scholarly journals Human Immunodeficiency Virus Status in Malnourished Children seen at Lagos

2018 ◽  
Author(s):  
EO Temiye ◽  
OF Adeniyi ◽  
IB Fajolu ◽  
AA Ogbenna ◽  
TA Ladapo ◽  
...  

AbstractIntroductionHuman immunodeficiency virus and protein energy malnutrition are still prevalent in Nigeria and the occurrence of the two conditions together confers a poor prognosis. The aim of this study was to determine the current categories of malnutrition amongst under 5 children in Lagos, document their HIV status and determine any peculiarities in the clinical features, haematological and some biochemical profile in these children.MethodsThe study was a prospective crossectional study conducted at the Paediatric department of the Lagos University Teaching Hospital and the Massey Street Children’s Hospital over a 6 month period. All the subjects had anthropometry, HIV testing, full blood count and serum proteins done. The factors associated with HIV status were determined with the logistic regression analysis.ResultsTwo hundred and fourteen (214) malnourished children ≤5 years were recruited into the study and 25(11.7%) were HIV positive. One hundred and five (49.1%) of the participants had moderate malnutrition while 25.2% had severe forms of malnutrition. Fever, cough and diarrhea were the commonest symptoms. Severe wasting, oral thrush, dermatoses and splenomegaly were seen more commonly in the HIV positive subjects. The haematological indices were comparable in the two groups, however, the total protein was significantly higher in the HIV positive subjects compared to the negative group (p=0.042). Multivariate analysis showed that the total protein (p=0.001) and platelet count (p=0.016) could significantly predict the occurrence of HIV in the malnourished childrenConclusionThe presence of severe wasting, oral thrush, diarrhea, splenomegaly, thrombocytopenia and high total proteins in malnourished children should heighten the suspicion of possible underlying associated HIV infection. This study reinforces the recommendation by the World Health Organisation (WHO) that all malnourished children should have mandatory HIV screening.

Author(s):  
Anna Maria Geretti ◽  
Alexander J Stockdale ◽  
Sophie H Kelly ◽  
Muge Cevik ◽  
Simon Collins ◽  
...  

Abstract Background Evidence is conflicting about how human immunodeficiency virus (HIV) modulates coronavirus disease 2019 (COVID-19). We compared the presentation characteristics and outcomes of adults with and without HIV who were hospitalized with COVID-19 at 207 centers across the United Kingdom and whose data were prospectively captured by the International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) World Health Organization (WHO) Clinical Characterization Protocol (CCP) study. Methods We used Kaplan-Meier methods and Cox regression to describe the association between HIV status and day-28 mortality, after separate adjustment for sex, ethnicity, age, hospital acquisition of COVID-19 (definite hospital acquisition excluded), presentation date, 10 individual comorbidities, and disease severity at presentation (as defined by hypoxia or oxygen therapy). Results Among 47 592 patients, 122 (0.26%) had confirmed HIV infection, and 112/122 (91.8%) had a record of antiretroviral therapy. At presentation, HIV-positive people were younger (median 56 vs 74 years; P < .001) and had fewer comorbidities, more systemic symptoms and higher lymphocyte counts and C-reactive protein levels. The cumulative day-28 mortality was similar in the HIV-positive versus HIV-negative groups (26.7% vs. 32.1%; P = .16), but in those under 60 years of age HIV-positive status was associated with increased mortality (21.3% vs. 9.6%; P < .001 [log-rank test]). Mortality was higher among people with HIV after adjusting for age (adjusted hazard ratio [aHR] 1.47, 95% confidence interval [CI] 1.01–2.14; P = .05), and the association persisted after adjusting for the other variables (aHR 1.69; 95% CI 1.15–2.48; P = .008) and when restricting the analysis to people aged <60 years (aHR 2.87; 95% CI 1.70–4.84; P < .001). Conclusions HIV-positive status was associated with an increased risk of day-28 mortality among patients hospitalized for COVID-19.


