scholarly journals Pathogenesis of HIV-Related Lung Disease: Immunity, Infection, and Inflammation

2020 ◽  
Vol 100 (2) ◽  
pp. 603-632 ◽  
Author(s):  
Sushma K. Cribbs ◽  
Kristina Crothers ◽  
Alison Morris
Keyword(s):  
Lung Diseases ◽  
Opportunistic Infections ◽  
People Living With Hiv ◽  
Immune Functions ◽  
Chronic Lung Diseases ◽  
Infection And Inflammation ◽  
Lung Immunology ◽  
Cellular Immune ◽  
Living With Hiv ◽  
The Impact

Despite anti-retroviral therapy (ART), human immunodeficiency virus-1 (HIV)-related pulmonary disease continues to be a major cause of morbidity and mortality for people living with HIV (PLWH). The spectrum of lung diseases has changed from acute opportunistic infections resulting in death to chronic lung diseases for those with access to ART. Chronic immune activation and suppression can result in impairment of innate immunity and progressive loss of T cell and B cell functionality with aberrant cytokine and chemokine responses systemically as well as in the lung. HIV can be detected in the lungs of PLWH and has profound effects on cellular immune functions. In addition, HIV-related lung injury and disease can occur secondary to a number of mechanisms including altered pulmonary and systemic inflammatory pathways, viral persistence in the lung, oxidative stress with additive effects of smoke exposure, microbial translocation, and alterations in the lung and gut microbiome. Although ART has had profound effects on systemic viral suppression in HIV, the impact of ART on lung immunology still needs to be fully elucidated. Understanding of the mechanisms by which HIV-related lung diseases continue to occur is critical to the development of new preventive and therapeutic strategies to improve lung health in PLWH.

scholarly journals Future Challenges for Changes in the Disease Burden of Inpatients Living With HIV in China: a Predictive Study

2021 ◽  
Author(s):  
Yong Shuai ◽  
Jingmin Nie ◽  
Yinqiu Huang ◽  
Yaokai Chen
Keyword(s):  
Quality Of Life ◽  
Infectious Disease ◽  
Metabolic Syndrome ◽  
Disease Burden ◽  
Opportunistic Infections ◽  
Age Groups ◽  
People Living With Hiv ◽  
Living With Hiv ◽  
The Impact

