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Sample records for hiv patients considerations

  1. Management of chronic hepatitis C in patients co-infected with HIV: focus on safety considerations.

    Science.gov (United States)

    Romero, Miriam; Pérez-Olmeda, Mayte; García-Samaniego, Javier; Soriano, Vicente

    2004-01-01

    Hepatitis C virus (HCV) infection is a significant public health problem and one of the most important causes of chronic liver disease worldwide. Co-infection with HCV and HIV occurs frequently, mainly because both viruses share the same transmission routes. In recent years, the life expectancy of patients with HIV disease has been increased due to the introduction of highly active antiretroviral therapy (HAART). Furthermore, several studies have established that HIV infection is associated with a major progression of the HCV-related liver disease. Thus, end-stage liver disease has become a leading cause of morbidity and mortality in this population, emphasising the importance of treatment of chronic hepatitis C in HIV-infected persons. The biological and histological benefit of interferon-alpha (IFNalpha) therapy in patients co-infected with HCV/HIV is not significantly different from that noted in similar patients without HIV when the HIV infection is adequately controlled. However, patients with low CD4+ cell counts tend to respond poorly to anti-HCV therapy.Given the relatively low sustained virological response rate to IFN alone, the use of IFNalpha monotherapy has been largely abandoned in favour of combination therapy with ribavirin. In the last 2 years, IFN plus ribavirin combination therapy has been the standard care for the treatment of chronic hepatitis C. Although information on the safety and efficacy of this dual therapy in HCV/HIV co-infected patients is scarce, recent trials have reported that the combination of IFN plus ribavirin is well tolerated and feasible in patients co-infected with HCV/HIV. However, the rates of sustained virological response seem to be worse than those observed in patients without HIV infection. New IFN formulations (e.g. pegylated interferon) plus ribavirin appear to be way of the future for the treatment of chronic hepatitis C in patients both with and without HIV co-infection.

  2. The potential anesthetic threats, challenges and intensive care considerations in patients with HIV infection

    Directory of Open Access Journals (Sweden)

    Sukhminder Jit Singh Bajwa

    2013-01-01

    Full Text Available Acquired immunodeficiency syndrome (AIDS has become a pandemic with ever looming danger of its transmission in health professionals. The number of AIDS patients has increased tremendously over the last two decades, who present for surgical procedures as well as who get admitted in intensive care unit for their critical condition. As such anesthesiologists and intensivists are exposed to potential risk of disease transmission on a daily basis from such patients. The guidelines and protocols formulated in the western world regarding prevention of disease transmission cannot be applied uniformly in the developing nations, such as India due to various factors and limitations. As such there is a continuous need felt in this arena to prevent the catastrophic consequences of AIDS in our medical fraternity while treating such patients in operation theatres and critical care units. This study reviews the various pathophysiological aspects, anesthetic considerations, intensive care implications, and various areas where current knowledge about AIDS can be applied to prevent its potential transmission in high-risk clinical groups.

  3. HIV testing and informed consent - ethical considerations

    African Journals Online (AJOL)

    against his will, even where the patient suffers as a consequence; and the need for informed consent for an HIV test performed for the patient's own sake is simply one instance of that general duty to respect the patient's autonomy. The general duty to gain ir-lformed consent for a medical procedure is subject to exceptions, ...

  4. Surgery-related death, complicated wounds, and anastomosis healing in HIV-positive patients with considerable immune deficit: assumption and reality.

    Science.gov (United States)

    Hájek, Marcel; Novák, Karel; Zikmundová, Kvetoslava

    2009-01-01

    This is to appreciate of truthness of predicate, that HIV-positive patients have, in most cases, the chance to develop postoperative complications and unsuccessful results. In the study, we assessed the experience of the first author in 3 years of expert work in Botswana, Southern Africa, and used nonparametric tests for statistical assessment of the results in those patients. In addition to clinical follow-up are patients assessed through study of CD4+ T lymphocytes and CD8+ T lymphocytes levels. Only in the most serious immunodeficiency group (Group C) were statistically important deviations in deaths and complications of wounds and anastomoses healing. For example, comparing HIV-positive patients and the HIV-negative population using a CD4+ T-lymphocyte level HIV-positive patients, 23.96%; HIV negative population 8.11%. The complication rate in HIV-positive patients with a CD4 level HIV-negative population was 9.46%. The study disputes the myth that, in the majority of HIV-positive patients, we can expect limited surgical results and a larger rate of deaths and complications in wounds and anastomoses healing.

  5. Periodontitis in HIV patients

    Directory of Open Access Journals (Sweden)

    Oseeva А.О.

    2011-09-01

    Full Text Available The article presents the study of formation mechanisms and periodontitis course in patients with subclinical stage of HIV-infection. The examination of 45 patients has enabled the division of patients into three basic groups: patients with periodontitis and HIV-infection; patients with periodontitis; and HIV patients without periodontitis. It has been determined that the patients with periodontitis and subclinical HIV-infection have developed local inflammatory reaction with infection, activation of anti-inflammatory cytokines in parodontal recess fluid. It has been proved that the causative factor of frequent and durable relapses in parodontal pathology with clinical HIV-infection was the development of pathologic process with endotoxicosis syndrome and imbalance of lipid peroxidation and antioxidant system

  6. HIV testing and informed consent - ethical considerations

    African Journals Online (AJOL)

    In the case of a cadaver donor, relatives, before granting consent, must be ... Exposures carrying a significant risk - the high-risk exposures, as they are called - are hollow needle-stick injuries, or injuries that are more traumatic still. The ground for this ... and health care workers from exposure to HIV-infective material (blood ...

  7. Tuberculosis in HIV Patient

    Directory of Open Access Journals (Sweden)

    Bidhan Nidhi Paudel

    2013-09-01

    Full Text Available Introduction: Strict monitoring of anti tuberculosis therapy (ATT and antiretroviral therapy (ART is crucial for proper management of TB/HIV co-infected patients. Methods: Between December 2006 and December 2008 a prospective observational study was conducted among 135 TB/HIV co-infected patients visiting antiretroviral therapy in Seti Zonal Hospital, Dhangadi. The diagnosed TB patients were subjected to ATT through directly observed treatment short-course (DOTS and its response was evaluated as per WHO guidelines. Results: Among 135 studied subjects, 71.9% were males and over 88 % of the patients were in the age group 21 to 50. Of the Total TB cases 68.1% presented pulmonary TB (PTB and 37.20% of the Extra-pulmonary Tuberculosis (EPTB cases were lymph node TB. 75.5% of them had completed ATT, 8.2% transfer out and 12.6% were default. Conclusions: Majority of the patients presented PTB, and lymph node TB was found to be the most common EPTB. Comparatively, high efficacy of ATT was found in HIV patients visiting this resource poor setting. Key words: antiretroviral therapy; anti TB therapy; Dhangadi; lymph node T; treatment response.

  8. Physiology Considerations in Geriatric Patients.

    Science.gov (United States)

    Alvis, Bret D; Hughes, Christopher G

    2015-09-01

    Physiology changes at the structural, functional, and molecular levels as people age, and every major organ system experiences physiologic change with time. The changes to the nervous system result mostly in cognitive impairments, the cardiovascular system develops higher blood pressures with lower cardiac output, the respiratory system undergoes a reduction of arterial oxyhemoglobin levels, the gastrointestinal system experiences delayed gastric emptying and reduction of hepatic metabolism, and the renal system experiences a diminished glomerular filtration rate. Combined, these changes create a complex physiologic condition. This unique physiology must be taken into consideration for geriatric patients undergoing general anesthesia. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Living with HIV: Patients Perspective

    Centers for Disease Control (CDC) Podcasts

    2009-06-04

    This podcast showcases three people who are living with HIV. The patients share their experiences of being diagnosed with HIV, of the treatments they are undergoing, and on taking responsibility for their health.  Created: 6/4/2009 by Division of HIV and AIDS Prevention (DHAP), National Center for HIV, Hepatitis, STD, and Tuberculosis Prevention ( NCHHSTP).   Date Released: 6/4/2009.

  10. Pulmonary considerations in the immunocompromised patient.

    Science.gov (United States)

    Belleza, Walter G; Browne, Brian

    2003-05-01

    The compromised patient who presents to the emergency department with pulmonary complaints is becoming a common occurrence. An immunocompromised state can result from a disease process such as HIV or from medications used to prevent graft rejection in solid organ recipients or to treat conditions such as collagen vascular disease. The emergency department physician should be familiar with the more common complications that can afflict this unique patient group. This article addresses the presentation, evaluation, and treatment of the more common pulmonary complications that can occur in solid organ transplant recipients, cancer patients, patients suffering from collagen vascular disease, and patients with HIV disease.

  11. Ethical considerations regarding oral preexposure prophylaxis in HIV prevention trials.

    Science.gov (United States)

    Sugarman, Jeremy

    2016-01-01

    Although substantial evidence supports oral preexposure prophylaxis with tenofovir disoproxil fumarate and emtricitabine (OPTF) for the primary prevention of HIV infection in certain settings, assessing whether other promising HIV prevention interventions are safe and effective as well as determining optimal prevention strategies necessitates research. However, given the established safety and efficacy of OPTF, it is necessary to determine when and how is it ethically acceptable to conduct this research, which is the focus of this review. Although they are somewhat intertwined, questions regarding OPTF in research can be considered in two broad categories: use in a comparison arm and as a standard of prevention. Major statements addressing these issues are described and recent literature directed at the particular issue of OPTF in research is reviewed and critiqued. There is now arguably a rebuttable presumption for the use of OPTF as a comparator or as part of the standard of prevention in much future HIV prevention research. However, making such determinations necessitates taking into account scientific considerations, the modality being evaluated, acceptability, adherence, and the local context. Doing so should be optimized by robust stakeholder engagement.

  12. Dental considerations in pregnant patient

    Directory of Open Access Journals (Sweden)

    khedmat S.

    1999-07-01

    Full Text Available During the human gestation period, various systemic alterations occur in the mother"nsecondary to endocrine changes. These changes, combined with the presence of the gravid uterus, result"nin conditions affecting the various systems of the mother which must be considered by the dentist."nFetal development is divided into three stages:"n1 The fertilization and implantation period"n2 The embryonic period and"n3 The fetal period."nThe second period characterized by organogenesis which taratogens may result in functional and"nmorphogenic malformations."nThe ideal dental treatment schedule for the pregnant patient is twice during first trimester, at least once"nduring second trimester and once during third trimester."nThe second trimester is an ideal time for performing dental treatment."nEmergency problem should be alleviated immediately during pregnancy."nIndicated medications should not be with held because of pregnancy but patients must be informed of"nbenefits and risks."nWith careful attention to the special needs of the pregnant patient, the dentist can provide high quality"ndental care while minimizing potential risks to mother and fetus."nEmphasis should be on preventive strategies and meticulous oral hygiene to manage common oral"nproblems associated with pregnancy.

  13. [Food habits among HIV patients].

    Science.gov (United States)

    Parrilla Saldaña, Josefa; Muñoz Sánchez, Isabel; Peñalver Jiménez, Carmen; Castro Rodríguez, Encarnación; Quero Haro, Antonia; Largo García, Esperanza

    2003-01-01

    The authors analyze the eating habits of a group of 108 patients suffering from HIV. The authors elaborate a chart about the composition and distribution of foods which contains all the required food groups necessary for a complete diet. This food chart lists the variable of this study as well as the frequency of their consummation. Once this chart was drawn up, it was approved by the Nutrition and Dietetic Unit at the Virgen de Valma University Hospital. Among the results obtained, there is a relationship between the necessity these patients have regarding eating a complete diet and diverse nutrients that are easy to chew as well as an abundance of liquids. The article "Nutrition for Patients suffering from HIV" written by the same authors published in the Revista ROL de Enfermera 2002; 25(12):816-820, is recommended in order to have a more complete understanding of this topic, nutrition for patients suffering from HIV.

  14. Are students being coerced into HIV testing? Ethical considerations ...

    African Journals Online (AJOL)

    A social marketing strategy, including substantial prizes, was used to promote HIV testing at 17 institutions of higher learning in South Africa. Over 20 000 students with a mean age of 19 years were counselled and tested for HIV. The majority were being tested for the first time. Afterwards they signed a public pledge: 'We, ...

  15. Vaccination scars in HIV infected patients – does vaccinia vaccination confer protection against HIV?

    DEFF Research Database (Denmark)

    Jespersen, Sanne; Hønge, Bo Langhoff; Medina, Candida

    Vaccination scars in HIV infected patients – does vaccinia vaccination confer protection against HIV?......Vaccination scars in HIV infected patients – does vaccinia vaccination confer protection against HIV?...

  16. Improving resource allocation decisions for health and HIV programmes in South Africa: Bioethical, cost-effectiveness and health diplomacy considerations.

    Science.gov (United States)

    Kevany, Sebastian; Benatar, Solomon R; Fleischer, Theodore

    2013-01-01

    The escalating expenditure on patients with HIV/AIDS within an inadequately funded public health system is tending towards crowding out care for patients with non-HIV illnesses. Priority-setting decisions are thus required and should increasingly be based on an explicit, transparent and accountable process to facilitate sustainability. South Africa's public health system is eroding, even though the government has received extensive donor financing for specific conditions, such as HIV/AIDS. The South African government's 2007 HIV plan anticipated costs exceeding 20% of the annual health budget with a strong focus on treatment interventions, while the recently announced 2012-2016 National Strategic HIV plan could cost up to US$16 billion. Conversely, the total non-HIV health budget has remained static in recent years, effectively reducing the supply of health care for other diseases. While the South African government cannot meet all demands for health care simultaneously, health funders should attempt to allocate health resources in a fair, efficient, transparent and accountable manner, in order to ensure that publicly funded health care is delivered in a reasonable and non-discriminatory fashion. We recommend a process for resource allocation that includes ethical, economic, legal and policy considerations. This process, adapted for use by South Africa's policy-makers, could bring health, political, economic and ethical gains, whilst allaying a social crisis as mounting treatment commitments generated by HIV have the potential to overwhelm the health system.

  17. South African HIV self-testing policy and guidance considerations

    Directory of Open Access Journals (Sweden)

    Francois Venter

    2017-10-01

    Full Text Available The gap in HIV testing remains significant and new modalities such as HIV self-testing (HIVST have been recommended to reach key and under-tested populations. In December 2016, the World Health Organization (WHO released the Guidelines on HIV Self-Testing and Partner Notification: A Supplement to the Consolidated Guidelines on HIV Testing Services (HTS and urged member countries to develop HIVST policy and regulatory frameworks. In South Africa, HIVST was included as a supplementary strategy in the National HIV Testing Services Policy in 2016, and recently, guidelines for HIVST were included in the South African National Strategic Plan for HIV, sexually transmitted infections and tuberculosis 2017–2022. This document serves as an additional guidance for the National HIV Testing Services Policy 2016, with specific focus on HIVST. It is intended for policy advocates, clinical and non-clinical HTS providers, health facility managers and healthcare providers in private and public health facilities, non-governmental, community-based and faith-based organisations involved in HTS and outreach, device manufacturers, workplace programmes and institutes of higher education.

  18. MANAGEMENT OF CANCER IN PATIENTS WITH HIV

    African Journals Online (AJOL)

    Owing to the effects of HIV on haemopoiesis and immune function, HIV infection of patients with cancer poses management difficulties for both the physician managing .... chemotherapy. In addition, the obvious susceptibility to infection is synergistic with the immune suppression of cytotoxic therapy. The HIV-positive patient ...

  19. ORAL MANIFESTATIONS AMONG ROMANIAN HIV PATIENTS

    Directory of Open Access Journals (Sweden)

    Manuela ARBUNE

    2013-03-01

    Full Text Available The objective of the study is to evaluate the oral health problems on HIV youth patients from Galati. Materials and method. A cross-sectional study assessed 102 patients with mean age 22. The most frequent oral manifestations on HIV infected youth under ART are erythema marginatum, periodontitis, candidosis and hypertrophia gingivalis. Results and discussion. Dental decay-missing-filled index on HIV patients is high. Viral HIV replication, long time pediatric exposure on HIV, male sex, smoking, and oral inflamation are related to dental poor condition. Exodontic therapy is comon among HIV youth. However, persistence of some associated oral infections is related to individual or behavioral risk factors, but also to some newly found mechanisms, such as disfunctional immune reconstruction. Seeing to antiretroviral treatment, the severity and frequency of oral manifestations decreased among HIV patients on antiretroviral treatment. Conclusions. Developing medical, social and educational programs is imperative for improving the oral health of HIV youth of Galati.

  20. Inflammation in HIV-Infected Patients

    DEFF Research Database (Denmark)

    Langkilde, Anne; Petersen, Janne; Klausen, Henrik Hedegaard

    2012-01-01

    To examine mechanisms underlying the increased inflammatory state of HIV-infected patients, by investigating the association of HIV-related factors, demography, lifestyle, and body composition with the inflammatory marker soluble urokinase plasminogen activator receptor (suPAR)....

  1. HIV-infected mental health patients: characteristics and comparison with HIV-infected patients from the general population and non-infected mental health patients

    Directory of Open Access Journals (Sweden)

    Schadé Annemiek

    2013-01-01

    Full Text Available Abstract Objectives HIV-infected patients are at increased risk of developing mental health symptoms, which negatively influence the treatment of the HIV-infection. Mental health problems in HIV-infected patients may affect public health. Psychopathology, including depression and substance abuse, can increase hazardous sexual behaviour and, with it, the chance of spreading HIV. Therefore, it is important to develop an optimal treatment plan for HIV-infected patients with mental health problems. The majority of HIV-infected patients in the Netherlands (almost 60% are homosexual men. The main objectives of this study were to describe the clinical and demographic characteristics of patients with HIV who seek treatment for their mental health symptoms in the Netherlands. Secondly, we tested whether HIV infected and non-infected homosexual patients with a lifetime depressive disorder differed on several mental health symptoms. Methods We compared a cohort of 196 patients who visited the outpatient clinic for HIV and Mental Health with HIV-infected patients in the general population in Amsterdam (ATHENA-study and with non-HIV infected mental health patients (NESDA-study. DSM-IV diagnoses were determined, and several self-report questionnaires were used to assess mental health symptoms. Results Depressive disorders were the most commonly occurring diagnoses in the cohort and frequent drug use was common. HIV-infected homosexual men with a depressive disorder showed no difference in depressive symptoms or sleep disturbance, compared with non-infected depressive men. However, HIV-positive patients did express more symptoms like fear, anger and guilt. Although they showed significantly more suicidal ideation, suicide attempts were not more prevalent among HIV-infected patients. Finally, the HIV-infected depressive patients displayed a considerably higher level of drug use than the HIV-negative group. Conclusion Habitual drug use is a risk factor for

  2. Parenting considerations in young adults with perinatally acquired HIV.

    Science.gov (United States)

    Evangeli, Michael; Greenhalgh, Clare; Frize, Graham; Foster, Caroline; Fidler, Sarah

    2014-01-01

    An increasing number of children born with perinatally acquired HIV (PAH) are surviving into late adolescence and early adulthood. At this developmental stage, developing intimate relationships and having children are potentially important goals with associated normative challenges. Young people with PAH face a variety of additional HIV-related stressors that may be associated with relationships and parenting. These may include managing HIV disclosure to their partner and adherence to antiretroviral medication to (a) prevent transmission to partners and future offspring and (b) maintain their own health. Some of these challenges may be impacted upon by issues associated with having been born with HIV, for example, managing long-standing secrecy about HIV and having been told from a young age that life expectancy could be shortened. To date, there has been limited research into the procreational and parenting reflections of young people with PAH. This study examined the hopes and the concerns that a group of young people with PAH have regarding having children. Seven participants (five females and two males) currently or previously in an intimate relationship, aged 18-23 years, two of whom were parents, were recruited from a UK hospital clinic. They were interviewed using a semi-structured interview, with data analysed according to the principles of Interpretative Phenomenological Analysis. Four main themes were elicited: the perceived impact of having a child on intimate relationships, the effect of normative beliefs on parenting intentions and expectations, the thoughts and feelings about disclosing parental HIV status to one's children in the future, and the perceived impact of HIV on procreational intentions. Implications for supporting young people with PAH in parenting decision-making are explored.

  3. Hospital treatment of HIV patients.

    Science.gov (United States)

    Ola, Samuel Olawale

    2006-12-01

    Treatment of patients with HIV/AIDS in Nigeria has progressed from the stage of inactivity, unconcern, abandonment and neglect to the present stage of holistic care involving treatment of the infection with Highly Active Anti Retroviral Agents, complications of the disease and side effects of antiretroviral therapy as well as that of human behavioural responses towards the disease with hope and promising outcome. The goal of the treatment is to prolong the patient's life while maintaining the best possible quality of health and life. It is now a continuum of care between the hospital and the different sectors of the community. Hospital treatment of patients with HIV-AIDS is complex and yet a simple task if there is healthy interaction of the patients and health care providers in a milieu of well equipped hospital setting with available treatment facilities for proper management of diseases. Similarly, for the care to achieve its goal, it requires a joint participation of the community and the commitment of the government not only on curtailment of the reservoir of HIV infection by antiretroviral therapy but total eradication of diseases, poverty and ignorance in all its entirety.

  4. Unboosted atazanavir in treatment of Hiv infection: consideration of ...

    African Journals Online (AJOL)

    2013-12-01

    Dec 1, 2013 ... suppression after induction : Hiv med. 2013 dec 9. (e pub). 8. castagna a, galli l, gianotti n, torti c, antinori a, maserati r, d'aminiomonforte a, Quiros-roldan c, Salpietro S, lazzarin a. boosted atazanavir or unboostedatazanavir as a simplification of lopinavir/ ritonavir regimens. New microbial. 2013;36:239-49 ...

  5. Physiology Considerations in the Geriatric Patient

    Science.gov (United States)

    Alvis, Bret D.; Hughes, Christopher G.

    2015-01-01

    Synopsis A person’s physiology is ever-changing at the structural, functional, and molecular levels as they age, and every major organ system experiences physiologic change with time. The changes to the nervous system result mostly in cognitive impairments, the cardiovascular system result in higher blood pressures with lower cardiac output, the respiratory system result in a reduction of arterial oxyhemoglobin, the gastrointestinal system result in delayed gastric emptying with a reduction of hepatic metabolism, and the renal system experiences a diminished glomerular filtration rate. All these changes are variable from patient to patient; however, combined, they create a complex physiological condition. This unique physiology must be taken into consideration for a geriatric patient undergoing general anesthesia. PMID:26315630

  6. Pharmacists' considerations when serving Amish patients.

    Science.gov (United States)

    Crawford, Stephanie Y; Manuel, Aimée M; Wood, Bruce D

    2009-01-01

    To introduce historical and sociocultural influences on health and health care decisions that should be considered by pharmacists and other health professionals when serving Amish patients and to describe the roles of pharmacists in working with Amish populations, as an example of culturally and linguistically appropriate care. Community independent pharmacy in Arthur, IL, from 1991 to 2008. Reflections of a pharmacist-owner whose community practice serves a sizeable Amish population. The Old Order Amish are a religious group that values health and actively participates in its health care decisions. The Amish possess a strong sense of community responsibility and often seek advice of friends, family, and community in health care decisions. Their explanatory models of health and illness differ, in some respects, from the larger American society. The Amish are open to the use of folk medicine, complementary and alternative medicine, and conventional care when deemed necessary. They are receptive to health care information and explanations of options from trusted sources and use increased self-care modalities, including herbal remedies. Knowledge of salient cultural differences is important, but care should be given to avoid stereotyping patients because Amish rules and customs differ across districts. Culturally competent pharmacist care should be individualized based on patient needs and in consideration of aspects of differences in Amish cultures and districts. When serving Amish patients, special consideration should be given to addressing potential barriers to health care use, such as unique dialects, affordability issues for largely cash-paying customers, lower prenatal care use, and lower vaccination rates. Enhanced awareness and sensitivity to Amish lifestyles and beliefs can lessen misconceptions and minimize barriers that interfere with optimal provision of patient-centered pharmacy care and services. By working through established community norms, building

  7. Tuberculosis screening in patients with HIV

    DEFF Research Database (Denmark)

    Bjerrum, Stephanie Mia Katrine; Bonsu, Frank; Hanson-Nortey, Nii Nortey

    2016-01-01

    BACKGROUND: Tuberculosis screening of people living with HIV (PLHIV) can contribute to early tuberculosis diagnosis and improved patient outcomes. Evidence-based guidelines for tuberculosis screening are available, but literature assessing their implementation and the quality of clinical practice...... is scarce. OBJECTIVES: To assess tuberculosis screening practices and the effectiveness of audit and performance feedback to improve quality of tuberculosis screening at HIV care clinics in Ghana. DESIGN: Healthcare providers at 10 large HIV care clinics prospectively registered patient consultations during...