2000 ◽  
Vol 38 (10) ◽  
pp. 3595-3607 ◽  
Author(s):  
Kaaren Vargas ◽  
Shawn A. Messer ◽  
Michael Pfaller ◽  
Shawn R. Lockhart ◽  
Jack T. Stapleton ◽  
...  

Strains of Candida albicans obtained from human immunodeficiency virus (HIV)-positive individuals prior to their first episode of oral thrush were already in a high-frequency mode of switching and were far more resistant to a number of antifungal drugs than commensal isolates from healthy individuals. Switching in these isolates also had profound effects both on susceptibility to antifungal drugs and on the levels of secreted proteinase activity. These results suggest that commensal strains colonizing HIV-positive individuals either undergo phenotypic alterations or are replaced prior to the first episode of oral thrush. They also support the suggestion that high-frequency phenotypic switching functions as a higher-order virulence trait, spontaneously generating in colonizing populations variants with alterations in a variety of specific virulence traits.


2011 ◽  
Vol 21 (9) ◽  
pp. 1684-1691 ◽  
Author(s):  
Shahila Tayib ◽  
Leon van Wijk ◽  
Lynette Denny

ObjectivesThe objective of the study was to describe the management of gestational trophoblastic neoplasia (GTN), with particular reference to concurrent human immunodeficiency virus (HIV) infection.MethodsThis retrospective descriptive study comprised all cases of GTN managed at Groote Schuur Hospital over a 10-year period (1999–2008).ResultsSeventy-six patients, with a median age of 30 years at presentation, were included in the study. Only 36 patients (47.4%) had known HIV status. Fourteen (18.4%) were HIV positive, and of these, 4 (28.6%) were on antiretroviral treatment (ARV). The mean CD4 count was 142 cells/μL for those on ARV and 543 cells/μL for those not on ARV (P= 0.001). Histologically, 44 patients (58%) had hydatidiform mole, and 21 (28%) had choriocarcinoma. In the remaining 10 cases, a clinical diagnosis was made. Based on the revised International Federation of Gynecology and Obstetrics (FIGO)/modified World Health Organization scoring, 43 patients (56.6%) were low risk, and 33 (43.4%) were high risk. Thirty-eight patients (50%) were staged as FIGO stage I. Of 73 patients who received chemotherapy, 56 (76.7%) achieved complete remission, 9 (12.3%) did not achieve any remission, 7 (9.6%) had a relapse, and 1 (1.4%) was lost to follow-up. Patients who never went into remission had frequent treatment delays due to poor compliance or inadequate blood counts. The overall survival at 60 months was 81.9%. Of the 13 patients (17.1%) who have died, 5 (38.5%) were HIV positive. The overall 5-year survival rates for FIGO stages I, II, III, and IV were 97.4%, 66.7%, 77.8%, and 46.2%, respectively. The overall 5-year survival for HIV-positive patients was 64.3% versus more than 85% for both the HIV-negative and HIV-unknown groups.ConclusionsApart from more advanced stage, HIV seropositivity and poor compliance with treatment also portend poorer outcome in GTN patients. In HIV-positive patients with poor CD4, little clarity is available whether ARV should be commenced speedily, and the administration of chemotherapy delayed until immune reconstitution occurs.


2020 ◽  
Author(s):  
Fikadu Ambaw Yehualashet ◽  
Eleni Tesfaye Tegegne ◽  
Mekbib Kassa Tessema ◽  
Mulualem Endeshaw

