scholarly journals Immunologic Response of HIV-Infected Children to Different Regimens of Antiretroviral Therapy: A Retrospective Observational Study

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Teshale Ayele Mega ◽  
Firehiwot Belayneh Usamo ◽  
Getandale Zeleke Negera
Keyword(s):  
Viral Load ◽  
Linear Regression ◽  
Lymphocyte Count ◽  
Immunological Response ◽  
Cd4 Count ◽  
Immunologic Response ◽  
Mixed Effect ◽  
Clinical Stages ◽  
Cd4 Lymphocyte Count ◽  
Cd4 Lymphocyte

Background. Both abacavir- (ABC-) based and zidovudine- (AZT-) based regimens are widely utilized for managing HIV infection in children. Unfortunately, there is a lack of data regarding their immunological response and associated risk factors in Ethiopia. Methods. A retrospective hospital-based cohort study was conducted on HIV-infected children in Jimma Medical Center (JMC). A total of 179 records were reviewed by including data from November 2015 to April 2017. Data were collected on sociodemographic, clinical characteristics of patients and drug-related variables. Data analysis was done using STATA 13.1. Mixed-effect linear regression was performed to assess the difference in CD4+ changes between groups adjusting for baseline characteristics. The change in predicted CD4 count attributed to each regimen was also assessed by marginal analysis. P<0.05 for slope of the random-effect linear regression was used as an indicator for the presence of association. Result. Of 179 patients, 98 (54.7%) were females. The mean (±SD) duration of follow-up was 939.8 ± 478.3 and 984.92 ± 453.1 days for ABC and AZT groups, respectively. AZT group had a significant CD4+ count gain per visit compared with their ABC counterparts ((β = 20.51, 95% CI [6.37–34.65]), P=0.004) over time. The regimen AZT + 3TC + LPV/r tended to have an excellent predicted CD4+ lymphocyte count change relative to all other regimens, while ABC + 3TC + LPV/r had the least immunologic recovery (margins 338.0 cells/mm3 versus 249.13 cells/mm3 (P<0.001)). Baseline CD4+ lymphocyte count, ART group, WHO clinical stages, and viral load were independent predictors for CD4+ change overtime. Conclusion. AZT-based regimens seem to have better immunological response compared to ABC-based regimens. Immunologic response was described worse in patients with a viral load of >1000copies/ml, low baseline CD4+ count, advanced WHO clinical stages, and ABC-containing regimens. Further study is needed to clarify these aspects.

Outcomes by sex following treatment initiation with darunavir/cobicistat in a large Spanish cohort of the CODAR study (GeSIDA 9316)

2019 ◽  
Vol 74 (10) ◽  
pp. 3044-3048
Author(s):  
M J Pérez Elías ◽  
B Alejos ◽  
M J Vivancos ◽  
E Ribera ◽  
M J Galindo ◽  
...  
Keyword(s):  
Viral Load ◽  
Lymphocyte Count ◽  
Ethics Committees ◽  
Hiv Viral Load ◽  
Women Living With Hiv ◽  
Load Response ◽  
Cd4 Lymphocyte Count ◽  
Previous Regimen ◽  
Cd4 Lymphocyte ◽  
Viral Load Response

Abstract Background Few women have been included in darunavir/cobicistat clinical development studies, and hardly any of them were antiretroviral experienced or treated with anything other than triple-based therapies. Objectives Our aim was to increase our knowledge about women living with HIV undergoing darunavir/cobicistat-based regimens. Methods A multicentre (21 hospitals), retrospective study including a centrally selected random sample of HIV-1 patients starting a darunavir/cobicistat-based regimen from June 2014 to March 2017 was planned. Baseline characteristics, 24 and 48 week viral load response (<50 copies/mL), CD4+ lymphocyte count increase, time to change darunavir/cobicistat and adverse event occurrence were all compared by sex. The study was approved by each of the 21 ethics committees, and patients signed informed consent. Results Out of 761 participants, 193 were women. Similar characteristics were found for both sexes, except that the women had a longer duration of HIV infection (P = 0.001), and were less frequently pre-treated with darunavir/cobicistat in their previous regimen (P = 0.02). The main reason for using a darunavir/cobicistat-based regimen was simplification, without differences by sex, while monotherapy seems to be more frequently prescribed in women than in men (P = 0.067). The main outcomes, HIV viral load response, CD4+ lymphocyte count increase at 24 or 48 weeks, occurrence of adverse events, main reasons for changing and time to the modify darunavir/cobicistat regimen, did not show differences between the sexes. Conclusions No sex disparities were found in the main study outcomes. These results support the use of a darunavir/cobicistat-based regimen in long-term pre-treated women. Clinical Trial.gov No. NCT03042390.

