scholarly journals Liver disease, HIV and aging

Sexual Health ◽  
2011 ◽  
Vol 8 (4) ◽  
pp. 512 ◽  
Author(s):  
Oluwaseun Falade-Nwulia ◽  
Chloe L. Thio
Keyword(s):  
Liver Disease ◽  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Highly Active Antiretroviral Therapy ◽  
Future Research ◽  
Hiv Replication ◽  
Highly Active ◽  
Living With Hiv ◽  
The Impact ◽  
Hiv Negative

The life expectancy of HIV-infected patients has increased due to the efficacy of highly active antiretroviral therapy (HAART) in controlling HIV replication; thus, the population living with HIV infection is steadily aging. Liver-related morbidity and mortality has emerged as a leading problem in HIV-infected patients. Since aging, HIV infection and HAART all affect the liver, understanding the impact of the combination of these factors on liver disease is crucial for optimisation of care in the aging HIV-infected population. This review will focus on the current understanding of liver disease in older (>50 years old) HIV-negative individuals and in HIV-infected individuals. Areas for future research in the area of HIV, liver disease and aging will also be discussed.

Human Immunodeficiency Virus–Associated Squamous Cell Cancer of the Anus: Epidemiology and Outcomes in the Highly Active Antiretroviral Therapy Era

2008 ◽  
Vol 26 (3) ◽  
pp. 474-479 ◽  
Author(s):  
Elizabeth Y. Chiao ◽  
Thomas P. Giordano ◽  
Peter Richardson ◽  
Hashem B. El-Serag
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Squamous Cell ◽  
Highly Active Antiretroviral Therapy ◽  
Cell Cancer ◽  
Cox Proportional Hazards ◽  
Administrative Databases ◽  
Hiv Positive ◽  
Highly Active ◽  
Hiv Negative

Purpose To evaluate and determine predictors of squamous cell carcinoma of the anus (SCCA) outcomes in the highly active antiretroviral therapy (HAART) era for HIV-positive and -negative individuals using large national Veterans Affairs (VA) Administration databases. Patients and Methods We used the VA administrative databases to perform a retrospective cohort study in 1,184 veterans diagnosed with SCCA between 1998 and 2004. We calculated HIV infection rates and used logistic regression to identify epidemiologic factors that were associated with HIV infection. Kaplan-Meier curves and Cox proportional hazards models were calculated to compare survival between HIV-positive and HIV-negative veterans. Results In our cohort, 175 patients (15%) were HIV positive. The median age of the HIV-negative and -positive patients was 63 and 49 years, respectively (P < .001). Individuals with HIV were eight times more likely to be male (P = .01) and three times more likely to be African American (P < .001). There were no differences between HIV-positive and HIV-negative individuals in the receipt of treatment. The 2-year observed survival rates were 77% and 75% among HIV-positive and HIV-negative individuals, respectively. In multivariate Cox analysis, significant predictors of survival were age, sex, metastasis at diagnosis, and comorbidity score. HIV infection did not affect survival. Conclusion A noteworthy proportion of individuals with SCCA in the VA system are HIV positive. HIV-associated SCCA seems mainly to be a disease among younger men. Survival of SCCA is equivalent between HIV-positive and HIV-negative individuals in the HAART era. Treatment should not be withheld or deintensified based on HIV status.

scholarly journals Impact of highly active antiretroviral therapy (HAART) on the incidence of opportunistic infections, hospitalizations and mortality among children and adolescents living with HIV/AIDS in Belo Horizonte, Minas Gerais State, Brazil

2007 ◽  
Vol 23 (suppl 3) ◽  
pp. S414-S423 ◽  
Author(s):  
Talitah M. S. Candiani ◽  
Jorge Pinto ◽  
Claudete A. Araújo Cardoso ◽  
Inácio R. Carvalho ◽  
Arlete C. M. Dias ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Children And Adolescents ◽  
Highly Active Antiretroviral Therapy ◽  
Opportunistic Infections ◽  
Average Hospital ◽  
Highly Active ◽  
Belo Horizonte ◽  
Living With Hiv ◽  
The Impact ◽  
Hiv Aids

The impact of highly active antiretroviral therapy (HAART) can be evaluated using indicators, such as rates of opportunistic infections, hospitalizations by cause of infection, and associated death. This study aimed to estimate the impact of HAART on the incidence of these indicators, in children and adolescents with HIV/AIDS. It was a hybrid cohort study; 371 patients were followed from 1989 to 2003. In December 2003, 76% of the patients were still being followed, while 12.1% had died, 9.5% had dropped out, and 2.4% had been transferred. The overall rate of opportunistic infections was 18.32 infections/100 persons-year and 2.63 in the pre- and post-HAART periods, respectively. In the multivariate analysis, the risk of developing an opportunistic infection was 5.4 times greater and 3.3 times greater for hospitalization risk before HAART. Respiratory causes represented 65% of the hospitalizations and they were reduced by 44.6% with therapeutic intervention. The average hospital stay of 15 days was reduced to 9.There was a post-HAART decline in deaths of 38%. This study demonstrates the effectiveness of HAART in significantly reducing opportunistic infections, hospitalizations, and deaths in this Brazilian cohort.

