scholarly journals TB Meningitis in HIV-Positive Patients in Europe and Argentina: Clinical Outcome and Factors Associated with Mortality

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Anne Marie W. Efsen ◽  
Alexander M. Panteleev ◽  
Daniel Grint ◽  
Daria N. Podlekareva ◽  
Anna Vassilenko ◽  
...  
Keyword(s):  
Eastern Europe ◽  
Rank Test ◽  
Hiv Positive ◽  
Cumulative Probability ◽  
Factors Associated ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Kaplan Meier ◽  
Adjusted Incidence Rate ◽  
Cd4 Cell

Objectives.The study aimed at describing characteristics and outcome of tuberculous meningitis (TBM) in HIV-positive patients and comparing these parameters with those of extrapulmonary TB (TBEP) and pulmonary TB (TBP).Methods.Kaplan-Meier estimation and Poisson regression models were used to assess the mortality following TB diagnosis and to evaluate potential prognostic factors for the 3 groups of TB patients separately.Results.A total of 100 patients with TBM, 601 with TBEP, and 371 TBP were included. Patients with TBM had lower CD4 cell counts and only 17.0% received antiretroviral therapy (ART) at TB diagnosis. The cumulative probability of death at 12 months following TB was 51.2% for TBM (95% CI 41.4–61.6%), 12.3% for TBP (8.9–15.7%), and 19.4% for TBEP (16.1–22.6) (P<0.0001; log-rank test). For TBM, factors associated with a poorer prognosis were not being on ART (adjusted incidence rate ratio (aIRR) 4.00 (1.72–9.09), a prior AIDS diagnosis (aIRR=4.82(2.61–8.92)), and receiving care in Eastern Europe (aIRR=5.41(2.58–11.34))).Conclusions.TBM among HIV-positive patients was associated with a high mortality rate, especially for patients from Eastern Europe and patients with advanced HIV-infection, which urgently calls for public health interventions to improve both TB and HIV aspects of patient management.

scholarly journals Factors associated with prognostic or treatment outcomes in HIV/AIDS patients with and without hypertension in Eswatini

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sabelo Bonginkosi Dlamini ◽  
Hans-Uwe Dahms ◽  
Ming-Tsang Wu
Keyword(s):  
Viral Load ◽  
P Value ◽  
Aids Patients ◽  
Large Hospital ◽  
Hypertensive Patients ◽  
Factors Associated ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Cd4 Cell ◽  
Hiv Aids

AbstractNon-communicable diseases are increasing faster in HIV/AIDS patients than in the general population. We studied the association between hypertension and other possible confounding factors on viral load and CD4-cell counts in hypertensive and non-hypertensive HIV/AIDS patients receiving antiretroviral therapy (ART) at a large hospital in Eswatini over a 4-year period. We performed a retrospective longitudinal review of the medical records of 560 ART patients divided into non-hypertension and hypertension groups (n = 325 and n = 235) from July 27 to September 8, 2018. Generalized Estimated Equation was used to analyze the longitudinal data. Hypertensive patients were more likely to have improved CD4-cell counts than non-hypertensive patients (OR = 1.83, [1.37–2.44]). ART patients with hypertension were more likely to have detectable viral loads, though not significant (OR = 1.37 [0.77–2.43]). In non-hypertensive patients, second line ART was significantly associated with viral load (OR = 8.61 [2.93–25.34]) and adverse side effects (OR = 3.50 [1.06–11.54]), while isoniazid preventive therapy was significantly associated with CD4-cell counts (OR = 1.68 [1.16–2.45]). In hypertensive patients, factors associated with viral load were WHO HIV stage (OR = 2.84 [1.03–7.85]) and adherence (OR = 8.08 [1.33–49.04]). In both groups, CD4-cell counts significantly and steadily increased over time (p-value < 0.001). Results show a significant association between hypertension and CD4 cell counts but not viral load. In ART patients with and without hypertension, the factors associated with prognostic markers were different. More attention may need to be paid to ART patients with well controlled HIV status to monitoring and controlling of hypertension status.

