Spectrum of opportunistic infections in relation to CD4 count in HIV-2 patients

2019 ◽  
Vol 12 (3) ◽  
pp. 137-141
Author(s):  
Kashmira Rajendra Hajare ◽  
◽  
Priya Patil ◽  
Rahul Kadu ◽  
◽  
...  
Keyword(s):  
Opportunistic Infections ◽  
Cd4 Count

scholarly journals Hematological abnormalities in HIV infected individuals in correlation to CD4 counts and ART status

2016 ◽  
Vol 7 (4) ◽  
pp. 14-18 ◽  
Author(s):  
R Raman Thulasi ◽  
D Manimaran ◽  
G Hemanathan ◽  
Tameem Afroz ◽  
Radha Sagar
Keyword(s):  
Opportunistic Infections ◽  
Hematological Parameters ◽  
Cd4 Count ◽  
Health Concern ◽  
Medical Sciences ◽  
Cd4 Counts ◽  
Medical Centers ◽  
Hematological Abnormalities ◽  
Set Up ◽  
One Year

Background: HIV is pandemic and remains as a public health concern for many decades. This infection though associated with many opportunistic infections and neoplasms, it is further complicated with marked hematological abnormalities. The aim of this study is to determine the magnitude & severity of hematological abnormalities in HIV infected individuals and also to analyze these abnormalities in correlation with the CD4 counts. We also compared these hematological abnormalities in patients on ART and those not on ART.Materials and Methods: The study was conducted for a period of one year, on 120 HIV positive cases including both patients on ART & not on ART. Controls with similar age and sex distribution was set up. The blood samples were collected and processed in an automated cell counter. The parameters were tabulated and analyzed with respect to CD4 count & ART status.Results: Among the total of 120 HIV cases, 77% had anemia, 21% had leucopenia and 5% had thrombocytopenia. The magnitude and severity of anemia, leucopenia, thrombocytopenia and other parameters was found to be more in patients not on ART, when compared to patients on ART. Similarly, the magnitude and severity of most of hematological abnormalities were inversely proportional to the CD4 count in non-ART cases but not with cases on ART.Conclusion: The basic hematological parameters can be used as a prospective screening test to assess the severity and progression of HIV infection when CD4 count is not available. These parameters can also be used to assess the response to anti-retroviral treatment. Therefore, these basic hematological investigations readily available at all medical centers are of great use while treating HIV infected patients.Asian Journal of Medical Sciences Vol.7(4) 2016 14-18 

scholarly journals A Profile Of Patients Registered At Art Centre At Surat Municipal Institute Of Medical Education & Research In Surat City, Gujarat, India

1970 ◽  
Vol 8 (2) ◽  
pp. 11-16
Author(s):  
B Modi ◽  
P Patel ◽  
S Patel
Keyword(s):  
Medical Education ◽  
Opportunistic Infections ◽  
Cross Sectional Study ◽  
Cd4 Count ◽  
People Living With Hiv ◽  
Time Duration ◽  
Cross Sectional ◽  
Study Results ◽  
Entry Points ◽  
Living With Hiv

Introduction: An estimated 2.4 million Indians are currently living with HIV. In India, the antiretroviral treatment program started with a free ART treatment in 2003. This study was conducted in order to understand the clinico-epidemiological profi le of patients attending ART centre and the effectiveness of the therapy. Methodology: A cross sectional study was conducted at an ART center of Surat Municipal Institute of Medical Education and Research (SMIMER), in Surat city of Gujarat State. The data of 2357 PLHAs (People Living with HIV/ AIDS) registered at ART centre in one year time duration starting from 21st January 2010 was included in the study. Results: Among the total 2357 subjects, 1483 (63%) were males. In our study 42.3% of patients were between 31 to 40 years of age. Among the employed subjects, 32.9% of patients were laborer. Voluntary Counseling and Testing Centre (VCTC) was most common entry point of patient with 50% followed by private practitioner with 23% and NGOs with 6.2%. Other entry points are self referred, RNTCP etc. Tuberculosis and diarrhoea were the most common opportunistic infections. There was signifi cant improvement in CD4 count, bodyweight and functional status of the subjects after receiving the ART for an average duration of 6 months. Conclusion: The economically productive & sexually active people and those with lesser education are at higher risk of becoming sero-positive. The subjects showed signifi cant improvement after receiving ART with respect to the CD4 count and average body weight. DOI: http://dx.doi.org/10.3126/saarctb.v8i2.5895 SAARCTB 2011; 8(2): 11-16

scholarly journals Treatment outcomes in a rural HIV clinic in South Africa: Implications for health care