scholarly journals The Difference Of PT, aPTT, Fibrinogen, D-Dimer Activities In HIV Patients With CD4 Count Of 200 uL

2021 ◽  
Vol 9 (12) ◽  
pp. 501-507
Author(s):  
Muhammad Hadian ◽  
Ricke Loesnihari ◽  
Tambar Kembaren
Keyword(s):  
General Hospital ◽  
Lymphocyte Count ◽  
Cd4 Count ◽  
P Value ◽  
Hiv Patients ◽  
Significant Difference ◽  
Cd4 Lymphocyte Count ◽  
The Difference ◽  
Cd4 Lymphocyte ◽  
D Dimer

ABSTRACT Introduction: HIV is a developing disease that has been a global problem. The progress of HIV infection is characterized by decreased CD4 count. Hemostasis disorder is often found in patients with HIV, where the formed virus-antibody complex can activate the coagulation system, beginning from the activation of the Hageman factor (Factor XII) into the active form (Factor XIIa). This factor will activate the fibrinolysis process. Fibrin polymer is broken down into fragments X and Y. Fragment Y is further broken down into Fragment D and E, which is known as D-dimer. Objective: To determine the difference of PT, aPTT, Fibrinogen, and D-Dimer in HIV patients with a CD4 lymphocyte count of < 200/µL and > 200/µL in H. Adam Malik General Hospital Medan. Hypothesis: There is a difference of PT and aPTT activities in HIV patients with a CD4 count of < 200 cells/µL and ≥ 200 cells/µL and a difference of D-dimer and fibrinogen levels in HIV patients with a CD4 count of < 200/µL and > 200/µL in H. Adam Malik General Hospital Medan. Methods: This study was conducted in the Clinical Pathology Laboratory, Department of Internal Medicine, H. Adam Malik General Hospital. Samples were collected with a consecutive sampling method which included patients diagnosed with HIV in H. Adam Malik General Hospital Medan from September 2019 to July 2020 who fulfilled the inclusion and exclusion criteria. Thirty-eight patients were divided into two groups, i.e., HIV patients with a CD4 count of < 200/µL and HIV patients with a CD4 lymphocyte count of > 200/ µL. Results: Mann-Whitney test was used to assess the comparison of PT and aPTT values between HIV patients with a CD4 count of < 200 cells/µL and ≥ 200 cells/µL. The result was significant with a p-value = 0.002, which means that there is a significant difference in PT and aPTT values between HIV patients with a CD4 count of < 200 cells/µL and ≥ 200 cells/µL. An Independent T-test was used to assess the difference in fibrinogen level between HIV patients with a CD4 count of < 200/µL and > 200/µL, which resulted in p-value = 0.032. This means that there is a significant difference in fibrinogen levels between HIV patients with a CD4 count of < 200/µL and > 200/µL. Mann-Whitney test was used to determine the comparison in D-dimer level between HIV patients with a CD4 count of < 200/µL and > 200/µL, which showed a p-value = 0.002. This indicated a significant difference in D-dimer level between HIV patients with a CD4 count of < 200/µL and > 200/µL. Conclusion: The lower the CD4 lymphocyte count, the higher the activities of PT, aPTT, fibrinogen, and D-dimer in HIV patients.   Keywords: HIV, PT, aPTT, D-Dimer, Fibrinogen, Hemostasis

scholarly journals Predictors for tuberculosis co-infection in people living with HIV/AIDS

2021 ◽  
Vol 21 (3) ◽  
pp. 995-1002
Author(s):  
Esra Zerdali ◽  
İnci Yılmaz Nakir ◽  
Serkan Sürme ◽  
Uğurcan Sayılı ◽  
Mustafa Yıldırım
Keyword(s):  
Viral Load ◽  
Lymphocyte Count ◽  
People Living With Hiv ◽  
Characteristic Analysis ◽  
Cell Counts ◽  
Tertiary Teaching ◽  
Cd4 Lymphocyte Count ◽  
Cd4 Lymphocyte ◽  
Living With Hiv ◽  
Hiv Aids

Background/aim: Tuberculosis (TB) is one of the most common chronic infectious conditions causing mortality and se- vere outcomes, particularly in people living with HIV/AIDS (PLWHA). In this study, we aimed to determine the prevalence and predictors of TB among PLWHA. Materials and methods: We conducted a retrospective and single-center study of adults (≥18 years) PLWHA registered at our tertiary teaching and research hospital between 2000 and 2016. Results: A total of 711 PLWHA were included. Of whom, 633 (89.0%) were male. Mean age was 36.53 ±11.55 years (range, 17-79). Thirty-eight (5.3%) patients were diagnosed with active TB. TB development was associated with low CD4+ lymphocyte count (p<0.001), high viral load (p=0.040) and alcohol consumption (p=0.004) but no association with age (p=0.392), gender (p=0.928) and duration since anti-retroviral therapy initiation (p=0.788) was found. Also, a receiver operating characteristic analysis showed that the area under the curves of CD4+ lymphocyte count as a predictor for TB development in PLWHA was 0.717 (p<0.001). Conclusion: There are still clinical challenges to predict TB diagnosis. However, CD4+ lymphocyte count and viral load may be considered as valuable predictors for TB development. Also, community strategies to reduce harmful effect of alco- hol use should be developed. Keywords: Tuberculosis; HIV viral load; CD4 cell counts.