Abstract Background: Disclosure of Human Immunodeficiency Virus positive status significantly reduced the transmission of HIV; yet, it remains a challenge for many HIV patients. Disclosure serves plays a crucial role to raise awareness and to reduce risky behaviors. Hence, this study aimed to determine the pooled prevalence and effect sizes of determinant factors of HIV positive status disclosure through a systematic review and meta-analysis of the results of the existing primary studies in Ethiopia. Method: This systematic review and meta-analysis was aimed to determine prevalence of HIV positive status disclosure and associated factors by considering and searching published primary articles from different sources. A sensitivity test was conducted to evaluate the presence of influential studies. Besides, the heterogeneity test has been conducted; and publication bias was examined through observing the funnel plot as well as objectively by interpreting the Egger’s regression test. Following the Egger’s regression test, P-value <0.05 was considered as statistically significant at 95% Confidence Interval. Result: A total of 18 primary studies were searched from different data sources. The overall pooled prevalence of HIV positive status disclosure among adult PLWHA in Ethiopia was indicated to be 75.95% (95% CI:69.93-81.98); the highest and lowest pooled estimated HIV status disclosure was in Amhara (82.78%) and Tigray (54.31%) regions respectively. Furthermore, Knowing the HIV positive status of sexual partner, AOR=19.66(95% CI: 10.19-37.91), having prior discussion about HIV testing with their partner, AOR=9.18(95% CI: 5.53-15.24), got Human Immunodeficiency Virus pretest counseling service AOR=4.29(95% CI: 2.56-7.21) and being a member of HIV/AIDS associations, AOR=3.34(95% CI: 2.17-5.12), were significantly associated with HIV positive status disclosure among People living With HIV/AIDS in Ethiopia.Conclusion: The pooled national estimate of HIV/AIDS positive status disclosure is low as compared to the WHO disclosure rate of developing countries and the findings of other national and international studies. Ministry of health and other stakeholders shall design new approaches and strategies to encourage disclosure of HIV status, educate the public about the negative impact of nondisclosure within family members. Health care providers working at Human HIV test centers shall emphasis extensive counseling on disclosure of status to a partner. Moreover, different stakeholders, health workers and community members shall establish, organize, and support HIV/AIDS Associations and motivate HIV positive people to be engaged and participated.


2019 ◽  
Vol 70 (1) ◽  
pp. 106-113 ◽  
Author(s):  
David C Boettiger ◽  
Luisa Salazar-Vizcaya ◽  
Gregory J Dore ◽  
Richard T Gray ◽  
Matthew G Law ◽  
...  

Abstract Background Human immunodeficiency virus (HIV)–positive gay and bisexual men (GBM) in Australia are well engaged in care. The World Health Organization’s (WHO) hepatitis C virus (HCV) elimination target of an 80% reduction in incidence by 2030 may be reachable ahead of time in this population. Methods We predicted the effect of treatment and behavioral changes on HCV incidence among HIV-positive GBM up to 2025 using a HCV transmission model parameterized with Australian data. We assessed the impact of changes in behavior that facilitate HCV transmission in the context of different rates of direct-acting antiviral (DAA) use. Results HCV incidence in our model increased from 0.7 per 100 person-years in 2000 to 2.5 per 100 person-years in 2016 and had the same trajectory as previously reported clinical data. If the proportion of eligible (HCV RNA positive) patients using DAAs stays at 65% per year between 2016 and 2025, with high-risk sexual behavior and injecting drug use remaining at current levels, HCV incidence would drop to 0.4 per 100 person-years (85% decline from 2016). In the same treatment scenario but with substantial increases in risk behavior, HCV incidence would drop to 0.6 per 100 person-years (76% decline). If the proportion of eligible patients using DAAs dropped from 65% per year in 2016 to 20% per year in 2025 and risk behavior did not change, HCV incidence would drop to 0.7 per 100 person-years (70% reduction). Conclusions Reaching the WHO HCV elimination target by 2025 among HIV-positive GBM in Australia is achievable.


