PREVALENCE OF CLINICAL FORMS OF CHRONIC SINUSITIS IN HIV INFECTED PATIENTS

2021 ◽  
pp. 60-64
Author(s):  
М.S. Zagurskaya ◽  
Keyword(s):  
Hiv Infection ◽  
Chronic Inflammation ◽  
Paranasal Sinuses ◽  
Who Classification ◽  
Chronic Sinusitis ◽  
Clinical Stage ◽  
Clinical Forms ◽  
Cd4 Lymphocyte ◽  
Immunological Deficiency ◽  
Cd4 Lymphocytes

Purpose: to identify patterns in the prevalence of various clinical forms of chronic sinusitis (exudative, proliferative, alterative) depending on the clinical and immunological stages of HIV infection. The study involved 108 HIV-infected patients who were diagnosed with chronic sinusitis. The prevalence of each of the clinical forms of chronic inflammation of the paranasal sinuses (exudative, proliferative, alterative) at different immunological and clinical stages of HIV infection was determined. The majority of HIV-infected persons with chronic sinusitis were diagnosed with a proliferative form of inflammation of the paranasal sinuses (61.1 ± 4.7). As the clinical stage of HIV infection progressed (WHO classification), a decrease in the prevalence of exudative forms of chronic sinusitis (from 84.8 ± 6.2 at the first stage to 4.0 ± 3.9 at the fourth) and, accordingly, an increase in proliferative forms (with 15.2 ± 6.2 at the first stage to 92.0 ± 5.4 at the fourth). As the number of CD4-lymphocytes in the blood of HIV-infected patients decreased, a significant decrease in the frequency of detection of exudative forms of chronic sinusitis was observed (from 85.0 ± 8.0 with a CD4-lymphocyte level of more than 500 uL-1 to 12.9 ± 4.3 with the level of CD4 lymphocytes is less than 200 uL-1) and, accordingly, an increase in the prevalence of proliferative forms of chronic inflammation of the paranasal sinuses (from 15.0 ± 8.0 to 83.9 ± 4.7, respectively). As immunological deficiency progresses in HIV-infected patients, the prevalence of proliferative forms of chronic inflammation of the paranasal sinuses increases, which is a factor determining the tactics of treating chronic sinusitis in this group of patients.

scholarly journals EVALUATION OF THE FEASIBILITY OF USING THE PUNCTURE METHOD IN THE TREATMENT OF CHRONIC SINUSITIS IN HIV-INFECTED PATIENTS

2021 ◽  
pp. 27-31
Author(s):  
M.S. Zagurskaya ◽  
Keyword(s):  
Paranasal Sinuses ◽  
Chronic Sinusitis ◽  
Clinical Stage ◽  
The Third ◽  
Clinical Stages ◽  
Hiv Negative

Indications for the use of the puncture method for the treatment of chronic sinusitis in HIV-infected patients depend on the form of inflammation of the paranasal sinuses (exudative, proliferative or alterative) and are determined by the clinical stage of immunodeficiency. The puncture method is indicated for the treatment of chronic sinusitis in HIV-infected individuals in the first and second clinical stages of immunodeficiency, since in these subgroups of patients the likelihood of an exudative form of chronic sinusitis is similar to that in HIV-negative individuals. The use of the puncture method for the treatment of chronic sinusitis is not indicated for HIV-infected patients at the third and fourth clinical stages of immunodeficiency, since these subgroups of patients are statistically significantly more likely to have a proliferative form of chronic sinusitis in comparison with HIV-negative individuals.

scholarly journals Estimating the time period between infection and diagnosis based on CD4+ counts at first diagnosis among HIV-1 antiretroviral naïve patients in Nigeria

2010 ◽  
Vol 4 (10) ◽  
pp. 662-667 ◽  
Author(s):  
Joseph C Forbi ◽  
Thanda D Forbi ◽  
Simon M Agwale
Keyword(s):  
Hiv Infection ◽  
Population Based ◽  
Time Interval ◽  
Hiv Diagnosis ◽  
Cd4 Counts ◽  
Cd4 Lymphocyte ◽  
Clinical Conditions ◽  
Hiv 1 ◽  
Cd4 Lymphocytes ◽  
First Diagnosis

