scholarly journals CD4 count and tuberculosis risk in HIV-positive adults not on ART: a systematic review and meta-analysis

PeerJ ◽  
2017 ◽  
Vol 5 ◽  
pp. e4165 ◽  
Author(s):  
Penelope K. Ellis ◽  
Willam J. Martin ◽  
Peter J. Dodd
Keyword(s):  
Cell Count ◽  
Meta Analysis ◽  
Cochrane Review ◽  
Fold Increase ◽  
Credible Interval ◽  
Hiv Positive ◽  
Cd4 Cell Count ◽  
Art Initiation ◽  
Hiv Positive Adults ◽  
Cd4 Cell

Background CD4 cell count in adults with human immunodeficiency virus (HIV) infection (PLHIV) not receiving antiretroviral therapy (ART) influences tuberculosis (TB) risk. Despite widespread use in models informing resource allocation, this relationship has not been systematically reviewed. Methods We systematically searched MEDLINE, Aidsinfo, Cochrane review database and Google Scholar for reports in English describing TB incidence stratified by updated CD4 cell count in cohorts of HIV-positive adults (age ≥15 years) not on ART (PROSPERO protocol no: CRD42016048888). Among inclusion criteria were: reporting precision for TB incidence, repeated CD4 measurements, and TB incidence reported for those not on ART or monotherapy. Study quality was assessed via the Newcastle-Ottawa tool for cohort studies. A Bayesian hierarchical model was fitted to estimate the pooled factor increase in TB incidence with respect to CD4 cell count decrement. Results A total of 1,555 distinct records were identified from which 164 full text articles were obtained. Common reasons for exclusion of full texts were: no valid TB incidence, no repeat CD4 measurements, and not reporting TB incidence by ART status. The seven studies included reported on 1,206 TB cases among 41,271 individuals, with a typical median follow-up of four years. Studies were generally rated as moderate or high quality. Our meta-analysis estimated a 1.43 (95% credible interval: 1.16–1.88)-fold increase in TB incidence per 100 cells per mm3 decrease in CD4 cell count. Discussion Our analysis confirms previous estimates of exponential increase in TB incidence with declining CD4 cell count in adults, emphasizing the importance of early ART initiation to reduce TB risk in PLHIV.

scholarly journals Assessment of Casual Relations, Direct and Indirect Effects of Latent Covariates On CD4 Cell Count Change Among HIV Positive Adults

2021 ◽  
Author(s):  
Awoke Seyoum Tegegne
Keyword(s):  
Cell Count ◽  
Indirect Effect ◽  
Latent Variables ◽  
Hiv Positive ◽  
Health Staff ◽  
Cd4 Cell Count ◽  
Hiv Positive Adults ◽  
Cd4 Cell ◽  
Count Change ◽  
Cd4 Cell Count Change

Abstract Background: The use of structural equation modelling and latent variables remains unusual in epidemiology despite its potential usefulness and assessment of casual relations. Measuring direct and indirect effect of latent variables helps for proper intervention and for the ART program to be effective. The main objective of current investigation was to assess casual relations, direct and indirect effect of latent covariates on CD4 cell count change for HIV positive adults under HAART. Methods: Based on the repeated measures of CD4 cell count change data obtained in ART section at Felege Hiwot Teaching and Specialized hospital, AMOS software was employed parameter estimation. The data was conducted on 792 randomly selected HIV positive adults. The data was collected by the health staff for sake of delivering medication adherence. Results: CD4 cell count change was directly and indirectly affected by the latent variables. The powers of effects of observed variables with and without latent variables were a little bit different from each other. Hence, the power effect of observed variables with latent variables was lower as compared to without latent variables. The direct effect of latent variables on the response variable was a little bit greater than indirect effect. Conclusion: The power of effects of observed variables were stronger than their effects with latent variables. Hence, the latent variables had significant contributions for progress of CD4 cell count change. Health related education about the direct and indirect effect of latent variables should be given for patients under HAART.

scholarly journals Socio-Demographic and Clinical Predictor Variables on CD4 Cell Count Change among HIV Positive adults; a Structural Equations Modelling

2020 ◽  
Author(s):  
Awoke Seyoum ◽  
Principal Ndlovu Ndlovu ◽  
Temesgen Zewotire Zewotire
Keyword(s):  
Cell Count ◽  
Structural Equation ◽  
Structural Equations ◽  
Equation Modeling ◽  
Hiv Positive ◽  
Cd4 Cell Count ◽  
Hiv Positive Adults ◽  
Cd4 Cell ◽  
Count Change ◽  
Cd4 Cell Count Change

