scholarly journals Opportunistic Fungal Infection in HIV Positive Patients Attending a Tertiary care Hospital in Eastern Nepal

2018 ◽  
Vol 1 (2) ◽  
pp. 81-87
Author(s):  
Rinku Sah ◽  
R. Gurung ◽  
N. Poudyal ◽  
R. Baral ◽  
S. Rijal ◽  
...  
Keyword(s):  
Fungal Infection ◽  
Cryptococcus Neoformans ◽  
Candida Species ◽  
Tertiary Care ◽  
Cd4 Count ◽  
Aspergillus Species ◽  
Hiv Positive ◽  
Care Hospital ◽  
Isolation And Identification ◽  
Major Health Problem

Background: HIV infection continues to be a major health problem with more than millions of AIDS related death annually. The risk of opportunistic infections increases with the depletion of CD4+ count in HIV positive patients which are responsible for the high mortality and morbidity. The spectrum of opportunistic infection (OIs) varies from one region to another. This study was carried out to see the occurrence of opportunistic fungal infection among the HIV positive patients in Eastern Nepal. Method: This was a hospital based descriptive study carried out in Microbiology laboratory, BPKIHS, Dharan, Nepal over a period of one year (15th May 2013 to 14th May 2014). Total 60 HIV positive patients with CD4+ count ≤200 cells/mm3 and suspected of having fungal infections were included. Samples were collected after taking an informed written consent from the patient. Isolation and identification was done as per standard Microbiological procedure. Result: Opportunistic fungal infection was identified in 51.66% patients. The most common fungi isolated were Candida species, Cryptococcus neoformans, Aspergillus species and Dermatophytes respectively being 33.3% (n= 20), 10% (n= 6), 3.3% (n= 2) and 8.3% (n= 5). Candida species comprised 60%, Cryptococcus neoformans 20%, Aspergillus species 5.7% and dermatophytes 14.3% of total fungal isolates. Conclusion: The common fungus isolated were Candida species, Cryptococcus neoformans, Aspergillus species and Dermatophytes in HIV positive patients in this hospital of Eastern Nepal.

scholarly journals Treatment outcome of antiretroviral treatment naive HIV infected patients initiated on antiretroviral therapy in a tertiary care hospital in South India

2018 ◽  
Vol 6 (5) ◽  
pp. 1704
Author(s):  
Rajendra Prasad S. ◽  
Subhash Chandra B. J.
Keyword(s):  
Side Effects ◽  
Antiretroviral Treatment ◽  
Opportunistic Infections ◽  
Tertiary Care ◽  
Cd4 Count ◽  
Clinical Profile ◽  
Hiv Positive ◽  
Care Hospital ◽  
Route Of Transmission ◽  
The Mean

Background: About 2.1 million people are infected with HIV in India. Clinical profile of patients has evolved over a period of time in the Antiretroviral treatment (ART) era. This study was done to document the clinical presentation of patients in a tertiary care in Mysuru in Karnataka. The aim of the study was to follow the patients who were initiated on ART over a period of time and to know its effect on the clinical outcome and overall morbidity and mortality of the patients.Methods: A prospective study of HIV positive patients who were initiated on ART was done regarding clinical profile and outcome over a period of one and a half to two years depending on when they were initiated on ART.Results: Totally 183 patients were registered during the period, out of which 114 patients (62.29%) were males and the rest were females (37.70%). The commonest route of transmission was heterosexual route seen in 97.3% (178). Most (56.8%) of the patients were asymptomatic. The mean basal CD4 count was 162.70. The mean age of patients was 39.07. The mean BMI was 20.29. A 23.5% (43) had one or other side effects. Anemia (44.2%) was the most common side effects seen. There were 18 deaths (12.2%). A 39.34% (72) patients had opportunistic infections (OI), the commonest being tuberculosis 45(%).Conclusions: It was concluded that patients with low CD4 count, low BMI were more prone for Opportunistic infections and death. Early initiation of ART can prevent such incidences and improve the quality of life of HIV positive patients.

scholarly journals Prevalence of tuberculosis in newly diagnosed HIV patients and its relationship with cluster of differentiation 4 count in a tertiary care hospital

