scholarly journals Clinical characteristics and predictors of mortality in hospitalized HIV-infected Nigerians

2011 ◽  
Vol 5 (05) ◽  
pp. 377-382 ◽  
Author(s):  
Patricia Aladi Agaba ◽  
Eunice Digin ◽  
Rahila Makai ◽  
Labake Apena ◽  
Oche O Agbaji ◽  
...  
Keyword(s):  
Cause Of Death ◽  
Highly Active Antiretroviral Therapy ◽  
Clinical Characteristics ◽  
Opportunistic Infections ◽  
Sub Saharan Africa ◽  
Cd4 Cell Count ◽  
Predictors Of Mortality ◽  
Cell Counts ◽  
Common Diagnosis ◽  
Cd4 Cell

Introduction: Human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) is a chief cause of death in sub-Saharan Africa. In this study, the clinical characteristics and predictors of mortality among hospitalized HIV infected adult Nigerians are reported. Methodology: The records of 354 patients were reviewed for demographic and clinical characteristics. Predictors of mortality using logistic regression in a retrospective study were also reviewed. Results: A total of 109 (30.8%) males and 245 (69.2%) females participated in the study. The mean age of all participants was 35 ± 8 years. Median baseline CD4 cell counts and viral load were 91 cells/mm³ and 63,438 copies/ml respectively. There was a total of 123 (34.8%) deaths while 231 (65.2%) patients were discharged home. Tuberculosis (TB) was the most common diagnosis on admission as well as the leading cause of death. Among all subjects, only male gender (adjusted odds ratio [AOR] 4.67, 95% confidence interval [CI]: 2.63-8.29); CD4 cell count ≤ 200 cells/mm3 (AOR 5.28, 95% CI: 2.99-9.31); length of hospital stay < 3 days (AOR 4.77, 95% CI: 1.35-16.86); and age ≥ 35 years (AOR 2.43, 95% CI: 1.41-4.19) were predictive of death. Conclusion: These findings illustrate the need for early diagnosis of HIV infection, appropriate treatment and prevention of opportunistic infections, and improved access to highly active antiretroviral therapy (HAART).

Initiation of highly active antiretroviral therapy in advanced AIDS with CD4 < 50 cells/mm3 in a resource-limited setting: efficacy and tolerability

2005 ◽  
Vol 16 (3) ◽  
pp. 243-246 ◽  
Author(s):  
Somnuek Sungkanuparph ◽  
Sasisopin Kiertiburanakul ◽  
Weerawat Manosuthi ◽  
Wiphawee Kiatatchasai ◽  
Asda Vibhagool
Keyword(s):  
Antiretroviral Therapy ◽  
Cell Count ◽  
Highly Active Antiretroviral Therapy ◽  
Adverse Drug Events ◽  
Opportunistic Infections ◽  
Transcriptase Inhibitor ◽  
Cd4 Cell Count ◽  
Hiv Rna ◽  
Highly Active ◽  
Cd4 Cell

In developing countries, patients often present late with advanced AIDS and a very low CD4 cell count. A retrospective cohort study was conducted in HIV-infected patients who had been initiated into highly active antiretroviral therapy (HAART) with CD4 cell count <50 cells/mm3. There were 159 patients of mean age 36.6 years and 60.4% had previous major opportunistic infections. Mean CD4 was 22 cells/mm3 and 80% had HIV RNA>100,000 copies/mL. The majority of HAART regimens is non-nucleoside reverse transcriptase inhibitor-based (81.8%). In as-treated analysis, 50, 71.2, 79.7, 79.4, and 80.1% of patients achieved undetectable HIV RNA (<50 copies/mL) at 12, 24, 36, 48, and 60 weeks, respectively. The corresponding mean CD4 counts were 95, 125, 166, 201, and 225 cells/mm3. Twenty two patients (13.8%) had adverse drug events and half of these had to discontinue HAART. Initiation of HAART in advanced AIDS with CD4 cell count <50 cells/mm3 is effective, safe, and well tolerated and should not be delayed.

scholarly journals Protein Status and CD4+ Cell Count in HIV Patients on Highly Active Anti-Retroviral Therapy

2019 ◽  
pp. 10-14
Keyword(s):  
Cell Count ◽  
Total Protein ◽  
Opportunistic Infections ◽  
Hiv Patients ◽  
Cd4 Cell Count ◽  
Highly Active ◽  
Protein Status ◽  
Cell Counts ◽  
Cd4 Cell

