scholarly journals A Stochastic Model for Assessing the Efficacy of Antiretroviral Therapy (ART) on Farmers Living with HIV/AIDS

2019 ◽  
Vol 1 ◽  
pp. 247-258
Author(s):  
P O Agada ◽  
B B Apeagee ◽  
I O Ogwuche
Keyword(s):  
Markov Chain ◽  
Cell Count ◽  
Poor Health ◽  
Health States ◽  
Cd4 Cell Count ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Patient Will ◽  
Cd4 Cell ◽  
Hiv Aids

The Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) remains one of the greatest public health challenges still facing Nigeria and the entire world as it has become drug resistant in some patients. Hence, treatment failure and spread of drug resistant HIV/AIDS results. In view of this, it becomes imperative to assess the efficacy of the Antiretroviral Therapy (ART) treatment and hence the life expectancy of the HIV/AIDS patients. This was achieved in this study via a stochastic model based on the Markov chain modelling methodology. The CD4 cell counts of a sample of 28,582 patients (farmers) receiving treatment every six (6) months at the HIV counselling and Testing (HCT) unit of the Federal Medical Centre Makurdi, Benue State was used in the modelling process. The CD4 cell count states were developed based on the United States Centres for Disease Control and Prevention (CDC) classification system as follows; State 1: CD4 cell counts ≥ 500 cells/μL, State 2: CD4 cell count in the range of 200 – 499 cells/ μL, and State 3: CD4 cell count < 200 cells/ μL. They represent the Good, Moderate and Poor health states of the patients respectively. The HIV/AIDS progression in the study was investigated using The N-Step transition probability Matrix of the Markov Chain while, the efficacy of the ART was examined from one CD4 cell count state to another using the Steady State probabilities of the Markov Chain as well as the Mean Recurrence Time of each CD4 count state. The study result shows that; the initial probabilities that a patient will stay in the good, moderate, and poor health states in the first six (6) months of the ART are; 0.834, 0.333 and 0.280 respectively. The overall efficacy of the ART showed a 78%, 19%, and 3.3% chances that a patient will be in the Good, Moderate and Poor health states respectively with respective mean recurrence times of 0.64, 2.69 and 14.99 years. Further results shows that the total life expectancy of patients in the good and moderate health states are 20.425 and 19.275 years respectively. The study recommends that the methodology be applied to a cohort study to further validate study these results.

scholarly journals Evaluation of CD4 Number In HIV / AIDS Patients Who Are Running The Antiretrovial Treatment Program

2020 ◽  
Vol 6 (2) ◽  
pp. 77
Author(s):  
Thatit Nurmawati ◽  
Yeni Kartika Sari ◽  
Aprilia Putri Hidayat
Keyword(s):  
Cell Count ◽  
Treatment Program ◽  
Secondary Data ◽  
Sampling Technique ◽  
Cd4 Cell Count ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
And Control ◽  
Cd4 Cell ◽  
Hiv Aids

HIV is a health problem for Indonesia and the world. Enforcement of diagnoses and control efforts  continue to be made to reduce the number of HIV / AIDS cases. ARVs are becoming efforts to cure HIV by increasing CD4 cell counts. CD4 cell count is a determinant of ARV therapy. The purpose of this study was to evaluate CD4 cell counts in people with HIV / AIDS who were implementing ARV programs. The study design was observational using secondary data in the form of medical record records. The study population was HIV sufferers who registered to run an HIV / AIDS antiretrovial treatment program at the Cendana Poly Ngudi Waluyo Regional Hospital in Blitar in June 2017. Samples in the study were 30 people according to inclusion and exclusion criteria with a sampling technique using a purposive sampling method. Research instruments using questionnaires. Data analysis uses descriptive method. The results showed that this CD4 cell count had a CD4 cell count of 200 cells / mm 3 by 10%, 200-499 by 90% in patients who were on ARV programs. The patient's condition and obata resistance result in a CD4 cell count not exceeding 500 mm / cell. Key words: amount CD4, ARV , patient HIV

scholarly journals The correlation of tuberculosis smear results and immuno-suppression with CD4+ counts as a surrogate marker among HIV infected patients.

