scholarly journals Depression and suicidal ideation among HIV seropositive patients attending the special treatment clinic of the University of Calabar Teaching Hospital, Calabar, Nigeria

2021 ◽  
Vol 4 ◽  
pp. 64-70
Author(s):  
Elvis Mbu Bisong ◽  
Chidi John Okafor ◽  
Agam Ebaji Ayuk ◽  
Udeme Essien Asibong ◽  
Henry Ohem Okpa
Keyword(s):  
Viral Load ◽  
Suicidal Ideation ◽  
Highly Active Antiretroviral Therapy ◽  
Cd4 Count ◽  
Special Treatment ◽  
Prevalence Rates ◽  
Highly Active ◽  
Study Participants ◽  
Hiv Seropositive ◽  
Hiv Aids

Objectives: The introduction of highly active antiretroviral therapy and innovations in healthcare has contributed in improving the lives of persons living with human immunodeficiency virus (HIV)/AID. Patients infected with HIV are more susceptible to develop psychiatric illnesses. Depression is common among patients suffering from chronic illness such as HIV/AIDS and can exacerbate these illnesses. Depression has been observed to be twice as common in HIV seropositive individuals than in the general population. Undiagnosed and untreated depression in patients suffering from HIV/AIDS could lead to poor adherence to medications and lower quality of life. Depression is associated with rapid HIV disease progression. The diagnosis of HIV infection may be associated with feelings of anger, denial, sadness, guilt feelings, loss of self-esteem among others. These negative feelings could lead to suicidal ideation and attempted suicide or suicide. We sought to determine the prevalence rates, sociodemographics and predictors, of depression and suicidal ideation among study participants. Material and methods: Two hundred and two adult participants who met the inclusion criteria were recruited into the study. Mini International Neuropsychiatric Interview English version 6.0.0 was employed to diagnose depression and suicidal ideation. Data were analyzed using Statistical Package for the Social Sciences version 20.0. Significant levels were set at P < 0.05. Results: This study revealed prevalence rates of 11.4% for depression and 7.9% for suicidal ideation among study participants. Majority of the participants were females in the young age group category of 30–40 years (45%) with mostly secondary education (47.8%), most had a higher CD4 count greater than 200 cells/µL (82.6%) and were mainly on zidovudine/lamivudine/nevirapine combination therapy (56.5%). Mean age, CD4 count, and viral load levels were lower in HIV patients with depression but were not statistically significant (P > 0.05). CD4 count and viral load were not significantly associated with suicidal ideation. Lower age (30–40 years) was significantly associated with suicidal ideation (P < 0.05). Suicidal ideation is a predictor of depression in the same way depression is a predictor of suicidal ideation (P < 0.05). Conclusion: Routine screening for depression and suicidal ideation especially among younger HIV/AIDS patients is recommended in the clinic setting.

scholarly journals Antiretroviral therapy, CD4, viral load, and disease stage in HIV patients in Saudi Arabia: a 2001–2013 cross-sectional study

2015 ◽  
Vol 9 (07) ◽  
pp. 765-769 ◽  
Author(s):  
Ziad A Memish ◽  
Jaffar A Al-Tawfiq ◽  
Sanaa M Filemban ◽  
Syed Qutb ◽  
Abdullah Fodail ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Viral Load ◽  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Cd4 Count ◽  
Disease Stage ◽  
Care Providers ◽  
Cross Sectional ◽  
Number Of Patients ◽  
Hiv Aids

Introduction: The incidence of HIV/AIDS is increasing worldwide and in the Middle East. In this study, we analyzed the use of antiretroviral therapy (ART), the patterns of CD4 and viral load (VL), and stage of presentation. Methodology: Laboratory variables, ART use, and CD4 count were obtained and analyzed retrospectively. Results: A total of 997 cases from eight HIV/AIDS care providers were included. Of the total cases, 274 (28.3%) had a CD4 count of < 200 cells/mm3, and 413 (42.3%) had a viral load of > 5 log10. Of the total cases, 50% were on highly active antiretroviral therapy (HAART), and the majority of cases were asymptomatic (70%). Of those patients on ART, 247 (39.5%) took tenofovir/emtricitabine combined with either efavirenz (147; 14.7%) or lopinavir/ritonavir (100; 10%), and 158 (15.8%) were on lamivudine and zidovudine with either efavirenz (32; 3.2%) or lopinavir/ritonavir (126; 12.6%). Other combinations were used in 70 (7%) patients. The mean (± standard deviation) of baseline CD4 and viral load were 401 cells/mm3 (322 cells/mm3) and 4.6 log1010 (1.3 log10), respectively. At diagnosis, 72% of patients were asymptomatic; 50% had AIDS and 20% had CD4 count < 350. Conclusions: ART use was in line with international guidelines, but the number of patients receiving ART was lower than expected. Large proportions of cases presented late with AIDS at diagnosis or had CD4 < 350. Further data is needed to evaluate the medical care of patients with HIV/AIDS in the Kingdom of Saudi Arabia.

