Faculty Opinions recommendation of Early versus delayed initiation of antiretroviral therapy for concurrent HIV infection and cryptococcal meningitis in sub-saharan Africa.

2010 ◽  
Author(s):  
Jeremy Day
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Cryptococcal Meningitis ◽  
Sub Saharan Africa ◽  
Delayed Initiation ◽  
Sub Saharan

scholarly journals Early versus Delayed Initiation of Antiretroviral Therapy for Concurrent HIV Infection and Cryptococcal Meningitis in Sub‐Saharan Africa

2010 ◽  
Vol 50 (11) ◽  
pp. 1532-1538 ◽  
Author(s):  
Azure T. Makadzange ◽  
Chiratidzo E Ndhlovu ◽  
Kudakwashe Takarinda ◽  
Michael Reid ◽  
Magna Kurangwa ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Cryptococcal Meningitis ◽  
Sub Saharan Africa ◽  
Delayed Initiation ◽  
Sub Saharan

Endocrine abnormalities in HIV infection

2011 ◽  
pp. 1563-1575
Author(s):  
Takara L. Stanley ◽  
Steven K. Grinspoon
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Opportunistic Infections ◽  
Sub Saharan Africa ◽  
Gonadal Function ◽  
Mineral Density ◽  
Sub Saharan ◽  
Salt And Water Balance ◽  
Living With Hiv ◽  
Untreated Individuals

Approximately 33 million people worldwide are living with HIV infection, and more than 2 million individuals are newly infected each year (1). Sub-Saharan Africa bears the majority of the disease burden, with 67% of all HIV cases and 75% of all HIV/AIDS related deaths occurring in this region (2). Although access to antiretroviral therapy has improved significantly over the past decade, antiretrovirals are available to only about 30% of those who need them (2). Availability of antiretroviral therapy greatly impacts the endocrine manifestations of HIV infection: individuals treated with antiretrovirals may develop peripheral fat loss, abdominal obesity, insulin resistance, and hyperlipidemia, whereas untreated individuals may develop undernutrition, wasting, and end-organ effects of opportunistic infections such as primary adrenal insufficiency secondary to adrenal destruction (Box 10.2.4.1). In all individuals with HIV infection, regardless of treatment, gonadal function, thyroid function, and bone mineral density may also be decreased, and salt and water balance may be affected (Box 10.2.4.2). The purpose of this chapter is to review the endocrine manifestations of HIV infection, including pathogenesis and treatment.

Clinical Experience with Parotid Gland Enlargement in HIV Infection: A Report of Five Cases in Nigeria

2005 ◽  
Vol 6 (1) ◽  
pp. 136-145 ◽  
Author(s):  
Foluso J. Owotade ◽  
Olawunmi A. Fatusi ◽  
Kehinde E. Adebiyi ◽  
Sunday O. Ajike ◽  
Morenike O. Folayan
Keyword(s):  
Antiretroviral Therapy ◽  
Parotid Gland ◽  
Hiv Infection ◽  
Clinical Experience ◽  
Needle Aspiration ◽  
Sub Saharan Africa ◽  
Parotid Swelling ◽  
Sub Saharan ◽  
Gland Enlargement ◽  
Hiv Aids

Abstract A changing picture of oral lesions associated with HIV/AIDS has been documented. With the use of antiretroviral therapy, salivary gland swellings and other less common conditions associated with HIV/AIDS are now becoming more common. Our review of the literature showed the presence of parotid swelling in HIV-1 infection has increased from a range of 5-10% to 20% in AIDS. However, to the best of our knowledge, none from sub-Saharan Africa, which is the epicenter of the HIV infection and where access to antiretroviral therapy is poorest, has been primarily reported in literature. This report documents five cases of bilateral parotid gland enlargement as the presenting clinical manifestation of HIV/AIDS. The combination of a fine needle aspiration (FNA) biopsy, ultrasound imaging, and histological diagnosis increased the accuracy of diagnosis. While two patients had access to antiretroviral therapy, other modes of management were cystic aspiration and parotidectomy. One of the patients treated with parotidectomy had facial nerve injury, and the short-term aesthetic outcome between surgical treatment and antiretroviral therapy did not appear different. However, all our patients were lost to follow-up within a 2-year period. For a resource-constrained environment like Nigeria where stigma and discrimination is high and access to antiretroviral therapy is limited, there is a need to understand how best to manage a lymphoepithelial lesion in HIV/AIDS patients. Citation Owotade FJ, Fatusi OA, Adebiyi KE, Ajike SO, Folayan MO. Clinical Experience with Parotid Gland Enlargement in HIV Infection: A Report of Five Cases in Nigeria. J Contemp Dent Pract 2005 February;(6)1:136-145.

scholarly journals Short term mortality outcomes of HIV-associated Cryptococcal meningitis in antiretroviral therapy naïve and experienced patients in sub-Saharan Africa

2021 ◽  
Author(s):  
Newton Kalata ◽  
Jayne Ellis ◽  
Cecilia Kanyama ◽  
Charles Kuoanfank ◽  
Elvis Temfack ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Cryptococcal Meningitis ◽  
Virologic Failure ◽  
Sub Saharan Africa ◽  
First Episode ◽  
Multicentre Phase ◽  
All Cause Mortality ◽  
Short Term Mortality ◽  
Sub Saharan ◽  
Study Participants

Abstract Background An increasing proportion of patients with HIV-associated cryptococcal meningitis have received antiretroviral therapy (ART) prior to presentation. There is some evidence suggesting an increased two-week mortality in those receiving ART for less than 14 days compared with those on ART for more than 14 days. However, presentation and outcomes for cryptococcal meningitis patients who have recently initiated ART, and those with virologic failure and/or non-adherence are not well described. Methods 678 adults with first episode of cryptococcal meningitis recruited into a randomized, non-inferiority, multicentre phase 3 trial in 4 sub-Saharan countries were analysed to compare clinical presentation and 2-and 10-week mortality outcomes between ART-naive and experienced patients, and between patients receiving ART for varying durations prior to presentation. Results Over half (56% (381/678)) the study participants diagnosed with a first episode of cryptococcal meningitis were ART-experienced. All-cause mortality was similar at 2-weeks (17% vs 20%; HR 0.85, 95%CI 0.6-1.2, p=0.35), and 10 weeks (38% vs 36%; HR 1.03, 95%CI 0.8-1.32, p=0.82) for ART-experienced vs ART-naïve patients, respectively. Among ART-experienced patients, using different cut-off points for ART duration, there were no significant differences in 2- and 10-week mortality based on duration of ART. Conclusion In this study, there were no significant differences in mortality at 2-and 10-weeks between ART- naive and experienced patients, and between ART-experienced patients according to duration on ART.

Sign in / Sign up

Export Citation Format

Share Document