  8. Orthodontic treatment considerations in Down syndrome patients

    Directory of Open Access Journals (Sweden)

    Sianiwati Goenharto

    2012-03-01

    Full Text Available Background: Down syndrome is an easily recognized congenital disease anomaly, a common autosomal chromosomal anomaly with high prevalence of malocclusion. Orthodontic treatment demand should be high but it seems difficult to be done because of specific condition of disability. Purpose: The purpose of this literature review was to discribe the orthodontic problems found in Down syndrome patients and several consideration that shoud be done to treat them. Reviews: Many studies report the high prevalence of malocclusion among people with Down syndrome. There is a greater frequency of clas III relationship, crossbite, crowding and also open bite. Several problems might appear in the treatment because of dental, medical, mental, and behavioural factor. Conclusion: It is concluded that orthodonic treatment can be performed in Down syndrome patient, although several difficulties may appear. Good consideration in mental, behavior, medical and also dental condition will influence whether the treatment will success or not. Special care and facilities will support the orthodontic treatment.Latar belakang: Sindroma Down adalah suatu kelainan congenital yang mudah dikenali, merupakan kelaian kromosom autosomal yang cukup banyak terjadi, dengan prevalensi maloklusi cukup tinggi. Seharusnya permintaan akan perawatan ortodonti juga tinggi meskipun tampaknya sulit dilakukan karena adanya kondisi ketidakmampuan/cacat yang spesifik. Tujuan: Tujuan studi pustaka ini adalah untuk menggambarkan problem perawatan ortodonti pada penderita sindroma Down dan pertimbangan apa yang sebaiknya diambil untuk mengatasi masalah tersebut. Tinjauan pustaka: Banyak penelitian melaporkan tentang prevalensi maloklusi yang tinggi pada penderita sindroma Down. Maloklusi yang sering dijumpai adalah relasi klas III, gigitan silang, berdesakan dan juga gigitan terbuka. Problem dapat terjadi saat perawatan ortodonti karena adanya faktor dental, medis, mental dan tingkah laku penderita

  9. Conducting Internet-based HIV/STD prevention survey research: considerations in design and evaluation.

    Science.gov (United States)

    Pequegnat, Willo; Rosser, B R Simon; Bowen, Anne M; Bull, Sheana S; DiClemente, Ralph J; Bockting, Walter O; Elford, Jonathan; Fishbein, Martin; Gurak, Laura; Horvath, Keith; Konstan, Joseph; Noar, Seth M; Ross, Michael W; Sherr, Lorraine; Spiegel, David; Zimmerman, Rick

    2007-07-01

    The aim of this paper is to advance rigorous Internet-based HIV/STD Prevention quantitative research by providing guidance to fellow researchers, faculty supervising graduates, human subjects' committees, and review groups about some of the most common and challenging questions about Internet-based HIV prevention quantitative research. The authors represent several research groups who have gained experience conducting some of the first Internet-based HIV/STD prevention quantitative surveys in the US and elsewhere. Sixteen questions specific to Internet-based HIV prevention survey research are identified. To aid rigorous development and review of applications, these questions are organized around six common criteria used in federal review groups in the US: significance, innovation, approach (broken down further by research design, formative development, procedures, sampling considerations, and data collection); investigator, environment and human subjects' issues. Strategies promoting minority participant recruitment, minimizing attrition, validating participants, and compensating participants are discussed. Throughout, the implications on budget and realistic timetabling are identified.

  10. Unboosted atazanavir in treatment of Hiv infection: consideration of ...

    African Journals Online (AJOL)

    2013-12-01

    Dec 1, 2013 ... Liver toxicity and diarrhoea resolved,while the patients maintained immunological and virological response to the unboosted atazanavir based regimen. Unboosted atazanavir is an effective option of therapy in patients with suppressed viral replication and have ritonavir tolerability and safety challenges.

  11. Unboosted Atazanavir in Treatment of HIV Infection: Consideration ...

    African Journals Online (AJOL)

    ... unboosted atazanavir in combination with two nucleoside analogues. Liver toxicity and diarrhoea resolved,while the patients maintained immunological and virological response to the unboosted atazanavir based regimen. Unboosted atazanavir is an effective option of therapy in patients with suppressed viral replication ...

  12. Stroke in a Patient With HIV Infection

    Directory of Open Access Journals (Sweden)

    Buse Rahime Hasırcı

    2015-08-01

    Full Text Available Stroke which is a common complication in Human immumodeficiency virus type 1 positive patients is seen between 1% and 5% in clinical series. Vasculopathy and atherogenesis in HIV are the main pathologic mechanisms of stroke. We report a 63 year old man with sudden onset of a right hemiplegia and who was diagnosed as HIV-related stroke.

  13. Mucocutaneous disorders in Hiv positive patients

    Directory of Open Access Journals (Sweden)

    Kar H

    1996-01-01

    Full Text Available Twenty eight HIV positive patients were included in this study. They were evaluated for their mucocutaneous disorders, sexually transmitted diseases and other systemic disorders between 1994-95 in the department of Dermatology and STD Dr R M L Hospital of New Delhi. The heterosexual contact with commercial sex workers (CSWs was the most common route of HIV transmission. Chancroid, syphilis and genital warts were common STDs found in HIV positive patients. Oral thrush (67.9% was the commonest mucocutaneous disorder found in these patients followed by herpes zoster (25% and seborrhoeic dermatitis (21.4%. There was no unusual clinical presentation seen in mucocutaneous disorders and STDs.

  14. Considerations for purposeful HIV status disclosure among women living with HIV in Ghana.

    Science.gov (United States)

    Poku, Rebecca A; Owusu, Adobea Yaa; Mullen, Patricia Dolan; Markham, Christine; McCurdy, Sheryl A

    2017-05-01

    Although disclosure of positive HIV status has recognized benefits, enacted and perceived stigma is a continuing problem in Ghana, especially affecting women living with HIV (WLHIV). This qualitative study investigates how WLHIV make these decisions. We interviewed 40 WLHIV, analysing their transcripts using thematic content analysis. Four themes emerged from the data: selectivity in disclosure; disclosure for education, prevention and to provide support; concern for the potential confident, and safety in secrets. Women's awareness of and concerns about HIV-related stigma led them to seriously weigh the costs and benefits of disclosure decisions. Overall, our participants disclosed only when they believed that disclosure would benefit them or the confidant. They did not condone open disclosure, and preferred non-disclosure to minimize harm to themselves and loved ones. Though disclosure occurred for HIV education and prevention purposes, personal safety was the priority. We recommend revision of current post-HIV testing and pre-treatment counselling procedures to incorporate WLHIVs' judgements about disclosure and discussion of the perceived benefits of disclosure. Disclosure is an intricate process that involves support seeking and educating others while averting harm. Continued research of the factors related to disclosure is important to enhance understanding of the disclosure process.

  15. Bone mineral density abnormalities in HIV infected patients and HIV ...

    African Journals Online (AJOL)

    To describe the occurrence of traditional risk factors associated with decreased BMD in the above populations (oral corticosteroid use, smoking, alcohol, previous bone fracture, body mass index and physical inactivity). Methods: This was a cross-sectional comparative group descriptive study of HIV positive adult patients on ...

  16. Sinusitis: Special Considerations for Aging Patients

    Science.gov (United States)

    ... there are special considerations for older Americans. Changing Physiology: With aging, the physiology and function of the nose changes. The nose ... American Academy of Otolaryngology–Head and Neck Surgery. Reproduction or republication strictly prohibited without prior written permission. ...

  17. Lipodystrophy syndrome associated with antiretroviral therapy in HIV patients: considerations for psychosocial aspects Síndrome de la lipodistrofia asociado con la terapia antiretroviral en pacientes con VIH: consideraciones para los aspectos psicosociales Sindrome da lipodistrofia associada com a terapia anti-retroviral em portadores do HIV: considerações para os aspectos psicossociais

    Directory of Open Access Journals (Sweden)

    Ana Paula Morais Fernandes

    2007-10-01

    Full Text Available Several side effects have been strongly associated with antiretroviral therapy in HIV patients. Among them, the lipodystrophy syndrome which presents alterations in body shape with central adipose hypertrophy and peripheral lipoatrophy, reported by patients as a visible marker identifying them as HIV patients. This manuscript presents an analysis of current literature regarding the psychosocial aspects of HIV patients with lipodystrophy associated with antiretroviral therapy. The results show that the alterations in body shape can be disturbing in terms of psychosocial well being, affecting quality of life and increasing the stigma associated with the disease, with consequent disturbances in social relations. This analysis provides a preliminary review of the psychosocial aspects of lipodystrophy and further studies are needed for a better understanding of this complex syndrome, which could provide new information to be used in nursing care for HIV patients affected by this problem.Varios efectos secundarios han sido fuertemente asociados con la terapia antiretroviral en pacientes con HIV. Entre ellos, el síndrome de la lipodistrofia se presenta con alteraciones en la forma del cuerpo con hipertrofia adiposa central y lipoatrofia periférica, las cuales son reportadas por pacientes como marcas visibles que los identifica como pacientes con VIH. En este manuscrito, presentamos un análisis de literatura actual con respecto a los aspectos psicosociales de pacientes con VIH presentándose con lipodistrofia asociado con la terapia antiretroviral. Los resultados demuestran que las alteraciones de la forma del cuerpo pueden ser inquietantes en lo que se refiere al bienestar psicosocial, afectando la calidad de vida y aumentando el estigma asociado con la enfermedad, con las consiguientes dificultades en las relaciones sociales. Este análisis provee un repaso preliminar de los aspectos psicosociales de la lipodistrofia; sin embargo, otros estudios

  18. HIV/AIDS among surgical patients in Butare University Teaching ...

    African Journals Online (AJOL)

    The main objective of the study was to determine the frequency HIV among these patients and associated surgical conditions. Methods: This 3-months prospective ... to avoid getting infected with HIV. We found no statistically significant difference in the surgical pathologies between HIV-positive and HIV-negative patients.

  19. Benefits of leptin therapy in HIV patients

    Directory of Open Access Journals (Sweden)

    Uma Sinha

    2012-01-01

    Full Text Available Leptin therapy in human recombinant form has recently been used in HIV-associated lipodystrophy syndrome on experimental basis in some small short-term clinical trials. It has shown its beneficial effects only in hypoleptinemic HIV-infected patients by causing definite improvement in their insulin sensitivity, glucose tolerance, lipid status, and truncal obesity. Leptin prevents lipotoxicity and activates insulin signaling pathways through several postulated mechanisms. Central leptin insufficiency with peripheral hyperleptinemia has come out to be a significant contributor to the development of obesity and metabolic syndrome. In this article, we will review the basis of leptin therapy in HIV patients, with its promises. However, further larger clinical trials are needed to prove its long-term efficacy in the control of metabolic complications related to HIV therapy.

  20. Colonic leishmaniasis in a patient with HIV: a case report

    Directory of Open Access Journals (Sweden)

    Estela Soria-López

    Full Text Available Background: To describe an unusual clinical presentation of visceral leishmaniasis affecting the colon. Case report: We report the case of an HIV-positive patient with visceral leishmaniasis. We describe the clinical case, the procedures performed, the treatment provided and the patient's evolution. A comparative table of previously reported similar cases is shown. Discussion: Visceral leishmaniasis with intestinal involvement is an uncommon process. Nevertheless, this possibility should be taken into consideration in the differential diagnosis of immunosuppressed patients with symptoms of diarrhea, as a favorable prognosis depends on early diagnosis and appropriate treatment.

  1. Clinical profile of HIV infected patients attending a HIV referral clinic in Pune, India

    Directory of Open Access Journals (Sweden)

    Megha Antwal

    2014-01-01

    Interpretation & conclusions: Signs and symptoms associated with HIV positivity observed in this study can be used by health care providers to detect HIV infection early. Moreover, similar to HIV testing in patients with tuberculosis, strategies can be developed for considering Herpes zoster as a predictor of HIV infection.

  2. Legionellosis in patients with HIV infection

    DEFF Research Database (Denmark)

    Bangsborg, Jette Marie; Jensen, B N; Friis-Møller, A

    1990-01-01

    During the five-year period 1984-1988 we received 192 specimens from 180 patients infected with the human immunodeficiency virus (HIV) for investigation of Legionella infection. The majority of specimens were bronchoalveolar lavage (BAL) fluids (84%), but tracheal suctions and lung tissue from...... specimens additionally for Pneumocystis carinii and mycobacteria. Legionellosis was not found to be common among HIV-infected patients, as only six specimens (3%) from six patients were found positive by DFA, and no specimens were culture-positive for Legionella species. Dual infection with Legionella and P...

  3. Correlation of serum HIV antigen and antibody with clinical status in HIV-infected patients.

    Science.gov (United States)

    Paul, D A; Falk, L A; Kessler, H A; Chase, R M; Blaauw, B; Chudwin, D S; Landay, A L

    1987-08-01

    An enzyme immunoassay (EIA) has been developed which detects antigen(s) (Ag) of the human immunodeficiency virus (HIV) in the serum of patients with the acquired immunodeficiency syndrome (AIDS), AIDS-related complex (ARC), and patients at high risk for HIV infection. The test has a sensitivity of approximately 50 pg/ml of HIV protein. The specificity of the assay was determined with various virus infected cell lines, normal human sera/plasma, and serum from patients not known to be at risk for HIV infection. No false-positive HIV-Ag results were seen. Sera from 69% of patients with AIDS were positive for HIV-Ag as were 46% of patients with ARC and 19% of asymptomatic, HIV-antibody-positive individuals. There were significant associations between the stage of HIV infection--ie, AIDS vs ARC vs asymptomatic--and the detection of HIV-Ag in serum (p less than 0.0001) and the lack of detection of antibody to HIV core Ag (p less than 0.0001). HIV-Ag was also found in the serum of two asymptomatic antibody-negative individuals who were at high risk for AIDS and who later developed HIV antibody. The presence of HIV-Ag in sera was confirmed by an inhibition procedure. Thus, HIV-Ag can be detected in the serum of infected individuals prior to antibody production and correlates with the clinical stage of HIV infection.

  4. Ophthalmic considerations in patients with Pfeiffer syndrome

    Directory of Open Access Journals (Sweden)

    Jeremy D. Clark

    2016-07-01

    Conclusions and importance: It is important for ophthalmologists to be aware of the ophthalmic complications associated with patients with craniosynostosis syndromes. Our case identifies the importance of close communication between ophthalmology and plastic reconstructive surgery to help formulate the most successful plan in treating corneal decompensation and proptosis in Pfeiffer Syndrome patients.

  5. Treating the elderly diabetic patient: special considerations

    Directory of Open Access Journals (Sweden)

    Kezerle L

    2014-08-01

    Full Text Available Louise Kezerle, Leah Shalev, Leonid Barski Department of Internal Medicine F, Soroka University Medical Center, Beer-Sheva, Israel Abstract: The prevalence of diabetes is rising in the >65 year-old group. The challenge of defining the goals of therapy arises from the heterogeneity of the aging process and the sparse clinical data in this patient population. In light of these challenges, the clinician should be aware of the pitfalls of caring for the older diabetic patient and prioritize an individualized treatment plan to ensure an optimal glycemic control, without placing the patient at unnecessary risk. We present a review of the current guidelines and literature that deal specifically with the treatment of the older diabetic patient in order to establish the principles of treatment in this age group and help the clinician make decisions regarding the care of these patients. Keywords: diabetes treatment, elderly, review

  6. Relative frequency of Human T-cell Lymphotropic Virus I/II in HIV/AIDS patients

    Directory of Open Access Journals (Sweden)

    Mohsen Meidani

    2014-01-01

    Conclusion: In our survey, relative frequency of HTLV-I/II was 1.8% in HIV+ patients. This study reveals that relative frequency of HTLV-I/II in HIV positive patients is considerable but determining the need for screening of HTLV-I/II requires further investigation.

  7. Dental considerations in patients with heart disease

    OpenAIRE

    Cruz Pamplona, Marta; Jiménez Soriano, Yolanda; Sarrión Pérez, María Gracia

    2011-01-01

    Summary: Cardiovascular diseases are one of the main causes of death in the developed world, and represent the first cause of mortality in Spain. In addition to their associated morbidity, such disorders are important due to the number of affected individuals and the many patients subjected to treatment because of them. Objective: An update is provided on the oral manifestations seen in patients with arterial hypertension, ischemic heart disease, arrhythmias and heart failure, and...

  8. Nutritional Profile in Households of HIV-Infected Patients receiving ...

    African Journals Online (AJOL)

    With a generalized HIV epidemiology in Cameroon, it would be vital to break this vicious circle between “malnutrition and HIV/AIDS” by promoting affordable, safe and rich food habits to people infected or affected by HIV. The goal of the study was to evaluate the nutritional status of HIV patients under treatment and their ...

  9. HIV as a chronic disease considerations for service planning in resource-poor settings

    Directory of Open Access Journals (Sweden)

    Reynolds Lucy

    2011-10-01

    Full Text Available Abstract This paper reviews the healthcare issues facing nations which have a substantial caseload of chronic HIV cases. It considers the challenges of extending antiretroviral coverage to an expanding caseload as supplier price rises and international trade agreements come into force to reduce the availability of affordable antiretrovirals just as the economic downturn restricts donor funding. It goes on to review the importance in this context of supporting adherence to drug regimens in order to preserve access to affordable antiretrovirals for those already on treatment, and of removing key barriers such as patient fees and supply interruptions. The demands of those with chronic HIV for health services other than antiretroviral therapy are considered in the light of the fearful or discriminatory attitudes of non-specialist healthcare staff due to HIV-related stigma, which is linked with the weakness of infection control measures in many health facilities. The implications for prevention strategies including those involving criminalisation of HIV transmission or exposure are briefly summarised for the current context, in which the caseload of those whose chronic HIV infection must be controlled with antiretrovirals will continue to rise for the foreseeable future.

  10. Anaesthetic considerations in patients with transverse myelitis

    African Journals Online (AJOL)

    2013-03-26

    Mar 26, 2013 ... foot drop in the left limb persisted. The bladder incontinence also continued, although ... (Devic's disease), systemic lupus erythematosis, Sjögren's syndrome, parainfectious myelitis or sarcoidosis, ... anaesthesia may worsen the disease course in patients with pre-existing central nervous disorders, while ...

  11. Brucella Infection in HIV Infected Patients

    Directory of Open Access Journals (Sweden)

    SeyedAhmad SeyedAlinaghi

    2011-12-01

    Full Text Available The purpose of this study was to assess the possible correlation between Brucella and HIV infections. Iran is a country where HIV infection is expanding and Brucellosis is prevalent. In the present study, 184 HIV infected patients were assigned and for all of them HIV infection was confirmed by western blot test. In order to identify the prevalence rate of Brucella infection and systemic brucellosis in these subjects, sera samples were obtained and Brucella specific serological tests were performed to reveal antibody titers. Detailed history was taken and physical examination was carried out for all of patients. 11 (6% subjects had high titers but only 3 of them were symptomatic. Most of these subjects were injection drug user (IDU men and one was a rural woman. Considering both prevalence rates of Brucella infection (3% and symptomatic brucellosis (0.1% in Iran, our HIV positive patients show higher rates of Brucella infection and systemic brucellosis. Preserved cellular immunity of participants and retention of granulocytes activity may explain this poor association; whereas other explanations such as immunological state difference and non-overlapping geographical distribution of the 2 pathogens have been mentioned by various authors.

  12. Insulin inhalation for diabetic patients: Nursing considerations

    Directory of Open Access Journals (Sweden)

    Hanan Mohammed Mohammed

    2016-04-01

    Full Text Available Scientific knowledge has advanced to enable the development of inhaled insulin. It is a form of diabetes medication administered via the pulmonary system that studies have shown to be efficacious in the treatment of both type 1 and type 2 diabetes. Inhaled insulin is a new, safe means to deliver insulin that may increase patient compliance with insulin therapy, helping them to achieve optimal glycemic control and possibly reducing their risk of developing cardiovascular complications. However, diabetes is a chronic illness requiring lifetime intervention. Empowering patients with the knowledge of the diabetes disease process may give them the confidence to be more autonomous in managing their diabetes. HIIP gives nurse practitioners a new option that may improve their patients’ acceptance of insulin therapy, and improve glycemic control.

  13. Dental considerations in patients with liver disease

    OpenAIRE

    Cruz Pamplona, Marta; Margaix Muñoz, María; Sarrión Pérez, María Gracia

    2011-01-01

    Introduction: Liver diseases are very common, and the main underlying causes are viral infections, alcohol abuse and lipid and carbohydrate metabolic disorders. The liver has a broad range of functions in maintaining homeostasis and health, and moreover metabolizes many drug substances. Objective: An update is provided on the oral manifestations seen in patients with viral hepatitis, alcoholic and non-alcoholic liver disease, cirrhosis and hepatocellular carcinoma, and on the dent...

  14. COST OF INPATIENT CARE FOR HIV- POSITIVE PATIENTS AT ...

    African Journals Online (AJOL)

    Enrique

    2004-11-01

    Nov 1, 2004 ... half were found to be underweight for their age, 20% were marasmic and 87% suffered some form of malnutrition at admission. HIV+ patients were 4.7 times more likely to die in hospital than HIV-ve patients. Their average length of stay in hospital was 9 days, compared with 4 days for HIV-ve patients.

  15. Psychometric Properties of the Korean Version of the HIV Self-Management Scale in Patients with HIV.

    Science.gov (United States)

    Kim, Gwang Suk; Chu, Sang Hui; Park, Yunhee; Choi, Jun Yong; Lee, Jeong In; Park, Chang Gi; McCreary, Linda L

    2015-06-01

    The purpose of this study was to examine validity and reliability of Webel and colleagues' HIV Self-Management Scale when used with a Korean sample. The original 20-item HIV Self-Management Scale was translated into Korean using translation and back-translation. Nine HIV nurse experts tested content validity. Principal component analysis (PCA) and confirmatory factor analysis (CFA) of data from 203 patients was used to test construct validity. Concurrent validity was evaluated using correlation with patients' self-rating as a "smart patient" measured using a visual analogue scale. Internal consistency was tested by Cronbach's alpha coefficients. All items were rated as having satisfactory content validity. Based on PCA and consideration of conceptual meaning, a three-factor solution was selected, explaining 48.76% of the variance. CFA demonstrated the adequacy of the three-domain structure of the construct HIV self-management: daily self-management health practices, social support and HIV self-management, and chronic nature of HIV self-management. Goodness-of-fit indices showed an acceptable fit overall with the full model (χ²/df(₁₆₄)=1.66, RMSEA=0.06, SRMR=0.05, TLI=0.91, and CFI=0.92). The Korean version of the HIV Self-Management Scale (KHSMS) was significantly correlated with patients' self-rated smart patient (r=.41). The subscale Cronbach's alpha coefficients ranged from .78 to .81; alpha for the total scale was .89. The KHSMS provides a valid and reliable measure of self-management in Korean patients with HIV. Continued psychometric testing is recommended to provide further evidence of validity with this population.

  16. Hyphema: Considerations in the Small Animal Patient.

    Science.gov (United States)

    Telle, Mary Rebecca; Betbeze, Caroline

    2015-09-01

    Classification, diagnosis, and treatment of hemorrhage into the anterior chamber of the eye, or hyphema, can be a challenging and frustrating process for many practitioners, especially in emergency situations. This review outlines an inclusive list of causes, diagnostics, and treatments for traumatic and nontraumatic hyphema in both canine and feline patients. The review is tailored to small animal practitioners, especially in emergency practice, and is designed to provide concise but thorough descriptions on investigating underlying causes of hyphema and treating accordingly. Published by Elsevier Inc.

  17. Bariatric surgery: nutritional considerations for patients.

    Science.gov (United States)

    Rickers, Lisa; McSherry, Ciara

    Nutritional deficiencies are common in patients who are obese and therefore individuals considering bariatric surgery may require dietary supplementation with multivitamins and minerals before surgery. Nutritional deficiencies following bariatric surgery are often proportional to the degree of malabsorption created by the surgical procedure or the extent of weight loss. Eating habits often contribute to nutritional deficiencies, so appropriate dietary and lifestyle counselling are essential following bariatric procedures to ensure appropriate macronutrient and micronutrient status. Nutritional supplementation following bariatric surgery commonly includes calcium with vitamin D, iron and vitamin B12 in addition to a daily multivitamin and mineral tablet. Although general guidelines exist, individual monitoring and tailoring are frequently required. This article provides an update of guidelines regarding the most common nutritional concerns and myths surrounding bariatric surgery.

  18. Lung cancer in HIV-infected patients

    Directory of Open Access Journals (Sweden)

    R Palacios

    2012-11-01

    Full Text Available Purpose: Several studies have shown that HIV patients are at higher risk of lung cancer. Our aim is to analyse the prevalence and features of lung cancer in HIV-infected patients. Methods: The clinical charts of 4,721 HIV-infected patients seen in three hospitals of southeast Spain (study period 1992–2012 were reviewed, and all patients with a lung cancer were analysed. Results: There were 61 lung cancers, giving a prevalence of 1.2%. There was a predominance of men (82.0%, and smokers (96.6%; mean pack-years 35.2, with a median age of 48.0 (41.7–52.9 years, and their distribution according to risk group for HIV was: intravenous drug use 58.3%, homosexual 20.0%, and heterosexual 16.7%. Thirty-four (56.7% patients were Aids cases, and 29 (47.5% had prior pulmonar events: tuberculosis 16, bacterial pneumonia 9, and P. jiroveci pneumonia 4. The median nadir CD4 count was 149/mm3 (42–232, the median CD4 count at the time of diagnosis of the lung cancer was 237/mm3 (85–397, and 66.1%<350/mm3. 66.7% were on ART, and 70% of them had undetectable HIV viral load. The most common histological types of lung cancer were adenocarcinoma and epidermoid, with 24 (40.0% and 23 (38.3% cases, respectively. There were 49 (80.3% cases with advanced stages (III and IV at diagnosis. The distribution of treatments was: only palliative 23 (39.7%, chemotherapy 14 (24.1%, surgery and chemotherapy 8 (13.8%, radiotherapy 7 (12.1%, surgery 4 (6.9%, and other combined treatments 2 (3.4%. Forty-six (76.7% patients died, with a median survival time of 3 months. The Kaplan-Meier survival rate at 6 months was 42.7% (at 12 months 28.5%. Conclusions: The prevalence of lung cancer in this cohort of HIV-patients is high. People affected are mainly men, smokers, with transmission of HIV by intravenous drug use, and around half of them with prior opportunistic pulmonary events. Most patients had low nadir CD4 count, and were immunosuppressed at the time of diagnosis

  19. Accelerated nail growth rate in HIV patients.

    Science.gov (United States)

    Sánchez-Moreno, Elisa C; Marioni-Manriquez, Selina; Fernández-Martínez, Ramón F; Moreno-Coutiño, Gabriela

    2017-05-01

    Many factors have been noted to alter the growth rate of both finger and toe nails, some with harder evidence than others. Infectious diseases are among the ones reported as slowing the growth rate. However, on previous studies we noticed that patients living with HIV and onychomycosis could be cured without the use of antifungal therapy, only with the immunological improvement provided by the combined antiretroviral therapy, and we wanted to prove that the growth rate is also increased in this group and thus probably contributes to the cure of onychomycosis. This was an observational, descriptive, and prospective study. We marked with a scalpel the nail plate of the first finger of the non-dominant hand and the same foot, and measured the nail growth in the subsequent medical appointments with a magnifying glass and a millimetric scale. Thirteen patients completed the study, and were paired with healthy controls by age and gender. After performing Mann-Whitney U test, our results showed statistical significance among both groups, showing that patients with HIV have faster nail growth rates than those in the HIV negative group. There is little data on HIV nail growth rate to compare our results, but what we see in the clinical practice is that this group of patients shows a faster nail growth rate, as has also been reported for longer eyelashes, and this could be an important factor in the cure rates of onychomycosis. © 2017 The International Society of Dermatology.