Background of Study: Malnutrition is associated with repeated opportunistic infections, rapid disease progression, and an increase in the incidence of human immunodeficiency virus (HIV) related mortality. The ability of anti-retroviral therapy (ART) in boosting the immune system depends on the nutritional status of the HIV patient. Aim: The study aimed at investigating the protein status and CD4+ cell counts in HIV patients taking highly active ART. Materials and Methods: The case-control study comprising of a total of 80 participants, compared the protein status and CD4+ cell count among baseline (ART-naïve n=20), switch (ART-resistant n=20), ART follow-up (n=20) patients, and apparently healthy controls (n=20). Results: The total protein of baseline patients was significantly (P<0.01) higher than that of the switch, follow-up, and controls. The CD4+ cell count of baseline patients was significantly (P=0.000) low compared to follow-up patients and controls. Total protein level and CD4+ cell count of switch patients were significantly (P=0.000) lower than that of follow-up patients and controls. Total protein of follow-up patients was significantly (P<0.02) higher than that of controls, while the CD4+ cell count of follow-up patients was significantly (P=0.000) lower than that of controls. Conclusion: The present study observed low protein along with low CD4+ cell count in switch patients, while a good outcome was observed in follow up patients.

Association between Sex, CD4 Cell Counts, Antiretroviral Medications, and Olfactory and Gustatory Functions of HIV-Infected Adults

2017 ◽  
Vol 158 (1) ◽  
pp. 90-99 ◽  
Author(s):  
Ayotunde James Fasunla ◽  
Ukamaka Nwankwo ◽  
Ayodeji Matthew Adebayo ◽  
Onyekwere George Nwaorgu
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
Clinical Information ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Cd4 Cell Count ◽  
Viral Loads ◽  
Highly Active ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Cd4 Cell

Objective To investigate the olfactory and gustatory functions of human immunodeficiency virus (HIV)–infected adults in Ibadan, Nigeria. Study Design A cross-sectional study of olfactory and gustatory functions of HIV-infected adults between March 2015 and December 2015. Setting Tertiary health institution. Subjects and Methods A structured questionnaire was administered to participants to obtain relevant sociodemographic and clinical information. Participants’ nadir and most recent CD4 cell count and viral loads were obtained from their medical records. Participants’ body mass indices were determined, and each subjectively rated their olfactory and gustatory performances. Objective olfactory and gustatory functions were determined using validated “Sniffin’ Sticks” and “Taste Strips” impregnated with 4 different concentrations of sucrose, quinine hydrochloride, sodium chloride, and citric acid. Results In total, 135 HIV-infected adults, comprising 41 (30.4%) men and 94 (69.6%) women, were evaluated. Their ages ranged from 20 to 70 years, mean 43.4 ± 10.4 years. Participants were on highly active antiretroviral therapy for a mean duration of 75.8 ± 36.9 months. The proportions of male participants in HIV stages 1, 2, and 3 were 18 (43.9%), 19 (46.3%), and 4 (9.8%), respectively, while female participants were 46 (48.9%), 41 (43.6%), and 7 (7.4%), respectively. Participants’ mean olfactory threshold, discrimination, identification, and TDI scores were 8.0 ± 4.9, 9.9 ± 4.7, 8.8 ± 4.5, and 26.7 ± 11.1, respectively, while total taste score was 25.1 ± 5.7. Conclusion HIV-infected adults have tendency to develop hyposmia and hypogeusia. These are worse with advanced stage of HIV infection.

Comparison of Demographic, Epidemiological, Immunological, and Clinical Characteristics of Patients with HIV Mono-infection Versus Patients Co-infected with HCV or/and HBV: A Serbian Cohort Study

2018 ◽  
Vol 16 (3) ◽  
pp. 222-230 ◽  
Author(s):  
J. Ranin ◽  
D. Salemovic ◽  
B. Brmbolic ◽  
J. Marinkovic ◽  
I. Boricic ◽  
...  
Keyword(s):  
Natural History ◽  
Hiv Infection ◽  
Highly Active Antiretroviral Therapy ◽  
Clinical Characteristics ◽  
Cell Counts ◽  
Therapy Initiation ◽  
Cd4 Cell Counts ◽  
History Of ◽  
Cd4 Cell ◽  
The Impact

