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 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. 

scholarly journals Prevalence of opportunistic infections in HIV-positive patients in Bahrain: a four-year review (2009-2013)

2015 ◽  
Vol 9 (01) ◽  
pp. 060-069 ◽  
Author(s):  
Nermin Kamal Saeed ◽  
Eman Farid ◽  
Afaf E Jamsheer
Keyword(s):  
Bacterial Infections ◽  
Opportunistic Infections ◽  
Arab World ◽  
Cd4 Count ◽  
Hiv Positive ◽  
Pneumocystis Jirovecii Pneumonia ◽  
Cd4 Counts ◽  
Significant Difference ◽  
Streptococcus Milleri ◽  
Mycobacteria Other Than Tuberculosis

Introduction: This study aimed to examine the prevalence of opportunistic infections in HIV-infected patients in Bahrain and its relation to absolute CD4 count, CD4%, and CD4/CD8 ratio. Methodology: This retrospective cohort study used laboratory records (January 2009 - May 2013) from a major hospital in Bahrain. Opportunistic infections (OIs); absolute CD4 counts, CD4%, and CD4/CD8 ratio were recorded. Results: CD4% and absolute CD4 count in HIV patients with associated infections (157 ± 295) was significantly lower than in those without associated infections (471 ± 285) (p < 0.001). There was no significant difference in CD4/CD8 ratio between the two groups. Infection with Staphylococcus aureus was the commonest infection, present in 9.8% of total HIV-infected patients and 28.7% of members of the AIDS patient group with OIs, followed by yeast infections (9.2% and 27.2%, respectively). Mycobacterium tuberculosis was present in 3.6% of total HIV-infected patients and 10.6% of the group with OIs, while mycobacteria other than tuberculosis (MOTT) was present in 2.5% and 7.5%, respectively. Pneumocystis jirovecii pneumonia (PCP) was observed in 5.1% and 15.1%, respectively. Herpes simplex II (HSV-II) was observed in 3% and 9%, respectively, while Cytomegalovirus antigenemia was only present in 2% and 6%, respectively. Streptococcus pneumoniae, Streptococcus milleri, Stenotrophomonas maltophilia, and Citrobacter species were bacterial infections observed least frequently. Conclusions: Studying the pattern of OIs in HIV-infected patients in Bahrain is of paramount importance due to the scarcity of data in the Arab world. This will help to improve physicians’ awareness to improve care of HIV-infected patients.

Drug Metabolism and Disposition Genes in Israeli HIV Patients: MDR1 and CYP3A4 Polymorphisms May Affect Susceptibility to HIV but Not the Course of the Disease.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 1434-1434
Author(s):  
Meirav Kedmi ◽  
Sara Bar Cohen ◽  
Michelle Hauzi ◽  
Shlomo Maayan ◽  
Deborah Rund
Keyword(s):  
Hiv Infection ◽  
Ethnic Group ◽  
Ethnic Groups ◽  
Mononuclear Cells ◽  
Opportunistic Infections ◽  
Statistical Significance ◽  
Cd4 Count ◽  
Multidrug Resistance Gene ◽  
Cd4 Counts ◽  
Over Time

Abstract Background: Some studies have suggested a relationship between different alleles of the multidrug resistance gene MDR1, and the course of HIV in treated or untreated patients (pts). It is controvertial whether polymorphisms alter the susceptibility to HIV infectivity. We therefore studied the C3435T polymorphism in MDR1, which may influence HIV. The normal allele has been associated with higher MDR1 activity than the polymorphic allele (Hitzl, 2001). We also studied the A to G polymorphism in the NFSE element of the promoter of the CYP3A4 gene, which metabolizes many important drugs. Methods: 96 pts, of either Ethiopian (57) or Caucasian (39) ethnicity, and 276 controls of these ethnic groups were studied using PCR based techniques. MDR1 activity was analyzed on peripheral blood mononuclear cells of 65 pts using rhodamine extrusion. CD4 counts, clinical course and opportunistic infections were recorded at the Hadassah Hospital AIDS Center where all pts are followed. Our pts are highly compliant with medical therapy and followup. Statistical significance was determined using the Cochrane-Armitage Trends test. Results: We found that the C allele of MDR1 C3435T was highly associated with being an HIV patient (p&lt;0.0001) as compared to controls. The reverse was true for the T allele. This association was found for all patients and also separately for each ethnic group. To analyze if this polymorphism affects the course of HIV, we compared CD4 counts in the patients of both ethnic groups according to genotypes. CD4 counts did not differ according to MDR1 C3435T genotype. Furthermore, C3435T genotypes did not affect the change in CD4 count over time in treated pts. CD4 counts rose following antiretroviral therapy in all pts. Twenty-eight of the pts were positive for HIV infection but were not yet treated. In untreated pts, the TT patients had more severe CD4 deficiency over time compared to CC pts. Our sample size is small, but this concurs with the findings of Lee who found that increased MDR1 activity correlated with decreased viral production (Lee, CG, FASEB J, 2000). Rhodamine extrusion did not vary according to MDR1 C3435T genotype. Opportunistic infections were rare and unaffected by genotype. For the CYP3A4 promoter polymorphism, we found a significantly increased probability of being infected with HIV (p&lt;0.0001) with the presence of the C allele, both in heterozygotes and in homozygotes. There were significantly fewer T alleles among the controls as compared to HIV pts. However when analyzed by ethnic group, this association was only found to be significant for Ethiopians and not for Caucasians (Ethiopians: p&lt; 0.0232 compared to p=0.44). There were no differences found in CD4 count, in treated or untreated patients, or in opportunistic infections according to CYP3A4 genotype. Conclusions: We conclude that for Israeli patients (Ethiopians and Caucasians), susceptibility to HIV infection may be altered according to MDR1 genotype. The C allele was highly associated with infection with HIV for both ethnic groups, as compared to normal controls. For Ethiopians, the CYP3A4 genotype may influence the predisposition to HIV infection (the C allele being associated with being a patient as compared to controls). However, the course of the disease and unsorted lymphocyte MDR1 activity were not influenced by the polymorphisms which we studied.

