scholarly journals Analysis of HIV-related mortality data in a tertiary South African neurology unit, 2006- 2012

2013 ◽  
Vol 14 (3) ◽  
pp. 121-124
Author(s):  
Clara Maria Schutte
Keyword(s):  
South African ◽  
Neurological Complications ◽  
Mortality Data ◽  
Hiv Positive ◽  
Steady Increase ◽  
Number Of Patients ◽  
High Prevalence ◽  
Living With Hiv ◽  
Related Mortality ◽  
Hiv Negative

Background. South Africa (SA) has a high prevalence of HIV infection with almost 11% of the population aged >2 years living with HIV. At the Steve Biko Academic Hospital, Pretoria, the Neurology Department has seen a steady increase in HIV-related neurology patients.Objective. To evaluate the mortality data of this unit as it relates to HIV infection.Methods. The study was a retrospective analysis of records. Patient mortality statistics for 2006, 2008, 2010 and 2012 were analysed regarding cause of death, sex, age and HIV status.Results. During 2006, 85 patients died: 33% were HIV-positive, 13% were HIV-negative and 54% had not tested for HIV. By 2010, these figures were 50%, 22% and 28%, respectively, changing little in 2012 (48%, 28% and 24%, respectively). Causes of death in the HIV-positive group were meningitis in 58% – with tuberculous meningitis the most common aetiology – followed by strokes (14%), space-occupying lesions (8%) and status epilepticus (7%). Among HIV-positive patients aged 20 - 30 years, a larger proportion of young women died than men. In the combined untested and HIV-negative group, strokes accounted for the vast majority of deaths.Conclusion. Neurological complications of HIV remain common in SA and contribute significantly to the overall mortality in our tertiary neurology unit, with TB posing a serious threat. A strong corps of clinical neurologists with training in infective neurology is needed urgently in the coming years to care for this growing number of patients. 

scholarly journals Loco-Regional Treatments for Hepatocellular Carcinoma in People Living with HIV

2022 ◽  
Vol 14 (1) ◽  
pp. 43-55
Author(s):  
Cristina Micali ◽  
Ylenia Russotto ◽  
Grazia Caci ◽  
Manuela Ceccarelli ◽  
Andrea Marino ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Cancer Staging ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Liver Cancers ◽  
Significant Difference ◽  
Cancer Specific Mortality ◽  
Living With Hiv ◽  
Hiv Negative

Hepatocellular carcinoma (HCC) accounts for approximately 75–90% of primary liver cancers and is the sixth most common cancer and the third leading cause of cancer-related deaths worldwide. In the HIV-positive population, the risk of HCC is approximately four times higher than in the general population, with higher cancer-specific mortality than in HIV-negative patients. In most cases, HCC diagnosis is made in patients younger than the HIV-negative population and in the intermediate-advanced stage, thus limiting the therapeutic possibilities. Treatment choice in HIV-positive patients with HCC is subject to cancer staging, liver function and health status, as for HIV-negative and non-HIV-negative HCC patients. There are relatively few studies on the efficacy and safety in HIV-positive patients to date in loco-regional treatments for HCC. So far, literature shows that curative treatments such as radiofrequency ablation (RFA) have no significant differences in overall survival between HIV-positive and HIV-negative patients, as opposed to palliative treatments such as TACE, where there is a significant difference in overall survival. Although it can be assumed that the most recently discovered loco-regional therapies are applicable to HIV-positive patients with HCC in the same way as HIV-negative patients, further studies are needed to confirm this hypothesis. The purpose of our review is to evaluate these treatments, their efficacy, effectiveness, safety and their applicability to HIV-positive patients.

