Prognostic Factors of Human Immunodeficiency Virus-Infected Patients on Chronic Hemodialysis

2017 ◽  
Vol 44 (3) ◽  
pp. 244-250
Author(s):  
Ivo Laranjinha ◽  
Patrícia João Matias ◽  
Jorge Dickson ◽  
Hermínia Estibeiro ◽  
Helena Boquinhas ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Prognostic Factors ◽  
Viral Load ◽  
Serum Albumin ◽  
Hiv Transmission ◽  
Opportunistic Infections ◽  
Chronic Hemodialysis ◽  
Lower Serum ◽  
Risk Of Death ◽  
Immunodeficiency Virus

Background/Aims: The number of human immunodeficiency virus (HIV)-infected patients on hemodialysis (HD) have increased, and their prognostic factors are still poorly clarified. The study aimed to identify factors that can influence the survival of HIV-infected patients on HD. Methods: We performed a retrospective cohort study of 44 HIV-infected patients on HD. Results: A total of 17 patients (39%) died. Median survival on HD was 30.8 months and the survival rate at 1 and 5 years was 82.5 and 62.9%, respectively. Male (relative risk [RR] 3.1, p = 0.040) and blacks (RR 2.5, p = 0.037) had higher risk of death. The patients who died had a shorter duration of HIV infection (p = 0.028), had a higher viral load (p = 0.044), more opportunistic infections (p = 0.013), and a lower serum albumin (p = 0.009). Lower serum albumin, nonsexual HIV transmission, viral load, opportunistic infections, and usage of catheters were associated with lower survival. Conclusion: Several demographic, viral, and dialysis variables may help to predict survival of this population. The intervention in these factors could improve their prognosis.

scholarly journals Plasmodium falciparum Infection Does Not Affect Human Immunodeficiency Virus Viral Load in Coinfected Rwandan Adults

2014 ◽  
Vol 1 (2) ◽  
Author(s):  
Krishanthi Subramaniam ◽  
Rebeca M. Plank ◽  
Nina Lin ◽  
Adam Goldman-Yassen ◽  
Emil Ivan ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Drug Resistance ◽  
Plasmodium Falciparum ◽  
Viral Load ◽  
Malaria Infection ◽  
Hiv Transmission ◽  
Falciparum Infection ◽  
Resistance Testing ◽  
Plasmodium Falciparum Infection ◽  
Immunodeficiency Virus

Abstract Background.  Plasmodium falciparum infection has been reported to increase human immunodeficiency virus (HIV) viral load (VL), which can facilitate HIV transmission. We prospectively studied the impact of mild P falciparum coinfection on HIV VL in Rwanda. Methods.  We measured plasma HIV VL at presentation with malaria infection and weekly for 4 weeks after artemether-lumefantrine treatment in Rwandan adults infected with HIV with P falciparum malaria. Regression analyses were used to examine associations between malaria infection and HIV VL changes. Samples with detectable virus underwent genotypic drug-resistance testing. Results.  We enrolled 28 HIV-malaria coinfected patients and observed 27 of them for 5 weeks. Three patients (11%) were newly diagnosed with HIV. Acute P falciparum infection had no significant effect on HIV VL slope over 28 days of follow-up. Ten patients with VL <40 copies/mL at enrollment maintained viral suppression throughout. Seventeen patients had a detectable VL at enrollment including 9 (53%) who reported 100% adherence to ARVs; 3 of these had detectable genotypic drug resistance. Conclusions.  Unlike studies from highly malaria-endemic areas, we did not identify an effect of P falciparum infection on HIV VL; therefore, malaria is not likely to increase HIV-transmission risk in our setting. However, routine HIV testing should be offered to adults presenting with acute malaria in Rwanda. Most importantly, we identified a large percentage of patients with detectable HIV VL despite antiretroviral (ARV) therapy. Some of these patients had HIV genotypic drug resistance. Larger studies are needed to define the prevalence and factors associated with detectable HIV VL in patients prescribed ARVs in Rwanda.

scholarly journals A-DROP and Blood Urea Nitrogen-to-Serum Albumin Ratio are Useful in Assessing the Severity of Pneumocystis Pneumonia in Patients Without Human Immunodeficiency Virus Infection: A Retrospective Study