scholarly journals Profile of patients undergoing third line anti-retroviral therapy

2020 ◽  
Vol 7 (9) ◽  
pp. 1394
Author(s):  
Dhileeban Maharajan P. ◽  
T. Jeetenkumar Singh ◽  
S. Bhagyabati Devi ◽  
H. Rebachandra Singh ◽  
Dipul Rudra Paul ◽  
...  
Keyword(s):  
Viral Load ◽  
Antiretroviral Therapy ◽  
Viral Suppression ◽  
Virologic Failure ◽  
Cd4 Count ◽  
Medical Sciences ◽  
Art Initiation ◽  
Number Of Patients ◽  
Third Line ◽  
One Year

Background: India has the third largest human HIV epidemic in the world. The advent of antiretroviral drug began a revolution in the management of HIV. Recent studies have shown that an increasing number of patients experiencing virologic failure on second line Antiretroviral therapy and require third line ART.Methods: This prospective cohort study was conducted in Regional Institute of Medical Sciences, Imphal for a period of two years, to study the clinical, immunological, and virological profile of patients undergoing third line Antiretroviral therapy and to study the early immuno-virological response to third line Antiretroviral therapy.Results: Mean CD4 count before third line ART initiation was 95.90±111.85 cells/μl with 60% of them had CD4 count <100 cells/μl. The mean CD4 count improved significantly (p<0.005) to 246.70±123.78 cells/μl after six months and 340.70±198.57 cells/μl after one year of the therapy. At the time of initiation of third line ART, none of the patients had viral load <150copies/ml while 60% of the population had viral load >100000 copies/ml. After one year of third line ART, 80 % of the patients showed viral suppression (VL<150copies/ml). At the end of one year, the improvement in CD4 count comparing to the Viral load was significant in those who showed viral suppression (VL<150 copies/ml).Conclusions: This study showed significant improvement in the CD4 count and viral suppression with third line medication without any major clinical adverse effect.

Study of Clinical Manifestations of HIV Infected Children in Relation to CD4 Count

2020 ◽  
pp. 1-8
Author(s):  
Archana Mishra ◽  
Narendra Nath Soren ◽  
Sristi Ganguly
Keyword(s):  
Opportunistic Infections ◽  
Nutritional Assessment ◽  
Clinical Stage ◽  
Clinical Manifestations ◽  
Cd4 Count ◽  
Pediatric Hiv ◽  
Clinical Staging ◽  
Categorical Variables ◽  
Chi Square ◽  
Cd4 Counts

Aims: To study the clinical profile of HIV infected children and correlate them with the CD4 count at the time of presentation. Study Design: Hospital based observational study Place and Duration of Study: ART centre of SCBMCH and Department of Pediatrics, SVPPGIP, Cuttack, Odisha during the period October 2017 to September 2019. Methodology: All children aged between 1.5 to 15 years who were confirmed to be HIV positive by ELISA or immunocomb II, either at present or past were included in the study. They were subjected to CD4 count testing, along with nutritional assessment and screened for opportunistic infections, apart from their socio-demographic details. All quantitative variables including age, weight, height, were compared by unpaired t-test. Categorical variables like sex mode of transmission were compared by chi-square test. Variables like clinical staging, immunological staging and CD4 counts were measured at presentation and analyzed with repeated ANOVA at 5% level of significance to allow for multiple comparisons. P<0.05 was considered significant and inferences were drawn. Results: Out of 103 cases, majority belonged to age 4- 7 years and 59.2% were malnourished. 24.3% were asymptomatic, with the most common clinical features noted were fever (65%), cough (47.8%), recurrent diarrhoea (41.8%) and weight loss (40.8%). The incidence of opportunistic infections was 24.3%, with tuberculosis (40%) and herpes zoster (36%) leading the list. Most cases (37.87%) came under WHO clinical stage-III. A significant correlation was found between CD4 count and age, WHO clinical staging, opportunistic infections in the population. Lower CD4 counts were associated with younger age, lower staging and less risk for symptoms and infections. Conclusion: CD4 count is a reliable market to assess the staging and risk for opportunistic infections in pediatric HIV and thus can be used as screening tool for complications/ deterioration in the child, for better management.