2019 ◽  
Vol 6 (6) ◽  
pp. 1849
Author(s):  
Archana B. ◽  
Vivek K. U.
Keyword(s):  
Extrapulmonary Tuberculosis ◽  
Tertiary Care ◽  
Cd4 Count ◽  
Hiv Positive ◽  
Clear Correlation ◽  
Pulmonary Medicine ◽  
Care Hospital ◽  
Newly Diagnosed ◽  
Hiv Patients ◽  
Pulmonary Tb

Background: Tuberculosis (TB) is the commonest opportunistic infection among Human Immunodeficiency Virus (HIV) positive patients in India and HIV/TB co-infection poses a major public health challenge in developing countries. It is estimated that 60-70% of HIV positive patients will develop tuberculosis in their lifetime. The aim of the present study is to record the clinical, radiological profile of pulmonary and Extrapulmonary Tuberculosis (EPTB) in HIV positive patients.Methods: This was a prospective study conducted in the department of Pulmonary medicine, Kempegowda institute of medical sciences. All newly diagnosed HIV patients during the study period were included and screened for tuberculosis irrespective of whether they had signs and symptoms.Results: Among 44(15.94%) patients among 276 HIV positive patients were diagnosed to have tuberculosis. Males (72.72%) were affected more than females (27.27%). Most common affected age group was 31-40 years with a mean age of 38.08 years. Unprotected heterosexual contact was the most common mode of HIV transmission. Fever, weight loss and cough were the commonest symptoms at presentation. Pulmonary TB was diagnosed in 10(22.7%) patients, EPTB in 30(68.3%) and disseminated TB in 4(9%) patients. All the pulmonary TB patients had CD4 count below 250, EPTB below 150 and disseminated TB patients below 50.6(13.63%) patients had pleural effusion, 5(11.36%) had abdominal TB, 5(11.36%) had tubercular meningitis, 4(9%) had intra thoracic lymphadenopathy and one (2.27%) patient had pericardial effusion. Low CD4 count (<150) had statically significant association with HIV/TB co-infection.Conclusions: The prevalence of HIV-TB co-infection was high. Moreover, HIV positive patients need early diagnosis and treatment of active TB. The study has shown clear correlation between clinical data and the laboratory parameter of immunodeficiency (CD4 count) and the temporal development of TB.

scholarly journals A comparative evaluation of the effects of ZLN and TLE anti-retroviral regimens in HIV positive patients: A retrospective record-based study

2021 ◽  
Vol 64 ◽  
pp. 298-302
Author(s):  
Ritika Singla ◽  
Neetu Sharma
Keyword(s):  
Opportunistic Infections ◽  
Tertiary Care ◽  
Cd4 Count ◽  
Hiv Positive ◽  
Care Hospital ◽  
Immunodeficiency Virus ◽  
Group A ◽  
The Mean ◽  
The Difference ◽  
Group B

Objectives: Until 2012, zidovudine+lamivudine+nevirapine (ZLN) was the first line treatment for human immunodeficiency virus (HIV)-positive patients, whereas in 2013, tenofovir+lamivudine+efavirenz (TLE) was recommended as a preferred regimen due to less adverse drug reactions and better virological response. The present study was done to compare the change in CD4 count and emergence of opportunistic infections (OIs) in HIV-positive patients on ZLN and TLE regimens. Materials and Methods: This retrospective record-based study was conducted at anti-retroviral therapy (ART) center of a tertiary care hospital on 150 charts of patients on ZLN (Group A) and TLE (Group B) regimens each for 1 year. Data were analyzed using GraphPad Prism version 6. Results: The mean age of patients in Group A was 38.72 (±10.5) years and Group B 37.75 (±11.57) years (P = 0.4460). After 1 year of ART, the mean CD4 count (cells/mm3) increased in both groups (Group A: 223.51 [±111.21] to 415.37 [±218.16] [P = 0.0001] vs. Group B: 255.05 [±164.50] to 433.12 [±247.66] [P = 0.0001]). With the baseline counts being comparable (P = 0.0527), the difference in mean CD4 counts between the groups post-ART was not statistically significant (P = 0.5105). The incidence of OI was 45% in Group A as compared to 25% in Group B. Overall, the most prevalent OI was tuberculosis (TB) (13.33%). Conclusion: Both ZLN and TLE regimens are equally effective in improving the immunological status of HIV-positive patients. Patients on ZLN have higher incidence of OI than those on TLE. However, therapy should be individualized as per patient’s suitability.