2020 ◽  
Author(s):  
Jumpei Akahane ◽  
Atsuhito Ushiki ◽  
Makoto Kosaka ◽  
Yuichi Ikuyama ◽  
Akemi Matsuo ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Prognostic Factors ◽  
Retrospective Study ◽  
Serum Albumin ◽  
Blood Urea Nitrogen ◽  
Treatment Initiation ◽  
Community Acquired Pneumonia ◽  
Urea Nitrogen ◽  
Albumin Ratio ◽  
Immunodeficiency Virus

Abstract Background: There is an increasing incidence of Pneumocystis pneumonia among individuals without the human immunodeficiency virus (HIV) infection (non-HIV Pneumocystis pneumonia). However, the prognostic factors for patients with non-HIV Pneumocystis pneumonia have not been identified. Moreover, A-DROP (for classifying the severity of community-acquired pneumonia) or the blood urea nitrogen-to-serum albumin ratio, which is reported to be predictor of mortality of community-acquired pneumonia, has not been established as an efficient prognostic factor in patients with non-HIV Pneumocystis pneumonia. In this study, we analyzed the prognostic factors for non-HIV Pneumocystis pneumonia and evaluated the effectiveness of A-DROP and the blood urea nitrogen-to-serum albumin ratio as prognostic factors.Methods: This retrospective study involved a chart review of the medical records of 102 patients diagnosed with non-HIV Pneumocystis pneumonia between January 2003 and May 2019 at five medical facilities. Prognostic factors associated with the 30-day mortality were assessed using multiple logistic regression analysis.Results: Among the 102 patients with non-HIV Pneumocystis pneumonia, 46 (45.1%) had autoimmune diseases, 19 (18.6%) had hematological malignancies, 18 (17.7%) had solid malignancies, and 19 (18.6%) had other diseases. The 30-day mortality rate for non-HIV Pneumocystis pneumonia was 20.5% in this study population. Compared with survivors, non-survivors had significantly lower serum albumin levels and a significantly higher age, corticosteroid dosage at the onset of Pneumocystis pneumonia, alveolar–arterial oxygen gradient, A-DROP score, lactate dehydrogenase levels, blood urea nitrogen levels, and blood urea nitrogen-to-serum albumin ratio. The results of multivariate analysis showed that a high A-DROP score and blood urea nitrogen-to-serum albumin ratio at treatment initiation were significantly associated with the 30-day mortality risk.Conclusions: A high A-DROP score and blood urea nitrogen-to-serum albumin ratio at treatment initiation are independent prognostic predictors of mortality risk in patients with non-HIV Pneumocystis pneumonia.

scholarly journals HIV infection in the west region of Pará

2021 ◽  
Vol 31 (1) ◽  
pp. e38938
Author(s):  
Carla Beatriz Bezerra Melo ◽  
Jord Thyego Simplício De Lima ◽  
Juciele Faria Silva ◽  
Erek Fonseca Da Silva ◽  
João Guilherme Pontes Lima Assy ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Viral Load ◽  
Medical Records ◽  
Opportunistic Infections ◽  
Western Region ◽  
Detectable Viral Load ◽  
The West ◽  
Reference Center ◽  
West Region ◽  
Immunodeficiency Virus

Aims: knowledge of the patient’s profile, for the evaluation and suggested behaviors, promotes a favorable outcome. Thus, the objective of the study is to analyze the socioeconomic, clinical, and immunological characteristics of patients infected by the human immunodeficiency virus in the western region of the state of Pará.Methods: were analyzed 1966 medical records of patients whose first visit to a reference center, in the municipality of Santarém-PA, was between 1998 and 2018. Socioeconomic, clinical, and immunological information was collected from patient medical records. Data were analyzed using descriptive and inferential statistics, adopting p <0.05.Results: there was a predominance of males (62.5%), aged 20-39 years (69.1%), elementary school (58.6%), single (57.3%), and employed (66.4%). Immunosuppression was present in 22% of patients and a viral load was detectable in 66%. Tuberculosis (37%) and toxoplasmosis (23%) predominated as opportunistic infections, and syphilis (62.6%) and human papillomavirus (HPV; 14%) as other infections.Conclusions: it is concluded that both opportunistic infections and other infections were present in 25-22% of the patients and that the presence of opportunistic infections favors the installation of another infection, or vice versa. Toxoplasmosis, HPV, and syphilis are positively associated with men, and toxoplasmosis and tuberculosis with age >35 years. Immunosuppression was shown to be positively associated with men and age >35 years, as well as favoring the onset of tuberculosis, toxoplasmosis, and detectable viral load.

