therapy ◽  
Medical Center ◽  
Resistance Mutation ◽  
Cd4 Cell Count ◽  
National Medical ◽  
Significant Difference ◽  
Cd4 Cell ◽  
Hiv 1

Introduction: Although both tipranavir (TPV) and darunavir (DRV) represent important options for the management of patients with multi-protease inhibitor (PI)-resistant human immunodeficiency virus (HIV), currently there are no studies comparing the effectiveness and safety of these two drugs in the Mexican population. The aim of this study was to compare the effectiveness of TPV versus DRV as a salvage therapy in HIV-1 treatment-experienced patients. Methodology: This was a comparative, prospective, cohort study. Patients with HIV and triple-class drug resistance evaluated at the Hospital de Infectología “La Raza”, National Medical Center, were included. All patients had the protease and retrotranscriptase genotype; resistance mutation interpretation was done using the Stanford database. Results: A total of 35 HIV-1 triple-class drug-resistant patients were analyzed. All of them received tenofovir and raltegravir, 22 received darunavir/ritonavir (DRV/r), and 13 received tipranavir/ritonavir (TPV/r) therapies. The median baseline RNA HIV-1 viral load and CD4+ cell count were 4.34 log (interquartile range [IQR], 4.15–4.72) and 267 cells/mm3 (IQR, 177–320) for the DRV/r group, and 4.14 log (IQR, 3.51–4.85) and 445 cells/mm3 (IQR, 252–558) for the TPV/r group. At week 24 of treatment, 91% of patients receiving DRV/r and 100% of patients receiving TPV/r had an RNA HIV-1 viral load < 50 copies/mL and a CD4+ cell count of 339 cells/mm3 (IQR, 252–447) and 556 cells/mm3 (IQR, 364–659), respectively. Conclusions: No significant difference was observed between DRV/r and TPV/r in terms of virological suppression in HIV-1 patients who were highly experienced in antiretroviral therapy.

scholarly journals Advanced HIV Infection in Treatment Naïve Individuals: Effectiveness and Persistence of Recommended Three-Drug Regimens

2022 ◽  
Author(s):  
Karam Mounzer ◽  
Laurence Brunet ◽  
Jennifer S Fusco ◽  
Ian R Mcnicholl ◽  
Helena Diaz Cuervo ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Cell Count ◽  
Viral Suppression ◽  
Proportional Hazards ◽  
Drug Regimen ◽  
Cox Proportional Hazards ◽  
Cd4 Cell Count ◽  
Significant Difference ◽  
Treatment Naïve ◽  
Cd4 Cell

Abstract Background Approximately 20% of newly diagnosed people with HIV (PWH) in the U.S. have advanced HIV infection, yet literature on current antiretroviral therapy (ART) options is limited. Discontinuation/modification and effectiveness of common regimens were compared among ART-naïve people with advanced HIV infection (CD4 cell count &lt;200 cells/μL). Methods ART-naïve adults with advanced HIV infection initiating bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) or a boosted darunavir (bDRV)-, dolutegravir (DTG)- or elvitegravir/cobicistat (EVG/c)-based three-drug regimen between 1JAN2018 and 31JUL2019 in the OPERA cohort were included. The association between regimen and discontinuation or viral suppression (&lt;50 or &lt;200 copies/mL) was assessed using Cox proportional hazards models with inverse probability of treatment weights. Results Overall, 961 PWH were included (416 B/F/TAF, 106 bDRV, 271 DTG, 168 EVG/c); 70% achieved a CD4 cell count ≥200 cells/μL over a 16 months median follow-up. All regimens were associated with a statistically higher likelihood of discontinuation than B/F/TAF (bDRV aHR: 2.65 [95% CI: 1.75, 4.02], DTG: 2.42 [1.75, 3.35], EVG/c: 3.52 [95% CI: 2.44, 5.07]). Compared to B/F/TAF, bDRV initiators were statistically less likely to suppress to &lt;50 copies/mL (0.72 [0.52, 0.99]) and &lt;200 copies/mL (0.55 [0.43, 0.70]); no statistically significant difference was detected with DTG or EVG/c. Conclusions Among people with advanced HIV infection, those initiating B/F/TAF were less likely to discontinue/modify their regimen than those on any other regimen, and more likely to achieve viral suppression compared to those on bDRV but not compared to those on other integrase inhibitors.

9. Epidemiological and Immunologic Profile in an Outpatient HIV Clinic in Southeastern Ontario

2016 ◽  
Author(s):  
Amir Rumman
Keyword(s):  
Viral Load ◽  
Cell Count ◽  
Age At Diagnosis ◽  
Bivariate Analysis ◽  
Cd4 Cell Count ◽  
Female Patients ◽  
Hiv Epidemic ◽  
Significant Difference ◽  
Cd4 Cell ◽  
Immunologic Status