Decrease in CD4 lymphocyte counts with rest; implications for the monitoring of HIV infection

1997 ◽  
Vol 8 (7) ◽  
pp. 423-426 ◽  
Author(s):  
P J Campbell ◽  
S Aurelius ◽  
G Blowes ◽  
D Harvey
Keyword(s):  
Lymphocyte Count ◽  
Daily Activity ◽  
Cd4 Count ◽  
Cd4 Counts ◽  
Immunodeficiency Virus ◽  
Cd4 Lymphocyte Count ◽  
Laboratory Workers ◽  
Strenuous Physical Activity ◽  
Cd4 Lymphocyte ◽  
Working Day

Measurement of the CD4 lymphocyte count is widely used as a prognostic marker and guide for the institution of antiretroviral therapy in patients infected with HIV (human immunodeficiency virus). CD4 counts are known to fluctuate with strenuous physical activity and diurnal variation but there is no information on the effects of rest or normal daily activity. We investigated the effects of rest on the absolute CD4 lymphocyte count in 20 healthy laboratory workers. Blood samples were obtained in 20 subjects upon arrival in the laboratory (CD4 0), following 30 and 60 min rest (CD4 30 and CD4 60 respectively) and 8 h into a normal working day (CD4 8). A significant decrease in the CD4 lymphocyte count was observed following 60 min rest; mean CD4 count at 0 min 1060 106/L, mean CD4 count at 60 min 660 106/L ( P =0.0017). These results demonstrate a significant effect of rest on CD4 lymphocyte counts in healthy volunteers. This biological variation may be important in HIV-infected patients and needs to be addressed by further studies.

scholarly journals The relationship between beta-2-microglobulin, CD4 lymphocyte count, AIDS and death in HIV-positive individuals

1997 ◽  
Vol 118 (3) ◽  
pp. 259-266 ◽  
Author(s):  
A. MOCROFT ◽  
M. A. JOHNSON ◽  
C. A. SABIN ◽  
M. BOFILL ◽  
G. JANOSSY ◽  
...  
Keyword(s):  
Lymphocyte Count ◽  
Multivariate Model ◽  
Cd4 Count ◽  
Risk Of Death ◽  
Increased Risk ◽  
Cd4 Lymphocyte Count ◽  
Beta 2 ◽  
Cd4 Lymphocyte ◽  
Beta 2 Microglobulin ◽  
The Relationship

The relationship, in 539 individuals infected with the human immunodeficiency virus (HIV), between two prognostic markers, the CD4 count and beta-2-microglobulin (B2M), and the development of the acquired immunodeficiency syndrome (AIDS) and death was investigated. Cox proportional hazards models were used to determine the risk of AIDS or death. In a multivariate model which adjusted for demographic factors and treatment, the most recent measurements of B2M (relative hazard (RH) 1·37 per g/l higher) and CD4 count (RH 2·17 per log-unit lower) were both significantly associated with the development of AIDS. Similarly, in a multivariate model which additionally adjusted for the development of AIDS as a time dependant covariate, there was a strong relationship with risk of death for the most recent measurements of B2M (RH 1·34 per g/l higher), and CD4 lymphocyte count (RH 1·91 per log-unit lower). A difference in the level of B2M could be used among patients with similar CD4 counts as an indicator of increased risk of progression to AIDS or death. Using the most recent values of these markers provides a better estimate of the risk of AIDS or death, compared to the more common method of analysis, where baseline values of the markers are used.

Ethnicity and discordance in plasma HIV-1 RNA viral load and CD4+ lymphocyte count in a cohort of HIV-1-infected individuals

2003 ◽  
Vol 26 (1) ◽  
pp. 101-107 ◽  
Author(s):  
Penelope R Smith ◽  
Liat Sarner ◽  
Maurice Murphy ◽  
Beki James ◽  
Janice M Thomas ◽  
...  
Keyword(s):  
Viral Load ◽  
Lymphocyte Count ◽  
Cd4 Lymphocyte Count ◽  
Cd4 Lymphocyte ◽  
Hiv 1
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