Objective:The study aimed to correlate the status of hepatitis C (HCV) and hepatitis B virus (HBV) co-infection in patients with human immunodeficiency virus (HIV) infection with clinical and demographic data prior to starting highly active antiretroviral therapy (HAART) and assess the impact of HCV and HBV co-infection on the natural history of HIV infection.Patients and Methods:The study involved a total of 836 treatment-naive patients with available serological status for HBV and HCV at the point of therapy initiation. Patients were stratified into four groups: HIV mono-infection, HIV/HCV, HIV/HBV, and HIV/HCV/HBV co-infection. Demographic, epidemiological, immunological and clinical characteristics were analyzed in order to assess the possible impact of HCV and HBV co-infection on HIV - related immunodeficiency and progression to AIDS.Results:The prevalence of HCV and HBV co-infection in our cohort was 25.7% and 6.3%, respectively. Triple HIV/HCV/HBV infection was recorded in 1.7% of the patients. In comparison with those co-infected with HCV, patients with HIV mono-infection had lower levels of serum liver enzymes activity and higher CD4 cell counts, and were less likely to have CD4 cell counts below100 cells/µL and clinical AIDS, with OR 0.556 and 0.561, respectively. No difference in the development of advanced immunodeficiency and/or AIDS was recorded between patients with HIV monoinfection and those co-infected with HBV, or both HCV/HBV.Conclusion:HIV/HCV co-infection was found to be more prevalent than HIV/HBV co-infection in a Serbian cohort. Co-infection with HCV was related to more profound immunodeficiency prior to therapy initiation, reflecting a possible unfavorable impact of HCV on the natural history of HIV infection.

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 Frequency of Cytomegalovirus Viral Load in Iranian Human Immunodeficiency Virus-1-Infected Patients with CD4+ Counts <100 Cells/mm3

Intervirology ◽  
2021 ◽  
pp. 1-5
Author(s):  
Mohammad Reza Jabbari ◽  
Hoorieh Soleimanjahi ◽  
Somayeh Shatizadeh Malekshahi ◽  
Mohammad Gholami ◽  
Leila Sadeghi ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Viral Load ◽  
Cell Count ◽  
Previous History ◽  
Cd4 Count ◽  
Cd4 Cell Count ◽  
Cell Counts ◽  
Immunodeficiency Virus ◽  
Cd4 Cell ◽  
Hiv 1

<b><i>Objectives:</i></b> The aim of present work was to assess cytomegalovirus (CMV) viremia in Iranian human immunodeficiency virus (HIV)-1-infected patients with a CD4+ count &#x3c;100 cells/mm<sup>3</sup> and to explore whether CMV DNA loads correlate with CD4+ cell counts or associated retinitis. <b><i>Methods:</i></b> This study was conducted at the AIDS research center in Iran on HIV-1-infected patients with CD4+ count &#x3c;100 cells/mm<sup>3</sup>, antiretroviral therapy-naive, aged ≥18 years with no previous history of CMV end-organ disease (CMV-EOD). <b><i>Results:</i></b> Thirty-nine of 82 patients (47.56%) had detectable CMV viral load ranging from 66 to 485,500 IU/mL. CMV viral load in patients with retinitis ranges from 352 to 2,720 IU/mL, and it was undetectable in 2 patients. No significant associations between CMV viremia and CD4+ cell count was found (<i>p</i> value = 0.31), whereas significant association of CMV viremia in HIV-infected patients with retinitis was found (<i>p</i> &#x3c; 0.02). <b><i>Conclusions:</i></b> We estimated the frequency of CMV viral load infection in Iranian HIV-1-infected patients with a CD4+ cell count &#x3c;100 mm<sup>3</sup>/mL in the largest national referral center for HIV-1 infection in Iran. Further research is required on the relevance of CMV viral load in diagnostic and prognostic value of CMV-EOD.

Factors associated with late presentation of HIV infection in Catalonia, Spain

2012 ◽  
Vol 23 (7) ◽  
pp. 475-480 ◽  
Author(s):  
N Vives ◽  
D Carnicer-Pont ◽  
P Garcia De Olalla ◽  
N Camps ◽  
A Esteve ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Late Presentation ◽  
Late Diagnosis ◽  
Cd4 Cell Count ◽  
Hiv Surveillance ◽  
Factors Associated ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Populations At Risk ◽  
Cd4 Cell

We sought to describe the prevalence, trends and factors associated with late diagnosis of HIV infection between 2001 and 2008 in Catalonia, Spain. Adults over 13 years of age with available CD4 cell counts, who were notified to the Catalonia Voluntary HIV Surveillance System between January 2001 and December 2008, were included in the study. Late presentation for HIV infection was defined as a CD4 cell count <350 cells/μL or with an AIDS-defining condition at presentation. Multivariable logistic regression was used to identify factors independently associated with late diagnosis of HIV. Of the 4651 newly diagnosed HIV-infected individuals with available CD4 counts, 2598 (55.9%) were diagnosed late. The proportion of people with a late diagnosis decreased from 60.4% in 2001 to 50% in 2008, a significant trend ( P < 0.001). Older age, male gender, foreign birth, heterosexuality and injecting drug use were independent risk factors for late diagnosis. Strategies to actively promote HIV testing to populations at risk of late diagnosis of HIV or those never attending health systems should be implemented.