2020 ◽  
Author(s):  
Fikadu Ambaw Yehualashet ◽  
Eleni Tesfaye Tegegne ◽  
Mekbib Kassa Tessema ◽  
Mulualem Endeshaw

Abstract Background: Disclosure of Human Immunodeficiency Virus positive status significantly reduced the transmission of HIV; yet, it remains a challenge for many HIV patients. Disclosure serves plays a crucial role to raise awareness and to reduce risky behaviors. Hence, this study aimed to determine the pooled prevalence and effect sizes of determinant factors of HIV positive status disclosure through a systematic review and meta-analysis of the results of the existing primary studies in Ethiopia. Method: This systematic review and meta-analysis was aimed to determine prevalence of HIV positive status disclosure and associated factors by considering and searching published primary articles from different sources. A sensitivity test was conducted to evaluate the presence of influential studies. Besides, the heterogeneity test has been conducted; and publication bias was examined through observing the funnel plot as well as objectively by interpreting the Egger’s regression test. Following the Egger’s regression test, P-value <0.05 was considered as statistically significant at 95% Confidence Interval. Result: A total of 18 primary studies were searched from different data sources. The overall pooled prevalence of HIV positive status disclosure among adult PLWHA in Ethiopia was indicated to be 75.95% (95% CI:69.93-81.98); the highest and lowest pooled estimated HIV status disclosure was in Amhara (82.78%) and Tigray (54.31%) regions respectively. Furthermore, Knowing the HIV positive status of sexual partner, AOR=19.66(95% CI: 10.19-37.91), having prior discussion about HIV testing with their partner, AOR=9.18(95% CI: 5.53-15.24), got Human Immunodeficiency Virus pretest counseling service AOR=4.29(95% CI: 2.56-7.21) and being a member of HIV/AIDS associations, AOR=3.34(95% CI: 2.17-5.12), were significantly associated with HIV positive status disclosure among People living With HIV/AIDS in Ethiopia.Conclusion: The pooled national estimate of HIV/AIDS positive status disclosure is low as compared to the WHO disclosure rate of developing countries and the findings of other national and international studies. Ministry of health and other stakeholders shall design new approaches and strategies to encourage disclosure of HIV status, educate the public about the negative impact of nondisclosure within family members. Health care providers working at Human HIV test centers shall emphasis extensive counseling on disclosure of status to a partner. Moreover, different stakeholders, health workers and community members shall establish, organize, and support HIV/AIDS Associations and motivate HIV positive people to be engaged and participated.


2015 ◽  
Vol 2 (3) ◽  
Author(s):  
Barbara Hasse ◽  
Philip E. Tarr ◽  
Pedro Marques-Vidal ◽  
Gerard Waeber ◽  
Martin Preisig ◽  
...  

Abstract Background.  Although acquired immune deficiency syndrome-associated morbidity has diminished due to excellent viral control, multimorbidity may be increasing among human immunodeficiency virus (HIV)-infected persons compared with the general population. Methods.  We assessed the prevalence of comorbidities and multimorbidity in participants of the Swiss HIV Cohort Study (SHCS) compared with the population-based CoLaus study and the primary care-based FIRE (Family Medicine ICPC-Research using Electronic Medical Records) records. The incidence of the respective endpoints were assessed among SHCS and CoLaus participants. Poisson regression models were adjusted for age, sex, body mass index, and smoking. Results.  Overall, 74 291 participants contributed data to prevalence analyses (3230 HIV-infected; 71 061 controls). In CoLaus, FIRE, and SHCS, multimorbidity was present among 26%, 13%, and 27% of participants. Compared with nonsmoking individuals from CoLaus, the incidence of cardiovascular disease was elevated among smoking individuals but independent of HIV status (HIV-negative smoking: incidence rate ratio [IRR] = 1.7, 95% confidence interval [CI] = 1.2–2.5; HIV-positive smoking: IRR = 1.7, 95% CI = 1.1–2.6; HIV-positive nonsmoking: IRR = 0.79, 95% CI = 0.44–1.4). Compared with nonsmoking HIV-negative persons, multivariable Poisson regression ide.jpegied associations of HIV infection with hypertension (nonsmoking: IRR = 1.9, 95% CI = 1.5–2.4; smoking: IRR = 2.0, 95% CI = 1.6–2.4), kidney (nonsmoking: IRR = 2.7, 95% CI = 1.9–3.8; smoking: IRR = 2.6, 95% CI = 1.9–3.6), and liver disease (nonsmoking: IRR = 1.8, 95% CI = 1.4–2.4; smoking: IRR = 1.7, 95% CI = 1.4–2.2). No evidence was found for an association of HIV-infection or smoking with diabetes mellitus. Conclusions.  Multimorbidity is more prevalent and incident in HIV-positive compared with HIV-negative individuals. Smoking, but not HIV status, has a strong impact on cardiovascular risk and multimorbidity.