scholarly journals Mortality and survival benefits in people living with human immunodeficiency virus initiated newly with Antiretroviral therapy irrespective of CD4 count

2020 ◽  
Vol 7 (2) ◽  
pp. 272
Author(s):  
Diwakar T. N. ◽  
Raghavendra B. C. ◽  
Keerthi Kumar N.
Keyword(s):  
Antiretroviral Therapy ◽  
Pulmonary Tuberculosis ◽  
Opportunistic Infections ◽  
Cd4 Count ◽  
People Living With Hiv ◽  
Art Initiation ◽  
Global Pandemic ◽  
Kaplan Meier ◽  
One Year ◽  
Living With Hiv

Background: HIV is a global pandemic with estimated 37.9 million people living with HIV(PLHIV) worldwide in which 23.3 million (62%) PLHIV take antiretroviral therapy (ART). In 2018 UNAIDS estimated 7,70,000 people died from AIDS related illness globally. India has around 21,40,000 PLHIV and 69,110 AIDS-related deaths in 2017 according to NACO report. This study aims to know the mortality and survival benefits in PLHIV newly initiated on ART as per test and treat policy.Methods: A prospective observational cohort study was conducted from June 2017 to June 2018, involving 100 ART-naïve PLHIV attending this ART Centre at Hospitals attached to BMCRI, Bangalore, India. Survival analysis was done by Kaplan Meier estimates. Spectrum of opportunistic infections and their role in cause of mortality was studied.Results: The overall survival rate was 92% at 6 months and 91% at one year after ART initiation. The mortality rate at the end of one year was 9%, out of which Pulmonary Tuberculosis is the most common cause of mortality. There was a significant increase in the CD4 count during follow up, the mean increase in the CD4 T-cell count at the end of 6 months and 12 months was 157 cells and 286 cells per cubic millimeter respectively above the baseline value.Conclusions: In this study early initiation of ART is found to be beneficial in clinical and immunological recovery with increase in CD4 counts and reduction in opportunistic infections in PLHIV. Pulmonary Tuberculosis remains the grave risk factor for mortality among PLHIV/AIDS patients on ART.

scholarly journals Scenario of mycobacterial and fungal infection in HIV seropositive patients and their co-relation with CD4 count in Western Uttar Pradesh

2018 ◽  
Vol 6 (7) ◽  
pp. 2473
Author(s):  
Richa Pandey ◽  
Amit Singh ◽  
Dharmendra Prasad Singh ◽  
Rajesh Kumar Verma ◽  
Manoj Kumar ◽  
...  
Keyword(s):  
Fungal Infection ◽  
Opportunistic Infections ◽  
Fungal Infections ◽  
Mycobacterial Infection ◽  
Cd4 Count ◽  
Hiv Positive ◽  
Early Screening ◽  
Candida Spp ◽  
Cd4 Counts ◽  
India Ink

Background: HIV infection is defined by sero-conversion and the detection of HIV-specific antibodies. Emergence and pandemic spread of acquired immunodeficiency syndrome is due to the exposure to human immunodeficiency virus (HIV). A decrease in CD4 count is at least partially responsible for the profound immunodeficiency that leads to various OIs in HIV- infected persons. When the CD4 count falls below 200cells/µL, there is irreversible breakdown of immune defence mechanism and patient become prey to a variety of human opportunistic pathogens.HIV positive patients must receive infections screening and access medical care before onset of advanced immunosuppression.Methods: In this study, total 230 HIV positive patients were selected during 18 months of study period. CD4 counts were estimated of all HIV positive cases. Positive HIV patients were investigated further to detect mycobacterial and fungal opportunistic infections. They were subjected to routine microscopy such as KOH mount, India ink, Gram’s staining for suspected fungal infection and ZN staining method for suspected mycobacterial infection. For fungal infection, samples were inoculated in two Sabouraud Dextrose Agar followed by different biochemical test and LPCB mount; for mycobacterial infection, samples were cultured on LJ medium followed by biochemical test.Results: In our study, maximum patients presented with complain of fever (90.43%), weight loss (73.91%) followed by loss of appetite (35.65%), breathlessness (33.91%), coughing (28.69%) and chest pain (22.17%). Overall prevalence of OIs (Mycobacterium and fungal) was 93 (40.43%) among 230 HIV positive patients. Among OIs 63(27.39%) patients were detected as having Mycobacterial infection and 41(17.82%) as had opportunistic fungal infections. Maximum OIs were related to patients with CD4 count 0-200 cells/µL followed by 201-400 Cells/µL. Most common OIs, among mycobacterial and opportunistic fungal infection were M. tuberculosis (50 isolates) and Candida spp. (26 isolates) respectively.Conclusions: This study provides important information about the risks of OIs at lower CD4 counts among HIV positive patients. These results highlight the need for early screening of HIV infected patients for opportunistic infections. There is also need to increase awareness in healthcare providers in order to improve decisions regarding prophylaxis for prevention of OIs and appropriate therapeutic intervention.