Introduction: CD4+ T-cell levels are an important criterion for categorizing HIV-related clinical conditions. Late diagnosis of infection contributes to poor medical outcomes and the continuation of viral transmission. This population-based cohort study in north central Nigeria reports the initial CD4+ lymphocyte counts at the time of first HIV diagnosis and determines the approximate time interval when HIV infection was acquired.. Methodology: Confirmed HIV-1 infected individuals (n = 588) for whom the dates of first HIV diagnosis were known were enrolled in this study. CD4+ lymphocyte counts were measured using a Fluorescence Activated Cell Sorter (FACS) platform that automatically quantifies CD4+ lymphocytes as absolute numbers of lymphocytes per μL of blood. The estimated time interval between HIV infection and time of first HIV diagnosis was determined as a function of the CD4+ lymphocytes' decay rate per calendar year. Results: The results showed that 22.1% and 49.7% of HIV-infected individuals present late with advanced (CD4+: 200-349 cells/mL) and severe (CD4+: < 200 cells/mL) immunosuppression respectively, while only 12.1% present with CD4+  500 cells/mL and 16.2%with CD4+ between 350-499 cells/mL. Mean CD4+ counts for females were higher when compared to those of males (p > 0.05), The time interval between HIV infection and first diagnosis was approximately 6.1 years for males and 7.3 years for females. Conclusion: The majority of HIV-infected individuals in this study accessed health care at late stages of infection, suggesting many HIV-infected individuals in Nigeria are unaware of their HIV status. More efficient programs for early diagnosis of HIV to prevent transmission are urgently required.

scholarly journals Independent predictors of forecasting the course of congenital HIV infection in children

2021 ◽  
Vol 20 (2) ◽  
pp. 27-32
Author(s):  
V. B. Denisenko ◽  
E. M. Simovanyan
Keyword(s):  
Viral Load ◽  
Hiv Infection ◽  
High Sensitivity ◽  
Multivariate Logistic Regression Model ◽  
Rapid Progression ◽  
Slow Progression ◽  
Cd4 Lymphocyte ◽  
Blood Viral Load ◽  
Higher Sensitivity ◽  
Cd4 Lymphocytes

The purpose is to characterize the clinical and laboratory parameters in children with different rates of congenital HIV infection progression and, based on the data obtained, to develop independent predictors of forecasting the course of the disease.Research methods. The comparison of clinical, immunological and virological parameters in 91 children with HIV infection with rapid (26%) and slow progression of the disease (74%) was carried out. The criterion for the rapid progression of HIV infection was considered the development of the AIDS clinic in the first two years of life.Results. Testing of clinical, immunological and virological parameters in a multivariate logistic regression model revealed independent predictors of rapid progression in children aged 6 months — HIV blood viral load more than 1 00 000 cop./ml (odds ratio OR 23.9; 95% confidence interval 95% CI 4.6—71.8; P < 0.001) and a decrease of blood CD4-lymphocytes less than 25% (OR 6.3; 95% CI 1.2—33.4; P = 0.029). The predictor «HIV blood viral load more than 100 000 cop./ml» was characterized by a higher sensitivity (91.3%), specificity (97.1 %) compared to the indicator «CD4 lymphocyte count less than 25%» (88.2% and 86.9%).Conclusion. In 26% of children with HIV infection, there is a rapid progression of the disease with the development of AIDS clinic during the first two years of life. The independent predictors of forecasting an unfavorable course of the disease are HIV blood viral load of more than 1 00 000 cop./ml and a decrease in CD4 lymphocytes in the blood of less than 25% at the age of 6 months. The level of viremia seems to be more preferable for predicting the course of HIV infection in children due to its high sensitivity and specificity.

scholarly journals CLINICAL FEATURES OF THE HIV INFECTION COURSE AND THE DEPENDENCE OF CHANGES IN LABORATORY PARAMETERS ON THE CLINICAL STAGE AND ON THE CD4 LYMPHOCYTES LEVEL