  20. CANDIDURIA AMONG HIV- INFECTED PATIENTS ATTENDING A ...

    African Journals Online (AJOL)

    Background: Candiduria is a common finding. However, in immunocompromised patients like HIV-infected individuals, it has high risk of ... highly active antiretroviral therapy (HAART). Female gender was a significant risk factor for acquiring candiduria. ..... Biofilm formation by and antifungal susceptibility of Candida isolates.

  1. Using Digital Technologies in Clinical HIV Research: Real-World Applications and Considerations for Future Work.

    Science.gov (United States)

    Andriesen, Jessica; Bull, Sheana; Dietrich, Janan; Haberer, Jessica E; Van Der Pol, Barbara; Voronin, Yegor; Wall, Kristin M; Whalen, Christopher; Priddy, Frances

    2017-07-31

    Digital technologies, especially if used in novel ways, provide a number of potential advantages to clinical research in trials related to human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) and may greatly facilitate operations as well as data collection and analysis. These technologies may even allow answering questions that are not answerable with older technologies. However, they come with a variety of potential concerns for both the participants and the trial sponsors. The exact challenges and means for alleviation depend on the technology and on the population in which it is deployed, and the rapidly changing landscape of digital technologies presents a challenge for creating future-proof guidelines for technology application. The aim of this study was to identify and summarize some common themes that are frequently encountered by researchers in this context and highlight those that should be carefully considered before making a decision to include these technologies in their research. In April 2016, the Global HIV Vaccine Enterprise surveyed the field for research groups with recent experience in novel applications of digital technologies in HIV clinical research and convened these groups for a 1-day meeting. Real-world uses of various technologies were presented and discussed by 46 attendees, most of whom were researchers involved in the design and conduct of clinical trials of biomedical HIV prevention and treatment approaches. After the meeting, a small group of organizers reviewed the presentations and feedback obtained during the meeting and categorized various lessons-learned to identify common themes. A group of 9 experts developed a draft summary of the findings that was circulated via email to all 46 attendees for review. Taking into account the feedback received, the group finalized the considerations that are presented here. Meeting presenters and attendees discussed the many successful applications of digital

  2. Using Digital Technologies in Clinical HIV Research: Real-World Applications and Considerations for Future Work

    Science.gov (United States)

    Bull, Sheana; Dietrich, Janan; Haberer, Jessica E; Van Der Pol, Barbara; Voronin, Yegor; Wall, Kristin M; Whalen, Christopher; Priddy, Frances

    2017-01-01

    Background Digital technologies, especially if used in novel ways, provide a number of potential advantages to clinical research in trials related to human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) and may greatly facilitate operations as well as data collection and analysis. These technologies may even allow answering questions that are not answerable with older technologies. However, they come with a variety of potential concerns for both the participants and the trial sponsors. The exact challenges and means for alleviation depend on the technology and on the population in which it is deployed, and the rapidly changing landscape of digital technologies presents a challenge for creating future-proof guidelines for technology application. Objective The aim of this study was to identify and summarize some common themes that are frequently encountered by researchers in this context and highlight those that should be carefully considered before making a decision to include these technologies in their research. Methods In April 2016, the Global HIV Vaccine Enterprise surveyed the field for research groups with recent experience in novel applications of digital technologies in HIV clinical research and convened these groups for a 1-day meeting. Real-world uses of various technologies were presented and discussed by 46 attendees, most of whom were researchers involved in the design and conduct of clinical trials of biomedical HIV prevention and treatment approaches. After the meeting, a small group of organizers reviewed the presentations and feedback obtained during the meeting and categorized various lessons-learned to identify common themes. A group of 9 experts developed a draft summary of the findings that was circulated via email to all 46 attendees for review. Taking into account the feedback received, the group finalized the considerations that are presented here. Results Meeting presenters and attendees discussed the many

  3. NUTRITION AND PATIENTS WITH HIV/AIDS

    Directory of Open Access Journals (Sweden)

    Dušica Stojanović

    2011-09-01

    Full Text Available Immune status of an individual depends on the organism’s nutritional status as well as on the choice of nutrients that enter the body. Malnutrition and HIV progression are closely linked and require an active cooperation between infectious disease physicians and nutritionist. It has been noticed that patients with HIV that receive antiretroviral therapy have a significantly greater loss of body weight, and therefore need an adequate diet modification. Oxidative stress represents an important etiological factor in diseases of immune deficiency, so that antioxidant agents (Vitamin A, Vitamin E, Vitamin B12 and certain minerals, such as zinc and selenium are crucial factors in HIV dietotherapy. Polyphenols from cocoa beans as well as from green and black tea (catechins and teaflavins have an important role in disease progress modification as well as disease transmission prevention. The patients also need their probiotic intestinal flora to be encouraged to grow properly in order to prevent opportunistic infections. All of these nutrition elements are already in use in prevention, therapy and alleviation of HIV symptoms, and further science development will make a personal diet modification for each patient possible.

  4. Family correlates of depression among hiv positive patients ...

    African Journals Online (AJOL)

    Background information: HIV infection may impact negatively on family relationship and vice versa. Members of the family of HIV positive patients may become frustrated because of the stigma of having a family member with HIV infection, and the burden of having to care for the patient. This can result into the family ...

  5. Knowledge of Hypertensive Patients With or Without HIV on ...

    African Journals Online (AJOL)

    Purpose: The study assessed the knowledge of both HIV and non-HIV hypertensive patients on hypertension and the role of pharmacists in their pharmaceutical care. Methods: The study was conducted at the hypertension and HIV clinics in government hospitals in Dar es Salaam, Tanzania. Patients were interviewed using ...

  6. Why HIV Positive Patients on Antiretroviral Treatment and/or ...

    African Journals Online (AJOL)

    Two focus group discussions - one at each site - were held with community health workers who work with HIV-positive patients (Western Cape [5] and in KZN [4]). Patient said to have used Traditional Healing Practices (THP) before they were diagnosed with HIV, and some who have been diagnosed with HIV continue using ...

  7. System and Patient Barriers to Care among People Living with HIV/AIDS in Houston/Harris County, Texas: HIV Medical Care Providers' Perspectives.

    Science.gov (United States)

    Mgbere, Osaro; Khuwaja, Salma; Bell, Tanvir K; Rodriguez-Barradas, Maria C; Arafat, Raouf; Essien, Ekere James; Singh, Mamta; Aguilar, Jonathan; Roland, Eric

    2015-01-01

    In the United States, a considerable number of people diagnosed with HIV are not receiving HIV medical care due to some barriers. Using data from the Medical Monitoring Project survey of HIV medical care providers in Houston/Harris County, Texas, we assessed the HIV medical care providers' perspectives of the system and patient barriers to HIV care experienced by people living with HIV/AIDS (PLWHA). The study findings indicate that of the 14 HIV care barriers identified, only 1 system barrier and 7 patient barriers were considered of significant (P ≤ .05) importance, with the proportion of HIV medical care providers' agreement to these barriers ranging from 73.9% (cost of health care) to 100% (lack of social support systems and drug abuse problems). Providers' perception of important system and patient barriers varied significantly (P ≤ .05) by profession, race/ethnicity, and years of experience in HIV care. To improve access to and for consistent engagement in HIV care, effective intervention programs are needed to address the barriers identified especially in the context of the new health care delivery system. © The Author(s) 2014.

  8. Wound healing after implant surgery in HIV-positive patients.

    Science.gov (United States)

    Harrison, W J; Lewis, C P; Lavy, C B D

    2002-08-01

    We performed a prospective, blind, controlled study on wound infection after implant surgery involving 41 procedures in patients infected with the human immunodeficiency virus (HIV) and 141 in HIV-negative patients. The patients were staged clinically and the CD4 cell count determined. Wound infection was assessed using the asepsis wound score. A risk category was allocated to account for presurgical contamination. In HIV-positive patients, with no preoperative contamination, the incidence of wound infection (3.5%) was comparable with that of the HIV-negative group (5%; p = 0.396). The CD4 cell count did not affect the incidence of infection (r = 0.16). When there was preoperative contamination, the incidence of infection in HIV-positive patients increased markedly (42%) compared with that in HIV-negative patients (11%; p = 0.084). Our results show that when no contamination has occurred implant surgery may be undertaken safely in HIV-positive patients.

  9. Management of mental health disorders in HIV-positive patients ...

    African Journals Online (AJOL)

    These guidelines are intended as a reference document to assist HIV nurse and doctor clinicians in managing mental health disorders. It is intended to improve awareness, knowledge and capacity to support patients living with HIV and mental health disorders.

  10. Cryptosporidiosis in HIV/AIDS Adult Patients in Jos | Banwat ...

    African Journals Online (AJOL)

    %) of the control group excreted the oocyst. Conclusion: The prevalence of Cryptosporidiosis is high in HIV/AIDS adult patients in this environment. KEY WORDS: Cryptosporiodiosis, Adults, HIV./AIDS, Jos. Highland Medical Research Journal ...

  11. Open tibia fractures in HIV positive patients.

    Science.gov (United States)

    Harrison, W J

    2009-12-01

    Open tibia fractures are common injuries, particularly in developing countries.Pedestrian or bicycle to motor car contact is the most common mechanism. These injuries result in high morbidity and often long-term disability. HIV infection complicates open fractures by raising the incidence of infectionin the open wound (5 of 7 patients in our series). This risk may be compounded if internal fixation techniques are used (5 of 12 HIV patients with internal fixation of any open fracture). There is also a suggestion that HIV may delay bone union (4 of 7 patients united at 6 months). External fixation offers an alternative method of fracture stabilisation. It avoids the risks associated with putting metal-ware in the wound, but creates a new issue of pin track sepsis. We found that pin track infection was more common in patients with HIV, but the rate at which pins required removal was 7%. We consider external fixation to be a lower-risk strategy than internal fixation in such patients but open fracture wound sepsis remains a problem. We have not yet demonstrated a difference in severity or frequency of complications in patients of low CD4 count, but logically one expects septic complications to increase as CD4 count falls. Antiretroviral medication decreases viral load and elevates the CD4 count. Research is underway regarding potential effectiveness of such drugs in reducing wound and fracture healing complications. Above all, meticulous and timely all-round care is required to achieve satisfactory results in immune-compromised patients. This includes, debridement, bony stability, and soft-tissue reconstruction.

  12. [Causes of death in patients with HIV infection in two Tunisian medical centers].

    Science.gov (United States)

    Chelli, Jihène; Bellazreg, Foued; Aouem, Abir; Hattab, Zouhour; Mesmia, Hèla; Lasfar, Nadia Ben; Hachfi, Wissem; Masmoudi, Tasnim; Chakroun, Mohamed; Letaief, Amel

    2016-01-01

    Antiretroviral tritherapy has contributed to a considerable reduction in HIV-related mortality. The causes of death are dominated by opportunistic infections in developing countries and by cardiovascular diseases and cancer in developed countries. To determine the causes and risk factors associated with death in HIV-infected patients in two Tunisian medical centers. cross-sectional study of HIV-infected patients over 15 years treated at Sousse and Monastir medical centers between 2000 and 2014. Death was considered related to HIV if its primary cause was AIDS-defining illness or if it was due to an opportunistic infection of unknown etiology with CD4 HIV if its primary cause wasn't an AIDS defining illness or if it was due to an unknown cause if no information was available. Two hundred thirteen patients, 130 men (61%) and 83 women (39%), average age 40 ± 11 years were enrolled in the study. Fifty four patients died, the mortality rate was 5.4/100 patients/year. Annual mortality rate decreased from 5.8% in 2000-2003 to 2.3% in 2012-2014. Survival was 72% at 5 years and 67% at 10 years. Death events were associated with HIV in 70.4% of cases. The leading causes of death were pneumocystis carinii pneumonia and cryptococcal meningitis in 6 cases (11%) each. Mortality risk factors were a personal history of opportunistic infections, duration of antiretroviral therapy HIV in Tunisia.

  13. Tuberculosis screening in patients with HIV

    DEFF Research Database (Denmark)

    Bjerrrum, Stephanie; Bonsu, Frank; Hanson-Nortey, Nii Nortey

    2016-01-01

    is scarce. OBJECTIVES: To assess tuberculosis screening practices and the effectiveness of audit and performance feedback to improve quality of tuberculosis screening at HIV care clinics in Ghana. DESIGN: Healthcare providers at 10 large HIV care clinics prospectively registered patient consultations during...... May and October 2014, before and after a performance feedback intervention in August 2014. The outcomes of interest were overall tuberculosis suspicion rate during consultations and provider adherence to the International Standards for Tuberculosis Care and the World Health Organizations' guidelines...... screen (any of current cough, fever, weight loss or night sweats). After feedback, patients with a positive WHO symptom screen were more likely to be suspected of tuberculosis (OR 2.21; 95% CI: 1.19-4.09) and referred for microscopy (OR 2.71; 95% CI: 1.25-5.86). CONCLUSIONS: A simple prospective audit...

  14. Sepsis in HIV-infected patients; epidemiology and host response

    NARCIS (Netherlands)

    Huson, M.A.M.

    2016-01-01

    In this thesis, we examined the impact of HIV infection on the epidemiology (Part I) of sepsis, and host response (Part II) to sepsis. We studied sepsis patients in Gabon, a setting with a high prevalence of HIV, and in Dutch intensive care units (ICUs). In Part I, we found that HIV positive

  15. Renal disease in HIV infected patients at University of Benin ...

    African Journals Online (AJOL)

    Background: HIV related renal disease is a common occurrence in patients with HIV infection. It is the third leading cause of end stage renal disease among African-American males between the ages of 20 and 64 years in USA. Renal function impairment has been reported at all stages of HIV infection. The aim of this study ...

  16. Low HIV testing rates among tuberculosis patients in Kampala, Uganda

    NARCIS (Netherlands)

    Sendagire, Ibrahim; Schreuder, Imke; Mubiru, Mesach; van der Loeff, Maarten Schim; Cobelens, Frank; Konde-Lule, Joseph

    2010-01-01

    HIV testing among tuberculosis patients is critical in improving morbidity and mortality as those found to be HIV positive will be offered a continuum of care including ART if indicated. We conducted a cross-sectional study in three Kampala City primary care clinics: to assess the level of HIV test

  17. Ocular manifestations in paediatric HIV/AIDS patients in Mulago ...

    African Journals Online (AJOL)

    Background: In Uganda the prevalence of HIV averages 12% as was reported to the STD/AIDS control surveillance unit. In Uganda there are approximately 30,000 HIV infected infants per year. The burden of HIV disease is high in Uganda and patients present with ocular complications. However, there is paucity of ...

  18. Prevalence of cryptococcosis among HIV-infected patients in ...

    African Journals Online (AJOL)

    Administrator

    toll, we recommend that its routine check should be integrated in the management of HIV/AIDS patients. Key words: Cryptococcosis, HIV/AIDS ... HIV infection and the AIDS management pattern4. In sub-Saharan Africa with the highest ... with undetermined reactions were subjected to API. 20C Aux (BioRad). Clinical history ...

  19. Disclosure of HIV status: experiences of patients enrolled in an ...

    African Journals Online (AJOL)

    The convergence between the tuberculosis (TB) and HIV epidemics has led to studies investigating strategies for integrated HIV and TB care. We present the experiences of a cohort of 17 patients enrolled in the first integrated TB and HIV treatment pilot programme, conducted in Durban, South Africa, as a precursor to a ...

  20. Comparative Analysis of Patient Satisfaction Levels in HIV/AIDS ...

    African Journals Online (AJOL)

    Background: Continuous quality improvement is linked to the use of timely and useful feedback from clients in HIV care. HIV experts and care professionals agree that consumer involvement, such as patient satisfaction survey, is an essential part of HIV care and policy making today. The introduction of Antiretroviral Drugs ...

  1. Prevalence of HIV infection among tuberculosis patients in Eastern India.

    Science.gov (United States)

    Manjareeka, Magna; Nanda, Sitikantha

    2013-10-01

    India has a high tuberculosis (TB) burden. A significant percentage of TB patients are human immunodeficiency virus (HIV) positive. As the HIV epidemic is fueling the global TB epidemic, the prevalence of the virus in TB patients is a sensitive indicator of the spread of HIV into the general population in many regions. The aim of this study was to determine the prevalence of HIV-TB co-infection among a less studied population of Eastern India. A cross-sectional record analysis study covering the period from 2000 to 2011 was conducted at Central Hospital of South Eastern Railway, Garden Reach, Kolkata, India. All tuberculosis patients consenting for HIV testing were included in the study after obtaining ethical clearance from the institution. The TB diagnosis was performed using clinical examination, sputum acid-fast bacillus (AFB) smear and chest radiography. HIV-positive cases were screened using an initial HIV tridot test, followed by repetitive tests using a Micro ELISA HIV Kit for HIV 1 and HIV 2 antigen. Overall, 50 (12.3%) of the consenting 406 TB patients were HIV positive. Of these 406 patients, 44% had pulmonary TB, and 56% had extrapulmonary TB (EPTB). Coughing was the most common symptom (90%), followed by fever (78%). Pleural effusion (60.7%) was the most common form observed in the EPTB cases. The prevalence of HIV-TB co-infection was 12.3%. Consequently, all TB patients should be assessed for HIV risk factors and counseled to undergo HIV testing. Conversely, all HIV-positive cases should be screened for TB. Copyright © 2013 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

  2. Healing after anal fistulotomy: comparative study between HIV+ and HIV- patients.

    Science.gov (United States)

    Nadal, S R; Manzione, C R; Galvao, V M; Salim, V R; Speranzini, M B

    1998-02-01

    The aim of this work was to compare wound-healing after anal fistulotomy in human immunodeficiency virus (HIV)+ and HIV- patients and to recognize healing parameters in HIV+ patients. Sixty patients were treated with fistulotomy for intersphincteric anal fistula. For each patient, we evaluated white blood cell count values, T CD4 counts, Centers for Disease Control and Prevention classification, and healing duration. There were 31 HIV+ patients (7 A2; 1 A3; 7 C1; 6 C2; 10 C3). Seven C3 patients had incomplete healing. Statistically, there was no difference in the healing duration in HIV+ A2, C1, C2, and HIV-negative patients. C3 patients who did heal took longer than other HIV+ patients. T CD4 counts were similar to healed and not healed C3 patients, although healed C3 values of white blood cell counts were higher than not healed C3 values (4,450 and 2,380/mm3). After anal fistulotomy, HIV+ C3 patients either had retarded healing or no healing at all. Therefore, we feel that surgery should be done only in emergency cases of anorectal diseases or in patients with more than 3,000 white blood cells/mm3.

  3. Transmission route and reasons for HIV testing among recently diagnosed HIV patients in HIV-TR cohort, 2011–2012

    Directory of Open Access Journals (Sweden)

    Basak Dokuzoguz

    2014-11-01

    Full Text Available Introduction: Routes of transmission and reasons for HIV testing are important epidemiologic data to analyze the epidemic and to tailor the response to AIDS. The aim of this study was to analyze reasons for testing and transmission ways of HIV among recently diagnosed HIV patients registered in the multicenter HIV-TR cohort in Turkey. Methods: Transmission ways and reasons for testing of all patients diagnosed in 2011 and 2012 were recorded on a web-based data collection system and were analyzed retrospectively. Results: The study included 693 patients (561 male, 132 female from 24 sites. Reason for HIV testing was available in 640 patients (92%. The most common reason for HIV testing was diagnostic workout for other conditions or illness followed by patient-initiated testing. The reasons for testing were listed in Table 1. The most common routes of HIV transmission were heterosexual intercourse (62.7% and sex among men who have sex with men (MSM (22.6%. At the time of HIV diagnosis, the mean CD4 lymphocyte cell count was 355/mm3 (3–1433/mm3. Primary HIV infection was determined in 42/693 (6% patients and 9/693 (% 1, 2 cases were considered “probable primary HIV infection.” The majority of the cases presented to a clinic for follow-up right after the diagnosis. On the other hand 32/616 (5.2% patients delayed their presentation for more than 3 months. The longest delay was 11 months. Conclusions: The results of the database suggest that targeted testing is lacking in the country. The shift toward homosexual transmission during the last 2 years emphasizes the need for targeted interventions. Patients present relatively late and HIV infection could only be diagnosed when immunosuppression related findings appeared. Patient-initiated testing,an indicator of awareness, was very low suggesting a need to scale-up awareness raising interventions.

  4. [HIV-related symptoms in patients with HIV infection enrolled in an HIV case management program in Taiwan].

    Science.gov (United States)

    Yeh, Mei-Ling; Liu, Hsiao-Ying; Ko, Wen-Chien; Lee, Hsin-Chun; Ko, Nai-Ying

    2009-02-01

    Patients with HIV (human immunodeficiency virus) experience multiple signs and symptoms that accompany the progress of HIV-related diseases. HIV-related symptoms are associated with side effects and HAART (highly active antiretroviral therapy) complications. The purposes of this study were to estimate the frequency and intensity of HIV-related signs and symptoms in patients with HIV infection and to explore relationships between HIV-related symptoms and the HAART regimen. Data on a total of 172 HIV-positive patients enrolled in an HIV case management program were analyzed for this study. Participants experienced an average of 9.73+/-7.27 symptoms, with fatigue, dry mouth and weakness the most frequently reported. Average mean symptom intensity among participants was 13.24+/-11.48. Insomnia, depression and disorientation were the most severe symptoms. No differences were recorded between HIV-related symptoms and disease progression. Fatigue intensity showed significant differences between NRTI (nucleoside reverse transcriptase inhibitors), +NNRTI (non-nucleoside reverse transcriptase inhibitors) and NRTI+PI (protease inhibitors) based regimens (p=.03). In addition, cluster symptoms of confusion/distress among participants without HAART had a significantly higher mean intensity than those with HAART (t=2.0, df=1, p=.04). Our study indicated that symptom management for fatigue and early detection of psychological distress is needed to improve quality of life for people living with HIV/AIDS.

  5. Clinical presentation and opportunistic infections in HIV-1, HIV-2 and HIV-1/2 dual seropositive patients in Guinea-Bissau

    DEFF Research Database (Denmark)

    Sørensen, Allan; Jespersen, Sanne; Katzenstein, Terese L

    2016-01-01

    HIV-2 is prevalent. In this study, we aimed to characterize the clinical presentations among HIV-1, HIV-2 and HIV-1/2 dual seropositive patients. Methods: In a cross-sectional study, newly diagnosed HIV patients attending the HIV outpatient clinic at Hospital Nacional Sim~ao Mendes in Guinea...... seropositive patients had a lower BMI and a higher prevalence of weight loss, skin rash and productive cough than HIV-2 seropositive patients (p value 0.03, 0.002, 0.03 and 0.04). Only four cases (2%) of pulmonary tuberculosis (TB) were diagnosed. One patient (1/96, 1%) was tested positive for cryptococcal...

  6. Diverticulitis in HIV-infected patients within the United States.

    Science.gov (United States)

    Cronley, K; Wenzke, J; Hussan, H; Vasquez, A M; Hinton, A; El-Dika, S; Conwell, D L; Krishna, S G; Stanich, P P

    2016-03-01

    Diverticulitis in patients on immunosuppressant therapy has been associated with increased mortality, but there are no data for HIV-infected patients. Our aim was to compare the outcomes of hospitalizations for diverticulitis in patients with and without HIV infection. Cross-sectional study of hospitalizations in the United States accessed through the Nationwide Inpatient Sample, Healthcare Cost and Utilization Project. Patients hospitalized for diverticulitis in 2007-2011 were included in the analysis. The primary outcomes of interest were mortality and surgical therapy rates. Patients from 2003 to 2011 were utilized to analyse trends in prevalence. There were 2375 patients with HIV infection hospitalized for diverticulitis and 1 160 391 patients without HIV infection hospitalized for diverticulitis from 2007 to 2011. The patients with HIV infection were younger and more likely to be male and nonwhite (P diverticulitis and HIV infection had a significantly increased in-hospital mortality rate [odds ratio (OR) 3.94 (95% confidence interval, CI, 1.52-10.20)] and a lower rate of surgical intervention [OR 0.74 (95% CI 0.57-0.95)]. From 2003 to 2011, there was a linear increasing trend in the prevalence of HIV infection among patients hospitalized for diverticulitis (P diverticulitis had increased mortality and received less surgical treatment in comparison to the general population. Diverticulitis in HIV-infected patients increased in prevalence over the study period. © 2016 British HIV Association.

  7. [Pain characteristics in HIV/AIDS patients].