2016 ◽  
Vol 17 (1) ◽  
Author(s):  
Olufemi B. Omole ◽  
Mary-Anne M.L. Semenya
Keyword(s):  
Treatment Outcomes ◽  
Antiretroviral Treatment ◽  
Hospital Admissions ◽  
Opportunistic Infections ◽  
Limpopo Province ◽  
Cd4 Count ◽  
Viral Rebound ◽  
Hospital Data ◽  
Adherence Support ◽  
Patient Retention

Objective: To assess the treatment outcomes of an HIV clinic in rural Limpopo province, South Africa.Methods: A retrospective cohort study involving medical records review of HIV-positive patients initiated on antiretroviral treatment (ART) was conducted from December 2007 to November 2008 at Letaba Hospital. Data on socio-demographic characteristics, CD4 counts, viral loads (VLs), opportunistic infections, adverse effects of treatment, hospital admissions, and patient retention at 6, 12, 24, and 36 months on ART were collected. Analysis included descriptive statistics, chi-square and t-tests.Results: Of 124 patient records sampled, the majority of patients were female (69%), single (49%), unemployed (56%), living at least 10 km from the hospital (52.4%), and were on treatment at 36 months (69%). Approximately 84% of patients achieved viral suppression (VLs < 400 copies/mL) by 6 months of ART and the mean CD4 count increased from 128 at baseline to 470 cells/mm3 at 24 months. There was a mean weight gain of 5.9 kg over the 36 months and the proportion of patients with opportunistic infections decreased from 54.8% (n = 68) at baseline to 15.3% (n = 19) at 36 months. Although the largest improvements in CD4, VLs, and weights were recorded in the first 6 months of ART, viral rebound became evident thereafter. Of all variables, only age < 50 years and being pregnant were significantly associated with higher VLs (p = 0.03).Conclusion: Good treatment outcomes are achievable in a rural South African ART clinic. However, early viral rebound and higher VLs in pregnancy highlight the need for enhanced treatment adherence support, especially for pregnant women to reduce the risk of mother to child transmission.Keywords: CD4 count; viral load; rura;, treatment outcomes; antiretroviral treatment; patient retention

scholarly journals A study of clinical spectrum of opportunistic infections in HIV infected children and its correlation with CD4 count and anti-retroviral therapy

2017 ◽  
Vol 4 (4) ◽  
pp. 1485
Author(s):  
Vishal Manohar Jadhav ◽  
Yashwant Raghu Gabhale ◽  
Mamatha Murad Lala ◽  
Nikita Dilip Shah ◽  
Mamta Vijay Manglani
Keyword(s):  
Opportunistic Infections ◽  
Molluscum Contagiosum ◽  
Cd4 Count ◽  
Clinical Spectrum ◽  
Pneumocystis Jiroveci ◽  
Female Ratio ◽  
Cd4 Counts ◽  
Pneumocystis Jiroveci Pneumonia ◽  
High Index Of Suspicion ◽  
Male To Female