Abstract Objective: In China, the widespread use of Combination Antiretroviral Therapy(cART) has significantly improved the prognosis and quality of life in people living with HIV(PLWH). However, some PLWH still got worse and were hospitalized for some reasons, including AIDS-Defining Diseases(AD, such as opportunistic infections and AIDS-related Malignancies), Non-AIDS-Defining Diseases (NAD, such as non-AIDS-defining Malignancies and metabolic syndrome). At present, the age and disease of inpatients living with HIV(ILWH) are undergoing some significant changes. For example, the average age of ILWH is gradually increasing, the proportions of ILWH with NAD in all age groups are increasing, and the proportion of ILWH suffering from multiple types of NAD is increasing, which will have a greater impact to both ILWH and infectious disease hospitals. We aim to predict the changes in ILWH in the next 10 years, analyze the impact of such changes on ILWH and infectious disease hospitals in China, and propose corresponding countermeasures. Methods: We have established a prediction model based on Artificial Neural Network and Time series, using 12618 data of ILWH admitted to Chongqing Public Health Medical Center during 2010-2020, to predict the age of ILWH, the proportion of AD and NAD, the proportion of multiple types of NAD, and the proportion of NAD occurrences among various age groups from 2021 to 2030.Results: Our model shows that the average age of ILWH has risen from 43.8 years in 2010 to 57.6 years in 2030, and the increase in the age of women is greater than that of men. The number of ILWH in different age groups has changed significantly. Among them, the proportion of ILWH under 50 years old has gradually decreased, and the proportion of ILWH over 50 years old has gradually raised. By 2030, the proportion of inpatients over 50 years old will be close to 80%. The proportion of fatal opportunistic infections among ILWH has decreased year by year, and the most common diseases are tuberculosis-related diseases. The proportions of ILWH with only AD or NAD have gradually decreased, and the proportion of ILWH with both AD and NAD has increased year by year. It is estimated that the proportion of all ILWH with both AD and NAD will exceed 80% by 2030. Among all kinds of diseases in NAD, metabolic syndrome will have the highest rate of increase. By 2030, it will account for 16% in all ILWH. The proportion of hepatobiliary and pancreatic system diseases and blood system diseases in NAD will gradually decrease, while the proportion of metabolic syndrome, kidney disease, gastrointestinal disease, non-AIDS defining malignancies(NADM), bone disease and neurological diseases in NAD will gradually increase. The proportion of ILWH with NAD in all age groups will increase significantly after 10 years. Among them, the proportion of ILWH with NAD in 50-60 years old will be more than 80%, and among the ILWH under 30 years old, the proportion of ILWH suffering from NAD will increase to 69.6%. The proportion of ILWH without NAD or only 1 NAD will decrease, while the proportion of ILWH with 3 or more NAD will rise sharply. The proportion of ILWH with 1 type of NAD will drop to 12.6%, while the proportion of ILWH with 2 types of NAD, and the proportion of ILWH with 3 or more types of NAD will increase greatly. Conclusions: Significant changes have took place in the disease burden of ILWH in China, including the aging, the increase in the proportion of ILWH with NAD, and the increase in the proportion of ILWH with multiple types of NAD. These changes mean that in the next 10 years, the diagnosis, treatment and care of ILWH, as well as the development and construction of infectious disease hospitals will all face new challenges. This finding is based on a large number of long-term ILWH data in Chongqing, China, so we can consider that our research strategy can be promoted in China to improve the cure rate and quality of life in ILWH.

scholarly journals Experiences of people with HIV/AIDS (PLWHA) at the critical condition due to AIDS

2017 ◽  
Vol 5 (4) ◽  
pp. 1357
Author(s):  
I Made Sukarja ◽  
Endang Sutedja ◽  
. Nursiswati ◽  
I Wayan Sukawana ◽  
I Made Sundayana
Keyword(s):  
Critical Condition ◽  
Opportunistic Infections ◽  
Health Workers ◽  
Pneumocystis Carinii ◽  
Critical Conditions ◽  
People Living With Hiv ◽  
Psychological Burden ◽  
Living With Hiv ◽  
The Impact ◽  
Hiv Aids

Background: PLWHA who suffered critical condition and being treated in intensive care the majority (84%) due to Pneumocystis carinii pneumonia, 47% experienced respiratory failure, sepsis, 12% and 11% neurologic disease. The death rate PLHIV patients treated in intensive reaches 83%. Of all patients passing through a critical phase, 27% survived for 1 year, 18% survive the second year, 13% survived 3 years and 11% last more than four years. They have the experience that need to be explored in a comprehensive manner to provide support to people living with HIV else.Methods: This research was conducted through qualitative research with phenomenological approach that focuses on the depth of the process through in-depth interviews on 10 participants. Participants in this study were HIV-positive people who visit the Polyclinic Teratai Hasan Sadikin Hospital in Bandung. Recruitment of participants was done by purposive sampling with criteria for inclusion namely 1) PLHIV been treated in hospital with critical conditions, 2) Ability to communicate with tray, 3) People who say they remember past experiences related to the care in critical condition.Results: The data were analysed to identify themes about the experiences of people living with HIV during critical condition. The results found six themes namely: 1) experiencing emotional response, 2) striving to overcome the feelings and the impact of illness, 3) closer to God, 4) undergoing their destiny as People Living with HIV/AIDS (PLWHA), 5) received support and prayers of people around, and 6) has a hope of a cure.Conclusions: PLWHA treated in a critical condition experience threat of death from opportunistic infections and had the psychological burden of disease due to the stigma of HIV/AIDS. This makes them slumped physically and psychologically, thus they felt helpless. The recommendation from the results of this research is that communities, families and health workers should provide a support system to people living with HIV in order to increase life expectancy due to a collapsed condition and hopelessness.