    Science.gov (United States)

    Pérez-Carranco, María Luisa; Guevara-López, Uriah; Covarrubias-Gómez, Alfredo; Alvarez, Julio Delgado; Villafaña-Tello, José de Jesús S; Espin-Paredes, Elena

    2009-01-01

    Human immunodeficiency virus infection (HIV), affects 0.6 % of world population and 0.3 % of the adult population in Mexico. Pain, in this group, is frequently not identified by the health care team, is poorly defined, and undertreated. Our objective was to evaluate the prevalence of pain and its characteristics in Mexican HIV patients. HIV diagnosed patients were included. Social and demographic information about pain characteristics, response to analgesic treatment and the presence of comorbidities were analyzed. The illness status was identified and CD4 cell count was documented. Pain was identified in 11 of 55 cases. Mean time of pain onset was 26 months (SD 28.6). Mean pain intensity by visual analogue scale was 7 (SD 2.3), and by verbal analogue scale proportions were reported as follows: 18 % mild, 36.5 % moderate, and 45 % severe pain. We observed that pain appeared in 20 % of subjects. CD4 count was observed to be related to pain decrease. Type of study and sample size does not permit a definite interpretation of the results; therefore a generation of prospective studies with larger samples is needed.

  8. Peripheral blood HIV-1 DNA dynamics in antiretroviral-treated HIV/HCV co-infected patients receiving directly-acting antivirals.

    Directory of Open Access Journals (Sweden)

    Gabriella Rozera

    Full Text Available Aim was to determine the dynamics of peripheral blood mononuclear cells (PBMC- associated total HIV-1 DNA in successfully ART-treated HIV/HCV co-infected patients receiving DAA treatment and to explore possible virological hypotheses underlying the phenomenon.Longitudinal, single-centre study measuring total HIV-1 DNA before the start of DAA, at the end of treatment (EOT, and 3 months after treatment. Univariable and multivariable analyses were used to assess factors associated with HIV-1 DNA increase ≥0.5 Log copies/million PBMC. Episomal 2-LTR forms, residual HIV-1 viremia and proviral DNA quasispecies evolution were also investigated.119 successfully ART-treated HIV/HCV co-infected patients were included. Median baseline HIV-1 DNA was 3.84 Log copies/million PBMC (95%CI 3.49-4.05, and no significant variation with respect to baseline was found at EOT and after 3 months of DAA termination. In 17% of cases an increase ≥0.5 Log copies/million PBMC was observed at EOT compared to baseline. HIV-1 DNA increase was independently associated with lower baseline HIV-1 DNA, longer HIV suppression, raltegravir-based ART and previous exposure to interferon/ribavirin for HCV treatment. In none of the patients with HIV-1 DNA increase, 2-LTR forms were detected at baseline, while in 2 cases 2-LTR forms were found at EOT, without association with residual HIV-1 RNA viremia. No evidence of viral evolution was observed.In successfully ART-treated HIV/HCV co-infected patients receiving DAA, PBMC-associated total HIV-1 DNA was quite stable over time, but some patients showed a considerable increase at EOT when compared to baseline. A significantly higher risk of HIV DNA increase was found, in presence of lower cellular HIV reservoir at baseline. Activation of replicative-competent virus generating new rounds of viral replication seems unlikely, while mobilization of cell-associated HIV from tissue reservoirs could be hypothesized.

  9. Evidence of an increased pathogenic footprint in the lingual microbiome of untreated HIV infected patients

    Directory of Open Access Journals (Sweden)

    Dang Angeline T

    2012-07-01

    Full Text Available Abstract Background Opportunistic oral infections can be found in over 80% of HIV + patients, often causing debilitating lesions that also contribute to deterioration in nutritional health. Although appreciation for the role that the microbiota is likely to play in the initiation and/or enhancement of oral infections has grown considerably in recent years, little is known about the impact of HIV infection on host-microbe interactions within the oral cavity. In the current study, we characterize modulations in the bacterial composition of the lingual microbiome in patients with treated and untreated HIV infection. Bacterial species profiles were elucidated by microarray assay and compared between untreated HIV infected patients, HIV infected patients receiving antiretroviral therapy, and healthy HIV negative controls. The relationship between clinical parameters (viral burden and CD4+ T cell depletion and the loss or gain of bacterial species was evaluated in each HIV patient group. Results In untreated HIV infection, elevated viremia was associated with significantly higher proportions of potentially pathogenic Veillonella, Prevotella, Megasphaera, and Campylobacter species in the lingual microbiome than observed in healthy controls. The upsurge in the prevalence of potential pathogens was juxtaposed by diminished representation of commensal Streptococcus and Veillonella species. Colonization of Neisseria flavescens was lower in the lingual microbiome of HIV infected patients receiving antiretroviral therapy than in uninfected controls. Conclusions Our findings provide novel insights into the potential impact of HIV infection and antiretroviral therapy on the community structure of the oral microbiome, and implicate potential mechanisms that may increase the capacity of non-commensal species to gain a stronger foothold.

  10. Perioperative considerations in the patient with Angelman syndrome.

    Science.gov (United States)

    Bevinetto, Cara M; Kaye, Alan D

    2014-02-01

    Angelman syndrome arises by one of 4 genetic mechanisms. Patients often have craniofacial abnormalities, vagal hypertonia, skeletal muscle atrophy or underdevelopment, a history of seizure disorders, and pharmacodynamic unpredictability. Its pathogenesis, clinical manifestations, diagnosis and treatment options, and perioperative anesthetic considerations are presented. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Surgical considerations in the emergent small animal patient.

    Science.gov (United States)

    Devey, Jennifer J

    2013-07-01

    To ensure a successful outcome when performing emergency surgery, the clinician must have the knowledge to be able to assess the patient to determine that surgical intervention is necessary, and to determine the urgency of the procedure. The clinician must have the skills to manage common surgical emergency procedures and the equipment necessary to perform the surgery. This article discusses surgical considerations for the emergent patient, including preoperative patient assessment, readiness, surgical instrumentation, and patient preparation. An overview of the trauma triad of death, options for providing effective hemostasis, damage control surgery, peritoneal lavage and drainage, and wound management are reviewed. Copyright © 2013 Elsevier Inc. All rights reserved.

  12. Disseminated Strongyloidiasis among HIV/AIDS Patients in Jimma ...

    African Journals Online (AJOL)

    Background and objectives:Strongyloidiasis has become a very important disease in HIV/AIDS patients. Reports pertaining to this aspect are very scarce in Ethiopia. The objective of this study was to determine the prevalence of Strongyloides stercoralis in stool and sputum samples of HIV/AIDS patients. Patients and ...

  13. Prevalence of HIV infection among trauma patients admitted to ...

    African Journals Online (AJOL)

    HIV infection, a major health problem worldwide, has been reported to be prevalent in trauma patients, thus presents an occupational hazard to health care workers who care for these patients. The purpose of this study was to establish the prevalence of HIV among trauma patients in our setting and to compare the outcome ...

  14. Yellow fever vaccine for patients with HIV infection.

    Science.gov (United States)

    Barte, Hilary; Horvath, Tara H; Rutherford, George W

    2014-01-23

    Yellow fever (YF) is an acute viral haemorrhagic disease prevalent in tropical Africa and Latin America. The World Health Organization (WHO) estimates that there are 200,000 cases of YF and 30,000 deaths worldwide annually. Treatment for YF is supportive, but a live attenuated virus vaccine is effective for preventing infection. WHO recommends immunisation for all individuals > 9 months living in countries or areas at risk. However, the United States Advisory Committee on Immunization Practices (ACIP) advises that YF vaccine is contraindicated in individuals with HIV. Given the large populations of HIV-infected individuals living in tropical areas where YF is endemic, YF vaccine may be an important intervention for preventing YF in immunocompromised populations. To assess the risk and benefits of YF immunisation for people infected with HIV. We used standard Cochrane methods to search electronic databases and conference proceedings with relevant search terms without limits to language. Randomised controlled trials and cohort studies of individuals with HIV infection who received YF vaccine (17DD or 17D-204). Two authors screened abstracts of references identified by electronic or bibliographic searches according to inclusion and exclusion criteria as detailed in the protocol. We identified 199 references and examined 19 in detail for study eligibility. Data were abstracted independently using a standardised abstraction form. Three cohort studies were included in the review. They examined 484 patients with HIV infection who received YF immunisation. Patients with HIV infection developed significantly lower concentrations of neutralising antibodies in the first year post immunisation compared to uninfected patients, though decay patterns were similar for recipients regardless of HIV infection. No study patient with HIV infection suffered serious adverse events as a result of YF vaccination. YF vaccination can produce protective levels of neutralising antibodies in

  15. HIV-2 diagnosis and quantification in high-risk patients

    Directory of Open Access Journals (Sweden)

    Kojic Erna

    2008-08-01

    Full Text Available Abstract Current diagnostic assays for HIV-1 do not always test for the presence of HIV-2 in the United States. We present the case of a patient from Cape Verde, who was admitted to our hospital with rapidly deteriorating neurological function and multiple white matter lesions on MRI likely secondary to progressive multifocal leukoencephalopathy (PML. Initially, the patient had a positive EIA for HIV, but a negative HIV-1 Western Blot and no viral load detected on a branched-DNA assay. A repeat viral load by reverse transcriptase methodology (RT-DNA detected 121,000 copies and an HIV-2 Western Blot was positive. The case highlights an extremely rare presentation of HIV-2 with severe neurological disease. We discuss the different tests available for the diagnosis and monitoring of HIV-2 in the United States.

  16. Conditional economic incentives to improve HIV treatment adherence: literature review and theoretical considerations

    OpenAIRE

    Galárraga, Omar; Genberg, Becky L.; Martin, Rosemarie A.; Laws, M. Barton; Wilson, Ira B.

    2013-01-01

    We present selected theoretical issues regarding conditional economic incentives (CEI) for HIV treatment adherence. High HIV treatment adherence is essential not only to improve individual health for persons living with HIV, but also to reduce transmission. The incentives literature spans several decades and various disciplines, thus we selectively point out useful concepts from economics, psychology and HIV clinical practice to elucidate the complex interaction between socio-economic issues,...

  17. Global HIV Prevention Programs for Long-Haul Truckers: Considerations for the U.S.

    Science.gov (United States)

    Winkelman, Sloane Burke; Kimuna, Sitawa R.; Haithcox-Dennis, Melissa

    2012-01-01

    In the United States, an estimated 1.2 million people are living with HIV/AIDS, and approximately 50,000 new cases of HIV are diagnosed each year. Globally, it is estimated that 33.3 million people are living with HIV/AIDS. The role of mobile populations in the spread of STIs and HIV is well-documented in many countries around the world. Long-haul…

  18. Associations between Social Capital and HIV Stigma in Chennai, India: Considerations for Prevention Intervention Design

    Science.gov (United States)

    Sivaram, Sudha; Zelaya, Carla; Srikrishnan, A. K.; Latkin, Carl; Go, V. F.; Solomon, Suniti; Celentano, David

    2009-01-01

    Stigma against persons living with HIV/AIDS (PLHA) is a barrier to seeking prevention education, HIV testing, and care. Social capital has been reported as an important factor influencing HIV prevention and social support upon infection. In the study, we explored the associations between social capital and stigma among men and women who are…

  19. HIV stigma: perceptions from HIV-positive and HIV-negative patients in a community dental clinic

    Directory of Open Access Journals (Sweden)

    Steven Toth

    2016-12-01

    Full Text Available Background. In the medical sense, stigma has been defined as the collection of negative attitudes and beliefs that are directed at people living with a particular condition or disease process. A cohort study was conducted to explore the HIV stigma that is perceived by HIV-positive individuals versus that perceived by the general population within a community-based dental clinic. Methods. Two separate and independent cross-sectional surveys, the Berger Stigma Scale and the Rutgers-Modified Berger Stigma Scale, were employed in order to analyze the stigma factors of an HIV-positive population versus an HIV-negative general population, respectively. The HIV stigma factors studied included personalized stigma, disclosure concerns, negative self-image, and concern with public attitudes. Results. The total stigma scale scores for the studied HIV-positive population were significantly lower than the total stigma scale scores for the studied HIV-negative population (P < 0.05. Conclusion. Interestingly, there is a misplaced expectation by the general population that HIV-positive individuals experience more stigma than the HIV-positive population in the clinic actually reported. Interventions to reduce HIV stigma should be an integral component of comprehensive care for all patients.

  20. Challenges in Detecting HIV Persistence during Potentially Curative Interventions: A Study of the Berlin Patient

    Science.gov (United States)

    Busch, Michael; Bentsen, Christopher; Chun, Tae-Wook; Douek, Daniel; Eisele, Evelyn; Haase, Ashley; Ho, Ya-Chi; Hütter, Gero; Justement, J. Shawn; Keating, Sheila; Lee, Tzong-Hae; Li, Peilin; Murray, Danielle; Palmer, Sarah; Pilcher, Christopher; Pillai, Satish; Price, Richard W.; Rothenberger, Meghan; Schacker, Timothy; Siliciano, Janet; Siliciano, Robert; Sinclair, Elizabeth; Strain, Matt; Wong, Joseph; Richman, Douglas; Deeks, Steven G.

    2013-01-01

    There is intense interest in developing curative interventions for HIV. How such a cure will be quantified and defined is not known. We applied a series of measurements of HIV persistence to the study of an HIV-infected adult who has exhibited evidence of cure after allogeneic hematopoietic stem cell transplant from a homozygous CCR5Δ32 donor. Samples from blood, spinal fluid, lymph node, and gut were analyzed in multiple laboratories using different approaches. No HIV DNA or RNA was detected in peripheral blood mononuclear cells (PBMC), spinal fluid, lymph node, or terminal ileum, and no replication-competent virus could be cultured from PBMCs. However, HIV RNA was detected in plasma (2 laboratories) and HIV DNA was detected in the rectum (1 laboratory) at levels considerably lower than those expected in ART-suppressed patients. It was not possible to obtain sequence data from plasma or gut, while an X4 sequence from PBMC did not match the pre-transplant sequence. HIV antibody levels were readily detectable but declined over time; T cell responses were largely absent. The occasional, low-level PCR signals raise the possibility that some HIV nucleic acid might persist, although they could also be false positives. Since HIV levels in well-treated individuals are near the limits of detection of current assays, more sensitive assays need to be developed and validated. The absence of recrudescent HIV replication and waning HIV-specific immune responses five years after withdrawal of treatment provide proof of a clinical cure. PMID:23671416

  1. Challenges in detecting HIV persistence during potentially curative interventions: a study of the Berlin patient.

    Directory of Open Access Journals (Sweden)

    Steven A Yukl

    Full Text Available There is intense interest in developing curative interventions for HIV. How such a cure will be quantified and defined is not known. We applied a series of measurements of HIV persistence to the study of an HIV-infected adult who has exhibited evidence of cure after allogeneic hematopoietic stem cell transplant from a homozygous CCR5Δ32 donor. Samples from blood, spinal fluid, lymph node, and gut were analyzed in multiple laboratories using different approaches. No HIV DNA or RNA was detected in peripheral blood mononuclear cells (PBMC, spinal fluid, lymph node, or terminal ileum, and no replication-competent virus could be cultured from PBMCs. However, HIV RNA was detected in plasma (2 laboratories and HIV DNA was detected in the rectum (1 laboratory at levels considerably lower than those expected in ART-suppressed patients. It was not possible to obtain sequence data from plasma or gut, while an X4 sequence from PBMC did not match the pre-transplant sequence. HIV antibody levels were readily detectable but declined over time; T cell responses were largely absent. The occasional, low-level PCR signals raise the possibility that some HIV nucleic acid might persist, although they could also be false positives. Since HIV levels in well-treated individuals are near the limits of detection of current assays, more sensitive assays need to be developed and validated. The absence of recrudescent HIV replication and waning HIV-specific immune responses five years after withdrawal of treatment provide proof of a clinical cure.

  2. Social media interventions to prevent HIV: A review of interventions and methodological considerations

    Science.gov (United States)

    Tso, Lai Sze; Tang, Weiming; Li, Haochu; Yan, H. Yanna; Tucker, Joseph D.

    2015-01-01

    Persistent new HIV infections and risky behaviors underscore the need for enhanced HIV prevention. Social media interventions may promote safe sexual behaviors, increase HIV testing uptake, and promote safe injection behaviors. This review discusses how social media interventions tap into the wisdom of crowds through crowdsourcing, build peer-mentored communities, and deliver interventions through social networks. Social media HIV prevention interventions are constrained by ethical issues, low social media usage among some key populations, and implementation issues. Comprehensive measurement of social media interventions to prevent HIV is necessary, but requires further development of metrics. PMID:26516632

  3. Antiretroviral treatment uptake in patients with HIV- associated TB ...

    African Journals Online (AJOL)

    Corresponding author: M Nglazi (Mweete.Nglazi@hiv-research.org.za). Background. Delivery of integrated care for patients with HIV-associated TB is challenging. We assessed the uptake and timing of antiretroviral treatment (ART) among eligible patients attending a primary care service with co-located ART and TB clinics.

  4. Determinants of HIV Testing Among Tuberculosis Patients on DOTS ...

    African Journals Online (AJOL)

    The main aim of the study was to assess determinants of HIV testing among Tuberculosis patients on DOTS in East Wollega zone, Ethiopia. Institution based case control study was conducted from January – March 2011. Cases were tuberculosis patients who have not accepted HIV testing while the controls were those who ...

  5. Uropathogens isolated from HIV-infected patients from Limpopo ...

    African Journals Online (AJOL)

    Uropathogens isolated from HIV-infected patients from Limpopo Province, South Africa. BC Iweriebor, CL Obi, O Akinyemi, NJ Ramalivhana, T Hattori, AI Okoh. Abstract. The primary aim of this study was to determine the prevalence and antibiotic susceptibility profiles of uropathogens isolated from HIV-infected patients in ...

  6. Ocular 'Manifestations of HIV/AIDS patients in Gondar University ...

    African Journals Online (AJOL)

    The spectrum of ocular diseases in HIV-infected patients in developing countries is .... Vernal conjunctivitis 1 (0.8). Sub conjucnctival ... of HIV infection. In this study, it was also 'found to be an important cause of unilateral blindness due to severe involvement of the eyes, late presentation of patients and failure of early ...

  7. Prevalence of intestinal parasites among HIV patients in Baringo ...

    African Journals Online (AJOL)

    Introduction HIV patients have reduced immune response which makes them more susceptible to different infections. This cross-sectional study was carried out to document the prevalence of intestinal parasites among HIV patients in Baringo County, Kenya. Methods Structured questionnaires were used to collect clinical ...

  8. (hiv) seropositivity in african patients presenting to the eye clinic

    African Journals Online (AJOL)

    %) patient each. These findings suggest that, patients with ocular disorders and who are otherwise healthy looking may infact be HIV seropositive and as such it may be necessary to observe all rules relating to HIV transmission so as to prevent ...

  9. Hypertension and obesity among HIV patients in a care programme ...

    African Journals Online (AJOL)

    Objective: To determine the prevalence of hypertension and obesity among HIV patients enrolled in the Sex Worker Outreach Programme (SWOP), Nairobi, Kenya. Design: A retrospective astudy. Setting: SWOP managed by the University of Manitoba, Nairobi team. Subjects: We selected clinic visit records from HIV patients ...

  10. Community Based Organizations in HIV/AIDS Prevention, Patient ...

    African Journals Online (AJOL)

    The various CBOs can be partners in HIV/AIDS prevention, patient care/support and control programs. They may facilitate efforts to curb the spread of HIV through the expansion of awareness creation and prevention initiatives and also provide patient care and support. The kebele may act as forum for community initiatives ...

  11. Dialysis and renal transplantation in HIV-infected patients

    DEFF Research Database (Denmark)

    Trullas, Joan Carles; Mocroft, Amanda; Cofan, Federico

    2010-01-01

    To determine prevalence and characteristics of end-stage renal diseases (ESRD) [dialysis and renal transplantation (RT)] among European HIV-infected patients.......To determine prevalence and characteristics of end-stage renal diseases (ESRD) [dialysis and renal transplantation (RT)] among European HIV-infected patients....

  12. A CLINICAL STUDY OF OCULAR MANIFESTATIONS IN HIV PATIENTS

    Directory of Open Access Journals (Sweden)

    Ravinder

    2015-12-01

    Full Text Available BACKGROUND HIV/AIDS is a multi system disorder with ocular involvement is about 70-80% of HIV patient occupational exposure to HIV is a significant health hazard for the treating clinicians including Eye Surgeons. AIM To study and evaluation of ocular manifestation in HIV patients attending out patient. MATERIALS AND METHODS It is observational study of 104 HIV+ve cases for a period of 1 year those patients who attended ophthalmic out patient department. RESULTS 73 were males (70.19% and 31 were females (29.80%. Majority of the patients belongs to age group of 15-50 years. Out of 104 patients 83(79.80% were married and 21(20.20% were unmarried. HIV was predominantly seen in labourers 41(32.42%. The predominant mode of transmission of sexual (Hetero Sexual transmission. HIV infection was predominantly seen in uneducated patients 64(61.53%. Total No. of ocular findings in 51 cases out of 75 with anterior Uveitis, Conjunctival microvasculopathy, Herpes Simplex Keratitis and Conjunctivitis are the most common anterior segment manifestation. CMV retinitis, HIV Microvasculopathy are the most common posterior segment manifestation. CONCLUSIONS Ophthalmologists should be familiar with common and uncommon ocular manifestations of AIDS+ve cases and their diagnosis and treatment, as early and proper treatment can Salvage their vision and improve the quality of life.

  13. Maximizing HIV partner notification opportunities for index patients ...

    African Journals Online (AJOL)

    Maximizing HIV partner notification opportunities for index patients and their sexual partners in Malawi ... contacts of an individual who has a sexually transmitted infection (STI), such as HIV, of their possible ... disease diagnosed in index patient, and greater than primary education in the index. To achieve success for ...

  14. Tuberculosis among HIV-positive patients across Europe

    DEFF Research Database (Denmark)

    Kruk, Alexey; Bannister, Wendy; Podlekareva, Daria

    2011-01-01

    To describe temporal changes in the incidence rate of tuberculosis (TB) (pulmonary or extrapulmonary) among HIV-positive patients in western Europe and risk factors of TB across Europe.......To describe temporal changes in the incidence rate of tuberculosis (TB) (pulmonary or extrapulmonary) among HIV-positive patients in western Europe and risk factors of TB across Europe....

  15. Patients-to-healthcare workers HIV transmission risk from sharp ...

    African Journals Online (AJOL)

    Epidemiological findings proved the infectious potential of this injury contaminated with a Human Immunodeficiency Virus (HIV)-infected patient's blood. Objective: This study aimed at estimating the risk of HIV transmission from patients to healthcare workers in Hawassa City, Ethiopia. Method: A probabilistic risk model was ...

  16. The attitudes of nurses towards HIV positive patients | Deetlefs ...

    African Journals Online (AJOL)

    The attitudes of nurses towards HIV positive patients. ... Negative attitudes may influence the quality of nursing care. In the light of this ... Nurses cope with the resulting discomfort by using defence and coping mechanisms, which hamper the development of a therapeutic relationship between them and HIV positive patients.

  17. Baseline CD4 lymphocyte count among HIV patients in Kano ...

    African Journals Online (AJOL)

    kemrilib

    HIV infection. Consequently, we evaluated baseline CD4 counts of 500 HIV seropsitive adults in a government sponsored anti-retroviral treatment (ART) scheme at our centre, for ... majority (92%) of our patients were within the sexually active, 3rd to 5th decade age group, ... Half of our patients (251 cases) had AIDS as.

  18. Treating depression in HIV-positive patients affects adherence

    African Journals Online (AJOL)

    2012-09-02

    Sep 2, 2012 ... ART adherence in a group of HIV-positive patients with depression at Chris Hani Baragwanath Academic Hospital. Treating depression in HIV-positive patients affects adherence. M Y H Moosa, F Y Jeenah. Division of Psychiatry, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg.

  19. Interleukin-2 therapy in patients with HIV infection

    DEFF Research Database (Denmark)

    Abrams, D; Lévy, Y; Losso, M H

    2009-01-01

    Interleukin-2 in HIV-Infected Patients with Low CD4+ Counts under Active Antiretroviral Therapy (SILCAAT) study and the Evaluation of Subcutaneous Proleukin in a Randomized International Trial (ESPRIT). In each, patients infected with the human immunodeficiency virus (HIV) who had CD4+ cell counts of either...

  20. Posterior segment ocular manifestations of HIV/AIDS patients.

    Science.gov (United States)

    Chiotan, C; Radu, L; Serban, R; Cornăcel, C; Cioboată, M; Anghelie, A

    2014-09-15

    Human immunodeficiency virus (HIV) has the ability to affect any organ in the body. In 70% of HIV -infected patients ocular manifestations were observed, these, in the vast majority reflect the systemic disease and may be the first signs of disseminated infections. The purpose of this paper is to determine the prevalence of posterior segment ocular manifestations in HIV / AIDS (Acquired Immunodeficiency Syndrome) patients. The study is retrospective, conducted in the Cabinet of Ophthalmology of "Matei Bals" Infectious Diseases Hospital in Bucharest, during the period 1 August 2007 - 1 August 2013 . Each patient was examined thoroughly at the biomicroscope ocular slit by using 90D microscope lens and 20D indirect lens after the administration of topical mydriatics. 348 patients with HIV/AIDS and ocular disorders were followed. There was a high number of children and young people with HIV who had eye disorders (194 patients aged between 14 and 25 years). 44.25% of patients had posterior segment ocular damage, 17.55% of them had the anterior segment affected. 22.90% of the 131 patients with compromised posterior segment microangiopathy have been diagnosed with HIV / AIDS. Doctors should be aware of the existence of ocular damage in HIV / AIDS and to emphasize the importance of regular ophthalmologic examination of patients with HIV / AIDS.

  1. Anesthetic considerations for patients with postpolio syndrome: a case report.

    Science.gov (United States)

    Wheeler, Donna

    2011-10-01

    Postpolio syndrome is a disorder related to the recurrence of neuromuscular symptoms in survivors of paralytic poliomyelitis. A comprehensive understanding of the pathophysiology is necessary for the anesthesia provider to develop a safe anesthetic plan. This case report discusses the anesthetic challenges and considerations in patients with postpolio syndrome, focusing on the importance of careful pharmacologic dosing of opioids, and neuromuscular agents as well as perioperative and postoperative issues related to aspiration risks, cold intolerance, and positioning.

