scholarly journals True “costs” of neurological illness in human immunodeficiency virus patients in a “free” health facility

2021 ◽  
Vol 0 ◽  
pp. 1-5
Author(s):  
Sridhar Amalakanti ◽  
Samdhani Syed
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
Financial Burden ◽  
Public Health Services ◽  
Hiv Patients ◽  
Face To Face ◽  
Neurological Illness ◽  
Immunodeficiency Virus ◽  
Neurological Illnesses ◽  
Hiv Seropositive

Objectives: Human immunodeficiency virus (HIV) infection and neurological illness cause heavy financial burden to the patients. The economic costs of each of the disease have been reported in many studies, but the toll of both together on the patients has not been studied clearly. As neurological illnesses are seen in up to one-third of HIV patients, the combined costs need to be understood. Even with free public health services, there are out of pocket expenditures on the patients. Material and Methods: In the tertiary Government General Hospital, Guntur in India, we studied the out-of-pocket costs of time and money borne by 50 HIV-seropositive individuals hospitalized for a neurological illness during April and May 2019. We obtained data from the patients and caregivers by face-to-face oral questionnaires. Results: The median duration of HIV infection was 2.5 (IQR 0.4–7.8) years. A high proportion of our patients (20/50) was diagnosed with tuberculous meningitis. The total median time lost by each HIV-seropositive patient due to neurological illness (private consultation, travel, and hospital stay) was 27.5 (8.7–134.3) days. The total median financial burden due to neurological disease requiring hospitalization (travel, food and medicine, wages lost, private consultation expense, and loans incurred) on each patient was ₹19,150 (855–59881). Conclusion: HIV patients with neurological illness are burdened by heavy costs of time and money. They are forced into debt and lose substantial wages, most of it due to private consultation.

Situational and Sociodemographic Characteristics of Children Infected With Human Immunodeficiency Virus From Pediatric Sexual Abuse

PEDIATRICS ◽  
1993 ◽  
Vol 91 (1) ◽  
pp. 39-44
Author(s):  
George A. Gellert ◽  
Michael J. Durfee ◽  
Carol D. Berkowitz ◽  
Kathleen V. Higgins ◽  
Vincent C. Tubiolo
Keyword(s):  
Risk Factors ◽  
Human Immunodeficiency Virus ◽  
Sexual Abuse ◽  
High Risk ◽  
Hiv Infection ◽  
Sociodemographic Characteristics ◽  
Antibody Testing ◽  
Immunodeficiency Virus ◽  
Hiv Antibody Testing ◽  
Hiv Seropositive

This study assessed the situational and sociodemographic characteristics of children infected with human immunodeficiency virus (HIV) from pediatric sexual abuse. A letter of inquiry was sent to 2147 professionals across health and social service disciplines involved with child abuse assessment, treatment, and prevention. Respondents working in programs where HIV antibody testing of abuse victims occurs and who had identified HIV infection in one or more abused children were sent a survey to assess the demographics of victims, the family/living situation where abuse occurred, alternative risks for HIV infection, bases for diagnosis of sexual abuse and for HIV antibody testing, and profiles of the perpetrator and type of abuse. Of 5622 estimated HIV antibody tests conducted during 113 198 sex abuse assessments, 28 children were infected with HIV and lacked any alternative transmission route to that of sexual abuse. A total of 41 HIV-infected children with a history of sexual abuse were identified. Thirteen cases had alternative risk factors and were excluded from analysis. Sixty-four percent of the 28 victims with sexual abuse as the sole risk factor were female and 71% were African-American. The mean age was 9 years. Coinfection with another sexually transmitted disease (STD) occurred in 9 (33%) cases. Sexual abuse was diagnosed on the basis of a victim disclosure in 21 (75%) cases. The basis for HIV antibody testing was physical findings suggestive of HIV infection in 9 (32%) cases, HIV-seropositive or high-risk perpetrator in 6 (21%) and 2 (7%) cases, respectively, and the presence of another STD in the victim in 4 (14%) cases. Perpetrators were a child's parent in 10 (42%) cases and another relative in 6 (25%) cases. Perpetrators had behavioral risk factors for or signs/symptoms of HIV infection in 14 (58%) cases. The serostatus of perpetrators was known at time of abuse assessment in 16 (67%) cases and all were seropositive. Duration and form of abusive acts were variable, with 3 victims reporting a single episode and 13 (68%) reporting 6 or more episodes. Penile vaginal and/or rectal penetration was reported in only 50% of cases. It is concluded that sexual abuse must be considered as a potential, although infrequent, mode of transmission of HIV infection in children. Children who have been abused should be evaluated selectively for HIV infection particularly if the perpetrator is known to be HIV seropositive or engages in HIV high-risk behavior, if abuse occurred in a geographic area of high disease prevalence, and if the child has symptoms of HIV infection or another STD. Children who are found to be HIV infected and lack risk factors such as prior transfusion or maternal (perinatal) infection should be assessed for pediatric sexual abuse.