scholarly journals Consequences of COVID-19 crisis for persons with HIV: the impact of social determinants of health

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kristie C. Waterfield ◽  
Gulzar H. Shah ◽  
Gina D. Etheredge ◽  
Osaremhen Ikhile
Keyword(s):  
Public Health ◽  
Health Care ◽  
Clinical Care ◽  
Hiv Infections ◽  
People Living With Hiv ◽  
Negative Consequences ◽  
Persons Who Inject Drugs ◽  
Persons Living With Hiv ◽  
Living With Hiv ◽  
The Impact

Abstract Background With the indiscriminate spread of COVID-19 globally, many populations are experiencing negative consequences such as job loss, food insecurity, and inability to manage existing medical conditions and maintain preventive measures such as social distancing and personal preventative equipment. Some of the most disadvantaged in the COVID-19 era are people living with HIV/AIDS and other autoimmune diseases. Discussion As the number of new HIV infections decrease globally, many subpopulations remain at high risk of infection due to lack of or limited access to prevention services, as well as clinical care and treatment. For persons living with HIV or at higher risk of contracting HIV, including persons who inject drugs or men that have sex with men, the risk of COVID-19 infection increases if they have certain comorbidities, are older than 60 years of age, and are homeless, orphaned, or vulnerable children. The risk of COVID-19 is also more significant for those that live in Low- and Middle-Income Countries, rural, and/or poverty-stricken areas. An additional concern for those living the HIV is the double stigma that may arise if they also test positive for COVID-19. As public health and health care workers try to tackle the needs of the populations that they serve, they are beginning to realize the need for a change in the infrastructure that will include more efficient partnerships between public health, health care, and HIV programs. Conclusion Persons living with HIV that also have other underlying comorbidities are a great disadvantage from the negative consequences of COVID-19. For those that may test positive for both HIV and COVID-19, the increased psychosocial burdens stemming from stress and isolation, as well as, experiencing additional barriers that inhibit access to care, may cause them to become more disenfranchised. Thus, it becomes very important during the current pandemic for these challenges and barriers to be addressed so that these persons living with HIV can maintain continuity of care, as well as, their social and mental support systems.

scholarly journals Free access to antiretroviral treatment and protection against the risk of catastrophic health expenditure in people living with HIV: evidence from Cameroon

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Marwân-al-Qays Bousmah ◽  
Marie Libérée Nishimwe ◽  
Christopher Kuaban ◽  
Sylvie Boyer
Keyword(s):  
Socioeconomic Status ◽  
Health Expenditure ◽  
Antiretroviral Treatment ◽  
Catastrophic Health Expenditure ◽  
Hiv Care ◽  
Free Access ◽  
People Living With Hiv ◽  
Art Policy ◽  
Living With Hiv ◽  
The Impact

Abstract Background To foster access to care and reduce the burden of health expenditures on people living with HIV (PLHIV), several sub-Saharan African countries, including Cameroon, have adopted a policy of removing HIV-related fees, especially for antiretroviral treatment (ART). We investigate the impact of Cameroon’s free antiretroviral treatment (ART) policy, enacted in May 2007, on catastrophic health expenditure (CHE) risk according to socioeconomic status, in PLHIV enrolled in the country’s treatment access program. Methods Based on primary data from two cross-sectional surveys of PLHIV outpatients in 2006–2007 and 2014 (i.e., before and after the policy’s implementation, respectively), we used inverse propensity score weighting to reduce covariate imbalances between participants in both surveys, combined with probit regressions of CHE incidence. The analysis included participants treated with ART in one of the 11 HIV services common to both surveys (n = 1275). Results The free ART policy was associated with a significantly lower risk of CHE only in the poorest PLHIV while no significant effect was found in lower-middle or upper socioeconomic status PLHIV. Unexpectedly, the risk of CHE was higher in those with middle socioeconomic status after the policy’s implementation. Conclusions Our findings suggest that Cameroon’s free ART policy is pro-poor. As it only benefitted PLHIV with the lowest socioeconomic status, increased comprehensive HIV care coverage is needed to substantially reduce the risk of CHE and the associated risk of impoverishment for all PLHIV.