2021 ◽  
Vol 74 (5) ◽  
pp. 1189-1195
Author(s):  
Oksana M. Chemych ◽  
Mykola D. Chemych ◽  
Anna A. Olefir ◽  
Oleh B. Berest
Keyword(s):  
Hiv Infection ◽  
Opportunistic Infections ◽  
Clinical Stage ◽  
Inflammatory Activity ◽  
Clinical Group ◽  
Oropharyngeal Candidiasis ◽  
Endogenous Intoxication ◽  
Criteria For Diagnosis ◽  
Important Objective ◽  
Cd4 Lymphocytes

The aim: Is to determine the features of the HIV infection and changes in indicators of endogenous intoxication and immunoreactivity depending on the clinical stage and the level of CD4 lymphocytes. Materials and methods: 72 HIV-patients were examined. Comparison group included 40 healthy blood donors. Clinical and laboratory examination was performed. Indicators of endogenous intoxication, nonspecific reactivity and inflammatory activity were calculated. Results:Main opportunistic infections were: oropharyngeal candidiasis; tuberculosis of different localization, more often pulmonary tuberculosis; and brain toxoplasmosis (p<0,05). Indices of endogenous intoxication and immunoreactivity are important objective criteria for diagnosis. In groups where the distribution of patients depended on the level of CD4 cells – HIV (CD4≥500) and HIV (CD4≤499-200), index changes were more pronounced than in the HIV I and HIV III groups. The most significant changes in indexes were in the HIV IV clinical group and the HIV (CD4≤199) group: endogenous intoxication indexes were increased by 1,2-7,5 and 1,9-13,7 times in both groups respectively. Non-specific reactivity indexes were decreased by 1,2-1,6 and 1,3-1,6 times, respectively; nuclear index (NI) in groups was 3 and 3,4 times higher (p<0,05–0,001). Changes in indexes of inflammatory activity were observed (p<0,05-0,001). Conclusions: Main diagnosed opportunistic infections were: oropharyngeal candidiasis; tuberculosis of different localization; and brain toxoplasmosis (p<0,05). Indices of endogenous intoxication and immunoreactivity are important objective criteria for diagnosis. The most significant changes in indexes were in the HIV IV clinical group and the HIV (CD4≤199) group (p<0,05-0,001).

scholarly journals PREDICTORS OF CHRONICKIDNEY DISEASEINHUMAN IMMUNODEFICIENCY VIRUS PATIENTS

2018 ◽  
pp. 32-37
Author(s):  
M.O. Andrushchak
Keyword(s):  
Viral Load ◽  
Hiv Infection ◽  
Clinical Stage ◽  
High Viral Load ◽  
Kidney Damage ◽  
Average Amount ◽  
Hiv Rna ◽  
Immunodeficiency Virus ◽  
The Difference ◽  
Cd4 Lymphocytes

Purpose: to determine the frequency of diagnosis and predictors of renal disease in HIV-infected patients. Patients and methods. 292 HIV-infected patients, who were on an outpatient screening at the Chernivtsi Regional AIDS Center, were screened. Results CKD was diagnosed in 153 out of292 (52.4%) of the examined patients. among which 105 (36.0%) patients were diagnosed with isolated albuminuria/proteinuria, 48 (16.4%) patients had albuminuria /proteinuria, in combination with a decrease in glomerular filtration rate. It has been established that the presence of proteinuria in HIV infection is accompanied by a significantly higher level of HIV RNA compared to patients without this symptom (p < 0.01). At the same time, the average amount of CD4+-lymphocytes in blood serum in patients with proteinuria is significantly lower than in HIV-infected individuals who did not show kidney damage. The difference between the values of the ratios of CD4+/CD8+-lymphocytes in the analyzed groups (p < 0,05) is also significant. In most patients who were in the III-IV clinical stage of HIV infection, antiretroviral therapy (ART) was effective and reduced the viral load. Therefore, it is obvious that the amount of HIV-RNA in the blood of these individuals was significantly lower compared to patients who did not receive such treatment. At the same time, the burden of HIV, as well as the number of CD4+-lymphocytes in the representatives of the comparable groups did not differ (p > 0.05). Conclusion. The main predictors of kidney damage in HIV-infected are: high viral load, decrease in absolute numbers. CD4+-lymphocytes less than 200. Co-infection with hepatitis B and/ or C viruses does not affect the level of proteinuria and GFR in HIV-infected patients.