Gynaecomastia, hyperprolactinaemia and HIV infection

2005 ◽  
Vol 42 (4) ◽  
pp. 301-303 ◽  
Author(s):  
Sashi Acharya ◽  
J J Rufus Fernando ◽  
Rousseau Gama
Keyword(s):  
Human Immunodeficiency Virus ◽  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Immune Reconstitution ◽  
Serum Prolactin ◽  
Diagnosis And Management ◽  
Hypogonadotrophic Hypogonadism ◽  
Immunodeficiency Virus ◽  
Hiv Seropositive ◽  
Endocrine Complications

Endocrine complications of human immunodeficiency virus (HIV) and its treatment are being increasingly recognized. We discuss the diagnosis and management of an HIV seropositive man who presented with bilateral gynaecomastia and 'hyperprolactinaemia' due to macroprolactin within six months of starting antiretroviral therapy. We suggest that the gynaecomastia may be a feature of immune reconstitution disease. Measurement of serum prolactin in the investigation of gynaecomastia should be reserved for those with hypogonadotrophic hypogonadism. Since macroprolactin contributes to circulating prolactin in HIV-seropositive subjects, hyperprolactinaemic samples in these patients should be tested for macroprolactin.

Unrecognised Human Immunodeficiency Virus Patients in an Emergency Department in Hong Kong: A Report of Four Cases

2005 ◽  
Vol 12 (3) ◽  
pp. 168-177
Author(s):  
KL Mok ◽  
PG Kan
Keyword(s):  
Emergency Department ◽  
Human Immunodeficiency Virus ◽  
Hong Kong ◽  
Hiv Infection ◽  
Opportunistic Infections ◽  
Hiv Patients ◽  
Accident And Emergency ◽  
Immunodeficiency Virus ◽  
High Index Of Suspicion ◽  
Immunodeficiency Syndrome

Human immunodeficiency virus (HIV) causes breakdown of the immune system and predisposes patients to various opportunistic infections and neoplasms. However, many patients may not be aware of the HIV infection before the development of their first HIV related complications. We reported four unrecognised HIV patients presenting to our accident and emergency department with common complications of HIV infection and the acquired immunodeficiency syndrome (AIDS). Although not as common as in America, emergency physicians in Hong Kong still have to take care of patients with unknown HIV status. The common presentations of HIV patients will be discussed. A high index of suspicion and knowledge of common HIV/AIDS complications are required for managing these patients.

Localization of Human Immunodeficiency Virus Core Antigen in Term Human Placentas

PEDIATRICS ◽  
1992 ◽  
Vol 89 (2) ◽  
pp. 207-209
Author(s):  
Carl F. T. Mattern ◽  
Karen Murray ◽  
Allison Jensen ◽  
Homayoon Farzadegan ◽  
Jenny Pang ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
Mononuclear Cells ◽  
Morphological Characteristics ◽  
Core Antigen ◽  
Hiv Replication ◽  
Immunodeficiency Virus ◽  
Maternal Hiv ◽  
Maternal Hiv Infection ◽  
Hiv Seropositive