  2. HBV/HIV coinfection is associated with poorer outcomes in hospitalized patients with HBV or HIV.

    Science.gov (United States)

    Rajbhandari, R; Jun, T; Khalili, H; Chung, R T; Ananthakrishnan, A N

    2016-10-01

    We examined the impact of HBV/HIV coinfection on outcomes in hospitalized patients compared to those with HBV or HIV monoinfection. Using the 2011 US Nationwide Inpatient Sample, we identified patients who had been hospitalized with HBV or HIV monoinfection or HBV/HIV coinfection using ICD-9-CM codes. We compared liver-related admissions between the three groups. Multivariable logistic regression was performed to identify independent predictors of in-hospital mortality, length of stay and total charges. A total of 72 584 discharges with HBV monoinfection, 133 880 discharges with HIV monoinfection and 8156 discharges with HBV/HIV coinfection were included. HBV/HIV coinfection was associated with higher mortality compared to HBV monoinfection (OR 1.67, 95% CI 1.30-2.15) but not when compared to HIV monoinfection (OR 1.22, 95% CI 0.96-1.54). However, the presence of HBV along with cirrhosis or complications of portal hypertension was associated with three times greater in-hospital mortality in patients with HIV compared to those without these complications (OR 3.00, 95% CI 1.80-5.02). Length of stay and total hospitalization charges were greater in the HBV-/HIV-coinfected group compared to the HBV monoinfection group (+1.53 days, P HBV/HIV coinfection is a risk factor for in-hospital mortality, particularly in liver-related admissions, compared to HBV monoinfection. Overall healthcare utilization from HBV/HIV coinfection is also higher than for either infection alone and higher than the national average for all hospitalizations, thus emphasizing the healthcare burden from these illnesses. © 2016 John Wiley & Sons Ltd.

  3. Caring for Patients of the Millennial Generation: Considerations for Nurses.

    Science.gov (United States)

    Johanson, Linda S

    2017-07-01

    Much has been written about teaching students of the Millennial Generation (those born between the years 1980 and 2000) and about intergenerational dynamics in the healthcare workforce. However, little can be found in the literature regarding generation-specific nursing care of Millennial patients. This article presents six categories of considerations for nurses caring for patients of the Millennial Generation based on the characteristics, attitudes, and values that have influenced them as well as the healthcare issues confronting this group of young adults. © 2016 Wiley Periodicals, Inc.

  4. Intimate relationships in young adults with perinatally acquired HIV: partner considerations.

    Science.gov (United States)

    Greenhalgh, Clare; Evangeli, Michael; Frize, Graham; Foster, Caroline; Fidler, Sarah

    2013-01-01

    Due to developments in anti-retroviral treatment, an increasing number of children with perinatally acquired HIV are now surviving into late adolescence and young adulthood. This cohort is facing normative challenges in terms of their intimate relationships as well as challenges that face all individuals with HIV regardless of the route of transmission (for example, concerns about disclosure). There may be additional issues specific to having grown up with HIV that affect intimate relationships, for example, the awareness of being HIV positive before the onset of intimate relationships and the way that identity is shaped by having lived with HIV from a young age. To date there has been some limited research on the experience of intimate relationships in perinatally infected adolescents but none in young adults. This exploratory study examined, in depth, experiences of intimate relationships in perinatally acquired young adults and how they perceived having grown up with HIV to have affected such relationships. Seven participants (five females, two males) aged 18-23 years, were interviewed, with the data analysed according to the principles of interpretative phenomenological analysis (IPA). Three themes emerged that related to partners' perceptions of HIV: (1) HIV being viewed by partners as being linked to AIDS and sexual transmission, (2) discrepancy between young people and their partners' views of HIV, (3) partner views of risk of HIV transmission. There were strong links between participants' personal experiences of HIV-related challenges, for example, disclosure and HIV-related stigma, and their thinking about the perceptions of partners. These findings have important implications for supporting young people in disclosing their HIV status to intimate partners in appropriate ways. Suggestions for future research are offered.

  5. Hearing function in patients living with HIV/AIDS.

    Science.gov (United States)

    Luque, Amneris E; Orlando, Mark S; Leong, U-Cheng; Allen, Paul D; Guido, Joseph J; Yang, Hongmei; Wu, Hulin

    2014-01-01

    During the earlier years of the HIV/AIDS epidemic, initial reports described sensorineural hearing loss in up to 49% of individuals with HIV/AIDS. During those years, patients commonly progressed to advanced stages of HIV disease and frequently had neurological complications. However, the abnormalities on pure-tone audiometry and brainstem-evoked responses outlined in small studies were not always consistently correlated with advanced stages of HIV/AIDS. Moreover, these studies could not exclude the confounding effect of concurrent opportunistic infections and syphilis. Additional reports also have indicated that some antiretroviral medications may be ototoxic; thus, it has been difficult to make conclusions regarding the cause of changes in hearing function in HIV-infected patients. More recently, accelerated aging has been suggested as a potential explanation for the disproportionate increase in complications of aging described in many HIV-infected patients; hence, accelerated aging-associated hearing loss may also be playing a role in these patients. We conducted a large cross-sectional analysis of hearing function in over 300 patients with HIV-1 infection and in 137 HIV-uninfected controls. HIV-infected participants and HIV-uninfected controls underwent a 2-hr battery of hearing tests including the Hearing Handicap Inventory, standard audiometric pure-tone air and bone conduction testing, tympanometric testing, and speech reception and discrimination testing. Three-way analysis of variance (ANOVA) and logistic regression analysis of 278 eligible HIV-infected subjects stratified by disease stage in early HIV disease (n = 127) and late HIV disease (n = 148) and 120 eligible HIV-uninfected controls revealed no statistically significant differences among the three study groups in either overall 4-frequency pure-tone average (4-PTA) or hearing loss prevalence in either ear. Three-way ANOVA showed significant differences in word recognition scores in the right ear

  6. Epidemiology of tuberculosis in HIV-infected patients in Denmark

    DEFF Research Database (Denmark)

    Dragsted, Ulrik Bak; Bauer, J; Poulsen, S

    1999-01-01

    no evidence to suggest that the increase in TB incidence among young Danes was caused by the HIV-epidemic or transmission from immigrants. TB among HIV-positive Danes is most often due to recent infection. The patients often belong to a subpopulation living in Copenhagen characterized by intravenous drug use.......Denmark is an area of low incidence of HIV and tuberculosis (TB). The number of newly reported cases of HIV has been stable during the 1990s, whereas the number of TB cases has doubled in Denmark in the past decade, mainly due to immigration. However, among native Danes the incidence of TB has...... increased in the younger age groups, indicating more newly infected persons. This study was performed in order to assess the impact of the HIV epidemic and immigration on TB incidence among native Danes. The study was also designed to reveal transmission patterns of TB among HIV-positive patients. Data from...

  7. HIV-positive patients' and their families' comprehension of HIV- and ...

    African Journals Online (AJOL)

    HIV-positive patients' and their families' comprehension of HIV- and AIDS-related information. ... perceived that pre- and post-counselling provided an opportunity for information sharing, but that they need health care workers to spend more time with them, to be non-judgemental and to make more use of visual aids.

  8. Liver function tests in HIV-1 infected asymptomatic patients and HIV ...

    African Journals Online (AJOL)

    Hepatic functions were assessed by serum assays of albumin (ALB), total protein (TP), total bilirubin (TB), conjugated bilirubin (CB), serum activities of alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP) and gamma – glutamyl transferase (GGT) in 51 HIV-1AIDS patients, 38 HIV-1 ...

  9. immunological profiles in hiv positive patients following haart ...

    African Journals Online (AJOL)

    2014-08-01

    Social. Cornum; all located in Kigali. Subjects: Thirty three (33) HAART initiation eligible HIV positive patients including 13 women and 20 men. Results: A drop in viral load (though only a small number of patients achieved an.

  10. FEATURES OF PNEUMONIA IN HIV-INFECTED PATIENTS

    Directory of Open Access Journals (Sweden)

    M. T. Vatutin

    2016-01-01

    Full Text Available The article presents the clinical, diagnostic and treatment features of pneumocystis pneumonia in HIV-infected patients. The clinical case of diagnosis verification in a patient 58 years old with severe respiratory failure is described.

  11. Mortality after myocardial infarction in HIV-infected patients who have initiated HAART

    DEFF Research Database (Denmark)

    Rasmussen, Line D; Gerstoft, Jan; Kronborg, Gitte

    2007-01-01

    We identified all Danish HIV patients registered with myocardial infarction (MI) when on HAART (44 patients) and compared their mortality with that of matched patients with MI and no HIV and patients with HIV and no MI. Mortality in HIV-infected MI patients was not significantly different...

  12. HIV-infected mental health patients: characteristics and comparison with HIV-infected patients from the general population and non-infected mental health patients

    NARCIS (Netherlands)

    Schade, A.; Grootheest, G.; Smit, J.H.

    2013-01-01

    Objectives: HIV-infected patients are at increased risk of developing mental health symptoms, which negatively influence the treatment of the HIV-infection. Mental health problems in HIV-infected patients may affect public health. Psychopathology, including depression and substance abuse, can

  13. HIV and parasitic co-infections in tuberculosis patients

    DEFF Research Database (Denmark)

    Range, N.; Magnussen, Pascal; Mugomela, A.

    2007-01-01

    A cross-sectional study was conducted in Mwanza, Tanzania, to determine the burden of HIV and parasitic co-infections among patients who were confirmed or suspected cases of pulmonary tuberculosis (PTB). Of the 655 patients investigated, 532 (81.2%) had been confirmed as PTB cases, by microscopy...... and Strongyloides stercoralis infections were less common, each recorded at a prevalence of HIV-positive than the PTB- patients (43.6% v. 62.6%; PHIV-positive had a significantly lower prevalence (12.1% v. 25%; P... intensity (49 v. 123 eggs/g; P=0.003) of hookworm infection than the HIV-negative. The PTB patients in the study area were, however, still frequently co-infected with HIV and with parasitic infections that may increase morbidity and accelerate the progression of HIV disease. Udgivelsesdato: 2007-Jun...

  14. [Incidence and etiology of psychotic disorders in HIV infected patients].

    Science.gov (United States)

    Niederecker, M; Naber, D; Riedel, R; Perro, C; Goebel, F D

    1995-05-01

    There are numerous case reports on psychoses in AIDS patients and, although more seldom, also in HIV-positive patients in early stages of infection; however, systematic investigations on the frequency, e.g., relevant for the indication of an HIV test in psychiatric patients, are missing. For this study, 1046 HIV-positive patients were examined regarding psychoses. A total of 301 patients (28.8%) were HIV-positive but asymptomatic, and 380 patients (36.2%) had the lymphadenopathy syndrome. One hundred thirty-two patients (12.6%) suffered from an AIDS-related complex and 233 patients (22.3%) from AIDS. Of these 1046 patients, only 9 (0.9%) suffered from psychoses. One patient with a paranoid-hallucinatory syndrome was asymptomatic; one in the lymphadenopathy syndrome was manic. The other 7 patients were all in late stages of the infection. A causal relationship between HIV infection and psychosis and probable in only 3 patients. These data do not indicate a markedly elevated prevalence of psychosis in HIV-positive or AIDS patients.

  15. Cardiopulmonary bypass considerations for pediatric patients on the ketogenic diet.

    Science.gov (United States)

    Melchior, R W; Dreher, M; Ramsey, E; Savoca, M; Rosenthal, T

    2015-07-01

    There is a population of children with epilepsy that is refractory to anti-epileptic drugs. The ketogenic diet, a high-fat, low-carbohydrate regimen, is one alternative treatment to decrease seizure activity. Special considerations are required for patients on the ketogenic diet undergoing cardiopulmonary bypass (CPB) to prevent exposure to glucose substrates that could alter ketosis, increasing the risk of recurrent seizures. A 2-year-old, 9 kilogram male with a history of infantile spasms with intractable epilepsy, trisomy 21 status post tetralogy of Fallot repair, presented to the cardiac operating room for closure of a residual atrial septal defect. All disciplines of the surgical case minimized the use of carbohydrate-containing and contraindicated medications. Changes to the standard protocol and metabolic monitoring ensured the patient maintained ketosis. All disciplines within cardiac surgery need to be cognizant of patients on the ketogenic diet and prepare a modified protocol. Future monitoring considerations include thromboelastography, electroencephalography and continuous glucose measurement. Key areas of focus with this patient population in the cardiac surgical theater are to maintain a multidisciplinary approach, alter the required CPB prime components, address cardiac pharmacological concerns and limit any abnormal hematological occurrences. © The Author(s) 2014.

  16. Oral and constitutional manifestations of HIV-infected hospital patients in Northern Vietnam

    DEFF Research Database (Denmark)

    Jensen, Tomas O; Tam, Vu V; Mai, Nguyen T

    2005-01-01

    candidiasis (OPC) with HIV infection and late stage HIV disease. Late stage HIV disease was defined as WHO stage III or IV and/or a total lymphocyte count below 1200 cells/mm3. The 56 HIV positive patients included all patients with a positive HIV test between July 7th and September 9th 2002. A total of 114...

  17. Leprosy in a patient infected with HIV.

    Science.gov (United States)

    Galtrey, Clare M; Modarres, Hamid; Jaunmuktane, Zane; Brandner, Sebastian; Rossor, Alexander M; Lockwood, Diana Nj; Reilly, Mary M; Manji, Hadi; Schon, Fred

    2017-04-01

    A 60-year-old Nigerian man, who had lived in Europe for 30 years but had returned home frequently, presented with right frontalis muscle weakness and right ulnar nerve palsy, without skin lesions. Neurophysiology showed a generalised neuropathy with demyelinating features. Blood tests were positive for HIV, with a normal CD4 count. There was nerve thickening both clinically and on MRI. Nerve biopsy showed chronic endoneuritis and perineuritis (indicating leprosy) without visible mycobacteria. His neuropathy continued to deteriorate (lepra reaction) before starting treatment with WHO multidrug therapy, highly active antiretroviral therapy and corticosteroids. There are 10 new cases of leprosy diagnosed annually in the UK. Coinfection with HIV is rare but paradoxically does not usually adversely affect the outcome of leprosy or change treatment. However, permanent nerve damage in leprosy is common despite optimal therapy. Leprosy should be considered in patients from endemic areas who present with mononeuritis multiplex. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  18. Disseminated tuberculosis in an AIDS/HIV-infected patient.

    Directory of Open Access Journals (Sweden)

    Zahra Abdi-Liae

    2013-08-01

    Full Text Available Disseminated tuberculosis (TB is commonly seen in HIV-infected patients and is major cause of death in these patients. In HIV-infected patients disseminated tuberculosis is frequently undiagnosed or misdiagnosed. In this article we report a case of disseminated TB in a HIV-infected patient with a relatively long history of fever and other complaints without definite diagnosis. Diagnosis of disseminated TB was confirmed by bone marrow biopsy and polymerase chain reaction analysis (PCR of the ascitic fluid. With anti-TB treatment signs and symptoms improved.

  19. Renal transplantation in HIV-infected patients: 2010 update.

    Science.gov (United States)

    Trullas, Joan C; Cofan, Federico; Tuset, Montse; Ricart, María J; Brunet, Mercedes; Cervera, Carlos; Manzardo, Christian; López-Dieguez, María; Oppenheimer, Federico; Moreno, Asuncion; Campistol, Josep M; Miro, Jose M

    2011-04-01

    The prognosis of human immunodeficiency virus (HIV) infection has improved in recent years with the introduction of antiretroviral treatment. While the frequency of AIDS-defining events has decreased as a cause of death, mortality from non-AIDS-related events including end-stage renal diseases has increased. The etiology of chronic kidney disease is multifactorial: immune-mediated glomerulonephritis, HIV-associated nephropathy, thrombotic microangiopathies, and so on. HIV infection is no longer a contraindication to transplantation and is becoming standard therapy in most developed countries. The HIV criteria used to select patients for renal transplantation are similar in Europe and North America. Current criteria state that prior opportunistic infections are not a strict exclusion criterion, but patients must have a CD4+ count above 200 cells/mm(3) and a HIV-1 RNA viral load suppressible with treatment. In recent years, more than 200 renal transplants have been performed in HIV-infected patients worldwide, and mid-term patient and graft survival rates have been similar to that of HIV-negative patients. The main issues in post-transplant period are pharmacokinetic interactions between antiretrovirals and immunosuppressants, a high rate of acute rejection, the management of hepatitis C virus coinfection, and the high cardiovascular risk after transplantation. More studies are needed to determine the most appropriate antiretroviral and immunosuppressive regimens and the long-term outcome of HIV infection and kidney graft. © 2011 International Society of Nephrology

  20. CD4 cell count response to first-line combination ART in HIV-2+ patients compared with HIV-1+ patients

    DEFF Research Database (Denmark)

    Wittkop, Linda; Arsandaux, Julie; Trevino, Ana

    2017-01-01

    Background: CD4 cell recovery following first-line combination ART (cART) is poorer in HIV-2+ than in HIV-1+ patients. Only large comparisons may allow adjustments for demographic and pretreatment plasma viral load (pVL). Methods: ART-naive HIV+ adults from two European multicohort collaborations...... underline the need to identify more potent therapeutic regimens or strategies against HIV-2......., COHERE (HIV-1 alone) and ACHIeV2e (HIV-2 alone), were included, if they started first-line cART (without NNRTIs or fusion inhibitors) between 1997 and 2011. Patients without at least one CD4 cell count before start of cART, without a pretreatment pVL and with missing a priori-defined covariables were...

  1. Tubuloreticular inclusions in skin biopsies from patients with HIV infection

    DEFF Research Database (Denmark)

    Pedersen, C; Horn, T; Junge, Jette

    1989-01-01

    Skin biopsies obtained from apparently normal skin from 15 HIV infected patients and 6 anti-HIV negative patients were examined by electron microscopy. Tubuloreticular inclusions (TRI) were detected within the cytoplasm of capillary endothelial cells in 5/5 AIDS patients and in 2/5 patients...... of the patients without TRI, interferon activity was below detection level. The occurrence of TRI was not dependent on the presence of free p24 antigen in serum. It is concluded that the occurrence of TRI in entothelial cells of skin capillaries is associated with late stages of HIV infection and this may...... with AIDS related conditions. Biopsies from 5 asymptomatic HIV positive patients and the 6 control subjects were without ultrastructural alterations. The occurrence of TRI was related to low numbers of CD 4+ lymphocytes. 5/7 patients with TRI had elevated serum interferon activity, and in all...

  2. Clinical value of determination HIV viral load in the cerebrospinal fluid of HIV-infected patients

    Directory of Open Access Journals (Sweden)

    V. B. Musatov

    2015-01-01

    Full Text Available Aim. To analyze the concentration of HIV RNA in the cerebrospinal fluid and to evaluate its significance in the pathology of the central nervous system among HIV infected persons.Materials: We examined 36 patients with HIV infection with signs of pathology of the central nervous system. All patients was done completed a standard investigation of cerebrospinal fluid, cytological examination and detection viral load of HIV in the cerebrospinal fluid and serum.Results. A different of opportunistic and HIV-related disease was diagnosed in 29 patients. The most frequent pathology of the nervous system (12 cases is a diffuse HIV-associated brain damage occurring in 7 patients in the form of aseptic non purulent meningitis and in 5 patients in the form of encephalitis. The average value of the absolute and relative count of CD4-lymphocytes in patients amounted 147,0 cells/μl (40,0; 408,75 and 10.0% (4,00; 18,50. Pathological changes in cellular composition and protein concentration of cerebrospinal fluid detected in 19 cases. Replication of HIV in the cerebrospinal fluid are detected in 31 of 32 patients not receiving antiretroviral therapy, including 17 patients with normal values of cerebrospinal fluid. The average HIV viral load in the cerebrospinal fluid was 15 133,0 copies/ml (2501,0; 30624,0 or 4,18 (3,35; 4,48 lg HIV RNA, average HIV viral load in serum – 62 784,0 copies/ml (6027,5; 173869,0 or 4,80 4,80 (3,7; 5,2 lg HIV RNA. The concentration of HIV in the cerebrospinal fluid was significantly lower than in serum (4,18 and 4,80 lg HIV RNA, p=0.027. 4 patients with severe, multietiology damage of the central nervous system viral, microbial and fungal etiology, there was an inverse relationship between the concentration of HIV in the cerebrospinal fluid and in serum, the concentrations of HIV was higher in the cerebrospinal fluid.Conclusion: Among the majority of HIV-infected patients with signs of the central

  3. Managing dyslipidemia in HIV/AIDS patients: challenges and solutions

    Directory of Open Access Journals (Sweden)

    Husain NE

    2014-12-01

    Full Text Available Nazik Elmalaika OS Husain,1 Mohamed H Ahmed21Department of Pathology, Faculty of Medicine and Health Sciences, Omdurman Islamic University, Khartoum, Sudan; 2Department of Medicine, Milton Keynes Hospital, NHS Foundation Trust, Milton Keynes, UK Abstract: Human immunodeficiency virus (HIV is a chronic disease associated with dyslipidemia and insulin resistance. In addition, the administration of combination antiretroviral therapy is associated with an increase in the incidence of metabolic risk factors (insulin resistance, lipoatrophy, dyslipidemia, and abnormalities of fat distribution in HIV patients. HIV dyslipidemia is a common problem, and associated with an increase in incidence of cardiovascular disease. Further challenges in the management of HIV dyslipidemia are the presence of diabetes and metabolic syndrome, nonalcoholic fatty liver disease, hypothyroidism, chronic kidney disease, the risk of diabetes associated with statin administration, age and ethnicity, and early menopause in females. Dyslipidemia in patients with HIV is different from the normal population, due to the fact that HIV increases insulin resistance and HIV treatment not only may induce dyslipidemia but also may interact with lipid-lowering medication. The use of all statins (apart from simvastatin and lovastatin is safe and effective in HIV dyslipidemia, and the addition of ezetimibe, fenofibrate, fish oil, and niacin can be used in statin-unresponsive HIV dyslipidemia. The management of dyslipidemia and cardiovascular disease risks associated with HIV is complex, and a certain number of patients may require management in specialist clinics run by specialist physicians in lipid disorders. Future research is needed to address best strategies in the management of hyperlipidemia with HIV infection. Keywords: HIV, dylipidaemia, cardiovascular disease, insulin resistance, fatty liver, lipid lowering medication

  4. Obstructive sleep apnea: management considerations in psychiatric patients

    Directory of Open Access Journals (Sweden)

    Heck T

    2015-10-01

    Full Text Available Taryn Heck,1 Monica Zolezzi21Pharmacy Department, University of Alberta Hospital, Alberta Health Services, Edmonton, AB, Canada; 2Clinical Pharmacy and Practice, College of Pharmacy, Qatar University, Doha, QatarAbstract: Psychiatric disorders and obstructive sleep apnea (OSA are often comorbid. However, there is limited information on the impact of psychotropic medications on OSA symptoms, on how to manage psychiatric pharmacotherapy in patients presenting with OSA, or on the effectiveness and challenges of OSA treatments in patients with comorbid mental illness. As such, the objective of this article is to provide an overview of some epidemiological aspects of OSA and treatment considerations in the management of OSA in individuals with comorbid psychiatric disorders. Predefined keywords were used to search for relevant literature in electronic databases. Data show that OSA is particularly prevalent in patients with psychiatric disorders. The medical care that patients with these comorbidities require can be challenging, as some of the psychiatric medications used by these patients may exacerbate OSA symptoms. As such, continuous positive airway pressure continues to be the first-line treatment, even in patients with psychiatric comorbidity. However, more controlled studies are required, particularly to determine continuous positive airway pressure compliance in patients with mental illness, the impact of treating OSA on psychiatric symptoms, and the impact of the use of psychotropic medications on OSA symptoms.Keywords: obstructive sleep apnea, psychiatric disorders, comorbidity, psychotropic medications

  5. Schistosomiasis-induced squamous cell bladder carcinoma in an HIV-infected patient

    DEFF Research Database (Denmark)

    Marbjerg, Lis Høy; Øvrehus, Anne Lindebo Holm; Johansen, Isik Somuncu

    2015-01-01

    haematuria for more than a year. Investigations revealed invasive S. haematobium-associated squamous cell bladder cancer. If her origin had been taken into account, the diagnosis might have been made earlier. Awareness of the disease prevalence among HIV co-infected patients from endemic areas and timely......The burden of Schistosoma haematobium-associated bladder cancer is very high in Africa; nevertheless the disease can pose considerable diagnostic challenges in low prevalence countries. We present the case of a 40-year-old HIV co-infected woman, originally from Mozambique, who had persisting...

  6. Epidemiology of tuberculosis in HIV-infected patients in Denmark

    DEFF Research Database (Denmark)

    Dragsted, Ulrik Bak; Bauer, J; Poulsen, S

    1999-01-01

    Denmark is an area of low incidence of HIV and tuberculosis (TB). The number of newly reported cases of HIV has been stable during the 1990s, whereas the number of TB cases has doubled in Denmark in the past decade, mainly due to immigration. However, among native Danes the incidence of TB has...... increased in the younger age groups, indicating more newly infected persons. This study was performed in order to assess the impact of the HIV epidemic and immigration on TB incidence among native Danes. The study was also designed to reveal transmission patterns of TB among HIV-positive patients. Data from...

  7. Epidemiology of tuberculosis in HIV-infected patients in Denmark

    DEFF Research Database (Denmark)

    Dragsted, Ulrik Bak; Bauer, J; Poulsen, S

    1999-01-01

    Denmark is an area of low incidence of HIV and tuberculosis (TB). The number of newly reported cases of HIV has been stable during the 1990s, whereas the number of TB cases has doubled in Denmark in the past decade, mainly due to immigration. However, among native Danes the incidence of TB has...... increased in the younger age groups, indicating more newly infected persons. This study was performed in order to assess the impact of the HIV epidemic and immigration on TB incidence among native Danes. The study was also designed to reveal transmission patterns of TB among HIV-positive patients. Data from...... HIV-TB co-infected patients identified in the national registers of TB and AIDS from 1992-95 were collected retrospectively from medical records. Restriction fragment length polymorphism (RFLP) analyses of TB isolates from co-infected patients were compared with all patterns registered...

