Tuberculosis and Human Immunodeficiency Virus Co-Infection: Clinico-Demographic Determinants at an Anti-Retroviral Therapy Center in Northern India

Background: In India, Tuberculosis (TB) is endemic and Human immunodefi ciency virus (HIV) infection is epidemic in few states. The risk of developing TB in people living with HIV (PLHIV) is about 19 (27-22) times greater than those without it. TB is major cause of death in HIV-TB co-infected patients. Globally 0.4 million deaths occur annually due to HIV-TB disease.Material & Methods:The present observational study was conducted at Darbhanga Medical College and Hospital ART (Antiretroviral therapy) center during period from January to June 2017. Data of HIV-TB co-infected patients was collected from HIV-TB register and entered into Microsoft Excel sheet for analysis using Statistical Package for the Social Sciences.Results:Young persons mostly from the labouring class working in other states were most affected. Pulmonary tuberculosis (sputum smear positive) was most common co-infection. Baseline CD4 cell count at the time of presentation was observed to be low (less than 200 cells/μL) in 46.64℅ HIV-TB co-infected patients.Conclusion: Rural young people working as migrant labourer need focus of health interventions. They should be educated and screened for HIV and TB. Baseline CD4 cell count should be done in all PLHIV cases to assess their immune status.SAARC Journal of Tuberculosis, Lung Diseases and HIV/AIDS, Vol. 14, No. 2, 2017, Page: 12-17

Prevalence and CD4 Cell Count Pattern of TB Co-infection Among HIV Infected Individuals In Nepal

Background: Mycobacterium tuberculosis (TB) and Human Immunodefi ciency Virus (HIV) infections are two major public health problems in many parts of the world, particularly in developing counties like Nepal. The objective of the study is to find out prevalence and clinical presentation of the TB co-infection among HIV infected individuals and pattern of CD4 cell count in relation to types of TB and response of ART. Methodology: This is a cross-sectional study carried out in three VCT clinics from Dharan and Kathmandu from April 2010 to March 2011. The appropriate samples, 313 HIV individuals were taken as study sample. Results: The study revealed that more than 36% of individuals were co-infected with TB. Among them, nearly 65% had pulmonary TB, more than one-forth had gland TB. There is signifi cant association of TB co-infection among male compared to females (P=0.021). Fever, weight loss and cough were found to have signifi cant symptoms associated with TB-HIV co-infection. The average CD4 count among TB co-infected population was signifi cantly less compared to uninfected ones just before starting ART (P=0.022) and even after six months (P=0.001). After one year of ART continuation, there was no signifi cant association on average CD4 count among the two groups. But then, the mean CD4 count became more in TB co-infected individuals compared to those who had no TB co-infection. Conclusion: TB-HIV co-infection is an emerging medical issue in Nepal. More than one third of HIV patients are co-infected with TB. Consideration of TB need to be made while caring patients with HIV infection and vice versa. ART plays very important role in increasing CD4 cell count among TB-HIV coinfected patients. SAARC Journal of Tuberculosis, Lung Diseases & HIV/AIDS; 2013; X(1); 27-36 DOI: http://dx.doi.org/10.3126/saarctb.v10i1.8674

Watering flowers in the rain: The elusive nature of executive dysfunction in HIV

ABSTRACTIndividuals infected with human immunodefi ciency virus (HIV) frequently experience both neurocognitive and psychiatric dysfunction. Apathy is a prominent neuropsychiatric symptom associated with HIV and is related to neurologic dysfunction. In contrast, depression is independent of neurocognitive impairment in HIV. This case report illustrates the importance of behavioral observations from family members of HIV-positive (HIV+) individuals as a valuable source of information. These behavioral observations can be particularly important in rural resource-limited settings, where cognitive testing is often limited to standardized mental status examinations.

Zidovudine-induced myopathy: A study in Indian patients

ABSTRACT Context: Literature is replete with studies on zidovudine-induced myopathy after prolonged use (use beyond 270 days on an average). However, all these studies have been done on patients of Caucasian, American and African ethnic origin. No such study has been carried out in Indian patients to our knowledge. Aims: To determine the correlation of zidovudine usage with serum creatine phosphokinase (CK) levels, clinical muscular weakness and muscle histology in Indian patients, we studied 147 physically active, Human Immunodefi ciency Virus infected men on prolonged zidovudine-based antiretroviral therapy (ART). Settings and Design: Cross-sectional study on hospital follow-up patients of HIV infection. Materials and Methods: All cases on ART who reported to our canter during a period of 18 months were evaluated for symptoms (muscle fatigue, myalgia), objective muscle strength (testing clinically) and serum CK levels, and a select group was evaluated by muscle biopsy. These patients were on zidovudine for 1 to 7 years. Results: None of the patients studied had signifi cant symptoms or objective muscle weakness and only a small fraction (10.8% of cases) had marginally raised serum CK levels. All muscle biopsies were normal on light microscopy. Conclusions: Zidovudine myopathy may be a constraint for use of the drug in the western population; however, it is a well-tolerated drug as regards myopathy in our study on Indian patients.

Anti-HIV Activity of New Substituted 1,3,4-Oxadiazole Derivatives and their Acyclic Nucleoside Analogues

A number of new 5-[(naphthalen-5-yloxy)methyl]-1,3,4-oxadiazole derivatives, 2 - 5 and 8 - 11, were synthesized. The 2-{5-[(naphthalen-5-yloxy)methyl]-1,3,4-oxadiazol-2-ylthio}acetohydrazones 6a and 6b were synthesized by the reaction of the hydrazide 4 with the corresponding monosaccharides. Cyclization of the sugar hydrazones 6a and 6b with acetic anhydride afforded the substituted oxadiazoline derivatives 7a and 7b. The synthesized compounds were evaluated for their antiviral activity against, the human immunodefi ciency virus (HIV-1) and some of these compounds showed moderate to high antiviral activity.