scholarly journals Isolation and identification of candida species from various clinical samples in a tertiary care hospital

2017 ◽  
Vol 5 (8) ◽  
pp. 3520 ◽  
Author(s):  
Vignesh Kanna B. ◽  
Amar Kumar G. ◽  
Swapna M. ◽  
Joshy M. Easow
Keyword(s):  
Candida Albicans ◽  
Candida Species ◽  
Secondary Infection ◽  
Tertiary Care ◽  
Vaginal Swab ◽  
Clinical Samples ◽  
Care Hospital ◽  
Inexpensive Method ◽  
Candida Spp ◽  
Isolation And Identification

Background: Candida spp is a member of the normal flora of the skin, mucous membrane and gastrointestinal tract. They are endogenous opportunists which cause secondary infection in individuals with underlying immunocompromised conditions. Candidiasis is a common fungal disease in humans. An increase in the prevalence of non-albicans species has been noted during the last decades because of increasing use of azoles. This study aims to Spectate Candida using chromogenic medium.Methods: A total of 50 Candida isolates from various clinical samples were included in the study. These isolates were subjected to gram's stain, germ tube test and inoculation on commercially available CHROM agar (HiMedia India).Results: In current study majority of isolates were from high vaginal swab (34%) followed by sputum (28%), urine (18%), pus from surgical sites and others constituted to 20%. Candida albicans (51%) was the most common candida species, followed by C. tropicalis (25%), C. krusei (16%), C. glabrata (6%) and C. dubliniensis (1%).Conclusions: Along with Candida albicans, non-albicans candida spp like C. tropicalis, C. krusei, C. glabrata, and C. dubliniensis are increasingly being isolated from clinical samples. CHROM agar is a simple, rapid and inexpensive method for identification of such species. Characterization to species level helps to identify species which might be intrinsically resistant to commonly used antifungal agents.

Sero-Prevalence of Parvovirus B 19 Infection Among HIV Positive Patients Attending Tertiary Care Hospital in Central India

2017 ◽  
Vol 01 (04) ◽  
pp. 127-132
Author(s):  
Bhushan Shrikhande ◽  
Meena Mishra ◽  
Mohiuddin Qazi ◽  
Arvind Kurhade ◽  
Chandrashekhar Unakal ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Central India ◽  
Hiv Positive ◽  
Care Hospital ◽  
Parvovirus B 19

Homelessness among an inpatient HIV-positive cohort at a tertiary care hospital in central London

2020 ◽  
Vol 31 (7) ◽  
pp. 705-707
Author(s):  
Venkateshwaran Sivaraj ◽  
Rudiger Pittrof ◽  
Olubanke Davies ◽  
Ranjababu Kulasegaram
Keyword(s):  
Bacterial Infections ◽  
Substance Misuse ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Hiv Positive ◽  
Care Hospital ◽  
Hiv Viral Load ◽  
Cd4 Cell Count ◽  
Cell Counts ◽  
Cd4 Cell

A cohort review was conducted at a central London tertiary care hospital trust on the prevalence of homelessness among human immunodeficiency virus (HIV)-positive inpatients over a year. Data were collected on the duration of inpatient stay, co-morbidities including acquired immune deficiency syndrome (AIDS)-defining illnesses, co-infections, initiation of antiretroviral therapy, CD4 cell count, HIV viral load and substance misuse. Homeless people were found to be at high risk for hepatitis C, mental health illness, substance misuse including injecting drug use, recurrent bacterial infections, AIDS-associated illnesses, lower CD4 cell counts and HIV viremia. They also had more missed HIV outpatient appointments. It was highlighted that a multidisciplinary approach in their care was necessary to address their needs and reduce the morbidity burden in this cohort.

scholarly journals Species identification of Candida isolated from clinical specimens in a tertiary care hospital