scholarly journals Impact of CD4 count in the development of mycobacterium tuberculosis in patients with HIV infection in a tertiary care centre

2018 ◽  
Vol 5 (2) ◽  
pp. 340
Author(s):  
Satyanarayan T. B. ◽  
Manjunath M. P. ◽  
Ranganath M. ◽  
Mahendra M.
Keyword(s):  
Hiv Infection ◽  
Opportunistic Infections ◽  
Tertiary Care ◽  
Cd4 Count ◽  
Cell Mediated Immunity ◽  
Pulmonary Medicine ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Cd4 Counts ◽  
Immunodeficiency Virus

Background: Patients with Human Immunodeficiency Virus (HIV) infection are predisposed to numerous opportunistic infections due to decreased cell mediated immunity, Tuberculosis being most common. Low CD4 count is associated with low immunity and higher risk of tuberculosis.Methods: Author conducted a retrospective study in the department of Pulmonary medicine in a tertiary care teaching hospital during January to December 2017. Author collected data of all the patients with HIV diagnosed with Tuberculosis from the ART centre. Author collected demographic details including age, sex, symptoms at presentation, details of diagnosis of TB including type of tuberculosis, CBNAAT results, CD4 count at the diagnosis of TB, details of ART therapy and ATT therapy and outcomes of treatment.Results: Eighty one patients with HIV-TB co- infection were included in the study. Males (70.37%) were more affected than females. Mean age of the study group was 39.97±10 years. Sixty one patients (75.4%) were diagnosed with Pulmonary Tuberculosis and 20 (24.6%) patients were diagnosed with extra pulmonary TB. Mean CD4 counts of the cohort was 226±110/µl. Eighty percent of patients developed Tuberculosis with CD4 count <250/µl.Conclusions: Author found in this study higher proportions of tuberculosis (80.2%) in patients with HIV infection with CD4 count <200/µl. Author also found higher proportion of pulmonary Koch’s in patients with low CD4 count (CD4 <200/µl).

Bioactivity of Phenolic Compounds Extracted from Strawberry against Formation of Pseudomonas aeruginosa Biofilm

2019 ◽  
Vol 10 (01) ◽  
Author(s):  
Baydaa Hussein ◽  
Zainab A. Aldhaher ◽  
Shahrazad Najem Abdu-Allah ◽  
Adel Hamdan
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Phenolic Compounds ◽  
Biofilm Formation ◽  
Opportunistic Infections ◽  
Formation Rate ◽  
Hydrocarbon Chain ◽  
Health Concern ◽  
Gas Chromatography Mass Spectrometry ◽  
Phenolic Contents

Background: Biofilm is a bacterial way of life prevalent in the world of microbes; in addition to that it is a source of alarm in the field of health concern. Pseudomonas aeruginosa is a pathogenic bacterium responsible for all opportunistic infections such as chronic and severe. Aim of this study: This paper aims to provide an overview of the promotion of isolates to produce a biofilm in vitro under special circumstances, to expose certain antibiotics to produce phenotypic evaluation of biofilm bacteria. Methods and Materials: Three diverse ways were used to inhibited biofilm formation of P.aeruginosa by effect of phenolic compounds extracts from strawberries. Isolates produced biofilm on agar MacConkey under certain circumstances. Results: The results showed that all isolates were resistant to antibiotics except sensitive to azithromycin (AZM, 15μg), and in this study was conducted on three ways to detect the biofilm produced, has been detected by the biofilm like Tissue culture plate (TCP), Tube method (TM), Congo Red Agar (CRA). These methods gave a clear result of these isolates under study. Active compounds were analyzed in both extracts by Gas Chromatography-mass Spectrometry which indicate High molecular weight compound with a long hydrocarbon chain. Conclusion: Phenolic compounds could behave as bioactive material and can be useful to be used in pharmaceutical synthesis. Phenolic contents which found in leaves and fruits extracts of strawberries shows antibacterial activity against all strains tested by the ability to reduce the production of biofilm formation rate.

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
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