2021 ◽  
Author(s):  
Kingsley Kamvuma ◽  
Yusuf ademola ◽  
Warren Chanda ◽  
Christopher Newton Phiri ◽  
Sam Bezza Phiri ◽  
...  
Keyword(s):  
Cell Count ◽  
Surrogate Marker ◽  
Hiv Positive ◽  
Sputum Smear ◽  
Cd4 Cell Count ◽  
Cd4 Counts ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Study Participants ◽  
Cd4 Cell

Abstract Background: Human immunodeficiency virus (HIV) and M.tuberculosis are two intracellular pathogens that interact at the cellular, clinical and population levels. Since the recognition of AIDS in 1981, the number of reported cases of TB in the has increased substantially, especially in regions with high incidence of AIDS. The main aim of this study was to establish weather there is a relationship between sputum smear positives and low CD4 cell counts among HIV infected patients.Materials and methods: This was a retrospective study involving 473 participants. The patients recruited in this study were those who tested HIV positive and smear positive for TB. Their HIV status was determined by performing an HIV blood test, if they were HIV positive their CD4 cell count were then made.Results: This study examined the relation between smear positivity and low CD4 (below 200cells/µl) together with CD8 and CD3 markers as a measure of immune function among patients infected with HIV. The study participants’ constituted males 67% and females 33%. The overall mean age was 33.2 (SD 6.9) with the youngest and oldest participants being 18 and 60 respectively. It was found that smear positive results negatively (r=-0.13; p=0.021) correlated with CD4+ below 200 cells/µl. No correlation was observed between smear positives and CD8+ or CD3+ since the calculated correlation coefficient was not significant 0.007 (p=0.9) and 0.03 (p=0.6) respectively. There are more 3+ smear results below 200 cells/µl than the others while above 200 cells/µl 1+ was the most commonly reported smear result. The scanty smear positives were the least commonly reported result in the low and high CD4 counts. Conclusion: The smear positive result negatively correlated with a low CD4+ (r=-0.13; p=0.021) but no correlation with low CD+8 and CD+3 results was observed. The long held theory that low bacillary counts in patients with low CD4+ counts needs to be revisited. The reduction of CD4+ cell count parallels' that of the total lymphocyte count and is more marked in patients with high bacillary counts. Further, studies are required to confirm these findings

scholarly journals Early Postseroconversion CD4 Cell Counts Independently Predict CD4 Cell Count Recovery in HIV-1–Postive Subjects Receiving Antiretroviral Therapy

2011 ◽  
Vol 57 (5) ◽  
pp. 387-395 ◽  
Author(s):  
Hemant Kulkarni ◽  
Jason F Okulicz ◽  
Greg Grandits ◽  
Nancy F Crum-Cianflone ◽  
Michael L Landrum ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Cell Count ◽  
Cd4 Cell Count ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Cd4 Cell ◽  
Hiv 1 ◽  
Count Recovery

scholarly journals Linear Mixed Modeling of CD4 Cell Counts of HIV-Infected Children Treated with Antiretroviral Therapy

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Belay Belete Anjullo ◽  
Derbachew Asfaw Teni
Keyword(s):  
Cell Count ◽  
Stage Iv ◽  
Observation Time ◽  
Square Root ◽  
Cd4 Cell Count ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
History Of ◽  
The Mean ◽  
Cd4 Cell

Background. Human immunodeficiency virus (HIV) is a major health problem in the world, and failure to implement prevention programs results in an increased number of infections among newborns. The goal of this study was to investigate the evolution and determinants of cluster of differentiation four (CD4) cell count among HIV-infected children who were under antiretroviral therapy (ART). Methods. We follow up a cohort of 201 children aged under fifteen years from October 2013 to March 2017 at Adama Hospital in Ethiopia. To get insight into the data, exploratory data analysis was performed on the change in the longitudinal CD4 cell count. Results. At the baseline, the average number of CD4 cell counts was 468.5 cells/mm3 of blood with a standard deviation of 319.11 cells/mm3. Here, we employed the random intercept and the random slope linear mixed-effects model to analyze the data. Among predictor variables, observation time, baseline age, WHO clinical stage, the history of tuberculosis (TB), and functional status were determinant factors for the mean change in the square root of the CD4 cell count. Conclusions. The finding revealed that the change in the square root of the CD4 cell count increases with an increment of age at diagnosis. Regarding WHO clinical stages of patients, those who were in stage III and stage IV of the HIV/AIDs disease stages relatively had lower CD4 cell counts than stage I patients. This shows the change in the square root of CD4 cell counts of stage III and stage IV patients was 6.43 and 9.28 times lower than stage I patients, respectively. Similarly, we noticed that observation time, the history of TB, and functional status were significantly associated with the mean change in the square root of the CD4 cell count.