scholarly journals Antiretroviral Therapy (ART) Use, Human Immunodeficiency Virus (HIV)-1 RNA Suppression, and Medical Causes of Hospitalization Among HIV-Infected Intravenous Drug Users in the Late ART Era

2014 ◽  
Vol 1 (1) ◽  
Author(s):  
Gabriel Vallecillo ◽  
Sergio Mojal ◽  
Marta Torrens ◽  
Roberto Muga
Keyword(s):  
Human Immunodeficiency Virus ◽  
Viral Load ◽  
Drug Users ◽  
Opportunistic Infections ◽  
Organ Damage ◽  
Intravenous Drug ◽  
Intravenous Drug Users ◽  
Discharge Diagnosis ◽  
Immunodeficiency Virus ◽  
Hiv 1

Abstract Background.  Antiretroviral therapy (ART) has reduced the rates and changed the causes of hospital admission. However, human immunodeficiency virus-positive intravenous drug users (HIV-IDU) continue to have increased hospitalizations and discharge diagnosis are less defined in the late ART era. Our aim was to examine ART use, HIV-1 RNA suppression, and hospital discharge diagnoses among HIV-IDU admitted to an urban hospital. Methods.  A retrospective analysis was made of HIV-IDU admitted for medical causes for the first time (2006–2010). Surgical, obstetric, or mental (except HIV-associated neurocognitive disorder) diagnoses were excluded. Clinical characteristics, number of admissions, and primary discharge diagnoses were determined for each patient. Results.  Three hundred and seventy-five admissions were recorded among 197 hospitalized HIV-IDU. Lifetime prevalence of ART use was 83.2% (164 of 197) and the rate of HIV-1 RNA &lt;50 copies/mL was 38.1% (75 of 197). Primary discharge diagnosis groups were as follows: bacterial infections (59.2%), chronic end-organ damage (16.8%), complications derived from injected drug use (16.8%), malignancies (9.1%), and opportunistic infections (6.6%). Chronic end-organ damage was diagnosed more frequently in patients with HIV-1 RNA &lt;50 copies/mL (36% vs 4.9%; P &lt; .000), and complications derived from injected drug use (23.8% vs 5.3%; P &lt; .0008) and acquired immune deficiency syndrome (AIDS) opportunistic infections (19.8% vs 1.3% P &lt; .019) were usually diagnosed in patients with HIV-1 RNA detectable viral load. Conclusions.  Human immunodeficiency virus-positive intravenous drug users are admitted to hospitals mainly for non-AIDS-related illnesses; however, sustained HIV-1 RNA viral load suppression is poor and determines hospital discharge diagnoses. Providers need to be aware of the management of HIV-related comorbidities and reinforce strategies to improve ART retention in this population.

scholarly journals STUDI LITERATUR PERSALINAN SC ELEKTIF PADA IBU HAMIL DENGAN HIV/AIDS

2020 ◽  
Vol 10 (2) ◽  
pp. 478-489
Author(s):  
Yuliana, Alexander
Keyword(s):  
Human Immunodeficiency Virus ◽  
Viral Load ◽  
Hiv Transmission ◽  
Google Scholar ◽  
Immunodeficiency Virus ◽  
Mother To Child ◽  
Hiv Aids