scholarly journals Vaccine responses in ageing and chronic viral infection

2021 ◽  
Author(s):  
Chloe Rees-Spear ◽  
Laura E McCoy
Keyword(s):  
Viral Infections ◽  
The Elderly ◽  
People Living With Hiv ◽  
Chronic Infections ◽  
Vaccine Responses ◽  
Inflammatory Conditions ◽  
Immunological Changes ◽  
Cellular Responsiveness ◽  
Living With Hiv ◽  
The Impact

Abstract Lay Summary Improved life expectancy in recent years has led to a growing population of adults over the age of 60. Age is commonly associated with increased inflammatory conditions and infections. Similar immunological changes have been observed during chronic infections, in particular HIV, where this is compounded by the success of antiretroviral therapy that has increased the number of people living with HIV into their sixties and beyond. The increased susceptibility of these groups to infection makes vaccination all the more important. However, the alterations to their immune systems call into question how effective those vaccinations may be. Here we discuss vaccine efficacy within elderly and chronically infected populations and investigate the immunological changes that may impact vaccine responsiveness. Over the last few decades, changing population demographics have shown that there is a growing number of individuals living past the age of 60. With this expanding older population comes an increase in individuals that are more susceptible to chronic illness and disease. An important part of maintaining health in this population is through prophylactic vaccination, however, there is growing evidence that vaccines may be less effective in the elderly. Furthermore, with the success of anti-viral therapies, chronic infections such as HIV are becoming increasingly prevalent in older populations and present a relatively unstudied population with respect to the efficacy of vaccination. Here we will examine the evidence for age-associated reduction in antibody and cellular responsiveness to a variety of common vaccines, and investigate the underlying causes attributed to this phenomenon, such as inflammation and senescence. We will also discuss the impact of chronic viral infections on immune responses in both young and elderly patients, particularly those living with HIV, and how this affects vaccinations in these populations.

scholarly journals Stigma, gay men and biomedical prevention: the challenges and opportunities of a rapidly changing HIV prevention landscape

Sexual Health ◽  
2017 ◽  
Vol 14 (1) ◽  
pp. 111 ◽  
Author(s):  
Graham Brown ◽  
William Leonard ◽  
Anthony Lyons ◽  
Jennifer Power ◽  
Dirk Sander ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Gay Men ◽  
Sexual Minorities ◽  
Research Policy ◽  
Scale Up ◽  
People Living With Hiv ◽  
Structural Level ◽  
Biomedical Technologies ◽  
Living With Hiv ◽  
The Impact

Improvements in biomedical technologies, combined with changing social attitudes to sexual minorities, provide new opportunities for HIV prevention among gay and other men who have sex with men (GMSM). The potential of these new biomedical technologies (biotechnologies) to reduce HIV transmission and the impact of HIV among GMSM will depend, in part, on the degree to which they challenge prejudicial attitudes, practices and stigma directed against gay men and people living with HIV (PLHIV). At the structural level, stigma regarding gay men and HIV can influence the scale-up of new biotechnologies and negatively affect GMSM’s access to and use of these technologies. At the personal level, stigma can affect individual gay men’s sense of value and confidence as they negotiate serodiscordant relationships or access services. This paper argues that maximising the benefits of new biomedical technologies depends on reducing stigma directed at sexual minorities and people living with HIV and promoting positive social changes towards and within GMSM communities. HIV research, policy and programs will need to invest in: (1) responding to structural and institutional stigma; (2) health promotion and health services that recognise and work to address the impact of stigma on GMSM’s incorporation of new HIV prevention biotechnologies; (3) enhanced mobilisation and participation of GMSM and PLHIV in new approaches to HIV prevention; and (4) expanded approaches to research and evaluation in stigma reduction and its relationship with HIV prevention. The HIV response must become bolder in resourcing, designing and evaluating programs that interact with and influence stigma at multiple levels, including structural-level stigma.