Evidence of human immunodeficiency virus (HIV) replication was sought in human placentas obtained at term from pregnancies complicated by maternal HIV infection. Placentas were obtained from the pregnancies of 19 HIV-seropositive women, 4 women who were seronegative, and 4 untested women with no risk factors for HIV infection. These placentas were each examined by immunoperoxidase immunocytochemistry using monoclonal anti-p24/55 antibodies. In addition, minced placental tissue from 11 of the seropositive pregnancies and the 3 seronegative pregnancies were co-cultivated with stimulated human peripheral blood mononuclear cells. The clinical status of the infants born to the HIV-seropositive women was assessed when the infants were 8 to 28 months of age. P24/55 antigen was detected in 5 of the 19 placentas of the HIV-seropositive pregnancies and in none of the 8 placentas of seronegative or low-risk pregnancies. This HIV core viral antigen was located exclusively in the cytoplasm of villous cells with morphological characteristics of macrophages. The HIV antigen-containing cells were very sparsely distributed. Staining of the trophoblast was not observed in any placental specimen. Human immunodeficiency virus was isolated in culture from 3 of the 11 placentas from seropositive pregnancies. Clinical follow-up has not revealed a relationship between infection of the infant and either p24/55 antigen identification or isolation of virus from the placenta. Virological and histological evidence of HIV replication is found in approximately one fourth of placentas obtained at term from pregnancies complicated by maternal HIV infection. Replicating virus appears localized to sparse macrophages located within the chorionic villi, but specifically not within the trophoblastic layer. It is unlikely that identification of HIV in the placenta either by culture or by immunocytochemistry will predict infection of infants born to seropositive women.

scholarly journals Feto-maternal outcome in human immunodeficiency virus seropositive mothers in co-relation with CD4 count

2020 ◽  
Vol 9 (3) ◽  
pp. 991
Author(s):  
Swati Trivedi ◽  
Oby Nagar ◽  
Prasoon Rastogi ◽  
Manish Bhardwaj
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
Cd4 Count ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Still Birth ◽  
Medical College ◽  
Immunodeficiency Virus ◽  
Mother To Child ◽  
Hiv Seropositive

Background: To study the effect of human immunodeficiency virus (HIV) infection on pregnancy outcomes and new born as mother to child transmission of HIV is a major route on new infections in children and compare it with HIV uninfected pregnancies.Methods: Prospective comparative study conducted on 40 HIV seropositive and 40 HIV seronegative pregnant women attending ANC and delivering in the department of obstetrics and gynecology, S. M. S. Medical College, Jaipur, Rajasthan, India.Results: CD4 count had no effect on birth weight of baby or term of delivery. HIV seropositive pregnancies were more prone to IUD, still birth and preterm birth (p=0.029). Mother to child transmission was 2.7%.Conclusions: HIV infection increases the risk of adverse foetal outcome in terms of intrauterine demise, still birth and preterm labour.

scholarly journals The breakdown of the cytokine network subsequent to human immunodeficiency virus infection

1995 ◽  
Vol 4 (5) ◽  
pp. 315-321
Author(s):  
M. Clerici ◽  
M. L. Villa ◽  
D. Trabattoni ◽  
G. M. Shearer
Keyword(s):  
Human Immunodeficiency Virus ◽  
T Lymphocytes ◽  
Hiv Infection ◽  
Hiv Disease ◽  
Cytokine Network ◽  
Type 2 Cytokines ◽  
Immunodeficiency Virus ◽  
Hiv Seropositive

