scholarly journals TB Presenting as Recurrent Pneumonia in a HIV-Infected Infant in Central Viet Nam

Reports ◽  
2018 ◽  
Vol 1 (2) ◽  
pp. 12
Author(s):  
Phuong Nguyen ◽  
Son Nguyen ◽  
Thinh Nguyen ◽  
Ben Marais
Keyword(s):  
Antiretroviral Treatment ◽  
Social Stigma ◽  
Correct Diagnosis ◽  
Severe Pneumonia ◽  
Careful Consideration ◽  
First Line ◽  
Recurrent Pneumonia ◽  
Infected Infant ◽  
Immunodeficiency Virus ◽  
Hiv Exposure

We report on a six-month-old infant admitted to our intensive care unit (ICU) with recurrent severe pneumonia. The mother was infected with human immunodeficiency virus (HIV)-infected, but initially failed to disclose this to doctors. Neither did she report the grandmother of the child’s chronic coughing, likely due to tuberculosis (TB). The infant was diagnosed with X-pert MTB/RIF® confirmed TB and tested positive for HIV infection. Once a correct diagnosis was established, the child demonstrated good recovery with appropriate TB and antiretroviral treatment (ART). The case demonstrates the importance of including TB in the differential diagnosis for young children not responding to first-line pneumonia treatment, especially in TB endemic areas. Taking a meticulous TB and HIV exposure history, with careful consideration of potential social stigma, is essential. It also demonstrates how the inaccessibility of HIV results and the absence of a continuous patient record may jeopardize patient care.

Lipid Profile in HIV Infected Children Receiving Antiretroviral Treatment

2018 ◽  
Vol 3 (02) ◽  
Author(s):  
Dr. Kavita J. Lall ◽  
Dr. Omesh Khurana ◽  
Dr. Ranjit S Ambad
Keyword(s):  
Human Immunodeficiency Virus ◽  
Antiretroviral Therapy ◽  
Lipid Profile ◽  
Antiretroviral Treatment ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Hiv Positive ◽  
Low Density ◽  
First Line ◽  
Immunodeficiency Virus

This study reviewed the lipid profile of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients in relation to use of antiretroviral therapy (ART). Lipid profile is becoming one of the common problems in human immunodeficiency virus infected patients receiving antiretroviral therapy. Data on lipid profile derangements induced by antiretroviral treatment. The aim of this study was to assess the lipid profile abnormalities in HIV infected children receiving ART. Material and Method - Information on sex, age, specific ART type in use , ART start date, duration of treatment, duration of HIV infection, BMI, relevant signs and symptoms and medications if any were collected by trained nurses using structured questionnaires and patients medical record. Blood Sample Collection, Transport and Processing - Following a standard and safety collection procedure, about 5 ml fasting venous blood was taken from the patients and the control groups by clinical nurses and senior laboratory technologist. Fasting serum samples were analyzed for total cholesterol (TC), triglyceride (TG), High Density Lipoprotein- Cholesterol (HDL-c). Low density lipoprotein cholesterol (LDL) and Very low density lipoprotein (VLDL) was determined by Friedewald Equation (13).   Result and conclusion - There was statistically significant difference between the two groups for TC, TG, TC/HDL-c ratio and TG/HDL –c ratio. On the basis of our study we concluded that the level of TG, TC, HDL-c and VLDL-c is high in HIV positive populations receiving first line ART (group I) as compared to ART naïve (group II). Considering that these altered lipid profiles can be an independent risk factors for coronary artery diseases and myocardial infarction, treatment with first-line ART may actually have potential risks for cardiovascular health of HIV positive people receiving ART.

scholarly journals Predictors of virological failure among people living with HIV receiving first line antiretroviral treatment in Myanmar: retrospective cohort analysis

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Anita Mesic ◽  
Alexander Spina ◽  
Htay Thet Mar ◽  
Phone Thit ◽  
Tom Decroo ◽  
...  
Keyword(s):  
Viral Load ◽  
Virological Failure ◽  
Antiretroviral Treatment ◽  
People Living With Hiv ◽  
First Line ◽  
Hiv Viral Load ◽  
Loss To Follow Up ◽  
History Of ◽  
Living With Hiv

Abstract Background Progress toward the global target for 95% virological suppression among those on antiretroviral treatment (ART) is still suboptimal. We describe the viral load (VL) cascade, the incidence of virological failure and associated risk factors among people living with HIV receiving first-line ART in an HIV cohort in Myanmar treated by the Médecins Sans Frontières in collaboration with the Ministry of Health and Sports Myanmar. Methods We conducted a retrospective cohort study, including adult patients with at least one HIV viral load test result and having received of at least 6 months’ standard first-line ART. The incidence rate of virological failure (HIV viral load ≥ 1000 copies/mL) was calculated. Multivariable Cox’s regression was performed to identify risk factors for virological failure. Results We included 25,260 patients with a median age of 33.1 years (interquartile range, IQR 28.0–39.1) and a median observation time of 5.4 years (IQR 3.7–7.9). Virological failure was documented in 3,579 (14.2%) participants, resulting in an overall incidence rate for failure of 2.5 per 100 person-years of follow-up. Among those who had a follow-up viral load result, 1,258 (57.1%) had confirmed virological failure, of which 836 (66.5%) were switched to second-line treatment. An increased hazard for failure was associated with age ≤ 19 years (adjusted hazard ratio, aHR 1.51; 95% confidence intervals, CI 1.20–1.89; p < 0.001), baseline tuberculosis (aHR 1.39; 95% CI 1.14–1.49; p < 0.001), a history of low-level viremia (aHR 1.60; 95% CI 1.42–1.81; p < 0.001), or a history of loss-to-follow-up (aHR 1.24; 95% CI 1.41–1.52; p = 0.041) and being on the same regimen (aHR 1.37; 95% CI 1.07–1.76; p < 0.001). Cumulative appointment delay was not significantly associated with failure after controlling for covariates. Conclusions VL monitoring is an important tool to improve programme outcomes, however limited coverage of VL testing and acting on test results hampers its full potential. In our cohort children and adolescents, PLHIV with history of loss-to-follow-up or those with low-viremia are at the highest risk of virological failure and might require more frequent virological monitoring than is currently recommended.

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