Abstract Background: The prevalence of HIV/AIDS among adult individuals has been increasing in Sub-Sahara African countries over the last decade. In Ethiopia , the prevalence of HIV among adults was 1%. Hence, 23, 000 people were newly infected with HIV and 11,000 people were died because of AIDS related illness in 2018. The purpose of this study was to identify the most significant socio-demographic, economic, individual and clinical determinants of CD4 cell count change in HIV positive adults who initiated HAART at Felege Hiwot Teaching and Specialized Hospital, North-West Ethiopia. Methods: A secondary and retrospective study design was conducted on 792 HIV positive adults. A structural equation modeling was employed to identify the socio-demographic and clinical covariates that have a statistically significant effect on the status of CD4 cell count change. Results: Literate patients, patients living with partner, patients living in urban area, patients disclosed the disease to family members, high income , ownership of cell, age and sex (male) were statistically significant variables. Conclusion: There was direct relation between socio-demographic variables with retention of HIV positive individuals in HAART program. There was also a direct and significant effect of clinical variables on adherence competence and adherence on CD4 cell change. Retention of patients in the HAART program had direct and significant effect on CD4 cell count change. This finding will be important for policy makers, health officials and for patients to easier access to healthcare service. Keywords: Socio-demographic, clinical factors, individual characteristics, Structural equation, CD4count change

scholarly journals Socio-demographic and Clinical Variables associated with the variation of CD4 Cell Count and Body Mass Index (BMI) for HIV Positive adults receiving HAART, a joint longitudinal data analysis

2020 ◽  
Author(s):  
Awoke Seyoum Tegegne ◽  
Principal Ndlovu Ndlovu ◽  
Temesgen Zewotir Zewotir
Keyword(s):  
Body Mass Index ◽  
Cell Count ◽  
Body Mass ◽  
Cell Phone ◽  
Hiv Positive ◽  
Economic Factors ◽  
Cd4 Cell Count ◽  
Hiv Positive Adults ◽  
Cd4 Cell

Abstract Objective The rate of prevalence of HIV/AIDS among adults has been increasing in Sub-Sahara African countries over the last decade. Currently, an estimated number of 722, 248 people are living with HIV, 23, 000 people are newly infected with HIV and 11,000 people are died because of AIDS related illness. The purpose of this study was to identify the most significant variables associated with the variation of CD4 cell count and body mass index (BMI) of HIV positive adults who initiated HAART at Felege Hiwot Teaching and Specialized Hospital, North-West Ethiopia. Methods To analyze the long-term CD4 cells count and body mass index of HIV infected adults, a prospective follow-up study of 792 HIV-infected patients was performed. A joint model was employed to identify the variables associated with the variation of CD4 cell count and body mass index of adults receiving HAART. A random of 792 samples was taken among charts in the hospital. Results Among the main effects, Socio-demographic variables (Level of education, level of exposedness of disease to persons living together, Marital status and residence area), individuals characteristics (age and weight), economic factors (ownership of cell phone, level of income), clinical factors (baseline CD4 cell count), level of retention (time to follow ups, food and medical adherence) and economic factors(owner of cell phone) significantly affected the variables of interests. Similarly, the interaction effects of time of follow-up visits * cell phone ownership, follow-up visits * gender, age * sex significantly affected both response variables through a linear link function in current investigation. Conclusion Socio-demographic, individual and Clinical variables had significant effect on CD4 cell count and BMI in HAART medication program. Time to follow ups in the HAART program had also direct and significant effect on the variables of interest.

Association between frailty phenotype, quantification of plasma HIV-1 RNA, CD4 cell count and HAART in HIV-positive subjects: a systematic review and meta-analysis of observational studies

AIDS Care ◽  
2021 ◽  
pp. 1-10
Author(s):  
Géssyca Cavalcante Melo ◽  
Aline Carla Araújo Carvalho ◽  
Mário Luis Tavares Mendes ◽  
Renee Oliveira do Nascimento ◽  
Karina Conceição Gomes Machado de Araújo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cell Count ◽  
Observational Studies ◽  
Meta Analysis ◽  
Hiv Positive ◽  
Frailty Phenotype ◽  
Cd4 Cell Count ◽  
Cd4 Cell ◽  
Hiv 1

scholarly journals Couples HIV testing and immediate antiretroviral therapy for serodiscordant HIV-positive partners: Translating evidence into programme in Vietnam

2019 ◽  
Vol 30 (8) ◽  
pp. 739-747 ◽  
Author(s):  
Duong D Bui ◽  
Nhan T Do ◽  
Linh TT Pham ◽  
Patrick Nadol ◽  
Van TT Nguyen ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Drug Use ◽  
Hiv Testing ◽  
Cell Count ◽  
Viral Suppression ◽  
Consistent Condom ◽  
Hiv Positive ◽  
Cd4 Cell Count ◽  
Art Initiation ◽  
Cd4 Cell

Injection drug use and heterosexual transmission from male key populations to their female partners have been the dominant modes of HIV transmission in Vietnam. A demonstration project was conducted to offer immediate antiretroviral therapy (ART) (regardless of CD4 cell count) to HIV-seropositive partners in serodiscordant couples. During March–December 2013, couples HIV testing and counselling (HTC) and immediate ART were offered in two drug use-affected provinces. Of 256 couples receiving couples HTC, 146 (57%) were serodiscordant; 134 (92%) seropositive partners initiated ART irrespective of CD4 cell count. Of these, 86% were male; 57% reported ever using illicit drugs; median CD4 cell count before ART initiation was 374 cells/mm3. Consistent condom use was reported by 58, 70 and 71% among HIV-positive partners at months 0, 3 and 12. At 12 months after ART initiation, 119 (89%) HIV-positive partners were retained in care; 96 (95% of those tested) achieved viral suppression (<1000 copies/ml). Uptake of immediate ART and viral suppression among those initiating ART were high, paving the way for ART regardless of CD4 cell count as national policy in Vietnam.