  8. Management of lipid disorders in patients living with HIV.

    Science.gov (United States)

    Myerson, Merle; Malvestutto, Carlos; Aberg, Judith A

    2015-09-01

    Since the discovery and development of antiretroviral therapy (ART), HIV has become a chronic disease with patients living longer lives and to ages where co-morbidities, such as cardiovascular disease (CVD) are prevalent. Diagnosis and management of risk factors for CVD, in particular dyslipidemia, have become an important part of the overall care for patients living with HIV infection. Existing guidelines and recommendations for the management of dyslipidemia for persons with HIV infection are largely based on guidelines for the general population. Clinical and epidemiologic research efforts are ongoing to provide information specific to patients living with HIV. This review offers a detailed guide for clinicians who manage dyslipidemia in patients infected with HIV. The first sections provide background information on dyslipidemia, risk stratification, and targets for lipid therapy. This is followed by a step-by-step approach for diagnosis and treatment with specific information on lipid drug use for patients with HIV. The recommendations presented here are based on existing guidelines for the general population, evidence from research in patients infected with HIV, and the clinical experience of the authors. Management issues for which little or no information is available specific to this patient population are noted and serve to highlight the many gaps in our knowledge that will need to be addressed. © 2015, The American College of Clinical Pharmacology.

  9. A Comparative Analysis of Intestinal Parasitic Infections between HIV+/AIDS Patients and Non-HIV Infected Individuals

    Directory of Open Access Journals (Sweden)

    EB Kia

    2007-04-01

    Full Text Available Background: The aim of this study was to verify the occurrence of intestinal parasitic infections in human immunodeficiency virus (HIV/acquired immunodeficiency syndrome (AIDS patients in Iran in comparison with non-HIV individuals. Methods: A total of HIV+/AIDS patients (Group I and 1220 clinically healthy individuals (Group II were submitted to coproparasitological examination from 2003 to 2005. Results: The overall prevalence of intestinal parasites in group I and group II was 11.4% and 11.6%, respectively, without significant difference between two groups. The prevalence of infection for each helminth and pathogenic protozoan, in every group, was as follows: Group I: Blastocystis hominis (6.1%; Giardia lamblia (4.2%; Cryptosporidium spp. (0.9%; Isospora belli (0.26%; Strongyloides stercoralis (0.26%; Hymenolepis nana (0.13%; and Rhabditis axei (0.13%. Group II: Blastocystis hominis (6.5%; Giardia lamblia (4.1%; Strongyloides stercoralis (0.33%; Hymenolepis nana (0.16%; and Trichostrongylus sp. (0.16%. Although the prevalence of infection for extracellular parasites was not statistically different between two groups, however, the infection rates for enteric coccidians including Cryptosporidium spp. and I. belli were significantly higher in patients at AIDS stage than Group II. Conclusion: The results emphasize the needs for especial consideration of enteropathogenic intracellular coccidians in immunocompromised patients.

  10. HIV misdiagnosis: A root cause analysis leading to improvements in HIV diagnosis and patient care.

    Science.gov (United States)

    Lang, Raynell; Charlton, Carmen; Beckthold, Brenda; Kadivar, Kiana; Lavoie, Stephanie; Caswell, Debbie; Levett, Paul N; Horsman, Greg B; Kim, John; Gill, M John

    2017-11-01

    Standard diagnostic testing for HIV infection has traditionally relied on a high sensitivity HIV antibody screening test using an enzyme-linked immunosorbent assay (ELISA) followed by a high specificity antibody confirmatory test such as a Western Blot. Recently several of the screening assays have been enhanced with an ability to identify p24 antigen thereby narrowing the diagnostic window. To explore the implications of enhanced HIV screening methods that may be leading to HIV misdiagnoses. A patient deemed to be an HIV infected 'elite controller' was found to be misdiagnosed when undergoing detailed investigations prior to initiating antiretroviral therapy. A root cause analysis was performed to identify the causative factors of this misdiagnosis. A retrospective review of all "elite controllers" in Alberta, Canada revealed challenges of current HIV testing algorithms. Technical and human factors were identified as being causative in this HIV misdiagnosis including (i) high rates of false reactive results on the Abbott ARCHITECT HIV-1&2 COMBO EIA, (ii) human error in reading the initial Western blot, (iii) HIV algorithmic directives in which confirmatory (Western blot) testing was not performed on a repeatedly reactive screen test. The outcome of this analysis identified opportunities for improvement, including implementation of a newly approved (automated) confirmatory assay and improved communication between the clinician and laboratory. HIV testing remains problematic despite significant advances in HIV test performance and algorithm development, presenting new and unexpected issues. Ensuring a high-quality management system including implementation of the latest HIV technologies and algorithms along with human resources and policies are required to minimize the impact of false positive diagnoses, especially in the era of universal screening and 'test and treat' recommendations. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.

  11. Glomerular Filtration Rate among HIV/AIDS Patients at Jos ...

    African Journals Online (AJOL)

    Background: Accurate assessment of renal function is important in human immunodeficiency virus (HIV) infected patients in order to adjust dosages of drugs excreted by the kidney. Furthermore, a number of commonly used antiretroviral drugs are potentially nephrotoxic. However, in most HIV clinics in Nigeria it is not ...

  12. Hepatitis B virus and HIV infection among patients with primary ...

    African Journals Online (AJOL)

    Background: Hepatitis B virus (HBV) is the commonest cause of primary hepatocellular (PHC) carcinoma worldwide. Coinfection with the HIV leads to more rapid progression of liver disease. Objectives: We described prevalence of HBV and HIV among patients with PHC admitted to Mulago Hospital, Kampala, Uganda.

  13. Sexual Dysfunction among HIV Patients: Three Case Reports and ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    appropriate research on sexual experiences and functioning amongst HIV patients in SSA and appropriate interventions to address them. Current efforts to link HIV/AIDS and sexual and reproductive health and rights (SRHR) and proposals to make. SRH services integrated and comprehensive provide are a good starting ...

  14. Open tibia fractures in HIV positive patients | Harrison | Malawi ...

    African Journals Online (AJOL)

    This risk may be compounded if internal fixation techniques are used (5 of 12 HIV patients with internal fixation of any open fracture). There is also a suggestion that HIV may delay bone ... Antiretroviral medication decreases viral load and elevates the CD4 count. Research is underway regarding potential effectiveness

  15. Prevalence of HIV infection in tuberculosis patients in Nguru ...

    African Journals Online (AJOL)

    None was a homosexual or IV drug abuser. Conclusion: The prevalence of HIV infection among patients with tuberculosis is high in this part of Nigeria and the most active and productive age groups as well as people in the lower socioeconomic stratum are most affected. Keywords: tuberculosis, HIV, prevalence, ...

  16. HIV status disclosure and ARV adherence among patients attending ...

    African Journals Online (AJOL)

    Although Anti Retroviral Therapy (ART) is the single most important management of HIV infection, success in decreasing viral load depends on adherence to a strict regimen ... Fear of such stigma related to these practices may thus prevent HIV status disclosure and deny the patient social support that may be important in

  17. Indications for HIV testing in paediatric surgical patients | Masache ...

    African Journals Online (AJOL)

    HIV testing is done in paediatric surgical patients at Queen Elizabeth Central Hospital, when HIV infection is suspected to be the underlying cause of the clinical presentation or contributing to morbidity. We conducted a retrospective, descriptive analysis of children with surgical conditions under the age of 15 who underwent ...

  18. Low HIV testing rates among tuberculosis patients in Kampala, Uganda

    NARCIS (Netherlands)

    I. Sendagire (Ibrahim); I. Schreuder (Imke); M. Mubiru (Mesach); M.S. van der Loeff (Maarten); F.G.J. Cobelens (Frank); J. Konde-Lule (Joseph)

    2010-01-01

    textabstractBackground: HIV testing among tuberculosis patients is critical in improving morbidity and mortality as those found to be HIV positive will be offered a continuum of care including ART if indicated. We conducted a cross-sectional study in three Kampala City primary care clinics: to

  19. Low HIV testing rates among tuberculosis patients in Kampala, Uganda

    NARCIS (Netherlands)

    Sendagire, I.; Schreuder, I.; Mubiru, M.; van der Loeff, M.S.; Cobelens, F.; Konde-Lule, J.

    2010-01-01

    Background: HIV testing among tuberculosis patients is critical in improving morbidity and mortality as those found to be HIV positive will be offered a continuum of care including ART if indicated. We conducted a cross-sectional study in three Kampala City primary care clinics: to assess the level

  20. Candiduria among HIV- Infected Patients Attending a Tertiary ...

    African Journals Online (AJOL)

    susceptibility to fluconazole and voriconazole in a tertiary hospital. Methods: A total of 300 subjects comprising of 200 HIV patients and 100 non-HIV individuals were used for this study. Clean catch midstream were collected from each individual and processed using standard microbiological techniques. Emergent Candida ...

  1. Strongyloides stercoralis infestation in HIV seropositive patients in ...

    African Journals Online (AJOL)

    Background: A contemporary surge in diarrhoeal illnesses due to parasitic infestations is believed to be a synergy between endemicity and HIV seropositivity. Aim: To determine the prevalence of Strongyloides stercoralis infestation among HIV seropositive patients at the University of Port Harcourt Teaching Hospital.

  2. Hearing disorder in HIV positive adult patients not on Anti ...

    African Journals Online (AJOL)

    Objectives: To determine the prevalence and type of hearing disorders in HIV positive patients not on anti - retroviral drugs (ARVs) and correlate this with the world health Organization (WHO) stage of HIV disease and CD4 positive cell counts. Design: Case control study. Setting: comprehensive care clinic (CCC) and ...

  3. Adequacy of pain management in HIV-positive patients ...

    African Journals Online (AJOL)

    Background: A growing body of literature supports the view that people infected with HIV suffer significant pain and that pain is not well recognised or managed by health care professionals. This study investigated the prevalence, severity, recognition and management of pain in adult patients with HIV infection in a South ...

  4. Hepatotoxicity and Associated Risk Factors in Hiv-Infected Patients ...

    African Journals Online (AJOL)

    Hepatotoxicity and Associated Risk Factors in Hiv-Infected Patients Receiving Antiretroviral Therapy at Felege Hiwot Referral Hospital, Bahirdar, Ethiopia. ... over use (P=0.014; AOR = 1.23; CI: 1.36- 3.29) and detectable HIV-1 RNA copies (P=0.015; AOR=2.07; CI: 1.15-3.74) independently predicts the elevation of ALT.

  5. Predictors of impaired renal function among HIV infected patients ...

    African Journals Online (AJOL)

    Predictors of impaired renal function among HIV infected patients commencing highly active antiretroviral therapy in Jos, Nigeria. ... Data were analysed for age, gender, weight, WHO clinical stage, CD4 count, HIV-1 RNA viral load, HBsAg and anti-HCV antibody status. Estimated glomerular filtration rate (eGFR) was ...

  6. Sexual Dysfunction among HIV Patients: Three Case Reports and ...

    African Journals Online (AJOL)

    This may affect individuals' quality of life, interpersonal relationships and HIV treatment. The sub-Saharan Africa (SSA) region is the epicentre of the HIV epidemic, majority of the patients being young (< 30 years old) and in long-term heterosexual relationships. With increased life expectancy due to expanded access to ...

  7. Attitudes and knowledge of nurses regarding HIV+/AIDS patients

    Directory of Open Access Journals (Sweden)

    Angeles Merino Godoy

    2004-06-01

    Full Text Available Objective: To know attitudes and knowledge of nursing personnel regarding HIV/AIDS patients in the Hospital General de Huelva. Methods: Descriptive cross-sectional study. Sample: Nursing staff of the Hospital General de Huelva (Registered nurses and Nursing auxiliar personnel randomised selected (N=980, n=88. Selected subjects were asked to answer a validated questionnaire including questions about personal and professional characteristics, attitudes about HIV+/AIDS patients and knowledge about HIV infection. Additionally, 8 interviews were performed to Nursing staff who suffered occupational accidents with HIV contaminated fluids. Another 8 interviews were performed to HIV+/AIDS patients about the nurses attitudes when working with them. Results: Participating subjects were worried about the risk of infection. A low rate of knowledge about HIV infection was observed. Conclusion: A modification of some attitudes of Nursing staff is mandatory as well as an improvement of specific knowledge about HIV infection and measures to avoid the infection in a professional setting. Strategies to improve nurses abilities when working with HIV+/AIDS patients should be provided.

  8. INTRACRANIAL MASS LESIONS IN HIV-POSITIVE PATIENTS ...

    African Journals Online (AJOL)

    m. INTRACRANIAL MASS LESIONS IN. HIV-POSITIVE PATIENTS - THE. KwAZuLU/NATAL EXPERIENCE. A I Bhigjee, K Naidoo, V B Patel, D Govender, for the. Neuroscience AIDS Research Group. Background. Neurological disease heralds the develop1l).~tof. AIDS in 10 - 20% of HIV-seropositive individuals. In over half.

  9. Patient satisfaction with health care services provided at HIV clinics ...

    African Journals Online (AJOL)

    Background: Since the establishment of free HIV/AIDS care and treatment services in Tanzania a lot of research has been done to assess how health care providers discharge their duties in these clinics. Little research however has been done regarding satisfaction of HIV patients with free health care services provided.

  10. Cryptosporidiosis and Isosporiasis among HIV/AIDS patients in ...

    African Journals Online (AJOL)

    Conclusion: This finding supports the view that the two opportunistic coccidian parasites, Cryptosoporidium parvum and Isospora belli, are highly associated with HIV infection and AIDS. Thiscalls for awareness of the opportunists for proper management of HIV/AIDS patients. Key words: Crytosporidiasis, Isosporiasis, ...

  11. Epidemiological and Clinical profile of HIV-infected patients ...

    African Journals Online (AJOL)

    Background: Treatment and care services for HIV patients in Tanzania began 2004 with free access to anti-retroviral therapy (ART). More than 1000 HIV clinics have been established to-date. Each clinic is obliged to provide statistical and clinical feedback for further improvement. Broad objective: The objective of this study ...

  12. Are HIV positive patients resistant to statin therapy?

    Directory of Open Access Journals (Sweden)

    Bennett Matthew T

    2007-10-01

    Full Text Available Abstract Background Patients with HIV are subject to development of HIV metabolic syndrome characterized by dyslipidemia, lipodystrophy and insulin resistance secondary to highly active antiretroviral therapy (HAART. Rosuvastatin is a highly potent HMG-CoA reductase inhibitor. Rosuvastatin is effective at lowering LDL and poses a low risk for drug-drug interaction as it does not share the same metabolic pathway as HAART drugs. This study sought to determine the efficacy of rosuvastatin on lipid parameters in HIV positive patients with HIV metabolic syndrome. Results Mean TC decreased from 6.54 to 4.89 mmol/L (25.0% reduction, p Conclusion This study found that rosuvastatin is effective at improving potentially atherogenic lipid parameters in HIV-positive patients. The lipid changes we observed were of a smaller magnitude compared to non-HIV subjects. Our results are further supported by a small, pilot trial examining rosuvastatin effectiveness in HIV who reported similar median changes from baseline of -21.7% (TC, -22.4% (LDL-C, -30.1% (TG with the exception of a 28.5% median increase in HDL. In light of the results revealed by this pilot study, clinicians may want to consider a possible resistance to statin therapy when treating patients with HIV metabolic syndrome.

  13. Candida colonisation in asymptomatic HIV patients attending a ...

    African Journals Online (AJOL)

    Background: Candidiasis is the commonest opportunistic fungal infection in patients infected with human immunodeficiency virus (HIV). CD4 lymphocyte counts have been found to be a marker of HIV disease progression. Aim: This study focused on determining the spectrum of Candida isolates in urine, stool, and oral ...

  14. Strongyloidiasis Epidemiology and Treatment Response in Patients with HIV Infection

    Science.gov (United States)

    Cortes-Penfield, Nicolas; Moore, Cody; Arduino, Roberto; Serpa, Jose

    2017-01-01

    Abstract Background We sought to characterize the epidemiology of HIV and S. stercoralis coinfection in an urban HIV cohort, and to investigate the effect of S. stercoralis infection on HIV virologic control and immune recovery. Methods We reviewed the medical records of all HIV-infected patients diagnosed with strongyloidiasis who received care at Thomas Street Health Center (Houston, TX) between 2000 and 2015. For each case we included up to two matched HIV-infected patients without strongyloidiasis (controls). Matching was based on age, sex, ethnicity, baseline CD4 percentage, and HIV viral load at the time of strongyloidiasis diagnosis in the case patient. We recorded patient demographics, comorbidities, CD4 count and percentage, HIV viral load, and absolute eosinophilia count (AEC) at the time of HIV diagnosis, strongyloidiasis diagnosis, and six and twelve months after ivermectin treatment. Results We identified 15 cases of HIV and S.stercoralis coinfection; 13 had at least one available matched control. The mean age of coinfected patients was 45; all were Hispanic, 84.6% were male, and the mean CD4 nadir was 146 cells/ul. At the time of strongyloidiasis diagnosis, the mean CD4 count was 460 cells/ul, HIV RNA viral load 2.07 logs/ml, and AEC was 1,360 cells/μL. At 6 and 12 months after treatment, CD4 counts were 514 and 464 cells/μL, HIV RNA viral loads 1.78 and 2.31 log/mL, and AECs 319 and 362 cells/μL, respectively. Although CD4 counts increased 6 months after treatment, they returned to baseline levels at 12 months; neither change achieved statistical significance. The reduction in AECs after ivermectin treatment was statistically significant (P < 0.001). Matched controls without S.stercoralis had lower AECs at baseline, 6 months, and 12 months; otherwise, there were no differences between cases and controls. Conclusion Strongyloidiasis treatment in HIV-infected patients led to normalization of the AEC at 6 months in most cases, but AECs

  15. Helping clinicians deliver consistent HIV prevention counseling to their HIV-infected patients.

    Science.gov (United States)

    Myers, Janet J; Kang Dufour, Mi-Suk; Koester, Kimberly A; Rose, Carol Dawson; Shade, Starley B; Maiorana, Andres; Morin, Stephen F

    2013-01-01

    The delivery of HIV risk assessment and behavioral counseling by clinicians in HIV clinical settings is one component in a comprehensive "positive prevention" strategy to help patients reduce their transmission risk behavior. Clinicians engage in behavioral prevention inconsistently, however, depending on whether patients are new to a practice or are established in regular care and on their attitudes and characteristics of their practices. We analyzed clinician reports of behavioral prevention delivered before and after participation in a large federal demonstration project of positive prevention interventions. The interventions that were part of this project were successful in increasing behavioral prevention among both new and returning patients. Prior to study interventions, clinicians reported counseling 69% of new patients and 52% of returning patients. In follow-up interviews 12 months after receiving training, clinicians reported delivering prevention messages to 5% more new patients and 9% of returning patients (both phelp clinicians more consistently deliver behavioral prevention messages to their HIV-infected patients.

  16. Acute retroviral syndrome in Slovenian patients infected with HIV

    Directory of Open Access Journals (Sweden)

    Mateja Pirš

    2005-06-01

    Full Text Available Background: Two to six weeks after primary infection with HIV 50 to 90 percent of patients develop an acute retroviral syndrome which usually presents with mononucleosis or flu-like illness. Due to nonspecific symptoms ARS is frequently misdiagnosed.Patients and methods: Data of Slovenian patients with acute retroviral syndrome is shown, as well as their symptoms, approaches to management and diagnostic particularities of primary HIV infection.Conclusions: The combination of particular symptoms and epidemiological data should lead us to consider the possibility of an early HIV infection.

  17. Considerations for refractive surgery in the glaucoma patient.

    Science.gov (United States)

    Ahmad, Meleha; Chocron, Isaac; Shrivastava, Anurag

    2017-07-01

    Given the popularity of keratorefractive surgery, and an aging populous of patients who have undergone these procedures, there is an increasing need for updated management protocols. This is particularly relevant for patients with chronic progressive diseases such as glaucoma, due to the variety of related diagnostic and management challenges inherent to these diseases. Here, we will review the current literature to provide an update on the management of patients with glaucoma who are undergoing, or have had laser ablative refractive surgery. Preoperative testing and eligibility considerations, intraoperative factors, and postoperative observation and follow-up will be discussed. Intraoperative intraocular pressure (IOP) rise during flap creation is associated with low risk of acute complications, and furthermore do not appear to have significant long term effects. Modern technologies have improved our ability to determine accurate IOP after refractive surgery despite postoperative changes in corneal architecture. Furthermore, advances in structural imaging allow for earlier detection of even subtle glaucomatous nerve damage. Although glaucoma remains a relative contraindication to refractive surgery, it is a safe procedure for many patients with appropriate perioperative management and follow-up. Advancements in diagnostic modalities have allowed for earlier detection of glaucomatous disease, and subsequent earlier intervention when appropriate. Standardized diagnostic algorithms and rigorous perioperative assessment are critical to safe management of glaucoma patients undergoing refractive corneal surgery.

  18. Management of HIV Infection in Patients With Substance Use Problems

    Science.gov (United States)

    Nijhawan, Ank; Kim, Soyun; Rich, Josiah D.

    2010-01-01

    Although highly active antiretroviral therapy (HAART) has greatly reduced overall morbidity and mortality in patients with HIV, patients with substance use issues have been less likely than other patients with HIV to realize these benefits. Social obstacles (eg, lack of housing, minimal social support), and medical comorbidities (eg, mental illness, hepatitis), complicate the management of this group of patients. Not only are drug and alcohol users less likely to access medical care, initiation of HAART may be delayed due to concerns for adherence and the potential development of drug resistance. Ultimately, a multidisciplinary comprehensive approach is needed to both engage and retain this population in care. Through the integration of case management, addiction therapy, and medical treatment of HIV, we may be able to improve outcomes for patients with HIV and addiction. PMID:18687208

  19. Ethambutol induced toxic optic neuropathy in HIV positive patients

    Directory of Open Access Journals (Sweden)

    Hamzah Mustak

    2013-08-01

    Full Text Available AIM:To determine whether HIV and the use of antiretroviral therapy is a risk factor for the development of ethambutol toxic optic neuropathy. To describe the clinical course of ethambutol toxic optic neuropathy in patients with HIV and to identify prognostic factors.METHODS: The case notes of 14 consecutive patients referred to the neuro-ophthalmology clinic were reviewed. Data regarding HIV status, antiretroviral therapy, visual function, ethambutol therapy dosage, and ethambutol therapy duration were collected and analysed.RESULTS: Eleven of the 14 patients were HIV positive. Ten of the HIV positive patients were receiving antiretroviral therapy. The mean dose of ethambutol was 17.25mg/kg/day. No statistically significant difference in mean dose, duration of therapy, age or CD4 count was found between those who showed visual improvement and those who did not. Delay in presentation of more than one month post symptom onset was correlated with poor visual outcome (P=0.001.CONCLUSION:HIV and, perhaps more importantly, the potential mitochondrial toxic effects of Nucleoside analogue reverse transcriptase inhibitors (NRTIs may be a risk factor for the development of toxic optic neuropathy from ethambutol therapy via a multiple hit effect. Delay in presentation results in poor visual outcome. Regular monitoring is recommended for HIV positive patients receiving antiretrovirals and requiring ethambutol therapy in order to avoid permanent visual loss.

  20. Ethambutol induced toxic optic neuropathy in HIV positive patients.

    Science.gov (United States)

    Mustak, Hamzah; Rogers, Graeme; Cook, Colin

    2013-01-01

    To determine whether HIV and the use of antiretroviral therapy is a risk factor for the development of ethambutol toxic optic neuropathy. To describe the clinical course of ethambutol toxic optic neuropathy in patients with HIV and to identify prognostic factors. The case notes of 14 consecutive patients referred to the neuro-ophthalmology clinic were reviewed. Data regarding HIV status, antiretroviral therapy, visual function, ethambutol therapy dosage, and ethambutol therapy duration were collected and analysed. Eleven of the 14 patients were HIV positive. Ten of the HIV positive patients were receiving antiretroviral therapy. The mean dose of ethambutol was 17.25mg/kg/day. No statistically significant difference in mean dose, duration of therapy, age or CD4 count was found between those who showed visual improvement and those who did not. Delay in presentation of more than one month post symptom onset was correlated with poor visual outcome (P=0.001). HIV and, perhaps more importantly, the potential mitochondrial toxic effects of Nucleoside analogue reverse transcriptase inhibitors (NRTIs) may be a risk factor for the development of toxic optic neuropathy from ethambutol therapy via a multiple hit effect. Delay in presentation results in poor visual outcome. Regular monitoring is recommended for HIV positive patients receiving antiretrovirals and requiring ethambutol therapy in order to avoid permanent visual loss.

  1. Cluster Headache: Special Considerations for Treatment of Female Patients of Reproductive Age and Pediatric Patients.

    Science.gov (United States)

    VanderPluym, Juliana

    2016-01-01

    Cluster headache is a rare disorder that is more common in adult male patients. It has a unique phenotype of unilateral, severe, to very severe headaches lasting 15 to 180 min with ipsilateral autonomic symptoms. Time to correct diagnosis can be protracted. A number of treatment options exist for the standard cluster headache patient, but special considerations must be made for female patients of reproductive age and pediatric patients. The objective of this article is to explore the current literature pertaining to special considerations in cluster headache management, including treatment of pregnant or breastfeeding patients and pediatric patients.

  2. Profile of the HIV epidemic in Cape Verde: molecular epidemiology and drug resistance mutations among HIV-1 and HIV-2 infected patients from distinct islands of the archipelago.