Quality of Life in People Living With HIV: An Exploratory Cross-Sectional Survey in Belgium

2021 ◽  
Vol 33 (3) ◽  
pp. 249-264
Author(s):  
Gert Scheerder ◽  
Sandra Van den Eynde ◽  
Patrick Reyntiens ◽  
Ria Koeck ◽  
Jessika Deblonde ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Negative Impact ◽  
Sexual Life ◽  
People Living With Hiv ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Related Stigma ◽  
Living With Hiv ◽  
The Impact

This cross-sectional survey explored the quality of life in 505 people living with HIV in Belgium. Several domains of quality of life were impaired: 26% had been diagnosed with depression and 43% had weak social support. HIV-related stigma is still widespread, with 49% believing most people with HIV are rejected and 65% having experienced discrimination due to HIV. The impact of HIV was limited on professional life, but 40% experienced a negative impact on life satisfaction and 41% a negative impact on sexual life. For several domains, people with a recent diagnosis of HIV and long-term survivors had significantly worse scores. This survey also uncovered strengths of people living with HIV, such as positive coping and HIV self-image. Expanding the scope of quality of life in people living with HIV may provide a more complete picture of relevant life domains that may be impacted by living with HIV, but this needs further validation.

scholarly journals Aging, Health, and Quality of Life for Older People Living With HIV in Sub-Saharan Africa: A Review and Proposed Conceptual Framework

2017 ◽  
Vol 31 (1) ◽  
pp. 109-138 ◽  
Author(s):  
Mark J. Siedner
Keyword(s):  
Quality Of Life ◽  
Conceptual Framework ◽  
Care Delivery ◽  
Sub Saharan Africa ◽  
People Living With Hiv ◽  
Sub Saharan ◽  
Living With Hiv ◽  
The Impact

Objective: The number of people living with HIV (PLWH) over 50 years old in sub-Saharan Africa is predicted to triple in the coming decades, to 6-10 million. Yet, there is a paucity of data on the determinants of health and quality of life for older PLWH in the region. Methods: A review was undertaken to describe the impact of HIV infection on aging for PLWH in sub-Saharan Africa. Results: We (a) summarize the pathophysiology and epidemiology of aging with HIV in resource-rich settings, and (b) describe how these relationships might differ in sub-Saharan Africa, (c) propose a conceptual framework to describe determinants of quality of life for older PLWH, and (d) suggest priority research areas needed to ensure long-term gains in quality of life for PLWH in the region. Conclusions: Differences in traditional, lifestyle, and envirnomental risk factors, as well as unique features of HIV epidemiology and care delivery appear to substantially alter the contribution of HIV to aging in sub-Saharan Africa. Meanwhile, unique preferences and conceptualizations of quality of life will require novel measurement and intervention tools. An expanded research and public health infrastructure is needed to ensure that gains made in HIV prevention and treamtent are translated into long-term benefits in this region.

scholarly journals The impact of a livelihood program on depressive symptoms among people living with HIV in Cambodia

2016 ◽  
Vol 9 (1) ◽  
pp. 31999 ◽  
Author(s):  
Mayumi Shimizu ◽  
Siyan Yi ◽  
Sovannary Tuot ◽  
Samedy Suong ◽  
Samrithea Sron ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
People Living With Hiv ◽  
Living With Hiv ◽  
The Impact
Sign in / Sign up

Export Citation Format

Share Document