Factors associated with late presentation of HIV infection in Catalonia, Spain

2012 ◽  
Vol 23 (7) ◽  
pp. 475-480 ◽  
Author(s):  
N Vives ◽  
D Carnicer-Pont ◽  
P Garcia De Olalla ◽  
N Camps ◽  
A Esteve ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Late Presentation ◽  
Late Diagnosis ◽  
Cd4 Cell Count ◽  
Hiv Surveillance ◽  
Factors Associated ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Populations At Risk ◽  
Cd4 Cell

We sought to describe the prevalence, trends and factors associated with late diagnosis of HIV infection between 2001 and 2008 in Catalonia, Spain. Adults over 13 years of age with available CD4 cell counts, who were notified to the Catalonia Voluntary HIV Surveillance System between January 2001 and December 2008, were included in the study. Late presentation for HIV infection was defined as a CD4 cell count <350 cells/μL or with an AIDS-defining condition at presentation. Multivariable logistic regression was used to identify factors independently associated with late diagnosis of HIV. Of the 4651 newly diagnosed HIV-infected individuals with available CD4 counts, 2598 (55.9%) were diagnosed late. The proportion of people with a late diagnosis decreased from 60.4% in 2001 to 50% in 2008, a significant trend ( P < 0.001). Older age, male gender, foreign birth, heterosexuality and injecting drug use were independent risk factors for late diagnosis. Strategies to actively promote HIV testing to populations at risk of late diagnosis of HIV or those never attending health systems should be implemented.

scholarly journals The correlation of tuberculosis smear results and immuno-suppression with CD4+ counts as a surrogate marker among HIV infected patients.

2021 ◽  
Author(s):  
Kingsley Kamvuma ◽  
Yusuf ademola ◽  
Warren Chanda ◽  
Christopher Newton Phiri ◽  
Sam Bezza Phiri ◽  
...  
Keyword(s):  
Cell Count ◽  
Surrogate Marker ◽  
Hiv Positive ◽  
Sputum Smear ◽  
Cd4 Cell Count ◽  
Cd4 Counts ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Study Participants ◽  
Cd4 Cell

Abstract Background: Human immunodeficiency virus (HIV) and M.tuberculosis are two intracellular pathogens that interact at the cellular, clinical and population levels. Since the recognition of AIDS in 1981, the number of reported cases of TB in the has increased substantially, especially in regions with high incidence of AIDS. The main aim of this study was to establish weather there is a relationship between sputum smear positives and low CD4 cell counts among HIV infected patients.Materials and methods: This was a retrospective study involving 473 participants. The patients recruited in this study were those who tested HIV positive and smear positive for TB. Their HIV status was determined by performing an HIV blood test, if they were HIV positive their CD4 cell count were then made.Results: This study examined the relation between smear positivity and low CD4 (below 200cells/µl) together with CD8 and CD3 markers as a measure of immune function among patients infected with HIV. The study participants’ constituted males 67% and females 33%. The overall mean age was 33.2 (SD 6.9) with the youngest and oldest participants being 18 and 60 respectively. It was found that smear positive results negatively (r=-0.13; p=0.021) correlated with CD4+ below 200 cells/µl. No correlation was observed between smear positives and CD8+ or CD3+ since the calculated correlation coefficient was not significant 0.007 (p=0.9) and 0.03 (p=0.6) respectively. There are more 3+ smear results below 200 cells/µl than the others while above 200 cells/µl 1+ was the most commonly reported smear result. The scanty smear positives were the least commonly reported result in the low and high CD4 counts. Conclusion: The smear positive result negatively correlated with a low CD4+ (r=-0.13; p=0.021) but no correlation with low CD+8 and CD+3 results was observed. The long held theory that low bacillary counts in patients with low CD4+ counts needs to be revisited. The reduction of CD4+ cell count parallels' that of the total lymphocyte count and is more marked in patients with high bacillary counts. Further, studies are required to confirm these findings

scholarly journals Prevalence and viral loads of polyomaviruses BKPyV, JCPyV, MCPyV, TSPyV and NJPyV and hepatitis viruses HBV, HCV and HEV in HIV-infected patients in China