    Science.gov (United States)

    de Pina-Araujo, Isabel Inês M; Guimarães, Monick L; Bello, Gonzalo; Vicente, Ana Carolina P; Morgado, Mariza G

    2014-01-01

    HIV-1 and HIV-2 have been detected in Cape Verde since 1987, but little is known regarding the genetic diversity of these viruses in this archipelago, located near the West African coast. In this study, we characterized the molecular epidemiology of HIV-1 and HIV-2 and described the occurrence of drug resistance mutations (DRM) among antiretroviral therapy naïve (ARTn) patients and patients under treatment (ARTexp) from different Cape Verde islands. Blood samples, socio-demographic and clinical-laboratory data were obtained from 221 HIV-positive individuals during 2010-2011. Phylogenetic and bootscan analyses of the pol region (1300 bp) were performed for viral subtyping. HIV-1 and HIV-2 DRM were evaluated for ARTn and ARTexp patients using the Stanford HIV Database and HIV-GRADE e.V. Algorithm Homepage, respectively. Among the 221 patients (169 [76.5%] HIV-1, 43 [19.5%] HIV-2 and 9 [4.1%] HIV-1/HIV-2 co-infections), 67% were female. The median ages were 34 (IQR = 1-75) and 47 (IQR = 12-84) for HIV-1 and HIV-2, respectively. HIV-1 infections were due to subtypes G (36.6%), CRF02_AG (30.6%), F1 (9.7%), URFs (10.4%), B (5.2%), CRF05_DF (3.0%), C (2.2%), CRF06_cpx (0.7%), CRF25_cpx (0.7%) and CRF49_cpx (0.7%), whereas all HIV-2 infections belonged to group A. Transmitted DRM (TDRM) was observed in 3.4% (2/58) of ARTn HIV-1-infected patients (1.7% NRTI, 1.7% NNRTI), but not among those with HIV-2. Among ARTexp patients, DRM was observed in 47.8% (33/69) of HIV-1 (37.7% NRTI, 37.7% NNRTI, 7.4% PI, 33.3% for two classes) and 17.6% (3/17) of HIV-2-infections (17.6% NRTI, 11.8% PI, 11.8% both). This study indicates that Cape Verde has a complex and unique HIV-1 molecular epidemiological scenario dominated by HIV-1 subtypes G, CRF02_AG and F1 and HIV-2 subtype A. The occurrence of TDRM and the relatively high level of DRM among treated patients are of concern. Continuous monitoring of patients on ART, including genotyping, are public policies to be implemented.

  3. Improving the Adherence to Antiretroviral Therapy, a Difficult but Essential Task for a Successful HIV Treatment—Clinical Points of View and Practical Considerations

    Directory of Open Access Journals (Sweden)

    Simona A. Iacob

    2017-11-01

    Full Text Available HIV infection is responsible for one the most devastating human pandemics. The advent of antiretroviral therapy has changed the course of the pandemic and saved millions of lives. Complex therapeutic regimens have been introduced since 1996 and have contributed to the transformation of HIV infection into a treatable chronic diseases. New types of potent antiretrovirals and their combinations, including “once daily” treatment, have simplified the regimens and diminished side effects. Nevertheless the adherence to antiretroviral therapy remains unsatisfactory and varies between 27 and 80% across different population in various studies, compared with the required level of 95%. The lack of adherence to antiretroviral therapy is a multi-factorial and dynamic process which raises considerable difficulties for long-term follow-up. Current solutions to this problem are complex. These should be applied by a multidisciplinary team and should take into account key features related to both the individual and social factors as well as to the population to whom it belongs (children, teenagers, elderly, marginalized population like drug users, incarcerated patients, sex workers, etc.. Importantly, adherence should continue to be monitored even in patients known to be compliant. In case of subsequent failure the team should identify the reasons for non-adherence and apply the appropriate methods. Where usual methods have no chance of success, a coordinated package of services also known as “harm reduction” can be offered in order to reduce the risks of transmission. The current article analyses the concept of adherence to antiretroviral therapy, the shortcomings of this medication and the methods that can be applied in practice to increase adherence. Emphasis is placed on the analysis of groups at high risk for HIV infection that currently represent the spearhead with which the HIV pandemic is spreading.

  4. Management of uveitis in pediatric patients: special considerations.

    Science.gov (United States)

    Smith, Justine R

    2002-01-01

    Uveitis refers to inflammation involving the uvea or middle coat of the eye. This condition occurs uncommonly, particularly in persons aged uveitis deserves special consideration for reasons that include the relatively poor prognosis, unique systemic associations, and various age-related treatment considerations. Accurate diagnosis requires history from both patient and parents, a complete ophthalmic examination that may require general anesthesia, and carefully selected investigations. Infections and masquerade syndromes, such as leukemia and retinoblastoma, must be excluded before treatment is commenced with immunosuppressive agents. Noninfectious anterior uveitis generally responds to topical corticosteroid and mydriatic therapy. Although used frequently in adults with posterior uveitis, periocular corticosteroid injections may require a general anesthetic, and systemic corticosteroids may cause serious adverse effects, including growth retardation, in pediatric patients. Consequently, in children, one or more corticosteroid-sparing immunosuppressive drugs are usually employed for vision-threatening noninfectious posterior eye inflammation. Methotrexate is the most commonly used systemic immunosuppressive agent for pediatric uveitis. It is effective in small retrospective clinical series, generally well tolerated, easy to administer, and inexpensive. Cyclosporin has also been used successfully in children with uveitis, being associated with a low risk of renal toxicity when used at standard doses. Although prescribed for severe ocular inflammation in adults, alkylating agents are generally contraindicated in children owing to risks including secondary malignancy, sterility and bone marrow suppression. Drugs that inhibit tumor necrosis factor-alpha have recently been used successfully to treat children with uveitis; however, in some patients there may be a risk of potentiating the ocular inflammation. Randomized clinical trials would provide valuable information

  5. Chronic diarrhoea in HIV patients: Prevalence of coccidian parasites

    Directory of Open Access Journals (Sweden)

    Gupta S

    2008-01-01

    Full Text Available The purpose of this study was to determine the prevalence of intestinal parasites in HIV patients with or without diarrhoea and to see an association between diarrhoea and the coccidian parasites in our setting. Stool samples from 113 HIV patients, 34 chronic diarrhoea and 79 without any history of diarrhoea were collected and examined for enteric parasites by microscopy. One hundred and thirteen control samples from HIV negative patients complaining of prolonged diarrhoea were also collected and analysed. Prevalence of coccidian parasites in HIV and non-HIV patients; with and without diarrhoea was compared using chi-square tests. Enteric parasites were detected in 55.8% HIV patients with diarrhoea compared to 16.4% in patients without diarrhoea ( P < 0.001. Isospora belli was found in 41.1% (14/34 of chronic diarrhoea and 6.3% (5/79 in non-diarrhoeal cases ( P < 0.001. Cryptosporidium was detected in 20.6% (7/34 of chronic diarrhoea and 2.5% (2/79 in non-diarrhoeal cases ( P < 0.01. Cyclospora cayetanensis associated diarrhoea was detected in only one case of chronic diarrhoea (2.9%. CD4+ T-cell count was lower (180 cells/μl0 in diarrhoeal HIV patients as compared to non-diarrhoeal patients. Coccidian parasites were seen at a mean CD4+ T-cell count of 186.3 cells/μL. This study concluded that Isospora belli was the predominant parasite followed by Cryptosporidium spp. and both were strongly associated with diarrhoea among HIV patients.

  6. Biomarker evidence of axonal injury in neuroasymptomatic HIV-1 patients.

    Directory of Open Access Journals (Sweden)

    Jan Jessen Krut

    Full Text Available Prevalence of neurocognitive impairment in HIV-1 infected patients is reported to be high. Whether this is a result of active HIV-related neurodegeneration is unclear. We examined axonal injury in HIV-1 patients by measuring the light subunit of neurofilament protein (NFL in CSF with a novel, sensitive method.With a cross-sectional design, CSF concentrations of neurofilament protein light (NFL (marker of neuronal injury, neopterin (intrathecal immunoactivation and CSF/Plasma albumin ratio (blood-brain barrier integrity were analyzed on CSF from 252 HIV-infected patients, subdivided into untreated neuroasymptomatics (n = 200, HIV-associated dementia (HAD (n = 14 and on combinations antiretroviral treatment (cART (n = 85, and healthy controls (n = 204. 46 HIV-infected patients were included in both treated and untreated groups, but sampled at different timepoints. Furthermore, 78 neuroasymptomatic patients were analyzed before and after treatment initiation.While HAD patients had the highest NFL concentrations, elevated CSF NFL was also found in 33% of untreated neuroasymptomatic patients, mainly in those with blood CD4+ cell counts below 250 cells/μL. CSF NFL concentrations in the untreated neuroasymptomatics and treated groups were equivalent to controls 18.5 and 3.9 years older, respectively. Neopterin correlated with NFL levels in untreated groups while the albumin ratio correlated with NFL in both untreated and treated groups.Increased CSF NFL indicates ongoing axonal injury in many neuroasymptomatic patients. Treatment decreases NFL, but treated patients retain higher levels than controls, indicating either continued virus-related injury or an aging-like effect of HIV infection. NFL correlates with neopterin and albumin ratio, suggesting an association between axonal injury, neuroinflammation and blood-brain barrier permeability. NFL appears to be a sensitive biomarker of subclinical and clinical brain injury in HIV and warrants further

  7. Meningitis in HIV-positive patients in sub-Saharan Africa: a review.

    Science.gov (United States)

    Veltman, Jennifer A; Bristow, Claire C; Klausner, Jeffrey D

    2014-01-01

    Meningitis is one of the leading causes of death among patients living with HIV in sub-Saharan Africa. There is no widespread tracking of the incidence rates of causative agents among patients living with HIV, yet the aetiologies of meningitis are different than those of the general population. We reviewed the scientific literature published in PubMed to determine the incidence rates of meningitis among hospitalized people living with HIV in sub-Saharan Africa and report our findings from seven studies across sub-Saharan Africa. We found high rates of cryptococcal meningitis (19-68%). Tuberculous meningitis was lower (1-36%), although some centres included possible cases as "other" meningitis; therefore, this may not be a true representation of the total cases. Pyogenic meningitis ranged from 6 to 30% and "other" meningitis ranged from 7 to 28% of all reported cases of meningitis. Mortality rates ranged from 25 to 68%. This review describes the most common aetiologies and provides practical diagnostic, treatment and prevention considerations as they apply to the individual living with HIV in sub-Saharan Africa. Diagnosis is often limited, and wider availability of accurate and low-cost laboratory diagnostics is desperately needed for prompt diagnosis and initiation of appropriate treatment. Wider acceptance and adoption of available preventative modalities can decrease the incidence of potentially fatal central nervous system infections in African patients living with HIV.

  8. Managing uncertainty around HIV/AIDS in an urban setting: private medical providers and their patients in Pune, India.

    Science.gov (United States)

    Kielmann, Karina; Deshmukh, Deepali; Deshpande, Sucheta; Datye, Vinita; Porter, John; Rangan, Sheela

    2005-10-01

    Changing epidemiological patterns and the advent of new rapid diagnostic technologies and therapies have created considerable uncertainty for providers working in HIV. In India, the demand for HIV care is increasingly being met by private practitioners (PPs), yet little is known about how they deal with the challenges of managing HIV patients. To explore HIV management practices in the private medical sector, a survey was conducted with 215PPs in Pune, India, followed by in-depth interviews focusing on the social context of practice among a sub-set of 27PPs. Drawing primarily on interview data, this paper illustrates a number of uncertainties that underlie the reported actions of providers in a competitive medical market. PPs perceive HIV as a 'new' and challenging disease for which they lack adequate knowledge and skills. Combined with the perceived high cost and complexity of antiretroviral treatment, preconceptions about HIV patients' social, financial and mental capacity lead to highly individualistic management practices. While these fall short of clinical 'best practice' guidelines, they reflect adaptive responses to the wider uncertainties surrounding HIV care in urban India. By highlighting contextual issues in PPs' management of HIV patients, the paper suggests the need to explicitly acknowledge the social, moral and economic bases of uncertainty beyond the clinical setting.

  9. Psychopathology and coping in recently diagnosed HIV/AIDS patients

    African Journals Online (AJOL)

    Psychopathology and coping in recently diagnosed HIV/AIDS patients- the role of gender. ... Women were more likely to suffer from post-traumatic stress disorder, and to use coping strategies of planning and ... a description of the source 29

  10. Clinical variations in dermatophytosis in HIV infected patients

    Directory of Open Access Journals (Sweden)

    Kaviarasan P

    2002-01-01

    Full Text Available Dermatophyte infections are common in HIV infected patients and can occur at some point during their illness. They may show clinical variations. The present study was to note the prevalence and clinical variations in dermatophytosis in HIV infected patients. Out of 185 HIV infected patients screened at our hospital, the diagnosis of dermatophytosis was made in 41 cases. The prevalence of dermatophytosis was 22.2% Male to female ratio was 3:1 The mean age of our patients was 30.7 years. The occupations of our patients in decreasing order of frequency were labourers (43.9%, drivers (29.3% and rest were housewives, commercial sex workers etc. Heterosexual route was the most common mode of acquisition of HIV infection. Tinea corporis was the commonest dermatophyte infection and was seen in 22 (53.7% cases, followed by tinea cruris in 18 (49.9%, tinea pedis in 7 (17.1, tinea faciei in 6 (14.7% and one patient had tinea manum infection. Tinea unguium was recorded in 11 cases. Out of the 22 patients with tinea corporis, 19 were in the HIV Group IV. Ten of them presented with multiple, large sharply marginated areas of hyperkeratosis resembling dry scaly skin (anergic form of tinea corporis. Proximal white subungual onychomycosis (PWSO, thought to be pathognomonic of HIV was seen in 3 cases only. This study has brought into focus variations in presentations of dermatophytosis.

  11. Liver retransplantation in HIV-infected patients: a prospective cohort study

    NARCIS (Netherlands)

    Gastaca, M.; Aguero, F.; Rimola, A.; Montejo, M.; Miralles, P.; Lozano, R.; Castells, L.; Abradelo, M.; Mata Mde, L.; San Juan Rodriguez, F.; Cordero, E.; Campo, S.; Manzardo, C.; Urbina, J.O. de; Perez, I.; Rosa Gde, L.; Miro, J.M.; Barrera, P.

    2012-01-01

    Information regarding liver retransplantation in HIV-infected patients is scant. Data from 14 HIV-infected patients retransplanted between 2002 and 2011 in Spain (6% retransplantation rate) were analyzed and compared with those from 157 matched HIV-negative retransplanted patients. In HIV-infected

  12. DIFFERENTIAL DIAGNOSTICS OF TUBERCULOSIS AND MYCOBACTERIOSIS IN HIV PATIENTS

    Directory of Open Access Journals (Sweden)

    A. M. Panteleev

    2017-01-01

    Full Text Available The article analyzes the differences in clinical and laboratory manifestations of tuberculosis and mycobacteriosis in HIV patients. It was found out that mycobacteriosis developed mostly in the socially well patients at the advanced stages of HIV infection. In case of mycobacteriosis, lesions were mostly located in the abdomen with limited inflammation in the chest, while in case of tuberculosis pulmonary lesions dominated. A negative result of sputum PCR assays for tuberculosis mycobacteria with a positive result of the test for AFB is an important sign for differential diagnostics. The obtained results allow performing differential diagnostics of these diseases in those HIV infected.

  13. [Mucocutaneous leishmaniasis in a HIV infected patient. Case report].

    Science.gov (United States)

    Montenegro-Idrogo, Juan J; Montañez-Valverde, Raúl A; Chian, Cesar; Benites-Villafane, Carlos

    2014-10-01

    Leishmaniasis is an endemic Andean vector-borne- tropical disease in Peru, whose mucocutaneous clinical presentation is rare. Leishmaniasis can occur in co-infections with HTLV-1 virus and HIV. We describe a case of L. mucocutaneous in a patient infected with HIV, with a history of cutaneous leishmaniasis with inadequate treatment 20 years ago. He was treated with stibogluconate with adequate response to treatment and regression of lesion after 4 weeks. Mucocutaneous leishmaniasis and HIV coinfection is rare and its clinical presentation may be atypically. It is important to consider it in patients coming from endemic areas and with a history of a previous cutaneous clinical presentation.

  14. Detention and incompatibility of HIV patients in Italy

    Directory of Open Access Journals (Sweden)

    Serena Dell'Isola

    2013-12-01

    Full Text Available In Italy, Law 231/99 and subsequent amendments standardize the conditions allowing or not a HIV positive inmate to remain in jail. Currently such clinical conditions are not automatically associated with the decline of preventive detention and the Court evaluates the incompatibility with detention on the basis of two additional and independent criteria. We have been observing the tendency by jailed HIV-positive patients to manipulate the disease state believing that the rules of incompatibility with the prison system are always applied. The management of HIV positive patients in jail involves significant sanitary and relational efforts, particularly for those suffering AIDS and/or with severe immunodeficiency.

  15. Lipid Profile of Anti Retroviral Treatment Naive HIV Infected Patients ...

    African Journals Online (AJOL)

    hypercholesterolemia [22.4% (22/98) vs. 10.4% (11/106), P = 0.02]. Lower HDL.C was associated with CD4+ cell count < 200 cells/ƒÊL (P = 0.02). Conclusion: Lipid abnormalities are common in treatment.naive HIV.infected patients even in the absence of major host.related risk factors for dyslipidemia. HIV.infected patients ...

  16. The Pharmacologic Management of Insomnia in Patients with HIV

    OpenAIRE

    Omonuwa, Toma S.; Goforth, Harold W.; Preud’homme, Xavier; Krystal, Andrew D.

    2009-01-01

    Insomnia is common in human immunodeficiency virus (HIV) seropositive populations. Some studies have estimated as many as 70% of HIV patients experience insomnia at some point during their illness. Insomnia has been linked to reduced quality of life as well as treatment non-adherence in these patients. However, there has been very limited research on the treatment of insomnia in this setting. Lacking treatment trials, we carried out a review of the available literature relevant to the pharmac...

  17. T-cell epitopes identified by BALB/c mice immunized with vaccinia expressing HIV-1 gag lie within immunodominant regions recognized by HIV-infected Indian patients

    Directory of Open Access Journals (Sweden)

    Ashwini V Shete

    2011-01-01

    Full Text Available Background: Human immunodeficiency virus (HIV antigens from transmitted strains of HIV would prove crucial in vaccine designing for prevention of HIV infection. Immune response generated by Vaccinia construct expressing the HIV-1 gag gene from transmitted Indian HIV-1 subtype C strain (Vgag in BALB/c mice is reported in the present study along with the identification of epitopes responsible for induction of the immune response. Aims: The aim of this study was to determine immune response generated by the constructs in a mouse model and to understand the epitope specificities of the response. Settings and Design: This was an observational study carried out in BALB/c mice. Materials and Methods: The immunogenecity of Vgag construct was evaluated in BALB/c mice after multiple immunizations. T-cell response was monitored by the interferon-γ ELISPOT assay using HIV-1 C Gag overlapping peptides and anti-P24 antibodies were estimated by ELISA. Statistical Analysis Used: Graphpad prism software was used for statistical analysis and for plotting graphs. Results: IFN-γ-secreting T cells and antibodies were detected against HIV Gag in mice after immunization. Although after repeated immunizations, antibody-mediated immune response increased or remained sustained, the magnitude of IFN-γ-secreting T cell was found to be decreased over time. The Gag peptides recognized by mice were mainly confined to the P24 region and had a considerable overlap with earlier reported immunodominant regions recognized by HIV-infected Indian patients. Conclusion: Vaccinia construct with a gag gene from transmitted HIV-1 virus was found to be immunogenic. The Gag regions identified by mice could have important implications in terms of future HIV vaccine designing.

  18. Neurological manifestations in HIV positive patients in Tehran, Iran

    Directory of Open Access Journals (Sweden)

    Minoo Mohraz

    2014-02-01

    Full Text Available Objective: To evaluate the neurological complications among Iranian HIV-positive patients. Methods: This cross-sectional study was conducted among 428 patients diagnosed with HIV infection between 2006 and 2009 at Imam Khomeini hospital, Tehran, Iran. Demographic and clinical variables as well as laboratory tests were extracted and analyzed. Also, another 100 patients refereed to Voluntary Counseling and Testing center of the hospital were visited and evaluated for neurological complications. Results: Among the patients, neurologic manifestations were observed in 34 (7.94% patients. Twenty three percent of the patients received antiretroviral therapy. Identified causes included brain toxoplasmosis (14.7%, progressive multi-focal leuko encephalopathy (5.9%, HIV encephalopathy (5.9%, TB meningitis (5% and unknown etiologies (11.8%. Also, among 100 patients who were admitted and visited at the Voluntary Counseling and Testing center, no one was diagnosed for any neurological manifestations. Conclusions: According to our results, toxoplasmosis is the most frequent cause of neurological conditions among Iranian HIV infected patients and should be considered in any HIV/AIDS patient with neurological manifestations.

  19. Late HIV Testing in a Cohort of HIV-Infected Patients in Puerto Rico.

    Science.gov (United States)

    Tossas-Milligan, Katherine Y; Hunter-Mellado, Robert F; Mayor, Angel M; Fernández-Santos, Diana M; Dworkin, Mark S

    2015-09-01

    Late HIV testing (LT), defined as receiving an AIDS diagnosis within a year of one's first positive HIV test, is associated with higher HIV transmission, lower HAART effectiveness, and worse outcomes. Latinos represent 36% of LT in the US, yet research concerning LT among HIV cases in Puerto Rico is scarce. Multivariable logistic regression analysis was used to identify factors associated with LT, and a Cochran‒Armitage test was used to determine LT trends in an HIV-infected cohort followed at a clinic in Puerto Rico specialized in the management and treatment of HIV. From 2000 to 2011, 47% of eligible patients were late testers, with lower median CD4 counts (54 vs. 420 cells/mm3) and higher median HIV viral load counts (253,680 vs. 23,700 copies/mL) than non-LT patients. LT prevalence decreased significantly, from 47% in 2000 to 37% in 2011. In a mutually adjusted logistic regression model, males, older age at enrollment and past history of IDU significantly increased LT odds, whereas having a history of amphetamine use decreased LT odds. When the data were stratified by mode of transmission, it became apparent that only the category men who have sex with men (MSM) saw a significant reduction in the proportion of LT, falling from 67% in 2000 to 33% in 2011. These results suggest a gap in early HIV detection in Puerto Rico, a gap that decreased only among MSM. An evaluation of the manner in which current HIV-testing guidelines are implemented on the island is needed.

  20. Unusual presentation of mucocutaneous leishmaniasis in HIV-infected patient.

    Science.gov (United States)

    Bains, Anupama; Vedant, Deepak; Gupta, Priyanka; Tegta, G R

    2016-01-01

    Leishmaniasis is caused by protozoan parasite of genus leishmania. Visceral leishmaniasis, diffuse cutaneous leishmaniasis, and atypical forms of cutaneous leishmaniasis are common in HIV-infected patients. Our patient presented with an obstructive mass in nasal cavity and was diagnosed as a case of mucocutaneous leishmaniasis. Spontaneous healing of lesions in HIV-infected patients is rare rather they are unresponsive to treatment and have frequent relapses, especially in patients with low CD4 count. However, in our patient, the lesion improved significantly after 2 months of highly active antiretroviral therapy and co-trimoxazole prophylaxis.

  1. Identifying the white matter impairments among ART-naive HIV patients: a multivariate pattern analysis of DTI data

    Energy Technology Data Exchange (ETDEWEB)

    Tang, Zhenchao [Shandong University, School of Mechanical, Electrical and Information Engineering, Weihai, Shandong Province (China); Institute of Automation, CAS Key Laboratory of Molecular Imaging, Beijing (China); Liu, Zhenyu; Yang, Xin; Wang, Shuo; Yu, Dongdong [Institute of Automation, CAS Key Laboratory of Molecular Imaging, Beijing (China); Li, Ruili; Li, Hongjun [Beijing YouAn Hospital, Capital Medical University, Department of Radiology, Beijing (China); Cui, Xingwei [Zhengzhou University, Cooperative Innovation Center of Internet Healthcare, Zhengzhou (China); Dong, Enqing [Shandong University, School of Mechanical, Electrical and Information Engineering, Weihai, Shandong Province (China); Tian, Jie [Institute of Automation, CAS Key Laboratory of Molecular Imaging, Beijing (China); University of Chinese Academy of Sciences, Beijing (China)

    2017-10-15

    To identify the white matter (WM) impairments of the antiretroviral therapy (ART)-naive HIV patients by conducting a multivariate pattern analysis (MVPA) of Diffusion Tensor Imaging (DTI) data We enrolled 33 ART-naive HIV patients and 32 Normal controls in the current study. Firstly, the DTI metrics in whole brain WM tracts were extracted for each subject and feed into the Least Absolute Shrinkage and Selection Operators procedure (LASSO)-Logistic regression model to identify the impaired WM tracts. Then, Support Vector Machines (SVM) model was constructed based on the DTI metrics in the impaired WM tracts to make HIV-control group classification. Pearson correlations between the WM impairments and HIV clinical statics were also investigated. Extensive HIV-related impairments were observed in the WM tracts associated with motor function, the corpus callosum (CC) and the frontal WM. With leave-one-out cross validation, accuracy of 83.08% (P=0.002) and the area under the Receiver Operating Characteristic curve of 0.9110 were obtained in the SVM classification model. The impairments of the CC were significantly correlated with the HIV clinic statics. The MVPA was sensitive to detect the HIV-related WM changes. Our findings indicated that the MVPA had considerable potential in exploring the HIV-related WM impairments. (orig.)