Background: To determine the clinical spectrum and prevalence of opportunistic infections (OIs) in HIV infected children and correlate the occurrence of opportunistic infections with their CD4 count and Anti-retroviral treatment (ART).Methods: A total of 100 HIV infected children diagnosed with opportunistic infections were included in the study. Demographic details, clinical examination and relevant investigations were done for all the children. Clinical spectrum of OIs and HIV staging was recorded. CD4 counts were done at baseline and were repeated at 6 monthly intervals.Results: Mean age of the patients was 7.08±3.48 years (ranging from 6 months to 15 years) at enrollment with male to female ratio of 1.2:1. Fever (91%) was a common presenting symptom followed by weight loss (74%), cough (37%), abdominal pain (29%) and breathlessness (16%). CD4 count was significantly associated with presence of opportunistic infection in the study group. Tuberculosis - pulmonary (32%) and extra-pulmonary (29%) was the most common oppurtunistic infections, followed by oral thrush (13%), Herpes zoster (10%), Molluscum Contagiosum (9%), Pneumocystis jiroveci pneumonia (3%), Parvovirus infection (3%) and Pruritic Papular Eruptions (2%). 70% children were on ART as per clinical and immunological staging of HIV.Conclusions: Low CD4 count is significantly associated with severe opportunistic infections, therefore drop in CD4 count should serve as an alarming signal for the treating physician. High index of suspicion is required to detect opportunistic infections and therefore CD4 counts should be done more frequently to predict occurrence of OIs. 

Opportunistic Infections in HIV Infection

2019 ◽  
Author(s):  
Elizabeth Williams
Keyword(s):  
Cryptococcal Meningitis ◽  
Opportunistic Infections ◽  
Oral Candidiasis ◽  
Pneumocystis Pneumonia ◽  
Late Diagnosis ◽  
Cd4 Count ◽  
Once Daily ◽  
Routine Hiv Testing ◽  
The Uk ◽  
Cd4 Percentage

An infection is defined as opportunistic when it affects those with severe immunosuppression, i.e. takes a n opportunity to cause disease in a host with a weakened immune system. In people living with HIV it mainly affects those with a CD4 count < 200 although it is not impossible in those with CD4 count > 200. The CD4 percentage is also important as those with a CD4% < 14 are also more likely to have an OI. The lower the CD4 count the higher the risk of OIs, and some OIs are seen much more commonly with very low CD4 counts, e.g. cryptococcal meningitis in those with CD4 count of < 100. Before the introduction of antiretroviral therapy OIs were much more common than they are now, with previously up to 80% of those with AIDS having pneumocystis pneumonia (PCP). Since the introduction of antiretrovirals (ARVs) the rates of OIs has reduced greatly but unfortunately there are people who are still diagnosed late with an OI at diagnosis. Those with poor adherence or difficulty accessing ARVs are also more likely to be affected. In the UK in 2014, 40% of people diagnosed with HIV had a CD4 count of <350 which is defined as a late diagnosis (and 22% had a CD4 count of <200 which is defined as a very late diagnosis). In comparison to someone diagnosed with HIV early, those who are diagnosed late have a 10 times higher risk of dying in the year after they are diagnosed. This highlights the need for routine HIV testing so that people are diagnosed early to reduce the incidence of OIs further. The most common OIs seen in the UK are pneumocystis pneumonia (PCP), central nervous system (CNS) toxoplasmosis, cryptococcal meningitis, cytomegalovirus (CMV) retinitis, Mycobacterium avium intracellulare (MAI) infection and candidiasis. All those with HIV and a CD4 count ≤ 200, or with a CD4% < 14 should be given prophylaxis against PCP. Prophylaxis should also be recommended for those with oral candidiasis or a previous AIDs – defining illness. The options are co-trimoxazole 480mg od or 960mg 3x/week (960mg once daily can be given although does not confer any greater protection and has increased risk of side effects), dapsone 50mg once daily, or pentamidine nebulisers 300mg once every 4 weeks.

The Immunocompromised Patient: AIDS

Chest Imaging ◽  
2019 ◽  
pp. 239-243
Author(s):  
Juliana Bueno
Keyword(s):  
Immune Deficiency ◽  
Opportunistic Infections ◽  
Kaposi Sarcoma ◽  
Immune Deficiency Syndrome ◽  
Pneumocystis Pneumonia ◽  
Deficiency Syndrome ◽  
Cd4 Count ◽  
Immunodeficiency Virus ◽  
Normal Chest ◽  
Acquired Immune Deficiency