scholarly journals HIV Infection in the Elderly: Arising Challenges

2016 ◽  
Vol 2016 ◽  
pp. 1-10 ◽  
Author(s):  
Bonaventura C. T. Mpondo
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Highly Active Antiretroviral Therapy ◽  
The Elderly ◽  
Advanced Age ◽  
Prolonged Survival ◽  
People Living With Hiv ◽  
Highly Active ◽  
Living With Hiv

Globally there is an increase in the number of people living with HIV at an advanced age (50 years and above). This is mainly due to prolonged survival following the use of highly active antiretroviral therapy. Living with HIV at an advanced age has been shown to be associated with a number of challenges, both clinical and immunological. This minireview aims at discussing the challenges encountered by elderly HIV-infected patients.

scholarly journals Physicians’ patient base composition and mortality among people living with HIV who initiated antiretroviral therapy in a universal care setting

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e023957
Author(s):  
Beverly Allan ◽  
Kalysha Closson ◽  
Alexandra B Collins ◽  
Mia Kibel ◽  
Shenyi Pan ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Base Composition ◽  
Cox Model ◽  
Cox Proportional Hazards ◽  
Future Research ◽  
People Living With Hiv ◽  
All Cause Mortality ◽  
Living With Hiv ◽  
The Impact

ObjectivesTo assess the impact of physicians’ patient base composition on all-cause mortality among people living with HIV (PLHIV) who initiated highly active antiretroviral therapy (HAART) in British Columbia (BC), Canada.DesignObservational cohort study from 1 January 2000 to 31 December 2013.SettingBC Centre for Excellence in HIV/AIDS’ (BC-CfE) Drug Treatment Program, where HAART is available at no cost.ParticipantsPLHIV aged ≥ 19 who initiated HAART in BC in the HAART Observational Medical Evaluation and Research (HOMER) Study.Outcome measuresAll-cause mortality as determined through monthly linkages to the BC Vital Statistics Agency.Statistical analysisWe examined the relationships between patient characteristics, physicians’ patient base composition, the location of the practice, and physicians’ experience with PLHIV and all-cause mortality using unadjusted and adjusted Cox proportional hazards models.ResultsA total of 4 445 PLHIV (median age = 42, Q1, Q3 = 34–49; 80% male) were eligible for our study. Patients were seen by 683 prescribing physicians with a median experience of 77 previously treated PLHIV in the past 2 years (Q1, Q3 = 23–170). A multivariable Cox model indicated that the following factors were associated with all-cause mortality: age (aHR = 1.05 per 1-year increase, 95% CI = 1.04 to 1.06), year of HAART initiation (2004–2007: aHR = 0.65, 95% CI = 0.53 to 0.81, 2008-2011: aHR = 0.46, 95% CI = 0.35 to 0.61, Ref: 2000–2003), CD4 cell count at baseline (aHR = 0.88 per 100-unit increase in cells/mm3, 95% CI = 0.82 to 0.94), and < 95% adherence in first year on HAART (aHR = 2.28, 95% CI = 1.88 to 2.76). In addition, physicians’ patient base composition, specifically, the proportion of patients who have a history of injection drug use (aHR = 1.11 per 10% increase in the proportion of patients, 95% CI = 1.07 to 1.15) or Indigenous ancestry (aHR = 1.07 per 10% increase , 95% CI = 1.03–1.11) and being a patient of a physician who primarily serves individuals outside of the Vancouver Coastal Health Authority region (aHR = 1.22, 95% CI = 1.01 to 1.47) were associated with mortality.ConclusionsOur findings suggest that physicians with a higher proportion of individuals who face potential barriers to care may need additional supports to decrease mortality among their patients. Future research is required to examine these relationships in other settings and to determine strategies that may mitigate the associations between the composition of physicians’ patient bases and survival.

scholarly journals Nocardia FarcinicaLung Abscess Presenting in the Context of Advanced HIV Infection: Spontaneous Resolution in Response to Highly Active Antiretroviral Therapy Alone

2009 ◽  
Vol 20 (3) ◽  
pp. e103-e106 ◽  
Author(s):  
Arienne S King ◽  
Jose G Castro ◽  
Gordon CK Dow
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Highly Active Antiretroviral Therapy ◽  
Opportunistic Pathogen ◽  
Cd4 Cell Count ◽  
Highly Active ◽  
Metastatic Infection ◽  
History Of ◽  
Cd4 Cell ◽  
The Impact