scholarly journals Socio-demographic and Clinical Variables associated with the variation of CD4 Cell Count and Body Mass Index (BMI) for HIV Positive adults receiving HAART, a joint longitudinal data analysis

2020 ◽  
Author(s):  
Awoke Seyoum Tegegne ◽  
Principal Ndlovu Ndlovu ◽  
Temesgen Zewotir Zewotir
Keyword(s):  
Body Mass Index ◽  
Cell Count ◽  
Body Mass ◽  
Cell Phone ◽  
Hiv Positive ◽  
Cd4 Cell Count ◽  
Specialized Hospital ◽  
Hiv Positive Adults ◽  
Cd4 Cell

Abstract Background: The rate of prevalence of HIV among adults has been increasing in Sub-Sahara African countries over the last decade. Currently, an estimated number of 722, 248 people are living with HIV, 23, 000 people are newly infected with HIV and 11,000 people are died because of AIDS related illness. The objective of this study was to identify the most significant variables associated with the variation of CD4 cell count and body mass index (BMI) of HIV positive adults who initiated HAART at Felege Hiwot Teaching and Specialized Hospital, North-West Ethiopia. This study also aimed to compared the precision of parameter estimates conducted by separate and joint models.Methods: To analyze the long-term CD4 cells count and body mass index of HIV infected adults, a cohort longitudinal study of 792 HIV-infected patients was performed. A joint model was employed to identify the variables associated with the variation of CD4 cell count and body mass index of adults receiving treatment at Felege Hiwot Teaching and specialized Hospital. A random of 792 samples was taken among patients using individual charts in the hospital.Results: Among the main effects, Socio-demographic variables (Level of education, level of disclosure of the disease to persons living together and Marital status ), individuals factors(age, weight and gender), economic factors (ownership of cell phone, level of income), clinical factors (baseline CD4 cell count) retention (food and medication adherence, follow-up time/visit) significantly affected the variables of interests. Similarly, the interaction effects of follow-up times/visits * cell phone ownership, follow-up times/visits * gender, age * gender of patients significantly affected both response variables in current investigation.Conclusion: Socio-demographic, individual and Clinical variables had significant effect on CD4 cell count and BMI in HAART medication program. Follow-up time/visit in the HAART program had also direct and significant effect on the variables of interest. Older HIV patients should be targeted by appropriate public health actions, such as opportunistic screening and easier access to healthcare service. The patients should be advised to disclose the disease to get support from communities around them.

scholarly journals Assessment of Markers of Depression and CD4 Cell Count among Adult HIV-Positive Patients on Anti-Retroviral at a Nigerian University Teaching Hospital

2020 ◽  
Vol 8 (4) ◽  
pp. 283-290
Author(s):  
A. Amoko ◽  
P.O. Ajiboye ◽  
F.A. Olagunju ◽  
R.O. Shittu
Keyword(s):  
Family Medicine ◽  
Cell Count ◽  
Teaching Hospital ◽  
Cd4 Count ◽  
Hiv Positive ◽  
P Value ◽  
People Living With Hiv ◽  
Cd4 Cell Count ◽  
Prevalence Of Depression ◽  
Cd4 Cell

Objective: Depression is a common mental health problem among people living with HIV/AIDS (PLWHA); because low count of lymphocytes with  cluster of differentiation 4 (CD4 cell count) is associated with severe symptoms of HIV infection, there are thoughts that low CD4 cells count can provoke depressive illness. This study was conducted to determine the relationship between CD4 count and depression among adult HIV positivepatients attending Family Medicine clinics at University of Ilorin Teaching Hospital (UITH), Ilorin, Nigeria.Method: A hospital based descriptive cross-sectional study was done over a period of 6 months among 350 systematically randomly selected adult HIV-positive patients. PHQ-9 was used to obtain information on depression and the CD4 count was determined using a flow-cytometric method. Data were obtained and analyzed using SPSS-17. Chi-square was used to determine degree of association between the depression and the level of CD4 count. P-value of < 0.05 was considered statistically significant.Results: The prevalence of depression among the respondents was 33.4%. The prevalence of depression was highest among respondents with low CD4 count (≤349cells/ul), 37.0%, and least among those with high CD4 count (≥500cells/ul), 28.3%. This relationship was however not statistically significant.Conclusion: The overall prevalence of depression was high among the respondents (33.4%) suggesting the need for routine depression screening among HIV positive patients. There was no statistically significant association between presence of depression and level of CD4 count (p-value=0.302). Keywords: Depression, CD4count, PLWHA, Family Medicine, UITH.

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