Five-year overall survival following chemoradiation among HIV-positive and HIV-negative patients with locally advanced cervical carcinoma in a South African cohort

2018 ◽  
Vol 151 (2) ◽  
pp. 215-220 ◽  
Author(s):  
Hannah M. Simonds ◽  
Matthys H. Botha ◽  
Alfred I. Neugut ◽  
Frederick H. Van Der Merwe ◽  
Judith S. Jacobson
Keyword(s):  
Overall Survival ◽  
South African ◽  
Cervical Carcinoma ◽  
Locally Advanced ◽  
Hiv Positive ◽  
Advanced Cervical Carcinoma ◽  
Hiv Negative

scholarly journals Dietary intake and body composition in HIV-positive and -negative South African women

2013 ◽  
Vol 17 (7) ◽  
pp. 1603-1613 ◽  
Author(s):  
Stephanie V Wrottesley ◽  
Lisa K Micklesfield ◽  
Matthew M Hamill ◽  
Gail R Goldberg ◽  
Ann Prentice ◽  
...  
Keyword(s):  
Body Composition ◽  
Dietary Intake ◽  
South African ◽  
Overweight And Obesity ◽  
African Women ◽  
Hiv Positive ◽  
Cd4 Counts ◽  
South African Women ◽  
The Impact ◽  
Hiv Negative

AbstractObjectiveThe present paper examines dietary intake and body composition in antiretroviral (ARV)-naïve HIV-positive compared with HIV-negative South African women, as well as the impact of disease severity on these variables.DesignBaseline data from a longitudinal study assessing bone health in HIV-negative and HIV-positive premenopausal South African women over 18 years of age were used. Anthropometry and body composition, measured by dual energy X-ray absorptiometry, were analysed together with dietary intake data assessed using an interviewer-based quantitative FFQ.SettingSoweto, Johannesburg, South Africa.SubjectsBlack, urban South African women were divided into three groups: (i) HIV-negative (HIV−; n 98); (ii) HIV-positive with preserved CD4 counts (HIV+ non-ARV; n 74); and (iii) HIV-positive with low CD4 counts and due to start ARV treatment (HIV+ pre-ARV; n 75).ResultsThe prevalence of overweight and obesity was high in this population (59 %). The HIV+ pre-ARV group was lighter and had a lower BMI than the other two groups (all P < 0·001). HIV+ pre-ARV women also had lower fat and lean masses and percentage body fat than their HIV− and HIV+ non-ARV counterparts. After adjustment, there were no differences in macronutrient intakes across study groups; however, fat and sugar intakes were high and consumption of predominantly refined food items was common overall.ConclusionHIV-associated immunosuppression may be a key determinant of body composition in HIV-positive women. However, in populations with high obesity prevalence, these differences become evident only at advanced stages of infection.

scholarly journals Cancer in HIV-positive and HIV-negative adolescents and young adults in South Africa: a cross-sectional study

2020 ◽  
Author(s):  
Tafadzwa G Dhokotera ◽  
Julia Bohlius ◽  
Matthias Egger ◽  
Adrian Spoerri ◽  
Jabulani Ncayiyana ◽  
...  
Keyword(s):  
South Africa ◽  
Cervical Cancer ◽  
Cross Sectional Study ◽  
Hiv Positive ◽  
Sectional Study ◽  
Hiv Status ◽  
Cross Sectional ◽  
Cancer Data ◽  
Living With Hiv ◽  
Hiv Negative

Objective: To determine the spectrum of cancers in AYAs living with HIV in South Africa compared to their HIV negative peers. Design: Cross sectional study with cancer data provided by the National Cancer Registry and HIV data from the National Health Laboratory Service. Setting and participants: The NHLS is the largest provider of pathology services in the South African public sector with an estimated coverage of 80%. The NCR is a division of the NHLS. We included AYAs (aged 10-24 years) diagnosed with cancer by public health sector laboratories between 2004 and 2014 (n=8 479). We included 3 672 in the complete case analysis. Primary and secondary outcomes: We used linked NCR and NHLS data to determine the spectrum of cancers by HIV status in AYAs. We also used multivariable logistic regression to describe the association of cancer in AYAs with HIV, adjusting for age, sex (as appropriate), ethnicity, and calendar period. Due to the large proportion of unknown HIV status we also imputed (post-hoc) the missing HIV status. Results: From 2004-2014, 8 479 AYAs were diagnosed with cancer, HIV status was known for only 45% (n=3812); of those whose status was known, about half were HIV positive (n=1853). AYAs living with HIV were more likely to have Kaposi's sarcoma (adjusted odds ratio (aOR) 218, 95% CI 89.9-530), cervical cancer (aOR 2.18, 95% CI 1.23-3.89), non-Hodgkin's lymphoma (aOR 2.12, 95% CI 1.69-2.66), and anogenital cancers other than cervix (aOR 2.73, 95% CI 1.27-5.86). About 44% (n=1 062) of AYAs with HIV related cancers had not been tested for HIV, though they were very likely to have the disease. Conclusions: Cancer burden in AYAs living with HIV in South Africa could be reduced by screening young women for cervical cancer and vaccinating them against human papilloma virus (HPV) infection.