2018 ◽  
Vol 10 (01) ◽  
pp. 060-063
Author(s):  
Ibrahim Abdulqadir ◽  
Sagir Gumel Ahmed ◽  
Aisha Gwarzo Kuliya ◽  
Jamilu Tukur ◽  
Aminu Abba Yusuf ◽  
...  

Abstract CONTEXT: Human immunodeficiency virus (HIV) scourge continues to affect young women within the reproductive age group and pregnancy is a recognized indication for the use antiretroviral (ARV) drugs among HIV-positive women. AIMS: The aim is to determine the combined effect of pregnancy, HIV and ARV drugs on the hematological parameters of the pregnant women. SETTINGS AND DESIGN: This was a comparative cross-sectional study conducted among 70 each of HIV-positive and negative pregnant women. SUBJECTS AND METHODS: Bio-demographic and clinical data were extracted from the client folder and 4 ml of blood sample was obtained from each participant. Full blood count was generated using Swelab automatic hematology analyzer while reticulocyte count and erythrocyte sedimentation rate (ESR) were conducted manually. STATISTICAL ANALYSIS USED: Data analysis was performed using SPSS version software 16 while P < 0.05 was considered statistically significant. RESULTS: Pregnant women with HIV had statistically significant lower hematocrit and white blood cell (WBC) and higher ESR than pregnant women without HIV (P < 0.000). There was no statistically significant difference between the two groups in terms of platelet and reticulocyte (P > 0.05). However, among HIV positive pregnant women, those with CD4 count <350/μL had statistically significant lower WBC and lymphocyte count than those with CD4 count ≥350/μL (P < 0.05), whereas, those on zidovudine (AZT)-containing treatment had statistically significant lower hematocrit and higher mean cell volume than those on non-AZT-containing treatment (P < 0.05), but there was no statistically significant difference in any of the hematological parameters (P > 0.050) between women on first- and second-line ARV regimens. CONCLUSIONS: There is a significant difference in terms of hematological parameters between HIV-positive and HIV-negative pregnant women in this environment.


Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 3821-3821
Author(s):  
Koichi Takahashi ◽  
Mariko Yabe ◽  
Ilan Shapira ◽  
Mala Verma