Acquired immune deficiency syndrome (AIDS) is caused by infection with human immunodeficiency virus (HIV) that results in decreased immunity and favors infectious or neoplastic conditions. The onset of clinical AIDS is defined by a CD4 count of less than 200 cells/mm3 or CD4 cells < 14% of all leukocytes in an HIV-positive patient, even in the absence of opportunistic infections. Imaging abnormalities in HIV(+) should be correlated with the CD4 count to narrow the differential diagnosis. Diffuse ground glass opacities (GGO) on CT in a patient with AIDS and hypoxemia, is virtually diagnostic of Pneumocystis pneumonia (PCP). CT is indicated in HIV(+) patients with respiratory symptoms and normal chest radiographs. Suspect tuberculosis (TB) in patients with advanced AIDS and low CD4 counts presenting with consolidation and lymphadenopathy. Kaposi sarcoma (KS) may simulate cardiogenic pulmonary edema on imaging and should be suspected in patients without clinical evidence of edema.

HIV-associated anaplastic large cell lymphoma

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e19563-e19563
Author(s):  
J. Castillo ◽  
C. Milani ◽  
L. Pantanowitz
Keyword(s):  
Viral Load ◽  
T Cell ◽  
Anaplastic Large Cell Lymphoma ◽  
Opportunistic Infections ◽  
Cell Lymphoma ◽  
Large Cell ◽  
Cd4 Count ◽  
Term Survival ◽  
Anaplastic Lymphoma ◽  
Large Cell Lymphoma

e19563 Background: Anaplastic large cell lymphoma (ALCL) is a CD30+ T-cell lymphoma that is generally unrelated to EBV in the non-HIV setting. Based upon anaplastic lymphoma kinase (ALK) expression, the new WHO classification provisionally distinguishes between ALK+ (favorable) and ALK- (unfavorable) ALCL. The characteristics of ALCL, such as ALK expression and EBV coinfection, in individuals with HIV infection have not been adequately evaluated. The aim of this study was to investigate these features in HIV-associated ALCL cases. Methods: A MEDLINE search for all cases of HIV-associated non-cutaneous ALCL was undertaken. Data regarding patient age, gender, HIV status (CD4 count, viral load, opportunistic infections), HAART, lymphoma features (B symptoms, stage, sites of involvement, immunophenotype, ALK expression, molecular studies), EBV coinfection, therapy and outcome (survival, cause of death) were extracted and analyzed. Results: A total of 23 cases were included. Patients were of median age 39 years with a male:female ratio of 7:1. Median CD4+ count was 76 cells/mm3 and HIV viral load 416,500 copies/ml. Most (67%) patients had an opportunistic infection, although only 3 (17%) were on HAART. ALCL was extranodal in 22 cases (96%) affecting most commonly lung, soft tissue and liver. Many (78%) patients had stage IV disease and B symptoms were reported in 9 cases (50%). T-cell receptor gene rearrangement was present in all cases, CD30 was positive in 22 (96%), and the vast majority (90%) were ALK-negative. EBV was identified in 8 (35%) cases. Therapy for ALCL was documented in 15 (67%) cases; 64% received CHOP. In 2 of the 3 patients who were on HAART, long-term survival was achieved. Many (68%) patients died, with a median survival of 9 months. Death was caused by either lymphoma progression (42%) or infection (58%). Conclusions: HIV-associated non-cutaneous ALCL appears to affect younger individuals and is associated with EBV infection in a subset of cases. Apart from marked immunosuppression, the poor prognosis of HIV-associated ALCL appears to be related to the absence of ALK expression, advanced stage at presentation with prominent extranodal disease, inadequate therapy including HAART, and poor response to CHOP. Further research is needed to better understand and treat this unique HIV-associated lymphoma. No significant financial relationships to disclose.

scholarly journals Disparities in the prevalence of AIDS related opportunistic infections in Nigeria- implications for initiating prophylaxis based on absolute CD4 Count

Retrovirology ◽  
2012 ◽  
Vol 9 (S1) ◽  
Author(s):  
Chioma Onyinye Nwuba ◽  
Robert Okonkwo ◽  
Oluwafemi Abolarin ◽  
Ngozi Ogbu ◽  
Pauline Modebelu
Keyword(s):  
Opportunistic Infections ◽  
Cd4 Count

scholarly journals Liver Enzymes Abnormalities among Highly Active Antiretroviral Therapy Experienced and HAART Naïve HIV-1 Infected Patients at Debre Tabor Hospital, North West Ethiopia: A Comparative Cross-Sectional Study

