High carriage rate of intestinal parasites among asymptomatic HIV-seropositive individuals on antiretroviral therapy attending the tertiary care hospital in Varanasi, India

Introduction: Human Immunodeficiency Virus (HIV) causes severe public health problems. Despite the use of Highly Active Antiretroviral Therapy (HAART), opportunistic infections remain a serious problem in HIV infection. HIV seropositive women are at a higher risk of acquiring Vulvovaginal Infections (VVI), compared to their HIV seronegative counterparts. Also, the large untreated asymptomatic populations remain a source for transmitting agent. Aim: To identify the occurrence of vaginitis in symptomatic and asymptomatic HIV seropositive women. Materials and Methods: HIV seropositive female patients (60 symptomatic and 60 asymptomatic for vulvovaginitis) in the reproductive age group of 18-60 years were screened for their vaginal flora in a tertiary care hospital in East Delhi, India. Wet mount, Gram stain, and culture were performed to screen the samples for vaginitis. Asymptomatic samples were processed to check for asymptomatic VVI. Nugent and Amsel’s score were calculated for Bacterial Vaginitis (BV), and Donders classification was used for Aerobic Vaginitis (AV). Sabouraud’s Dextrose Agar (SDA) was used for fungal cultures, and Fluconazole and Voriconazole sensitivity was tested. The descriptive analysis of compiled data with Chi-square tests where applicable to compare differences between proportions was done. Results: As per the Nugent's score, 90% of symptomatic and 86.66% asymptomatic HIV reactive females had BV. Nugent scoring was found to be a better diagnostic criterion for BV. AV was observed in 33.33% asymptomatic patients. Candida albicans (C.albicans)was the most common agent isolated from 68.75% of Vulvovaginal Candidiasis (VVC) cases. Dual infection of BV and Candidiasis was reported to be 18.33% in symptomatic and 15% in asymptomatic HIV seropositive females. Conclusion: In the present study, despite Antiretroviral Therapy (ART), attendees manifested significantly with BV infection in both groups. VVC due to C. albicans was also predominant in both groups. Co-infection with BV and VVC was the highlight of this study as dual infections of BV and AV remain under-diagnosed as per Sexually Transmitted Infection (STI) syndromic management protocols. The clinicians need to identify AV as a separate entity as treatment modalities are essentially different.

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Study of Opportunistic Intestinal Parasitic Infections in Stool of HIv Seropositive Patients ot A Tertiary Care Hospital n India

International Journal of Scientific Research ◽

10.15373/22778179/july2014/135 ◽

2012 ◽

Vol 3 (7) ◽

pp. 430-431

Author(s):

Dr Desai Kairavi J ◽

◽

Dr Malek Saklainhaider S ◽

Dr Purohit Payal H

Keyword(s):

Tertiary Care Hospital ◽

Tertiary Care ◽

Parasitic Infections ◽

Care Hospital ◽

Intestinal Parasitic Infections ◽

Hiv Seropositive

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A comparison of human papillomavirus genotypes among HIV seropositive and seronegative Mexican women: a cross-sectional survey at a tertiary care hospital

The Lancet ◽

10.1016/s0140-6736(13)62259-x ◽

2013 ◽

Vol 382 ◽

pp. S11

Author(s):

S Flores ◽

R Figueroa

Keyword(s):

Human Papillomavirus ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Mexican Women ◽

Care Hospital ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Hiv Seropositive

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Opportunistic infection at the start of antiretroviral therapy and baseline CD4+ count less than 50 cells/mm3 are associated with poor immunological recovery

Journal of Basic and Clinical Physiology and Pharmacology ◽

10.1515/jbcpp-2018-0105 ◽

2019 ◽

Vol 30 (2) ◽

pp. 163-171

Author(s):

Amod Tilak ◽

Smita Shenoy ◽

Muralidhar Varma ◽

Asha Kamath ◽

Amruta Tripathy ◽

...

Keyword(s):

Antiretroviral Therapy ◽

Opportunistic Infection ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Hiv Positive ◽

P Value ◽

Care Hospital ◽

Long Term Treatment ◽

Immunological Recovery

AbstractIntroductionThere is a dearth of studies assessing the efficacy and immunological improvement in patients started on antiretroviral therapy (ART) in India. This study was undertaken to assess the 2-year treatment outcomes in HIV-positive patients initiated on ART in a tertiary-care hospital.MethodsAfter approval from the Institutional Ethics Committee, adult HIV-positive patients from a tertiary-care hospital, initiated on ART between January 2013 and February 2015, were included in the study. Data on clinical and immunological parameters were obtained from medical case records over a period of 2 years after initiation of therapy. Intention-to-treat analysis was done using a descriptive approach, using SPSS version 15 (SPSS Inc. Released 2006. SPSS for Windows, Version 15.0. Chicago, SPSS Inc.). A logistic regression analysis was done to assess the predictors for poor outcomes. A p-value <0.05 was considered statistically significant.ResultsART was initiated in 299 adult patients. At 1 and 2 years, the median (interquartile range) change in CD4+cell count was 65 (39, 98) cells/mm3and 160 (95, 245) cells/mm3. The change observed after 2 years of treatment initiation was statistically significant compared with that after 1 year. Three deaths occurred during the study period and 28 were lost to follow-up. Male sex, presence of at least one opportunistic infection at the start of therapy, and baseline CD4+count <50 cells/mm3were associated with poor immunological recovery.ConclusionsWith long-term treatment and regular follow-up, sustained clinical and immunological outcomes can be obtained in resource-limited settings.

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