Sexual function and dysfunction in older HIV-positive individuals

Sexual Health ◽  
2011 ◽  
Vol 8 (4) ◽  
pp. 502 ◽  
Author(s):  
Darren B. Russell
Keyword(s):  
Sexual Dysfunction ◽  
Sexual Functioning ◽  
Hiv Transmission ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Organ Systems ◽  
The World ◽  
Risk Of Disease ◽  
Living With Hiv ◽  
Hiv Negative

With many parts of the world seeing an aging cohort of people living with HIV (PLHIV), it is becoming clear that some organ systems in these individuals are at a greater risk of disease. There are effects on sexual functioning in aging PLHIV, with many studies finding higher levels of sexual dysfunction in HIV-positive individuals compared with those who are HIV-negative. HIV itself, along with antiretroviral agents, may cause dysfunction. Treatment involves making an assessment of the dysfunction and using the usual methods available, although treatment may be complicated by hormonal deficiencies in HIV-positive individuals, along with the effects of antiretroviral therapy, and drug interactions involving such medications. Furthermore, the issue of HIV transmission needs to be addressed in those seeking treatment for sexual dysfunction.

scholarly journals Comparison of HTLV-associated myelopathy (HAM) in HIV-positive and HIV-negative patients at a tertiary South African hospital

2012 ◽  
Vol 103 (1) ◽  
pp. 43 ◽  
Author(s):  
Clara Maria Schutte ◽  
T Townsend ◽  
R Van Coller ◽  
S Olorunju
Keyword(s):  
South African ◽  
Hiv Positive ◽  
Hiv Negative

scholarly journals Ko-infeksi Human Immunodeficiency Virus (HIV) dengan Mycobacterium leprae

2017 ◽  
Vol 9 (1) ◽  
pp. 1
Author(s):  
Yuni Eka Anggraini
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
Hiv Positive ◽  
Case Control Studies ◽  
Highly Active ◽  
Number Of Patients ◽  
Immunodeficiency Virus ◽  
Leprosy Patients ◽  
Low Incidence ◽  
Hiv Negative

Human immunodefficiency virus (HIV) epidemic covers several countries with endemic leprosy without any significantincrease in the number of patients co-infected with HIV and leprosy, so it can be concluded that HIV-positive does notincrease the risk of developing leprosy. Clinicopathological spectrum of leprosy patients who are co-infected withHIV is not changed. Leprosy may be attributed to the presence of immune recovery syndrome after the administrationof highly active antiretroviral therapy (HAART). Long-term incubation period and the low incidence of leprosy inpatients with HIV make prospective cohort or case-control studies on the prevalence of leprosy among a group of HIVpositive and HIV negative hardly possible to be performed. The benefit of this circumstance is the HIV pandemicdoes not become a nuisance of the effort to control leprosy. Further studies on the molecular pathogenesis of M.leprae and other mycobacterial can provide an understanding of the differences of the pathogenesis in patients withHIV infection.

scholarly journals Electrocardiographic and echocardiographic abnormalities in urban African people living with HIV in South Africa