A 43-year-old man, known to be HIV-positive, presented with a six-week history of symptoms including cough, hemoptysis, anterior chest pain, fever and wasting. His CD4 cell count was 46 cells/μL, and his chest x-ray showed a cavitating lesion in the left upper lobe. Sputum culture was positive forNocardia farcinica. His infection resolved following initiation of antiretroviral therapy.Nocardiais an uncommon opportunistic pathogen in patients with HIV infection and is usually associated with advanced CD4 depletion, cavitary pneumonia, metastatic infection and high mortality. The impact of antiretroviral therapy onNocardiainfection in the setting of HIV has not been clearly elucidated. The current report is the first to present a case in which a complete clinical cure ofNocardiapneumonia has been documented, primarily in response to highly active antiretroviral therapy alone.

scholarly journals Impact of HIV infection and smoking on lung immunity and related disorders

2015 ◽  
Vol 46 (6) ◽  
pp. 1781-1795 ◽  
Author(s):  
Theresa M. Rossouw ◽  
Ronald Anderson ◽  
Charles Feldman
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Highly Active Antiretroviral Therapy ◽  
Opportunistic Infections ◽  
Healthcare Providers ◽  
Adverse Health Effects ◽  
Highly Active ◽  
Life Years ◽  
Primary Focus ◽  
The Impact

HIV-infected persons not only have higher rates of smoking than the general population, but are also unusually vulnerable to the associated adverse health effects, both infective and noninfective in origin. Indeed, in the setting of well-organised care and availability of highly active antiretroviral therapy, HIV-infected smokers lose more life-years to smoking than to HIV infection per se, presenting a major challenge to healthcare providers. Not surprisingly, the respiratory system is particularly susceptible to the damaging interactive chronic inflammatory and immunosuppressive effects of HIV and smoking, intensifying the risk of the development of opportunistic infections, as well as lung cancer and obstructive lung disorders. The impact of smoking on the immunopathogenesis and frequencies of these respiratory conditions in the setting of HIV infection, as well as on the efficacy of antiretroviral therapy, represent the primary focus of this review.

scholarly journals Highly active antiretroviral therapy increases fibrinolytic and protein activity in pregnant women

2018 ◽  
Vol 37 (3) ◽  
pp. 181
Author(s):  
Evarista Odaburhine Osime ◽  
Catherine Obar
Keyword(s):  
Antiretroviral Therapy ◽  
Pregnant Women ◽  
Highly Active Antiretroviral Therapy ◽  
Protein C ◽  
Protein S ◽  
Enzyme Linked Immunosorbent Assay ◽  
Hiv Positive ◽  
Highly Active ◽  
The Impact ◽  
Hiv Negative

<p><strong>BACKGROUND</strong></p><p>Various studies have examined optimal methods for Prevention of Mother to Child Transmission (PMTCT) of human immunodeficiency virus (HIV) and subsequent outcome of response to highly active antiretroviral therapy (HAART) as well as the impact of pregnancy on outcomes of HIV in the Pre-HAART era. Little is known of the impact of pregnancy in response to HAART in Africa. This study is aimed to evaluate euglobulin lysis time (ELT), protein C and protein S in HIV-positive pregnant women on HAART.</p><p><strong> </strong></p><p><strong>METHODS</strong></p><p>This was a cross-sectional study comprised of 150 participants attending Ante-Natal Clinic (ANC) in Central Hospital, Benin City. Pregnant women on HAART (Test subjects) (n=50, mean age 34 years), 50 pregnant newly diagnosed HIV-positive women that had not yet commenced HAART (n=50, mean age 31 years) and 50 pregnant HIV-negative women (n=50, mean age 30 years) which served as controls. The ELT was determined by methods described by Bain, protein C and protein S were determined using Enzyme Linked Immunosorbent Assay (ELISA).</p><p><strong> </strong></p><p><strong>RESULTS</strong></p><p>There was a significant increase in ELT in both pregnant women on HAART and not on HAART) when compared to HIV-negative pregnant women (p&lt;0.05). There was a significant decrease in protein C in test subjects when compared with controls (p&lt;0.05) and protein S increased significantly in HIV-positive pregnant women on HAART when compared to those not on HAART and HIV-negative pregnant women (p&lt;0.05).<strong> </strong></p><p><strong> </strong></p><p><strong>CONCLUSION</strong></p>There are changes in ELT, protein C and protein S parameters with the introduction of HAART in pregnancy.

scholarly journals Organ Transplantation in HIV Infected Individuals: The Time Has Come - Should there Be Criteria?

2006 ◽  
Vol 17 (1) ◽  
pp. 8-10
Author(s):  
Sharon Walmsley
Keyword(s):  
Hepatitis C Virus ◽  
Liver Disease ◽  
Hepatitis C ◽  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Organ Transplantation ◽  
Highly Active Antiretroviral Therapy ◽  
Causes Of Death ◽  
Underlying Liver Disease ◽  
Highly Active

Before the advent of highly active antiretroviral therapy (HAART), HIV and its associated infectious and malignant complications were the major causes of death in patients with HIV infection, including those with serious comorbidities involving the heart, liver or kidney (1). Consequently, therapy of the underlying liver disease, such as hepatitis C virus (HCV), was often not attempted, and transplantation of scarce organs was not a consideration.

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