Immunologic Benefits of Enfuvirtide in Patients Enrolled in a Drug Assistance Program

2008 ◽  
Vol 42 (5) ◽  
pp. 621-626 ◽  
Author(s):  
Parya Saberi ◽  
Nikolai H Caswell ◽  
Cristina I Gruta ◽  
Jason N Tokumoto ◽  
Betty J Dong
Keyword(s):  
Cell Count ◽  
Viral Suppression ◽  
Cd4 Cell Count ◽  
Hiv Rna ◽  
Cell Counts ◽  
Background Regimen ◽  
Cd4 Cell Counts ◽  
Cd4 Cell ◽  
Cell Count Increase

Background: Randomized clinical trials have demonstrated that enfuvirtide plus an optimized background regimen can cause a significant increase in CD4+ cell counts and a reduction in HIV RNA levels. Objective: To describe and anaiyze CD4+ cell count and HIV RNA changes in HIV-infected patients receiving enfuvirtide and a prescribed background regimen (PBR) in a primarily clinical setting. Methods: A retrospective review from September 1998 through August 2005 of CD4+ cell counts and HIV RNA changes from baseline was conducted in patients receiving enfuvirtide. Data were stratified and analyzed according to baseline CD4+ cell count and HIV RNA. Results: A mean CD4+ cell count increase of approximately 102 cells/mm3 was observed, regardless of baseline CD4+ cell count, in 187 patients receiving enfuvirtide during a mean of 19.4 months of follow-up. During 3 years of follow-up, patients initiating enfuvirtide at CD4+ cell counts less than 100 cells/mm3 never achieved absolute CD4+ cell counts comparable to the counts in patients starting enfuvirtide at CD4+ cell counts of 100 cells/mm3 or more. In 38.3% of patients achieving an undetectable HIV RNA level, a mean CD4+ cell count increase of 185 cells/mm3 was observed. An unexpected finding was that a mean CD4+ cell count increase of 76 cells/mm3 occurred in 61.7% of patients not achieving complete viral suppression. Conclusions: Immunologic benefits were observed in subjects continuing enfuvirtide plus a PBR irrespective of baseline CD4+ cell count, complete viral suppression, or antiretroviral susceptibility data. Dala suggest that initiation of enfuvirtide at CD4+ cell counts greater than 100 celis/mm3 may be immunologically advantageous and independent of complete virologic response.

Impact of Combined Anti-Retroviral Therapy on HIV-Associated Non-Hodgkin-Lymphoma - a Prospective European Multi-Cohort Study on Behalf of the Collaboration of Observational HIV Epidemiological Research Europe (COHERE) Study Group

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 878-878
Author(s):  
Julia Bohlius
Keyword(s):  
Risk Factors ◽  
Cell Count ◽  
Hodgkin Lymphoma ◽  
Cd4 Cell Count ◽  
Non Hodgkin Lymphoma ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
One Year ◽  
Cd4 Cell ◽  
Hiv 1