CSF antiretroviral drug penetrance and the treatment of HIV-associated psychomotor slowing

Neurology ◽  
2001 ◽  
Vol 57 (3) ◽  
pp. 542-544 ◽  
Author(s):  
N. Sacktor ◽  
P. M. Tarwater ◽  
R. L. Skolasky ◽  
J. C. McArthur ◽  
O. A. Selnes ◽  
...  
Keyword(s):  
Viral Load ◽  
Highly Active Antiretroviral Therapy ◽  
Neuropsychological Tests ◽  
Plasma Viral Load ◽  
Cd4 Count ◽  
Psychomotor Speed ◽  
Psychomotor Slowing ◽  
Highly Active ◽  
Antiretroviral Drug ◽  
The Mean

The authors evaluated whether highly active antiretroviral therapy (HAART) with multiple CSF-penetrating drugs results in greater improvement in HIV-associated psychomotor slowing than HAART with a single CSF-penetrating drug. Both groups had improvement in CD4 count, plasma viral load, as well as two tests of psychomotor speed. Comparing the two groups, there were no differences in the mean change for CD4 count, viral load, or any of the neuropsychological tests. Multiple and single CSF-penetrating HAART may be equivalent for treating HIV-associated psychomotor slowing.

scholarly journals Immunological and virological discordance among people living with HIV on highly active antiretroviral therapy in Tigray, Northern Ethiopia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Genet Gebrehiwet Hailu ◽  
Araya Gebreyesus Wasihun
Keyword(s):  
Risk Factors ◽  
Treatment Adherence ◽  
Highly Active Antiretroviral Therapy ◽  
Cd4 Count ◽  
People Living With Hiv ◽  
Northern Ethiopia ◽  
Highly Active ◽  
Associated Risk Factors ◽  
Study Participants ◽  
Living With Hiv

Abstract Background People living with human immunodeficiency virus (HIV) with immuno-virological discordant responses are at an increased risk to develop acquired immunodeficiency syndrome (AIDS) and severe non AIDS events which are risk factors for death. This study was aimed to assess prevalence of immuno- virological discordant responses and associated risk factors among highly active antiretroviral therapy (HAART) users in Tigray, Northern Ethiopia. Methods A cross sectional study was conducted from September to December 30, 2016 on 260 people living with HIV who started first line HAART from January 2008 to March 2016 at Mekelle hospital and Ayder comprehensive specialized hospital. Baseline and follow-up clinical data and CD4+ result were collected from patient charts. Besides, socio-demographic data and blood samples for CD4 + count and viral load measurement were collected during data collection period. Fisher’s exact test, bivariate and multivariate logistic regressions were used for data analysis. P-value < 0.05 with 95% CI was considered as statistically significant. Result Among the 260 study participants, 8.80% (95% Confidence Interval (CI) =8.77–8.84%) and 2.70% (95% CI = 2.68–2.72%) had virological and immunological discordant responses, respectively with an overall immuno-virological discordance response of 11.50% (95% CI = 11.46–11.54%). The median age of the study participants at HAART initiation was 35 (IQR: 28–44 years). More than half (58.1%) of the study participants were females. Age at or below 35 years old at HAART initiation (AOR ((95% CI) = 4.25(1.48–12.23), p = 0.007)), male gender ((Adjusted Odds Ratio (AOR) (95% CI) =1.71(1.13–1.10), p = 0.029)), type of regimen given ((AOR(95% CI) = 0.30 (0.10–0.88), p = 0.028)) and good treatment adherence ((AOR (95% CI) = 0.12 (0.030–0.0.48), p = 0.003)) were associated risk factors for virological discordant response. Likewise, immunological discordant response was associated with tuberculosis co-infections (p = 0.016), hepatitis B virus co-infections (p = 0.05) and low CD4+ count (≤100 cells/μl) at baseline (p = 0.026). Conclusions Over all, immuno-virological discordance response was 11.5% in the study area. Males, low baseline CD4+ count, poor/fair treatment adherence, and TB and HBV co-infections were significantly associated with higher immuno-virological discordance. We recommend that decision of patient treatment outcome, regimen change and patient management response should be done using trends of both viral load and CD4+ count concurrently.

scholarly journals Hematological Profile of HIV-Infected Patients on First-Line Highly Active Antiretroviral Therapy and Its Correlation With CD4 Count

2021 ◽  
Author(s):  
John Jospeh Diamond Princy ◽  
Kshetrimayum Birendra Singh ◽  
Ningthoujam Biplab ◽  
Ningthoukhongjam Reema ◽  
Rajesh Boini ◽  
...  
Keyword(s):  
Platelet Count ◽  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Highly Active Antiretroviral Therapy ◽  
Cd4 Count ◽  
Total Leukocyte Count ◽  
Hiv Patients ◽  
Positive Correlation ◽  
Highly Active ◽  
The Mean