The acquired immunodeflciency syndrome (AIDS) is a clinically multifaceted disease induced by infection with the human immunodeficiency virus (HIV). HIV infection results in a complex pattern of immunologic alterations that leads to the development of AIDS in the majority of HIV seropositive (HIV+) individuals. The reduction in CD4 T lymphocyte counts is the hallmark of HIV infection; nevertheless, long before the reduction in CD4 counts reaches critical levels, a series of profound and complex defects that impair the function of CD4 T lymphocytes can be detected. Thus, HIV infection is characterized by quantitative and qualitative defects affecting CD4 T lymphocytes. It was suggested recently that programmed cell death (PCD) is an important mechanism leading to CD4 depletion in HIV infection, and that susceptibility of peripheral lymphocytes to PCD is differentially regulated by diverse cytokines. Thus, type 1 cytokines would protect CD4 lymphocytes against PCD, whereas type 2 cytokines would not protect against, and could augment, PCD. We suggest that the qualitative alterations of the immune response provoke the CD4 depletion characteristic of HIV disease via type 2 cytokinemediated augmentation of PCD, and are therefore ultimately responsible for the progression of HIV infection. Finally, we summarize recent data showing that three correlates of disease progression: emergence of HIV strains with syncitium-inducing ability (SI), type 1-to-type 2 cytokine shift, and CD4 depletion, are significantly associated, suggesting a complex interconnected virologic-immunologic pathogenesis of HIV infection.

Depressive Syndromes and Symptoms in Subjects with Human Immunodeficiency Virus (HIV) Infection

1996 ◽  
Vol 168 (S30) ◽  
pp. 117-122 ◽  
Author(s):  
Mario Maj
Keyword(s):  
Human Immunodeficiency Virus ◽  
Depressive Symptoms ◽  
Hiv Infection ◽  
Social Rejection ◽  
Hiv Epidemic ◽  
The Social ◽  
Immunodeficiency Virus ◽  
Depressive Syndromes ◽  
Aids Study ◽  
Hiv Seropositive

The association between the infection produced by the human immunodeficiency virus (HIV) and syndromal or subsyndromal depression has been the topic of several studies in recent years. The results of the WHO Neuropsychiatric AIDS Study, conducted in the five geographical areas predominantly affected by the HIV epidemic, suggest that the symptomatic stages of HIV infection are associated with an increased prevalence of depressive symptoms, and, at least in some contexts in which the spreading of the infection is more recent and the social rejection of HIV-seropositive subjects is harsher, may also be associated with an increased prevalence of a syndromal diagnosis of depression.

scholarly journals Intestinal Parasitosis among Human Immunodeficiency Virus Infected Patients Visiting Different Care Centers of Eastern Nepal

2018 ◽  
Vol 2 ◽  
pp. 20-25
Author(s):  
Hemanta Khanal ◽  
Sanjita Bhujel
Keyword(s):  
Human Immunodeficiency Virus ◽  
Prevalence Rate ◽  
Intestinal Parasites ◽  
Parasitic Infections ◽  
Hiv Patients ◽  
Intestinal Parasitosis ◽  
Significant Difference ◽  
Immunodeficiency Virus ◽  
Enteric Parasites ◽  
Hiv Seropositive

Gastrointestinal parasitic infections are the major sources of diarrheal disease in developing countries and Human Immunodeficiency virus (HIV) infected patients are at the most risk. The objective of this study was to determine the prevalence of intestinal parasitic infections (IPIs) in the HIV-infected individuals visiting different care centers of Morang and Sunsari districts. The present cross-sectional study was conducted from two different HIV rehabilitation centers and one antiretroviral therapy center from eastern Nepal. A semi structured questionnaires was provided to HIV patients and 149 stool specimens were collected to analyze macroscopically and microscopically for the presence of enteric parasites. Data were analyzed by SPSS version 16. A total of 149 HIV seropositive patients with and without diarrhea were included in the study. Overall prevalence rate of enteroparasites was 19.46%. The prevalence rate of enteric parasites in HIV patients showed higher rate of protozoan infections (58.6%) than helminths (41.4%). High prevalence of parasitic infection was seen in male and also among male in the age groups of 31-40 years. The polyparasitism was not detected. A significant difference (p<0.05) was observed in the level of infection of intestinal parasites between the HIV seropositive with gastrointestinal tract (GIT) symptoms and HIV seropositive without GIT symptoms. The enteric parasitic infections were detected in 19.46% among HIV seropositive patients. Early detection of enteric parasitic infections could help in the management and improvement of the quality of life for HIV-infected individuals.