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Xianfeng Zhou ◽  
Kenji Nakashima ◽  
Masahiko Ito ◽  
Xiaoling Zhang ◽  
Satoshi Sakai ◽  
...  
Keyword(s):  
Hiv Positive ◽  
Hepatitis Viruses ◽  
Positive Group ◽  
Viral Loads ◽  
Hiv Rna ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Significant Difference ◽  
Potential Risk Factors ◽  
Cd4 Cell

Abstract Human polyomaviruses (PyVs) and hepatitis viruses are often more prevalent or persistent in human immunodeficiency virus (HIV)-infected persons and the associated diseases are more abundant than in immunocompetent individuals. Here, we evaluated seroreactivities and viral loads of human PyVs and hepatitis viruses in HIV/AIDS patients and the general population in China in the combination antiretroviral therapy (cART) era. A total of 810 HIV-1-infected patients and age- and sex-matched HIV-negative individuals were enrolled to assess seroprevalence of PyVs BKPyV, JCPyV, MCPyV, TSPyV, and NJPyV and hepatitis viruses HBV, HCV, and HEV. 583 (72%) patients received cART, and among them, 31.2% had undetectable HIV RNA. While no significant difference was observed in prevalence of anti-PyV antibodies between HIV-positive and -negative groups, serum DNA positivity and DNA copy level of MCPyV were higher in the HIV-positive group. Among HIV-infected patients, BKPyV DNA positivity was significantly higher in patients with CD4 + cell counts < 200 cells/mm3 compared to those with CD4 + cell counts > 500 cells/mm3, suggesting possible reactivation caused by HIV-induced immune suppression. Higher HBV and HCV seropositivities but not HEV seropositivity were also observed in the HIV-positive group. Further correlation analyses demonstrated that HBV and HEV are potential risk factors for increased prevalence of PyV infection.

Syphilis infection does not affect immunodeficiency progression in HIV-infected men who have sex with men in China

2020 ◽  
Vol 31 (5) ◽  
pp. 488-496
Author(s):  
Liping Huang ◽  
Weibin Cheng ◽  
Zhigang Han ◽  
Yuanhao Liang ◽  
Hao Wu ◽  
...  
Keyword(s):  
Syphilis Infection ◽  
Cd4 Cell Count ◽  
Logistic Analysis ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Kaplan Meier ◽  
Lower Baseline ◽  
Sex With Men ◽  
Cd4 Cell ◽  
Hiv 1

Syphilis and human immunodeficiency virus (HIV) co-infection is expected to play a role in HIV-1-related immunodeficiency progression; however, studies involving syphilis/HIV co-infection have not been conclusive. We investigated the factors associated with co-infection of syphilis and HIV and to assess the effect of syphilis on HIV progression in the context of HIV-1 diversity in an observational cohort of 246 newly-diagnosed HIV-infected but antiretroviral therapy-naive men who have sex with men enrolled in Guangzhou, China between 2008 and 2012. CD4+ cell counts of all the participants were measured from the time of diagnosis until 2015 with an average of 32 ± 18 months. Logistic analysis indicated that patients with syphilis/HIV co-infection were more likely to be older with an adjusted odds ratio (AOR) of 2.48 (95% CI: 1.28–4.80) for those aged between 31 and 40 years and 3.20 (1.11–9.22) for those aged ≥40 years as compared to 16–30  year-olds. The AOR of patients infected with HIV-1 CRF07_BC as compared to CRF01_AE was 2.14 (95% CI: 1.01–4.53). Co-infection of syphilis and HIV was associated with lower baseline CD4+ cell count (0.45, 95% CI: 0.22–0.94), but was not associated with HIV disease progression (HR: 1.03; 95% CI, 0.86–1.23) based on Kaplan–Meier analysis. Our results provide new evidence about the interaction between syphilis and HIV and indicate differential rates of immunodeficiency progression as a function of HIV-1 genetic diversity.

scholarly journals Persistence of oncogenic and non-oncogenic human papillomavirus is associated with human immunodeficiency virus infection in Kenyan women

2020 ◽  
Vol 8 ◽  
pp. 205031212094513
Author(s):  
Yan Tong ◽  
Philip Tonui ◽  
Aaron Ermel ◽  
Omenge Orang’o ◽  
Nelson Wong ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
High Risk ◽  
Hiv Infection ◽  
Low Risk ◽  
International Agency ◽  
Factors Associated ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Kenyan Women ◽  
Cd4 Cell