Abstract Introduction Human immunodeficiency virus (HIV) infection is a state of profound immunodeficiency. Disorders of hematopoietic system are a common but often overlooked complication of HIV infection. This can manifest at any stage of the disease but more commonly in the advanced stage with low CD4 count. Anemia is the most common hematological abnormality in HIV patients and prevalence ranges from 1.3 to 95%. As HIV disease progresses, the prevalence and severity of anemia also increase. Hence, this study was undertaken to assess the hematological parameters of HIV-infected patients on highly active antiretroviral therapy (HAART) at different treatment durations with the hope to improve the HAART outcome in HIV patients and its correlation with CD4 count. Methods This prospective longitudinal study enrolled 134 HIV-infected patients admitted to or attending the OPD in the Department of Medicine or Antiretroviral Therapy (ART) Center (Center of Excellence), Regional Institute of Medical Sciences (RIMS), Imphal, Manipur, from 2018 to 2020. Complete hemogram, CD4 count, and other related-blood investigations were studied. Results The mean age of the study population was 39.9 ± 11.04 years. Of the 134 patients, 75 (56%) were males and 59 (44%) were females. Twelve (9%) patients had a history of injecting drug use (IDU). TLE (tenofovir, lamivudine, efavirenz) regimen was started on 112 (83.6%) patients and the majority of them (69/134 [51.5%]) had a CD4 count of 200 to 499 cells/mm3, which increased significantly 6 months after HAART to 99 to 1,149 cells/mm3, with a mean of 445 ± 217 cells/mm3. There were significant improvements in hemoglobin (Hb) levels, total leukocyte count (TLC), absolute neutrophil count (ANC), and absolute lymphocyte count (ALC) after HAART indicating a positive correlation with CD4 count (p < 0.05). Thrombocytopenia was observed higher after HAART when compared to baseline. There was a positive correlation between platelet count and CD4 count. However, the mean corpuscular volume (MCV) and erythrocyte sedimentation rate (ESR) had a negative correlation with CD4 count. Conclusion The study inferred a strong positive correlation between CD4 and Hb levels, TLC, ANC, ALC, and platelet count after HAART with improvement in these values as CD4 count increases. Specific treatment intervention based on the changes in the immunohematological profile trends can help prevent most of the adverse effects on HIV patients in our community.

scholarly journals Suicidal ideation, psychopathology and associated factors among HIV-infected adults in Indonesia

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Youdiil Ophinni ◽  
Adrian ◽  
Kristiana Siste ◽  
Martina Wiwie ◽  
Gina Anindyajati ◽  
...  
Keyword(s):  
Suicidal Ideation ◽  
Single Point ◽  
Cross Sectional Study ◽  
Anxiety Symptoms ◽  
Cd4 Count ◽  
Depression Symptoms ◽  
Early Screening ◽  
Cross Sectional ◽  
Aids Epidemic ◽  
Hiv Aids

Abstract Background Suicidal behavior is a prevalent psychiatric emergency in HIV-infected adults. Detection of suicidal ideation is important in planning early psychiatric intervention and optimizing HIV/AIDS management. Characterization of suicidal ideation among HIV-infected adults is crucial; however, practically there is no data in Indonesia, the country with the second largest burden of HIV/AIDS epidemic in Asia. This study aims to identify suicidal ideation and analyze the associated psychopathology and determining factors among HIV-infected adults in Indonesia. Methods An observational cross-sectional study was conducted among HIV-infected adults aged 18–65 years old receiving antiretroviral therapy (ART). Measurement using Symptom Checklist-90 (SCL-90) was performed to assess the existing psychopathology. Firth’s penalized logistic regression analysis was performed to identify factors associated with suicidal ideation. Results A total of 86 subjects were recruited. Most subjects were male (65.1%), median age was 35 years, and median latest CD4 count was 463 cells/μl. Lifetime suicidal ideation was identified in 20 subjects (23.3%). Mean SCL-90 T-score for depressive and anxiety symptoms were both significantly higher among subjects with suicidal ideation (M = 60.75, SD = 12.0, p = 0.000 and M = 57.9, SD = 2.8, p = 0.001, respectively) compared to those without. Bivariate analyses showed that lifetime suicidal ideation was associated with depressive and anxiety symptoms, non-marital status, CD4 count < 500 cells/μl, and efavirenz use. Multivariate analysis identified that a single-point increase in SCL-90 depression symptoms score (AOR 1.16, 95% CI 4.5–123.6, p = 0.000) and efavirenz use (AOR 5.00, 95% CI 1.02–24.6, p = 0.048) were significant independent factors related to suicidal ideation. Conclusion Suicidal ideation is commonly found among Indonesian HIV-infected adults on ART. Depressive symptoms and efavirenz use are independent factors related to the presence of suicidal ideation. Thus, early screening of psychopathology as well as substitution of efavirenz with other ART regiment are recommended to prevent suicide and improve HIV/AIDS management outcome.

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