Assessment of Biventricular Function by Three-Dimensional Speckle Tracking Echocardiography in Adolescents and Young Adults with Human Immunodeficiency Virus Infection: A Pilot Study

Cardiology ◽  
2019 ◽  
Vol 144 (3-4) ◽  
pp. 101-111 ◽  
Author(s):  
Lidia Capotosto ◽  
Gabriella D’Ettorre ◽  
Camilla Ajassa ◽  
Nelson Cavallari ◽  
Maria Rosaria Ciardi ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Circumferential Strain ◽  
Speckle Tracking Echocardiography ◽  
Three Dimensional ◽  
Hiv Patients ◽  
Immunodeficiency Virus ◽  
Normal Controls

Background: The purpose of the study was to assess biventricular parameters of wall deformation with three-dimensional speckle tracking echocardiography (3DSTE) in adolescents and young adults with human immunodeficiency virus (HIV) infection on antiretroviral therapy in order to detect a possible subclinical myocardial dysfunction. Methods: Twenty-one patients aged 12–39 years with HIV, 21 normal controls of the same age and sex, and 21 patients with idiopathic nonischemic dilated cardiomyopathy (DCM) were studied with 3DSTE. All HIV patients were stable in terms of HIV infection, with no history of heart disease or other chronic systemic disease except HIV infection, and were on highly active antiretroviral therapy with good immunological control. Standard echocardiographic measures of left ventricular (LV)-right ventricular (RV) function were assessed. 3D LV global longitudinal strain (GLS), circumferential strain, radial strain, and LV twist were calculated. Global area strain (GAS) was calculated by 3DSTE as percentage variation in surface area defined by the longitudinal and circumferential strain vectors. 3D RV global and free-wall longitudinal strain (FWLS) were obtained. Results: LV GLS and GAS were lower in HIV patients compared to normal controls (p = 0.002, and p = 0.01, respectively). There were no significant differences in LV ejection fractions between the groups. There was a weak positive correlation between LV GLS and age (r = 0.215, p = 0.034) and a weak negative correlation between LV GLS and nadir-CD4 T-cells count (r = 0.198, p = 0.043). DCM patients had more marked and widespread reduction in LV GLS and GAS compared to controls (p < 0.001), whereas in HIV patients LV strain impairment (p < 0.05) was more localized in basal and apical regions. RV FWLS was significantly reduced in HIV patients when compared with the control group (p = 0.03). No patient had pulmonary systolic pressure higher than 35 mm Hg. Conclusions: 3DSTE may help to identify HIV patients at high cardiovascular risk allowing early detection of biventricular dysfunction in the presence of normal LV ejection fraction and in the absence of pulmonary hypertension. LV strain impairment in HIV patients is less prominent and widespread compared to DCM patients.

Epidemiological Characteristics on Human Immunodeficiency Virus Infection and Acquired Immunodeficiency Syndrome in Japan

1994 ◽  
Vol 5 (4) ◽  
pp. 273-278 ◽  
Author(s):  
Motonobu Miyazaki ◽  
Mitsuhiro Naemura
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
Acquired Immunodeficiency Syndrome ◽  
Heterosexual Contact ◽  
Immunodeficiency Virus ◽  
Acquired Immunodeficiency ◽  
Mode Of Transmission ◽  
Immunodeficiency Syndrome ◽  
Epidemiological Characteristics ◽  
Hiv Seropositive

The first case of human immunodeficiency virus (HIV) infection/acquired immunodeficiency syndrome (AIDS) in Japan was diagnosed in a homosexual male in 1985. The Ministry of Health and Welfare formed the AIDS Surveillance Committee, which publishes HIV seropositive and AIDS data at 2–month intervals. Excluding persons infected through blood products there were 971 HIV seropositives by April 1993, and 204 reported cases of AIDS. One of the epidemiological characteristics of HIV infection and AIDS in Japan is the rapid increase of cases of transmissioin through heterosexual contact since 1991. Before this, homosexual transmission was the commonest reported mode of transmission. Sporadic cases of mother-to-child transmission and some cases due to injecting drug use were also reported. It is predicted that heterosexual contact will be the primary mode of transmission of HIV in the future. Virtually all the diagnosed AIDS cases so far have been reported to this surveillance network, and it will be an important task of the network to monitor the HIV seropositive cases.

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