Abstract Abstract 3821 Background: Human Immunodeficiency Virus (HIV) infection has known to increase the risk of several malignancies including B-cell non-Hodgkin's lymphoma and Kaposi's sarcoma. With the prolonged survival of HIV-infected patients conferred by the use of effective anti-retroviral and prophylactic strategies, other malignancies, including Hodgkin's disease and solid tumors, have also been reported in this setting, although relationship with HIV infection is still not fully understood. HIV infected patients also can manifest multiple hematologic abnormalities and bone marrow specimens in most of those cases reveal so called myelodysplastic features. However bona fide myelodysplastic syndrome (MDS) is not common in this population and its real incidence, clinical course and outcome is yet unknown. Aim: The aim of this study is to compare the clinical characteristics and outcome of HIV associated MDS to non-HIV MDS. Methods: This is a retrospective cohort study of 81 patients who were diagnosed with MDS in our allied three teaching hospitals in New York City from 2005 to 2010. Available clinical history, pathological data, cytogenetic studies, and laboratory data were obtained through electronic medical records. HIV was confirmed by enzyme-linked immunosorbent assay (ELISA) testing with western blot confirmation as well as HIV-1/2 viral PCR. MDS diagnosis was confirmed with bone marrow morphology, laboratory data, and cytogenetic studies and was classified both according to the French-American-British (FAB) classification and World Health Organization (WHO) criteria. Results: Of 81 patients, 9 patients had confirmed HIV status and 72 were non-HIV. HIV positive group was consisted with younger patients (mean age 55.7 vs 72.7 p<0.01). Other baseline characteristics such as sex, laboratory profile, blast count and MDS classification were not significantly different between two groups. Cytogenetic studies were available in 79/81 patients (9/9 in HIV positive group and 70/72 in non-HIV group). Cytogenetic abnormalities were more frequently seen in HIV positive group compared to non HIV group (89% vs 47% p <0.05). When stratified by International Prognostic Scoring System (IPSS), HIV positive group carried worse prognostic karyotypes (67% vs 27%, p<0.05). Of those, chromosome 7 was more frequently found to be abnormal in HIV positive group (75% vs 33%, p<0.05). There was no statistically significant difference of abnormalities in other chromosomes between two groups. Survival data was available in 61/81 patients (9/9 in HIV positive group and 52/72 in non HIV group). Median survival of HIV positive group was 8 months and non-HIV MDS group was 66 months (Log rank p=0.013). Conclusions: In this retrospective analysis, when compared to non HIV-MDS, HIV-MDS is associated with a higher incidence of poor prognostic karyotype abnormalities and has poorer survival outcome after the diagnosis of MDS. To the best of our knowledge, this is the first report that compared clinical features of HIV-MDS and non HIV-MDS. Although further prospective controlled observations are needed to confirm these results, these findings suggest that HIV status can be one of the poor prognostic factors in MDS patients, and may prompt consideration of early intervention or treatment. Disclosures: No relevant conflicts of interest to declare.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Raymond Bernard Kihumuro ◽  
David Jolly Muganzi ◽  
Elton George Wandira ◽  
Racheal Alinaiswe ◽  
Jovitah Joselyne Nanyunja ◽  
...  

Abstract Background The number of human immunodeficiency virus (HIV) positive adolescents in secondary school has increased over the years. Little is known on how the students cope to the pressures and demands of their academic and health lives in the boarding secondary schools. This study explored the factors surrounding their anti-retroviral therapy adherence as well as their experiences. Methods We did a qualitative study that employed in-depth interviews amongst purposively selected 19 HIV positive adolescent students in boarding secondary school and seven key informants. Key informants were members of boarding secondary school staff directly taking care of the adolescents living with human immune virus and had spent at least two academic terms in that school. The study participants were recruited from four health facilities in Bushenyi district, southwestern Uganda, and key informants from five boarding secondary schools in Bushenyi. These were engaged in in-depth interviews using an interview guide. Data was transcribed, coded and the content analyzed thematically. Results Adolescents living with human immunodeficiency virus in boarding secondary school face challenges similar to adolescents outside boarding school settings. However, some challenges are unique to them. Students faced numerous barriers which made it difficult to adhere to their medication. Stigmatization in its different forms was also a major challenge amongst students. Willingness disclosure of serostatus was beneficial to the students since it guaranteed support while at school; facilitating adherence and better living. However, students were uneasy to disclose their status. Some students adopted negative coping mechanisms such as telling lies, escaping from school, and class to access medication. Conclusions Adolescents in boarding secondary schools face similar challenges as compared to their counterparts with some being unique to them. Few school mechanisms help these students to cope while at school. Limited disclosure has proven useful but some adolescents have opted not to disclose their status and hence used negative coping mechanisms. These challenges need to be addressed and a safe environment to encourage limited disclosure should be made.


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