STUDI LITERATUR PERSALINAN SC ELEKTIF PADA IBU HAMIL DENGAN HIV/AIDS  [1]Yuliana, [2]Alexander Akademi Kebidanan Panca Bhakti Pontianak Email Korespendensi: [email protected] Abtrak Human Immunodeficiency Virus (HIV) adalah virus yang menyerang sel darah putih (sel CD4) dan sehingga tidak dapat digunakan untuk sistem kekebalan tubuh. Persalinan merupakan salah satu pintu masuk Mother to Child HIV Transmission (MTCT) dari ibu kepada bayi melalui darah atau cairan vagina yang terinfeksi virus HIV. Penatalaksanaan pada ibu hamil dengan HIV harus berfokus pada penurunan risiko MTCT dan komplikasi maternal – neonatal melalui metode persalinan caesar secara elektif (ketika viral load > 1000 kopi/ml karena dapat terjadi peningkatan MTCT sebanyak 12 kali lipat. Penelitian ini bertujuan untuk mengetahui pola penularan HIV / AIDS dari ibu kepada bayi. penatalaksanaan persalinan SC elektif pada ibu bersalin dengan HIV / AIDS dan persayaratan yang harus dipenuhi serta mengetahui penatalaksanaan pada bayi baru lahir dari ibu dengan HIV / AIDS. Desain penelitian yang digunakan adalah literatur review. Hasil penelusuran dari google scholar diperoleh dari 5 jurnal sesuai dengan kriteria inklusi. Hasil penelitian ini penularan HIV / AIDS dapat terjadi pada masa kehamilan karena penurunan sel T dan proses persalinan yang meningkatkan risiko terpapar darah atau cairan vagina yang tertelan bayi pada jalan lahir serta penularan HIV melalui ASI diketahui merupakan faktor penting penularan paska persalinan dan meningkatkan risiko transmisi dua kali lipat. Pada ibu hamil yang positif HIV di sarankan untuk melakukan persalinan secara SC Elektif yang dilakukan satu hingga dua minggu sebelum tanggal kelahiran bayi dan persalinan SC secara Elektif dapat dilakukan jika ada nya kontraindikasi persalinan pervaginam, indikasi fetal dan indikasi maternal. Kesimpulan penelitian ini semua ibu hamil dengan HIV positif disarankan untuk melakukan persalinan dengan seksio sesaria dan persalinan pervaginam yang direncanakan hanya boleh dilakukan oleh wanita yang mengkonsumsi HAART dengan viral load <50 kopi/mL. Kata kunci: Persalinan, Sectio Caesarean Elektif Pada Ibu Dengan HIV / AIDS  

scholarly journals Some Case Studies of AIDS/HIV Patients in India

2014 ◽  
Vol 1 (3) ◽  
Author(s):  
Ankit Patel
Keyword(s):  
Mental Health ◽  
Human Immunodeficiency Virus ◽  
Immune System ◽  
Antiretroviral Treatment ◽  
Opportunistic Infections ◽  
Human Immune System ◽  
Unprotected Sexual Intercourse ◽  
Needle Exchange Programs ◽  
Risk Of Death ◽  
Immunodeficiency Virus

The present study deals with the mental health of AIDS patients. Therefore it is essential that we should have some clear ideas about the scientific nature of AIDS and mental health. Human Immunodeficiency Virus Infection / Acquired Immunodeficiency Syndrome (HIV/AIDS) is a disease of the human immune system caused by infection with human immunodeficiency virus (HIV). During the initial infection, a person may experience a brief period of influenza-like illness. This is typically followed by a prolonged period without symptoms. As the illness progresses, it interferes more and more with the immune system, making the person much more likely to get infections, including opportunistic infections and tumors that do not usually affect people who have working immune systems. HIV is transmitted primarily via unprotected sexual intercourse (including anal and even oral sex), contaminated blood transfusions, hypodermic needles, and from mother to child during pregnancy, delivery, or breastfeeding. Some bodily fluids, such as saliva and tears, do not transmit HIV. Prevention of HIV infection, primarily through safe sex and needle-exchange programs, is a key strategy to control the spread of the disease. There is no cure or vaccine; however, antiretroviral treatment can slow the course of the disease and may lead to a near-normal life expectancy. While antiretroviral treatment reduces the risk of death and complications from the disease, these medications are expensive and may be associated with side effects.

scholarly journals Human immunodeficiency virus infection with multiple opportunistic infections: lessons learnt from a non-adherent patient

2021 ◽  
Vol 2021 (3) ◽  
Author(s):  
Manish Soneja ◽  
Anivita Aggarwal ◽  
Parul Kodan ◽  
Nitin Gupta
Keyword(s):  
Human Immunodeficiency Virus ◽  
Antiretroviral Therapy ◽  
Virus Infection ◽  
Human Immunodeficiency Virus Infection ◽  
Cytomegalovirus Infection ◽  
Opportunistic Infections ◽  
Pneumocystis Carinii ◽  
Adherent Patient ◽  
Immunodeficiency Virus ◽  
Adherence Counselling

Abstract We report a case of advanced human immunodeficiency virus (HIV) infection with multiple opportunistic infections (Pneumocystis carinii pneumonia, cryptosporidiosis, oesophagal candidiasis and cytomegalovirus infection). The patient was presumed to be adherent on antiretroviral therapy (ART) and was initiated on respective treatments for the opportunistic infections but continued to deteriorate. On further reviewing, he was found to be poorly adherent to ART and was advised enhanced adherence counselling after which his condition improved. We report this case to emphasize the importance of adherence to ART medications in the management of patients with HIV.

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