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Melashu Balew Shiferaw ◽  
Ketema Tafess Tulu ◽  
Amtatachew Moges Zegeye ◽  
Amarech Asratie Wubante
Keyword(s):  
Antiretroviral Therapy ◽  
Viral Hepatitis ◽  
Liver Enzyme ◽  
Highly Active Antiretroviral Therapy ◽  
Opportunistic Infections ◽  
Cd4 Count ◽  
Cross Sectional ◽  
North West ◽  
Highly Active ◽  
Hiv 1

Liver disease has emerged as the most common non-AIDS-related cause of death in HIV patients. However, there is limited data regarding this condition including our setting in Ethiopia. Hence, liver enzyme abnormalities among highly active antiretroviral therapy (HAART) experienced and HAART naïve patients were assessed in this study. A total of 164 HAART experienced and 164 HAART naïve patients were studied. Blood specimen was collected to determine alanine aminotransferase (ALT) and aspartate aminotransferase (AST), CD4 count, and viral hepatitis. The prevalence of liver enzyme abnormality was 20.1% and 22.0% among HAART experienced and HAART naïve patients, respectively. The HAART experienced patients had higher mean ALT than HAART naïve patients (P=0.002). Viral hepatitis (AOR = 6.02; 95% CI = 1.87–19.39), opportunistic infections (AOR = 2.91; 95% CI = 1.04–8.19), current CD4 count <200 cells/mm3(AOR = 2.16; 95% CI = 1.06–4.39), and male sex (AOR = 1.83; 95% CI = 1.001–3.33) were associated with elevated ALT and/or AST. In conclusion, liver enzyme abnormalities were high in both HAART experienced and HAART naïve HIV-1 infected patients. Hence, monitoring and management of liver enzyme abnormalities in HIV-1 infected patients are important in our setting.

scholarly journals Frequency of opportunistic infection in PL HIV and its role in monitoring of ART 1 failure

2020 ◽  
Vol 7 (7) ◽  
pp. 1165
Author(s):  
Narendra Singh ◽  
Lalit Kumar ◽  
Desh Nidhi Singh ◽  
Vipin Kumar
Keyword(s):  
Pulmonary Tuberculosis ◽  
Opportunistic Infection ◽  
Opportunistic Infections ◽  
Oral Candidiasis ◽  
Tertiary Care ◽  
Cd4 Count ◽  
Institute Of Medicine ◽  
Post Graduate Institute ◽  
Centre Hospital ◽  
Tubercular Lymphadenitis

Background: There is so many opportunistic infection is present in PL HIV patient when patient immunity disturbed and their CD4 count decreased .this study was conducted for frequency of opportunistic infection in PL HIV and its role in monitoring of ART 1 failure. Aims and objective was to study the frequency of opportunistic infection in PL HIV and its role in monitoring of ART1 failure.Methods: This study was conducted in ART plus centre K.P.S. Post Graduate Institute of Medicine (G.S.V.M. Medical College, Kanpur) tertiary care teaching hospital and is clinical (assessment with investigation) continuous longitudinal, prospective and retrospective, observational, single centre hospital based study at ART Centre, Kanpur and considered All the patient on 1st line ART treating attending in centre were screened for treatment failure decided by SACEP from 2016 to 2018.Results: In this study there was opportunistic infection present that maximum in oral candidiasis but overall tuberculosis is maximum that is considered pulmonary tuberculosis, extra pulmonary tuberculosis, tubercular lymphadenitis and tubercular pericarditis, Abdominal knocks, TBM. LRTI and chronic diarrhea is also present. The male and rural area are more having opportunistic infections and all are have CD4 count 100 to 200 micrometer /Litre.Conclusions: The opportunistic infection mostly are oral candidiasis and tuberculosis, present in CD4 count in the range of 100-200 /ml.it is the indication of ART failure during treatments.

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