Kingston represents a unique enclave within Southeastern Ontario owing to the preponderance of correctional facilities within its environs, as well as its geographic location at the crossroads between three of Canada’s largest cities – Toronto, Ottawa and Montreal. This gives the Kingston HIV epidemic a distinctive character. This study provides attempts to construct the epidemiological profile of HIV‐infected patients in Kingston by two prognostic variables –CD4 cell count and viral load– to elucidate any trends in immunologic status and efficacy of treatment for patients followed at the Clinical Immunology Outpatient Clinic (CIOC) in Kingston, Ontario. We conducted a retrospective analysis of HIV‐infected patients managed at the CIOC. Patients were stratified according to gender and year of diagnosis. Median CD4 cell count and viral load at first and most recent visit were compared for both groups. Bivariate analysis of age, gender, HCV co‐infection, nadir CD4 cell count and proportion of patients achieving viral suppression was also undertaken. 528 patients were included in the analysis: 158 active, 106 incarcerated, 94 transferred, 93 known deceased and 77 lost to follow‐up. There were 453 males and 75 females. Male patients had a greater age at diagnosis and a lower proportion of HCV coinfection. Female patients had a greater median CD4 cell count for both the first and most recent visit. There was no significant difference in viral load values between male and female patients. 439 patients had a year of diagnosis on file; 290 were diagnosed before 1997 and 149 were diagnosed in or after 1997. There was no significant change in gender distribution or HCV co‐infection, but patients diagnosed after 1997 had a greater age at diagnosis, a greater first viral load, a greater most recent CD4 cell count and were less likely to be virologically suppressed at first visit. The demographics of patients presenting at the CIOC have been changing in concert with a broader Canada‐wide shift. The findings of this study indicate differences in immunologic status and other prognostic parameters between males and females and a marked shift in demographic and immunologic parameters following the introduction of Highly Active  Antiretroviral Treatment (HAART) in 1997. New treatment stratagems will have to be implemented to reflect the changing face of HIV epidemic in Kingston and Ontario.

scholarly journals Asymptomatic oral carriage of Candida species in HIV-infected patients in the highly active antiretroviral therapy era

2006 ◽  
Vol 48 (5) ◽  
pp. 257-261 ◽  
Author(s):  
Carolina Rodrigues Costa ◽  
Ana Joaquina Cohen ◽  
Orionalda Fátima Lisboa Fernandes ◽  
Karla Carvalho Miranda ◽  
Xisto Sena Passos ◽  
...  
Keyword(s):  
Viral Load ◽  
Cell Count ◽  
Highly Active Antiretroviral Therapy ◽  
Positive Culture ◽  
Cd4 Cell Count ◽  
Candida Sp ◽  
Significant Difference ◽  
Oral Carriage ◽  
Oral Candida ◽  
Cd4 Cell

Oropharyngeal candidiasis is the most common opportunistic fungal infection in individuals infected with human immunodeficiency virus. CD4+ lymphocytes count and the quantification of viral RNA in blood plasma have been found to be the main markers of HIV disease progression. The present study was conducted to evaluate Candida sp. diversity in the oral cavity of HIV-infected patients and to determine whether there was association of CD4+ cell count and viral load with asymptomatic oral Candida carriage. Out of 99 HIV-positive patients studied, 62 (62.6%) had positive culture for Candida (oral carriage) and 37 patients (37.4%) had Candida negative culture (no oral carriage). The etiologic agents most common were C. albicans and C. tropicalis. The range of CD4+ was 6-2305 cells/mm³ in colonized patients and 3-839 cells/mm³ for non-colonized patients, while the viral load was 60-90016 copies/mL for colonized patients and 75-110488 copies/mL for non colonized patients. The viral load was undetectable in 15 colonized patients and in 12 non colonized patients. Our results showed that there was no significant difference of the variables CD4+ cell count and viral load between oral candida carriage and no oral candida carriage patients.

Microbial translocation predicts disease progression of HIV-infected antiretroviral-naive patients with high CD4+ cell count

AIDS ◽  
2011 ◽  
Vol 25 (11) ◽  
pp. 1385-1394 ◽  
Author(s):  
Giulia Marchetti ◽  
Alessandro Cozzi-Lepri ◽  
Esther Merlini ◽  
Giusi M. Bellistrì ◽  
Antonella Castagna ◽  
...  
Keyword(s):  
Cell Count ◽  
Disease Progression ◽  
Microbial Translocation ◽  
Cd4 Cell Count ◽  
Cd4 Cell

scholarly journals Modelling Trends of Cd4 Counts for Patients on Antiretroviral Therapy (Art) : After a Change in Who Guidelines in Kenya

2021 ◽  
Author(s):  
Caroline W Mugo ◽  
Ziv Shkedy ◽  
Samuel Mwalili ◽  
Roel Braekers ◽  
Dolphine Wandede ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Cell Count ◽  
Cd4 Count ◽  
Care Clinic ◽  
Cd4 Cell Count ◽  
Cd4 Counts ◽  
Significant Difference ◽  
Drug Regimens ◽  
Cd4 Cell ◽  
Over Time

Abstract Background In resource-limited settings, changes in CD4 counts constitute an important component in patient monitoring and evaluation of treatment response as these patients do not have access to routine viral load testing. In this study, we quantified trends on CD4 counts in patients on highly active antiretroviral therapy (HAART) in a comprehensive health care clinic in Kenya between 2011 and 2017.We evaluated the rate of change in CD4 cell count in response to antiretroviral treatment. We further assessed factors that influenced time to treatment change focusing on baseline characteristics of the patients and different initial drug regimens used. The study involved 529 naïve HIV patients that had at least two CD4 count measurements for the period. The relationship between CD4 cell count and time was modeled using a semi parametric mixed effects model while the Cox proportional hazards model was used to assess factors associated with the first regimen change. Results The results demonstrated that CD4 counts increased over time and these trends were similar regardless of the treatment regimen used. Males were less likely to have drug regimens switch (adjusted hazard ratio (aHR) 0.5101, 95% CI: 0.1906 -1.3647) compared to females.Tenoforvir (TDF) based regimens had a lower drug substitution (aHR 0.2796, 95% CI: 0.0961-0.8629) compared to Zinovudine (AZT). Conclusion The backbone used was found to be associated with regimen changes among the patients with fewer switches being observed, with the use of TDF when compared to AZT. There was however no significant difference between TDF and AZT in terms of the change in CD4 count over time.

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