Clinical features of HIV/AIDS patients presenting to an inner city clinic in Ho Chi Minh City, Vietnam

2007 ◽  
Vol 18 (7) ◽  
pp. 482-485 ◽  
Author(s):  
Stephen A Klotz ◽  
Hao Cong Nguyen ◽  
Tam Van Pham ◽  
Liem Thanh Nguyen ◽  
Dong Thi Anh Ngo ◽  
...  
Keyword(s):  
Cell Count ◽  
Opportunistic Infections ◽  
Extrapulmonary Tuberculosis ◽  
Pneumocystis Carinii ◽  
Population Data ◽  
World Health ◽  
Ho Chi Minh City ◽  
Cd4 Cell Count ◽  
To Come ◽  
Cd4 Cell

An outpatient HIV clinic was opened in March 2005 in Binh Thanh District, a poor section of Ho Chi Minh City, Vietnam. Over 1500 patients were seen in the first year. The average age of patients was 27 years. Men represented 77% of the clinic population, women, 23% and children under the age of 16 years of age, 5% of the population. The most common risk factor among men was being an injecting drug user (IDU), 76%, and among women, being married to an IDU HIV-positive man, 35%. Physical signs of disease were uncommon: lymphadenopathy in 24% and hepatomegaly and splenomegaly in 4% and 3%, respectively. Men and women were anaemic at presentation, with a mean haemoglobin of 11.9 g/dL and 11.1 g/dL, respectively. An overwhelming majority of patients had profound immunodeficiency. The mean CD4+ cell count was 164 cells/mL and the median was 69 cells/mL. No correlation was found between the World Health Organization's stage of disease and the CD4+ cell count. Thus, the former is a poor predictor of immunity in this population. Data regarding opportunistic infections diagnosed at the first visit were studied. Candidiasis of the oral pharynx, oesophagus or vagina was found in 34.5% of the patients, and pulmonary and extrapulmonary tuberculosis was found in 32% of the patients. Pneumocystis carinii pneumonia (PCP) was diagnosed in only 3% of the patients. Cotrimoxazole prophylaxis is advocated for HIV-infected Vietnamese, but the incidence of PCP is negligible and resources could be spent elsewhere. The various opportunistic infections seen in this resource-poor clinic setting is likely to be a pattern of presentation of HIV-infected Vietnamese for some time to come.

scholarly journals The THE SPECTRUM OF OPPORTUNISTIC INFECTIONS AND ASSOCIATED FACTORS AMONG PEOPLE LIVING WITH HIV/AIDS ON HIGHLY ACTIVE ANTI-RETROVIRAL THERAPY AT MERPATI CLINIC, BALI, INDONESIA: A RETROSPECTIVE STUDY

2020 ◽  
pp. 68-71
Author(s):  
NOVIANA JOENPUTRI ◽  
KETUT SURYANA
Keyword(s):  
Retrospective Study ◽  
Marital Status ◽  
Cell Count ◽  
Associated Factors ◽  
Opportunistic Infections ◽  
People Living With Hiv ◽  
Cd4 Cell Count ◽  
Highly Active ◽  
Living With Hiv ◽  
Cd4 Cell

Objective: Infections contributed to higher morbidity and mortality in people living with HIV/AIDS (PLWHA) in both developed and developing countries. This study aimed to describe the spectrum of opportunistic infections (OIs) and associated factors among PLWHA on highly active antiretroviral therapy (HAART) at Merpati Clinic, Wangaya Regional General Hospital in Denpasar, Bali. Methods: This was a retrospective study. All of PLWHA, who still receiving HAART at Merpati Clinic from January 2018 to January 2020, who met inclusion and exclusion criteria, were included as subjects in this study. All data were collected through a review of the complete medical record of patients. Results: The prevalence of OIs in this study was 43.4%. Most PLWHA who experienced OIs were male (68.8%), age ≤40 y old with a median of age 36 y old, educational status senior high school (57.7%), married (62.1%), employed (89.7%), CD4 cell count ≥ 200 cells/µl (67.6%) and transmission route of HIV non-Intravenous (IV) drug user (99.2%). Sex, age, marital status, and CD4 cell count were significantly associated with OIs, p=0.000, p=0.005, p=0.005, and p=0.000, respectively. Conclusion: The commonest OI in this study was pulmonary tuberculosis. The presence of OIs was associated with sex, age of HIV diagnosis, marital status, and CD4 cell count. With the knowledge of OIs spectrum, clinicians are expected to be able to prevent, diagnose and treat OIs promptly to decrease the morbidity and mortality caused by OIs efficiently.

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