2016 ◽  
Vol 9 (1) ◽  
pp. 20 ◽  
Author(s):  
Lsmet Nigar ◽  
Shirin Tarafder ◽  
Rehana Razzak Khan ◽  
S. M. Ali Ahmed ◽  
Ahmed Abu Saleh
Keyword(s):  
Candida Albicans ◽  
Candida Species ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Common Species ◽  
Blood Stream ◽  
Care Hospital ◽  
Emerging Pathogens ◽  
Predisposing Factor ◽  
Clinical Specimens

<p><strong>Background:</strong> Candida species are responsible for various clinical manifestations from mucocutaneous overgrowth to blood stream infections especially in immunocompromized situations. Although C. albicans is the most prevalent species, high incidence of non-albicans Candida species with antifungal resistance are emerging which is posing a serious threat to the patients care.</p><p><strong>Objective:</strong> This study aimed to isolate and identify different species of Candida from different clinical specimens. Methods: A total of 100 different clinical specimens were studied of which 35 were oral swab, 28 were high vaginal swab, 15 were urine, 14 were nail, 04 were bronchoalveolar lavage and peritoneal fluid were 04. Among 100 clinical specimens, Candida isolates were identified in 64 specimens. Isolation of Candida species was done by primary culture in SDA. Subsequent identification of species were performed by germ tube test, subculture in chromo­genic agar medium and carbohydrate assimilation test with commonly used twelve sugars.</p><p><strong>Results:</strong> Out of 64 isolated Candida species, Candida albicans were 51.56% and the non-albicans Candida species were 48.44%. The most prevalent Candida species was C. albicans 33 (51.53%) followed by C. tropicalis 17 (26.56%). C. glabrata 4 (6.25%), C. parapsilo­sis 4 (6.25%), C. krusei 3 (4.68%) and C. guilliermondii 2 (3.2%). One of the isolated Candida species was unidentified.</p><p><strong>Conclusion:</strong> Though Candida albicans was found as the most common species, but non-albicans Candida species are appearing as emerging pathogens as well. Exposure to chemotherapy appeared to be the commonest predisposing factor for Candida infection followed by indwelling urinary catheter in situ for prolong period.</p>

scholarly journals Per-vaginal Findings among the Women with Pelvic Inflammatory Diseases at a Tertiary Care Hospital in Dhaka City

2018 ◽  
Vol 8 (2) ◽  
pp. 90-93
Author(s):  
Tahamina Khanum ◽  
Nasima Begum ◽  
Kazi Mobina Akhter
Keyword(s):  
Vaginal Discharge ◽  
Inflammatory Diseases ◽  
Tertiary Care ◽  
Lower Abdominal Pain ◽  
Care Hospital ◽  
Perineal Tear ◽  
Cross Sectional ◽  
Major Health Problem ◽  
Cervical Motion ◽  
Cervical Motion Tenderness

Background: Pelvic inflammatory disease (PID) is a major health problem for adult female. Women presented with pelvic inflammatory diseases give different per-vaginal findings. So we designed this study to assess the per-vaginal findings among the women presented with pelvic inflammatory diseases.Objective: The purpose of the present study was to measure the pervaginal findings among the women with PID.Materials and Methods: This cross-sectional study was conducted in the Department of Obstetrics and Gynaecology at Dhaka Medical College & Hospital, Dhaka during January to June 2007. Women in the age group of 15−45 years presented with lower abdominal pain, tenderness, per-vaginal discharge and cervical motion tenderness were included in this study. After taking verbal consent from the patients, a pre-designed data collection sheet was filled in after per-vaginal examination.Results: The study was done on 50 cases, of which 20% patients had 1st degree perineal tear, 6% had utero-vaginal prolapse and 24% had foul-smelling vaginal discharge. Majority (90%) patients had healthy vagina. Ninety percent patients had anteverted uterus; and uterus was mobile in 60% cases. Cervical motion tenderness was present in 44% cases, tenderness of fornix was found in 34% cases and thickening of fornix was found in 22%.Conclusion: In this study first degree perineal tear, foul smelling vaginal discharge and cervical motion tenderness are the commonest findings among the women presented with pelvic inflammatory diseases.J Enam Med Col 2018; 8(2): 90-93

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