Abstract Background: Following its introduction in 1996, combination antiretroviral therapy (cART) has led to a substantial reduction in HIV-associated morbidity and mortality. The decline has, however, been less pronounced for non-Hodgkin lymphoma (NHL) than for other HIV-related complications, and NHL has become the most common cancer associated with HIV. Within the framework of a large prospective European multi-cohort project, the Collaboration of Observational HIV Epidemiological Research Europe (COHERE), we studied the incidence and risk factors for the development and survival of NHL in HIV-infected patients in the cART era. Methods: We analyzed the data of HIV- infected adult patients (aged >16 years) who were cART naïve at inclusion and started cART after 01.01.1998, at a time when cART had become well established and widely used in Europe. cART was defined as a regimen of at least 3 antiretroviral drugs. Patients had to have CD4 count measurements available before the start of cART and the diagnosis of NHL. Patients developing NHL before receiving cART (“not on cART”) and patients developing NHL while receiving cART (“on cART”) were analyzed separately. Both patients with Primary Brain Lymphoma (PBL) and systemic NHL were included in the analysis. Incidence rates were calculated based on the Poisson distribution; risk factors were estimated using crude and adjusted Weibull models, with random effects to account for heterogeneity between cohorts. Models with time varying covariates were used to explore the effects of CD4 cell counts and plasma HIV-RNA loads over time. Survival was estimated using Kaplan-Meier life table probabilities, with 95% confidence intervals (95% CI). Results: For the incidence analysis 56,305 patients from 22 cohort studies across Europe with 212,042 person-years at risk were evaluated. The incidence for NHL (both systemic NHL and PBL) in patients not on cART was 519 (95% CI 448 to 602) per 100,000 personyears compared to 229 (95% CI 208 to 252) per 100,000 person-years in those on cART. The corresponding rates for PBL were 57 (95% CI 36 to 89) per 100,000 person-years and 24 (95% CI 18 to 33) per 100,000 person years. In cART naïve patients risk factors for NHL were older age and low CD4 cell count nadirs. When included as time up-dated variables, high plasma HIV-1 RNA loads and low CD4 cell counts emerged as important risk factors. In patients receiving cART risk factors included low CD4 cell count nadirs, older age, and groups associated with HHV-8 infection, i.e. men having sex with men and patients with a previous diagnosis of Kaposi Sarcoma. Time up-dated HIV-1 RNA plasma concentration and CD4 cell count were also associated with developing NHL while on cART. For the survival analysis 847 NHL patients were eligible. Of those, 364 (43%) were cART naïve at diagnosis of NHL. After one year 66% (95% CI 63%–70%) of patients with systemic NHL and 54% (95% CI 43%–65%) of patients with PBL were alive. Risk factors for death were diagnosis of PBL, low CD4 cell count nadir and history of injection drug use. Conclusions: Combined anti-retroviral therapy reduces the risk of developing NHL. In the era of cART more advanced immunodeficiency is the dominant risk factors for developing NHL both in patients receiving and not receiving cART. Two thirds of patients diagnosed with HIV-related NHL other than PBL survive for longer than one year after diagnosis. Survival is poorer in patients diagnosed with PBL.

scholarly journals The Effect of Vitamin D Supplementation on the Increase in CD4 count of HIV/AIDS Patients Receiving Antiretroviral Therapy

2020 ◽  
Vol 5 (1) ◽  
pp. 144-147
Author(s):  
Mega Permata ◽  
Harun Hudari ◽  
Mediarty ◽  
Taufik Indrajaya
Keyword(s):  
Vitamin D ◽  
Cell Count ◽  
Hypovitaminosis D ◽  
Vitamin D Supplementation ◽  
Antiretroviral Drugs ◽  
Aids Patients ◽  
Cd4 Cell Count ◽  
Cell Counts ◽  
Cd4 Cell ◽  
Hiv Aids

Introduction. Vitamin D plays a role in health overall, but hypovitaminosis D stilloccurs throughout the world. HIV/AIDS patients are prone to suffer fromhypovitaminosis D because of the infection itself and the side effects of antiretroviraltherapy. Various effort have been tried to improve the immune status of HIV/AIDSpatients, one of them is by adding vitamin D. Vitamin D acts as an antiinflammatoryso that it can prevent apoptosis of CD4 T cells and increase CD4 cell count.Methods. This is a randomized control trial add on a study that aims to determinethe effect of vitamin D to increase in CD4 counts of HIV / AIDS patients who havereceived antiretroviral drugs. Subjects were HIV / AIDS patients who had receivedantiretroviral drugs. A total of 20 subjects were divided randomly into two groups;one group received vitamin D (calcitriol 0.5 mcg per day) for eight weeks, and theother group that received a placebo. Each group was measured of CD4 cell countbefore and after treatment. Results. There was a significant increase in the CD4 cellcount of the vitamin D group (p = 0.046), but not in the CD4 cell count of bothgroups (p = 0.985). The comparison of mean CD4 cell counts between groups beforetreatment was not significantly different (p = 0.057), but after treatment, it becamesignificantly different (p = 0.040). Conclusion. Vitamin D has been successful inincreasing CD4 cell count in the vitamin D group, and it is recommended to giveHIV / AIDS patients to increase CD4 cell count.