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0244742
Author(s):  
Geert V. T. Roozen ◽  
Ruchika Meel ◽  
Joyce Peper ◽  
William D. F. Venter ◽  
Roos E. Barth ◽  
...  
Keyword(s):  
South Africa ◽  
Viral Load ◽  
Left Ventricular Mass ◽  
Qt Interval ◽  
Left Ventricular ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Living With Hiv ◽  
Negative Controls ◽  
Hiv Negative

Background Studies from high income countries report that HIV-positive people have an impaired systolic and diastolic cardiac function compared to HIV-negative people. It is unclear if results can be translated directly to the Sub-Saharan Africa context. This study assesses electro- and echocardiographic characteristics in an urban African population, comparing HIV-positive people (treated and not yet treated) with HIV-negative controls. Methods We conducted a cross-sectional study in Johannesburg, South Africa. We enrolled HIV-positive participants from three randomized controlled trials that had recruited participants from routine HIV testing programs. HIV-negative controls were recruited from the community. Data were collected on demographics, cardiovascular risk factors, medical history and electrocardiographic and echocardiographic characteristics. Results In total, 394 HIV-positive participants and 153 controls were enrolled. The mean age of HIV-positive participants was 40±9 years (controls: 35±10 years), and 34% were male (controls: 50%). Of HIV-positive participants 36% were overweight or obese (controls: 44%), 23% had hypertension (controls: 28%) and 12% were current smoker (controls: 37%). Median time since HIV diagnosis was 6.0 years (IQR 2.3–10.0) and median treatment duration was 4.0 years (IQR 0.0–8.0), 50% had undetectable viral load. The frequency of anatomical cardiac abnormalities was low and did not differ between people with and without HIV. We observed no relation between HIV or anti-retroviral therapy (ART) and systolic or diastolic heart function. There was an association between ART use and corrected QT interval: +11.8 ms compared to HIV-negative controls (p<0.01) and +18.9 ms compared to ART-naïve participants (p = 0.01). We also observed a higher left ventricular mass index in participants on ART (+7.8 g/m2, p<0.01), but this association disappeared after adjusting for CD4 cell count, viral load and HIV-duration. Conclusion The low number of major cardiac abnormalities in this relatively young, well managed urban African HIV-positive population is reassuring. The increase in corrected QT interval and left ventricular mass may contribute to higher cardiac mortality and morbidity in people living with HIV in the long term.

scholarly journals SYMPTOMS OF TUBERCULOSIS IN HIV POSITIVE CHILDREN AND THE IMPACT OF PREVENTION ON THE DEVELOPMENT AND COURSE OF THE DISEASE

2019 ◽  
Vol 97 (3) ◽  
pp. 35-39
Author(s):  
E. Yu. Zorkaltseva ◽  
L. V. Zaritskaya ◽  
S. V. Pugacheva
Keyword(s):  
Retrospective Study ◽  
Medical Records ◽  
Inpatient Treatment ◽  
Hiv Positive ◽  
X Ray ◽  
High Prevalence ◽  
Severe Intoxication ◽  
Tuberculosis Therapy ◽  
The Impact ◽  
Hiv Negative

The objective of the study: to compare the clinical and X-ray signs of tuberculosis in HIV positive and HIV negative children, to identify factors that are more common in HIV infected children in the region with a high prevalence of both infections. Subjects and methods. 264 children with tuberculosis, and 41 children with HIV infection and tuberculosis undergoing inpatient treatment were enrolled in the study, which was the retrospective study of medical records. The patients underwent standard clinical and X-ray examinations, and microbiological tests. Results. Disseminated forms of tuberculosis (39.1%), tuberculous meningoencephalitis (4.9%) were more frequent in the HIV positive children, while in HIV negative children, it made 1.9 and 0.4% respectively. Among HIV positive children, 34% had several sites of tuberculosis, and 19.5% suffered from generalized forms. In HIV positive children, tuberculosis was more often detected in the infiltration phase, it was accompanied by severe intoxication symptoms, while when taking anti-tuberculosis therapy in combination with ART, they had more rapid positive changes.

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