scholarly journals A hereditary component in development of immune disturbances in children with chronic sinusitis

2014 ◽  
Vol 18 (3 (71)) ◽  
Author(s):  
S. А. Levytska
Keyword(s):  
Immune Response ◽  
Chronic Inflammation ◽  
Paranasal Sinuses ◽  
Chronic Sinusitis ◽  
Specific Resistance ◽  
Cell Immune Response ◽  
Nonspecific Resistance ◽  
Immune Reactions ◽  
Immunity Response ◽  
Hereditary Component

The immune disturbances in exudative and hyperplastic forms of chronic sinusitis are accompanied by depression of cell immune response and activation of the humoral one; by a deficit of the factors and mechanisms of nonspecific resistance of organism. A hypothesis of genetic conditionality of the peculiarities of immune reactions and development of the type of chronic inflammation in paranasal sinuses was put forward. The cytosine in position 511 of the promoter zone of ІL-1β-gene aggravates the suppression of the cell-link of immunity response and a deficit of factors of nonspecific resistance in case of chronic exudative sinusitis while thymine in position 590 of promoter zone of ІL-4-zone increases the deficit of factors of non-specific resistance in case of chronic polypous inflammation of paranasal sinuses.

scholarly journals Distribution of microRNA profiles in pre-clinical and clinical forms of murine and human prion disease

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Lesley Cheng ◽  
Camelia Quek ◽  
Xia Li ◽  
Shayne A. Bellingham ◽  
Laura J. Ellett ◽  
...  
Keyword(s):  
Prion Disease ◽  
Molecular Subtype ◽  
Prion Diseases ◽  
Clinical Stage ◽  
Clinical Samples ◽  
Serum Samples ◽  
Prion Infection ◽  
Clinical Forms ◽  
Therapeutic Development ◽  
The Brain

AbstractPrion diseases are distinguished by long pre-clinical incubation periods during which prions actively propagate in the brain and cause neurodegeneration. In the pre-clinical stage, we hypothesize that upon prion infection, transcriptional changes occur that can lead to early neurodegeneration. A longitudinal analysis of miRNAs in pre-clinical and clinical forms of murine prion disease demonstrated dynamic expression changes during disease progression in the affected thalamus region and serum. Serum samples at each timepoint were collected whereby extracellular vesicles (EVs) were isolated and used to identify blood-based biomarkers reflective of pathology in the brain. Differentially expressed EV miRNAs were validated in human clinical samples from patients with human sporadic Creutzfeldt-Jakob disease (sCJD), with the molecular subtype at codon 129 either methionine-methionine (MM, n = 14) or valine-valine (VV, n = 12) compared to controls (n = 20). EV miRNA biomarkers associated with prion infection predicted sCJD with an AUC of 0.800 (85% sensitivity and 66.7% specificity) in a second independent validation cohort (n = 26) of sCJD and control patients with MM or VV subtype. This study discovered clinically relevant miRNAs that benefit diagnostic development to detect prion-related diseases and therapeutic development to inhibit prion infectivity.

Correlation between total and CD4 lymphocyte counts in HIV infection: not making the good an enemy of the not so perfect

1996 ◽  
Vol 7 (6) ◽  
pp. 422-428 ◽  
Author(s):  
E J Beck ◽  
E J Kupek ◽  
M M Gompels ◽  
A J Pinching
Keyword(s):  
T Cell ◽  
Hiv Infection ◽  
Lymphocyte Count ◽  
Cell Subset ◽  
Total Lymphocyte Count ◽  
Aids Patients ◽  
T Cell Subset ◽  
Total Lymphocyte ◽  
Asymptomatic Patients ◽  
Cd4 Lymphocyte