scholarly journals Does community-based point of care HIV testing reduce late HIV diagnosis? A retrospective study in England and Wales

2017 ◽  
Vol 28 (11) ◽  
pp. 1098-1105 ◽  
Author(s):  
Nell Freeman-Romilly ◽  
Paula Sheppard ◽  
Sarika Desai ◽  
Nick Cooper ◽  
Michael Brady
Keyword(s):  
Hiv Testing ◽  
Cell Count ◽  
Point Of Care ◽  
Community Settings ◽  
Hiv Diagnosis ◽  
Cd4 Cell Count ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Hiv Test ◽  
Cd4 Cell

The objective of this study was to investigate if patients diagnosed in community clinics have higher baseline CD4 cell counts than those diagnosed in Genitourinary medicine (GUM)/HIV clinics. We undertook a retrospective review of baseline CD4 cell counts for patients receiving a reactive HIV test in community-testing clinics. Eleven local HIV clinics were contacted to determine the baseline CD4 cell counts of these patients. Baseline CD4 cell counts of those diagnosed in the community were compared with mean local GUM/HIV clinic and median national baseline CD4 cell count for their year of diagnosis. Clients diagnosed in community settings had a mean baseline CD4 cell count of 481 cells/mm3 (SD 236 cells/mm3) and median baseline of 483 cells/mm3 (interquartile range 311–657 cells/mm3). This was significantly higher than those diagnosed in the GUM/HIV clinic local to the community-testing site (mean baseline CD4 397 cells/mm3, p = 0.014) and the national median for that year (336 cells/mm3, p < 0.001). HIV testing in community settings identifies patients at an earlier stage of infection than testing in clinical settings.

scholarly journals Korelasi Jumlah CD4 Pasien Yang Diberi Isoniazid Dengan Ko-infeksi TB Pada Pasien HIV/AIDS

2020 ◽  
Vol 1 (4) ◽  
pp. 284-290
Author(s):  
Niken Ayu Farida Salim ◽  
Zulfian ◽  
Neno Fitriyani Hasbie ◽  
Arif Effendi
Keyword(s):  
Total Sample ◽  
Cross Sectional ◽  
Cd4 Cell Count ◽  
Tb Treatment ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Significant Difference ◽  
Latent Tb Infection ◽  
Cd4 Cell ◽  
Hiv Aids

The interaction between TB and HIV infection is complex. In HIV-infected individuals, this situation will decrease the immune system and increase vulnerability to TB incidence. HIV causes reactivation, reinfection, and progression of latent TB infection to active tuberculosis. It also led to differences in the clinical presentation of TB in HIV patients, complications, and response to anti-TB treatment than in HIV negative patients. The purpose of this study To Know Correlation CD4 counts in patients with HIV / AIDS in hospitals Dr.H. Abdul Moeloek Lampung Province 2018. Research methods: cross-sectional approach, in which several variables tested in this research object data got from the medical record. Analysis of the data used is the Mann-Whitney statistical test. Research The total sample of 160 medical records of patients seen that the Asymp. Sig. (2-tailed) is 0,000. Half of this significance value ½ (0.000) is <0.05. It can be concluded that reject H0 and Ha accepted, which implies a significant difference in CD4 cell counts in patients given isoniazid as TB prevention with patients TB co-infection. With all forces, correlation means that their relationship CD4 cell counts in patients given isoniazid to prevent TB and TB co-infection. There is a significant relationship between CD4 cell count in patients who given isoniazid for the prevention of TB and TB co-infection in HIV / AIDS patients in hospitals Dr.H. Abdul Moeloek Lampung Province 2018.

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