Objectives: Cervical cancer is caused by persistent infection with oncogenic, or “high-risk” types of human papillomaviruses, and is the most common malignancy in Kenyan women. A longitudinal study was initiated to investigate factors associated with persistent human papillomavirus detection among HIV-infected and HIV-uninfected Kenyan women without evidence of cervical dysplasia. Methods: Demographic/behavioral data and cervical swabs were collected from HIV-uninfected women (n = 82) and HIV-infected women (n = 101) at enrollment and annually for 2 years. Human papillomavirus typing was performed on swabs (Roche Linear Array). Logistic regression models of human papillomavirus persistence were adjusted for demographic and behavioral characteristics. Results: HIV-infected women were older and less likely to be married and to own a home and had more lifetime sexual partners than HIV-uninfected women. All HIV-infected women were receiving anti-retroviral therapy at enrollment and had satisfactory CD4 cell counts and HIV viral loads. One- and two-year persistent human papillomavirus detection was significantly associated with HIV infection for any human papillomavirus, high-risk human papillomavirus, International Agency for the Research on Cancer-classified high-risk human papillomavirus, and non-oncogenic “low-risk” human papillomavirus. Conclusion: Persistent detection of oncogenic and non-oncogenic human papillomavirus was strongly associated with HIV infection in Kenyan women with re-constituted immune systems based on satisfactory CD4 cell counts. In addition to HIV infection, factors associated with an increased risk of human papillomavirus persistence included a higher number of lifetime sex partners. Factors associated with decreased risk of human papillomavirus persistence included older age and being married. Further studies are needed to identify the immunological defects in HIV-infected women that allow human papillomavirus persistence, even in women receiving effective anti-retroviral therapy. Further studies are also needed to determine the significance of low-risk human papillomavirus persistence in HIV-infected women.

scholarly journals Toxoplasmosis Among HIV Patients and Healthy Volunteers in Port Harcourt, Rivers State, Nigeria

2020 ◽  
Vol 7 (2) ◽  
Author(s):  
Evelyn O Onosakponome ◽  
Austin E Abah ◽  
Michael Wogu
Keyword(s):  
Risk Factors ◽  
Healthy Volunteers ◽  
Hiv Positive ◽  
Hiv Patients ◽  
Aids Patients ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Port Harcourt ◽  
Cd4 Cell ◽  
Hiv Aids

Background: Toxoplasmosis is a serious infection, especially among the immune-compromised people such as HIV/AIDS patients. Objectives: This study assessed the seroprevalence and associated risk factors of toxoplasmosis among HIV patients and healthy volunteers or immuno-competent persons (IP) in Port Harcourt. Methods: A total of 400 (200 per group) randomly-selected sera were tested for IgG and IgM T. gondii antibodies using ELISA technique. CD4 cell counts were also determined. Demographic and risk factors were determined using a well-structured questionnaire. Results: Overall seroprevalence for HIV and IP using IgG and IgM toxoplasma antibodies was 36.0%, 21.5%, and 1.5%, 7.0%, respectively. The age group f 40 years and above had the highest seroprevalence of 25.3% among the HIV positive persons, while the age groups 25 - 29 years had the highest seroprevalence of 20.0% among the IP. Traders’ positive with HIV had the highest seroprevalence of 30.0% and 0.9% for IgG and IgM toxoplasma antibodies, respectively. HIV subjects with a secondary education showed the highest seroprevalence of 20.0%. More HIV positive females were infected with toxoplasmosis 18.5%. In all, 6.7% (P > 0.05) of the seropositive patients had CD4 cell counts of less than 200 cells/µL, indicating no correlation between seroprevalence and CD4 cell counts of HIV/AIDS patients. Risk factors in this study included the history of living with pets, farming and eating improperly-washed fruits and vegetables. Conclusions: Seroprevalence of Toxoplasmosis was high among HIV patients in Port Harcourt. It is suggested that the institutions included the Toxoplasmosis test as one of the routine tests for HIV patients.

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