The aim of this study was to assess the correlation and average cost of total lymphocyte count compared with CD4 count as a broad estimate of immunosuppression in HIV-1 infected individuals. Spearman's partial rank correlation were calculated between total lymphocyte count, absolute CD4 count and CD4 per cent stratified by stage of HIV-1 infection for routinely collected samples. Data were collected prospectively from a T cell-subset register combined with clinical data obtained retrospectively from case notes of HIV-infected patients managed at St Mary's Hospital, London 1982-1991. Costing data were obtained through a survey of the departments of haematology and immunology 1989 90 prices . The correlation between 1534 paired absolute lymphocyte count and CD4 lymphocyte count was found to be high R 0.76 . When analysed by stage of HIV infection, the correlation increased from R 0.64 for asymptomatic patients, to R 0.72 for patients with symptomatic non-AIDS HIV infection and R 0.73 for AIDS patients. Correlations between absolute lymphocyte count and CD4 per cent were considerably weaker: R 0.41 all paired counts; R 0.32 for asymptomatic patients; R 0.25 for symptomatic non-AIDS patients; R 0.32 for AIDS patients. Average cost was 8 per full blood count compared with 38 per T-cell subset analysis. The high correlation between total and CD4 lymphocyte counts, especially for patients with symptomatic HIV disease, demonstrates the suitability of the use of total lymphocyte count in the absence of CD4 counts. Given the considerably lower prices of total lymphocyte counts compared with T-cell subset analysis, this is particularly relevant for developing countries.

scholarly journals Longitudinal analysis of sociodemographic, clinical and therapeutic factors of HIV-infected individuals in Kinshasa at antiretroviral therapy initiation during 2006-2017

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259073
Author(s):  
Nadine Mayasi Ngongo ◽  
Gilles Darcis ◽  
Hippolyte Situakibanza Nanituna ◽  
Marcel Mbula Mambimbi ◽  
Nathalie Maes ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Early Detection ◽  
Hiv Infection ◽  
Median Time ◽  
Clinical Stage ◽  
Hiv Care ◽  
Hiv Disease ◽  
Art Initiation ◽  
Time To Initiation ◽  
Advanced Hiv Disease

Background The benefits of antiretroviral therapy (ART) underpin the recommendations for the early detection of HIV infection and ART initiation. Late initiation (LI) of antiretroviral therapy compromises the benefits of ART both individually and in the community. Indeed, it promotes the transmission of infection and higher HIV-related morbidity and mortality with complicated and costly clinical management. This study aims to analyze the evolutionary trends in the median CD4 count, the median time to initiation of ART, the proportion of patients with advanced HIV disease at the initiation of ART between 2006 and 2017 and their factors. Methods and findings HIV-positive adults (≥ 16 years old) who initiated ART between January 1, 2006 and December 31, 2017 in 25 HIV care facilities in Kinshasa, the capital of DRC, were eligible. The data were processed anonymously. LI is defined as CD4≤350 cells/μl and/or WHO clinical stage III or IV and advanced HIV disease (AHD), as CD4≤200 cells/μl and/or stage WHO clinic IV. Factors associated with advanced HIV disease at ART initiation were analyzed, irrespective of year of enrollment in HIV care, using logistic regression models. A total of 7278 patients (55% admitted after 2013) with an average age of 40.9 years were included. The majority were composed of women (71%), highly educated women (68%) and married or widowed women (61%). The median CD4 was 213 cells/μl, 76.7% of patients had CD4≤350 cells/μl, 46.1% had CD4≤200 cells/μl, and 59% of patients were at WHO clinical stages 3 or 4. Men had a more advanced clinical stage (p <0.046) and immunosuppression (p<0.0007) than women. Overall, 70% of patients started ART late, and 25% had AHD. Between 2006 and 2017, the median CD4 count increased from 190 cells/μl to 331 cells/μl (p<0.0001), and the proportions of patients with LI and AHD decreased from 76% to 47% (p< 0.0001) and from 18.7% to 8.9% (p<0.0001), respectively. The median time to initiation of ART after screening for HIV infection decreased from 40 to zero months (p<0.0001), and the proportion of time to initiation of ART in the month increased from 39 to 93.3% (p<0.0001) in the same period. The probability of LI of ART was higher in married couples (OR: 1.7; 95% CI: 1.3–2.3) (p<0.0007) and lower in patients with higher education (OR: 0.74; 95% CI: 0.64–0.86) (p<0.0001). Conclusion Despite increasingly rapid treatment, the proportions of LI and AHD remain high. New approaches to early detection, the first condition for early ART and a key to ending the HIV epidemic, such as home and work HIV testing, HIV self-testing and screening at the point of service, must be implemented.

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