  2. Prevalence of the consumption of anticholinergic drugs in HIV patients

    Directory of Open Access Journals (Sweden)

    Ricardo Zafra-Morales

    2018-01-01

    Full Text Available Objective: To analyse anticholinergic agent consumption in HIV patients 50 years or older; to determine anticholinergic risk using the ACB and ARS scales; and to determine if these patients use any type of benzodiazepine. Method: A descriptive observational study of 256 HIV patients 50 years or older. Results: 73.1% were men. Mean age was 56 ± 5.9 years. 55.9% of the patients were coinfected with HCV. Excluding HIV drugs, mean drug consumption was 2.9 ± 2.9 drugs per patient. The ACB and ARS scales showed that 26.2% and 17.2% of the patients took an anticholinergic agent, and that 43.3% and 36.4% presented high anticholinergic risk, respectively. 30.5% of patients consumed benzodiazepines. Conclusions: The percentage of HIV patients aged 50 years or older who were taking anticholinergic agents was statistically significantly higher on the ACB scale than on the ARS scale. No studies are available on the HIV population with which to compare our results, but there is evidence that this group of drugs can affect older adults.

  3. Clinically significant mutations in HIV-infected patients with lung adenocarcinoma.

    Science.gov (United States)

    Thaler, Jonathan; Sigel, Carlie; Beasley, Mary Beth; Wisnivesky, Juan; Crothers, Kristina; Bauml, Joshua; Hysell, Kristen; Emu, Brinda; Borsu, Laetitia; Sigel, Keith

    2017-10-24

    Lung cancer is a major cause of death in HIV-infected (HIV+) persons. In this study, we compared the prevalence of tumour EGFR and KRAS mutations in a cohort of lung adenocarcinoma patients by HIV status. We collected data from 55 HIV+ patients with lung adenocarcinoma matched to 136 uninfected comparators. We compared the prevalence of EGFR and KRAS mutations by HIV status. We then compared survival by HIV status and by cancer mutation status among HIV+ subjects. Presence of KRAS and EGFR genetic alterations did not vary by HIV status (all P>0.1). There was no difference in overall survival by HIV status or by mutation status among HIV+ subjects. We found no major differences in the prevalence of EGFR or KRAS lung adenocarcinoma mutations by HIV status, suggesting that mutational testing should be conducted similarly regardless of the HIV status.

  4. HIV, Hepatitis B and C viruses' coinfection among patients in a ...

    African Journals Online (AJOL)

    Introduction: Hepatitis co-infection with HIV is associated with increased morbidity and mortality. Methods: This cross sectional study was carried out among HIV positive patients and HIV negative blood donors, HIV infected patients were recruited from the antiretroviral therapy clinics of the Lagos State University Teaching ...

  5. Impaired production of cytokines is an independent predictor of mortality in HIV-1-infected patients

    DEFF Research Database (Denmark)

    Ostrowski, Sisse R; Gerstoft, Jan; Pedersen, Bente K

    2003-01-01

    With regard to the natural history of HIV-1 infection this study investigated whether whole-blood culture cytokine production was associated with mortality in HIV-1-infected patients.......With regard to the natural history of HIV-1 infection this study investigated whether whole-blood culture cytokine production was associated with mortality in HIV-1-infected patients....

  6. Isosporiasis in HIV/AIDS Patients in Edo State, Nigeria.

    Science.gov (United States)

    Olusegun, Akinbo Frederick; Okaka, Christopher Ehis; Luiz Dantas Machado, Ricardo

    2009-07-01

    The role of opportunistic infections in accelerating disease progression in HIV-positive individuals, leading to quick death, is still receiving serious attention. The objective of this study was to determine the prevalence of Isospora belli infections in HIV-positive patients in Edo State, Nigeria between August 2007 and March 2008. A total of 268 samples from HIV-positive patients and 20 samples from HIV-negative patients were processed using the modified Ziehl-Neelsen staining technique to microscopically identify the presence of I. belli oocysts. The overall prevalence of the coccidian was 3.1%. Gender and age had no correlation with the prevalence of the parasite (P > 0.05). There was a significant relationship between isosporiasis and CD4+ T cell counts in HIV-positive patients (OR=11.388, 95% CI= 2.797-46.371, P=0.0004). Routine investigation of I. belli in HIV-positive subjects is advocated in tertiary health institutions.

  7. Knowledge of Hypertensive Patients With or Without HIV on ...

    African Journals Online (AJOL)

    Erah

    of pharmacists in the counselling of these patients was also ... Formal education. 1. 0.5. -. - patients, it was 47.1 years (range: 21 to 80 years). The male/female ratio was low in each group with females being twice as many as males. ... Table 3: Involvement of health workers in counseling of hypentensive and HIV patients.

  8. Penile gangrene in a HIV patient

    African Journals Online (AJOL)

    L.E. Mubenga

    2016-11-16

    Nov 16, 2016 ... Received 29 May 2016; received in revised form 30 August 2016; accepted 21 ... sels damages such are diabetes, hepatitis or cigarette smoking were absent. .... Human immunodeficiency virus (HIV) infects human arterial.

  9. Defining epitope coverage requirements for T cell-based HIV vaccines: Theoretical considerations and practical applications

    Science.gov (United States)

    2011-01-01

    Background HIV vaccine development must address the genetic diversity and plasticity of the virus that permits the presentation of diverse genetic forms to the immune system and subsequent escape from immune pressure. Assessment of potential HIV strain coverage by candidate T cell-based vaccines (whether natural sequence or computationally optimized products) is now a critical component in interpreting candidate vaccine suitability. Methods We have utilized an N-mer identity algorithm to represent T cell epitopes and explore potential coverage of the global HIV pandemic using natural sequences derived from candidate HIV vaccines. Breadth (the number of T cell epitopes generated) and depth (the variant coverage within a T cell epitope) analyses have been incorporated into the model to explore vaccine coverage requirements in terms of the number of discrete T cell epitopes generated. Results We show that when multiple epitope generation by a vaccine product is considered a far more nuanced appraisal of the potential HIV strain coverage of the vaccine product emerges. By considering epitope breadth and depth several important observations were made: (1) epitope breadth requirements to reach particular levels of vaccine coverage, even for natural sequence-based vaccine products is not necessarily an intractable problem for the immune system; (2) increasing the valency (number of T cell epitope variants present) of vaccine products dramatically decreases the epitope requirements to reach particular coverage levels for any epidemic; (3) considering multiple-hit models (more than one exact epitope match with an incoming HIV strain) places a significantly higher requirement upon epitope breadth in order to reach a given level of coverage, to the point where low valency natural sequence based products would not practically be able to generate sufficient epitopes. Conclusions When HIV vaccine sequences are compared against datasets of potential incoming viruses important

  10. Defining epitope coverage requirements for T cell-based HIV vaccines: Theoretical considerations and practical applications

    Directory of Open Access Journals (Sweden)

    Currier Jeffrey R

    2011-12-01

    Full Text Available Abstract Background HIV vaccine development must address the genetic diversity and plasticity of the virus that permits the presentation of diverse genetic forms to the immune system and subsequent escape from immune pressure. Assessment of potential HIV strain coverage by candidate T cell-based vaccines (whether natural sequence or computationally optimized products is now a critical component in interpreting candidate vaccine suitability. Methods We have utilized an N-mer identity algorithm to represent T cell epitopes and explore potential coverage of the global HIV pandemic using natural sequences derived from candidate HIV vaccines. Breadth (the number of T cell epitopes generated and depth (the variant coverage within a T cell epitope analyses have been incorporated into the model to explore vaccine coverage requirements in terms of the number of discrete T cell epitopes generated. Results We show that when multiple epitope generation by a vaccine product is considered a far more nuanced appraisal of the potential HIV strain coverage of the vaccine product emerges. By considering epitope breadth and depth several important observations were made: (1 epitope breadth requirements to reach particular levels of vaccine coverage, even for natural sequence-based vaccine products is not necessarily an intractable problem for the immune system; (2 increasing the valency (number of T cell epitope variants present of vaccine products dramatically decreases the epitope requirements to reach particular coverage levels for any epidemic; (3 considering multiple-hit models (more than one exact epitope match with an incoming HIV strain places a significantly higher requirement upon epitope breadth in order to reach a given level of coverage, to the point where low valency natural sequence based products would not practically be able to generate sufficient epitopes. Conclusions When HIV vaccine sequences are compared against datasets of potential incoming

  11. Fluctuating anaemia in treated HIV patients: could be a PICA?

    Science.gov (United States)

    Ajana, Faiza; Pasquet, Armelle; Auffret, Marine; Gautier, Sophie

    2013-01-01

    HIV infected patients are frequently exposed to anaemia, due to antiretroviral agents and/or prophylactic treatment of opportunistic infections. Anemia due to PICA, unusually evoked in our western countries, could be a more frequent situation than imagined. We report two cases of fluctuating anemia with no HIV or iatrogenic origin, observed in two HIV infected women, 47 years old and 33 years old respectively, coming from Africa and treated with antiretroviral agents. The anemia was explained by a culturally sanctioned practice of kaolin ingestion, in the broader context of PICA and resolved after the withdrawal of kaolin ingestion. PICA, and in particular kaolin ingestion, must be investigated when HIV infected patients came from Africa and presented significative unexplained anemia. © 2013 Société Française de Pharmacologie et de Thérapeutique.

  12. Oral and systemic manifestations in HIV-1 patients

    Directory of Open Access Journals (Sweden)

    Tatiany Oliveira de Alencar Menezes

    2015-02-01

    Full Text Available INTRODUCTION: This study aimed to estimate the prevalence of the most frequent oral and systemic manifestations in human immunodeficiency virus-1 (HIV-1-positive patients. METHODS: The study was conducted on 300 HIV-1 patients attending the Reference Unit Specialized in Special Infectious Parasitic Diseases in Belém, Pará, Brazil. RESULTS: The most prevalent oral conditions were caries (32.6%, candidiasis (32%, and periodontal disease (17%. Among the systemic manifestations, hepatitis (29.2%, gastritis (16%, arterial hypertension (14.7%, and tuberculosis (12% were the most commonly observed. CONCLUSIONS: We here reported on the most prevalent oral and systemic conditions in HIV-1-positive patients. The healthcare professional's knowledge of the various manifestations among these patients is fundamental to ensure prompt and accurate diagnosis and treatment, and for improving the quality of life of these patients.

  13. Osteonecrosis en pacientes infectados por HIV Osteonecrosis in HIV-infected patients

    Directory of Open Access Journals (Sweden)

    Edgardo G. Bottaro

    2004-08-01

    Full Text Available Según la literatura, la osteonecrosis tiene una mayor incidencia en los pacientes infectados con HIV que en la población general. Ello sería resultado de la confluencia de factores de riesgo clásicos y de otros propios de esta población o más prevalentes en ella, como el tratamiento con inhibidores de proteasa, la dislipemia producto de su consumo, la presencia de anticuerpos anticardiolipina séricos, la hipercoagulabilidad, la restauración inmune y las vasculitis. Presentamos una serie de 13 pacientes infectados con HIV con osteonecrosis. El motivo de consulta fue dolor en grandes articulaciones. Cuatro eran alcoholistas, 8 tabaquistas y 9 tenían dislipemia. Once habían recibido esteroides en algún momento de la vida aunque sólo uno estaba recibiéndolos al momento del inicio del dolor. En 2 se detectaron anticuerpos anticardiolipina séricos. Doce tenían sida y recibían tratamiento antirretroviral de alta eficacia (11 con inhibidores de proteasa. Ellos lograron una adecuada recuperación inmunológica. Consideramos necesario incluir la osteonecrosis como diagnóstico diferencial de artralgia persistente en pacientes infectados con HIV e investigar infección por HIV en todo paciente con osteonecrosis sin claros factores predisponentes.Osteonecrosis, also known as avascular necrosis, is chiefly characterized by death of bone caused by vascular compromise. The true incidence of osteonecrosis in HIV-infected patients is not well known and the pathogenesis remains undefined. Hypothetical risk factors peculiar to HIV-infected individuals that might play a role in the pathogenesis of osteonecrosis include the introduction of protease inhibitors and resulting hyperlipidemia, the presence of anticardiolipin antibodies in serum leading to a hypercoagulable state, immune recovery and vasculitis. Hereby we present a series of 13 HIV-infected patients with osteonecrosis. The most common symptom upon presentation was arthralgia. The majority

  14. Proteinuria is common among HIV patients: what are we missing?

    Science.gov (United States)

    Antonello, Vicente Sperb; Antonello, Ivan Carlos Ferreira; Herrmann, Sandra; Tovo, Cristiane Valle

    2015-10-01

    HIV-related renal diseases are the leading causes of chronic kidney diseases worldwide. The present study aimed to investigate the prevalence of pathological proteinuria and its risk factors among HIV patients. A review of the medical records of 666 HIV-infected individuals aged 18 years or older in an urban HIV/AIDS clinic based in Porto Alegre in southern Brazil. Overt proteinuria was defined as a protein-to-creatinine ratio greater than 150 mg/g according to Kidney Disease: Improving Global Outcomes. The prevalence of pathological proteinuria in the present study cohort was 20%. Characteristics associated with pathological proteinuria after univariate analysis included alcohol abuse, hepatitis C virus coinfection, the occurrence of diabetes and therapy including tenofovir. Adjusted residuals analysis indicated an association between pathological proteinuria and both a CD4 lymphocyte count below 200 cells/mm3 and a viral load higher than 1000 copies/mL. Additionally, an absence of pathological proteinuria was associated with a CD4 lymphocyte count higher than 500 cells/mm3. After adjustment for variables with pproteinuria. The risk of chronic kidney diseases in this large contemporary cohort of HIV-infected individuals appeared to be attributable to a combination of HIV-related risk factors. In addition to the traditional risk factors cited in the literature, both regimens containing tenofovir and HIV disease severity seem to be associated with chronic kidney diseases in patients with HIV. Assessment of proteinuria constitutes a novel method for chronic kidney disease staging in HIV-infected individuals and may be effectively used to stratify the risk of progression to end-stage renal disease.

  15. Proteinuria is common among HIV patients: what are we missing?

    Directory of Open Access Journals (Sweden)

    Vicente Sperb Antonello

    Full Text Available OBJECTIVES:HIV-related renal diseases are the leading causes of chronic kidney diseases worldwide. The present study aimed to investigate the prevalence of pathological proteinuria and its risk factors among HIV patients.METHODS:A review of the medical records of 666 HIV-infected individuals aged 18 years or older in an urban HIV/AIDS clinic based in Porto Alegre in southern Brazil. Overt proteinuria was defined as a protein-to-creatinine ratio greater than 150 mg/g according to Kidney Disease: Improving Global Outcomes.RESULTS:The prevalence of pathological proteinuria in the present study cohort was 20%. Characteristics associated with pathological proteinuria after univariate analysis included alcohol abuse, hepatitis C virus coinfection, the occurrence of diabetes and therapy including tenofovir. Adjusted residuals analysis indicated an association between pathological proteinuria and both a CD4 lymphocyte count below 200 cells/mm3 and a viral load higher than 1000 copies/mL. Additionally, an absence of pathological proteinuria was associated with a CD4 lymphocyte count higher than 500 cells/mm3. After adjustment for variables with p<0.2 in the univariate analysis using a Poisson regression model, tenofovir-containing regimens and a CD4 lymphocyte count below 200 cells/mm3 were significantly associated with pathological proteinuria.CONCLUSION:The risk of chronic kidney diseases in this large contemporary cohort of HIV-infected individuals appeared to be attributable to a combination of HIV-related risk factors. In addition to the traditional risk factors cited in the literature, both regimens containing tenofovir and HIV disease severity seem to be associated with chronic kidney diseases in patients with HIV. Assessment of proteinuria constitutes a novel method for chronic kidney disease staging in HIV-infected individuals and may be effectively used to stratify the risk of progression to end-stage renal disease.

  16. Prevalence of HIV Infection Among Tuberculosis Patients in Bali, Indonesia

    Directory of Open Access Journals (Sweden)

    Partha Muliawan

    2016-01-01

    Full Text Available Background: During 1998-2007, TB and HIV cases in Bali had shown a significant increase respectively. In general, both of these diseases are chronic diseases that need long term treatment, and together they could worsen the patients’ condition. To prevent the double burden of those patients, we need to know HIV infection prevalence among TB cases in Bali. Method: One thousands of TB cases diagnosed at TB health services unit (UPK at primary health centers (puskesmas and public hospitals in Bali, in September-November 2008, were given information and their blood samples were taken for HIV tests. Samples were chosen proportionally according to the number of TB cases registered in each UPK. Five milliliters of blood sample were taken from each eligible patient by laboratory staff or nurse at the UPK for HIV tests which were conducted at Bali Health Laboratory. HIV test used in this study were the two types of rapid test in accordance with WHO standard. Discussion: Thirty-nine out of 1,000 blood samples were found HIV positive. The highest HIV prevalence among TB cases was in the Buleleng District (11.5% and followed by Denpasar City (5.1%. This prevalence showed a different figure from the HIV/AIDS cases in VCT clinics registered at Bali Provincial Health Agency, where the highest prevalence found in Denpasar, followed by Buleleng and Badung. If we compare, the difference in figure between Badung and Buleleng, might be due to the difference in routes of HIV transmission. In Buleleng, most of the cases (90% were sexually transmitted, while in Badung 48% transmission were through injecting drug users. The IDUs seek health services at private health centers and rarely utilize public/government services such as puskesmas and hospitals. Conclusion: The HIV prevalence among TB patients in Bali was 3.9%. The characteristics of the patients showed that they are mostly male, aged between 31-40 years old, have junior high school-university education

  17. [Intestinal parasitic diseases in HIV-infected patients in Uzbekistan].

    Science.gov (United States)

    Nurtaev, Kh S; Badalova, N S; Zalialieva, M V; Osipova, S O

    2005-01-01

    Intestinal parasitic diseases were diagnosed in 100 HIV-infected patients at different stages of disease (its asymptomatic form, persistent generalized lymphoadenopathy, pre-AIDS, and AIDS) (Group 1), 100 Tashkent residents (Group 2), and 349 patients with gastrointestinal diseases, allergic dermatoses, and skin depigmentation foci (Group 3). The HIV-infected patients were found to have virtually all parasites, such as Giardia lamblia, Cryptosporidium parvum, Chilomastix mesnili, Entamoeba coli, Iodamoeba butschlii, Entamoeba histolytica/dispar, Endolimax nana, Blastocystis hominis, Enlerobius vermicularis, Ascaris lumbricoides, Hymenolepis nana, detectable in the population of Tashkent. The highest infestation with intestinal protozoa, including nonpathogenic amoebas and helmninths, was found in Groups 1 and 3. However, in all the forms of HIV infection, the infestation with E. histolytical/dispar was 10 times greater than that in Groups 2 and 3 (1% and 0.8%, respectively). G. lamblia was detected in 16, 21, and 45.2% in Groups 1, 2, and 3, respectively. In all the HIV-infected patients, the content of CD8 lymphocytes was increased, but that of CD20 lymphocytes was normal. Parasites were detectable with different levels of CD4 lymphocytes, but C. parvum was found only if its count was > 200/ml. In the HIV-infected patients, the hyperproduction of IgE was caused mainly by helminths rather than protozoa. In these patients, the increased level of IgE was also noted in the absence of parasites.

  18. A shift in referral patterns for HIV/AIDS patients.

    Science.gov (United States)

    Fournier, Phillip O; Savageau, Judith A; Baldor, Robert A

    2008-02-01

    With the rapid development (and complex prescribing patterns) of drugs for HIV/AIDS care, it is challenging for physicians to keep current. We conducted a follow-up study to a 1994 cohort study to see how care and referral patterns have changed over the last decade. In this study, we examined how family physicians in Massachusetts were caring for their HIV-infected patients, and to see whether FPs were referring more patients to specialists for care compared with a decade ago. We designed a cross-sectional survey as an 11-year follow-up to a previous study. It was mailed in 2005 to the active membership of the Massachusetts Academy of Family Physicians. Compared with the cohort of 1994, the number of HIV+ patients in individual practices remained about the same, but the number of practices with no AIDS patients was significantly higher. 85.3% of FPs noted that they were more likely to refer HIV/AIDS patients immediately compared with their own practice patterns a decade ago. In this study, 39.0% of current respondents referred HIV+ patients immediately, 57.0% co-managed patients, and 4.1% managed these patients alone (the data for the 1994 cohort was 7.0%, 45.8%, and 47.2%, respectively; P<.0001). Similar changes were seen in regard to care patterns for AIDS patients. Among the current cohort, 61.7% reported that they referred patients immediately, compared with only 18.3% in 1994; 36.8% noted that they co-managed these patients (vs 74.3% in 1994); and only 1.5% reported that they managed these patients alone (vs 7.4% in 1994; P<.0001). A significant shift amongst FPs with regard to their referral patterns for patients with HIV/AIDS has occurred over the last decade. The community health center has emerged as a resource for patients with HIV/AIDS. Funding for specific training programs on HIV/AIDS care should be targeted to community health centers.

  19. Survival Benefit of Kidney Transplantation in HIV-infected Patients.

    Science.gov (United States)

    Locke, Jayme E; Gustafson, Sally; Mehta, Shikha; Reed, Rhiannon D; Shelton, Brittany; MacLennan, Paul A; Durand, Christine; Snyder, Jon; Salkowski, Nicholas; Massie, Allan; Sawinski, Deirdre; Segev, Dorry L

    2017-03-01

    To determine the survival benefit of kidney transplantation in human immunodeficiency virus (HIV)-infected patients with end-stage renal disease (ESRD). Although kidney transplantation (KT) has emerged as a viable option for select HIV-infected patients, concerns have been raised that risks of KT in HIV-infected patients are higher than those in their HIV-negative counterparts. Despite these increased risks, KT may provide survival benefit for the HIV-infected patient with ESRD, yet this important clinical question remains unanswered. Data from the Scientific Registry of Transplant Recipients were linked to IMS pharmacy fills (January 1, 2001 to October 1, 2012) to identify and study 1431 HIV-infected KT candidates from the first point of active status on the waiting list. Time-dependent Cox regression was used to establish a counterfactual framework for estimating survival benefit of KT. Adjusted relative risk (aRR) of mortality at 5 years was 79% lower after KT compared with dialysis (aRR 0.21; 95% CI 0.10-0.42; P <0.001), and statistically significant survival benefit was achieved by 194 days of KT. Among patients coinfected with hepatitis C, aRR of mortality at 5 years was 91% lower after KT compared with dialysis (aRR 0.09; 95% CI 0.02-0.46; P < 0.004); however, statistically significant survival benefit was not achieved until 392 days after KT. Evidence suggests that for HIV-infected ESRD patients, KT is associated with a significant survival benefit compared with remaining on dialysis.

  20. [Recurrent tuberculosis in patients with coinfection by HIV].

    Science.gov (United States)

    García Ordóñez, M A; Martínez González, J; Orihuela Cañadas, F; Jiménez Oñate, F; Colmenero Castillo, J D

    2003-06-01

    Analysis and identification of factors associated with the tuberculosis (TB) recurrence in HIV-infected patients. The HIV-infected patients diagnosed with TB between 1995-2000 and with correct completion of the treatment were selected. There were compared those patients who presented a tuberculous disease recurrence with those which did not presented it. Multivariate analysis was carried out by logistic regression in order to identify factors associated with a new episode of TB. In the total sample of 223 diagnosed HIV-infected patients with TB, 159 (71.3%) patients completed adequately the treatment and were considered cured. The rest were excluded because of: death before completing the treatment (5.8%), lost in the follow-up (11.7%), therapeutic abandonment (9.4%), and therapeutic failure (1.8%). In the 159 patient final sample, 14 (8.8%) patients presented later recurrence. The patients with recurrent TB presented a greater degree of immunosuppression, more previous complications indicative of AIDS, and greater frequency of extrapulmonary TB in the initial episode. After the multivariate analysis, a count of lymphocytes CD4 lower than 100/mm3 in the first episode of TB was associated with recurrent tuberculous disease (odds ratio [OR]: 4,6; 95% confidence index [CI]: 1,3-18,2). Mortality was high (35.7%) in the patients with recurrent episodes. The recurrence of TB in patients coinfected by HIV occurs in individuals with profound immunossuppression and is associated to high mortality.

  1. Pain in hospitalized HIV-positive patients: clinical and therapeutical issues

    Directory of Open Access Journals (Sweden)

    Elisa Miranda Aires

    Full Text Available Pain is frequently reported by patients infected with Acquired Immunodeficiency Virus (HIV, and its causes and specific treatment should be appropriately investigated. We evaluated 197 hospitalized HIV-positive patients with serial interviews and analysis of prescriptions and clinical evolution charts. The main characteristics of pain reported by these patients were: high intensity (60.7%, high frequency (72.0% and well-known causes (88.8%. Fifty-two per cent of the patients reported persistent or frequent pain during the two weeks before hospital admission. Parameters such as gender, educational level and Karnofsky Index showed no direct relation to the presence or absence of pain. The most commonly affected sites were the head (28.0% and the abdomen (26.2%. The frequency of indications of pain in the clinical evolution charts (46.2% was considerably lower than the frequency of complaints reported by patients during the interviews (76.3%. Pain was undertreated in 83.2% of patients, both due to poor efficacy of the prescribed medications and to the excessive and inefficient use of standing order ("if necessary" regimens. We observed that pain was better managed during the hospitalization period, although this cannot be explained by improvement of the analgesic treatment; it might be due to successful treatment of the underlying disease. We concluded that pain reported by hospitalized HIV-positive patients is often underestimated and inadequately treated by assisting doctors, in spite of its severity and frequency.

  2. The changing face of HIV/AIDS in treated patients.

    Science.gov (United States)

    Llibre, Josep M; Falco, Vicenç; Tural, Cristina; Negredo, Eugenia; Pineda, Juan A; Muñoz, Jose; Ortega, Enrique; Videla, Sebastia; Sirera, Guillem; Martinez, Esteban; Miralles, Celia; Iribarren, Josean; Galindo, Maria J; Domingo, Pere; d'Arminio-Monforte, Antonella; Miro, Jose M; Clotet, Bonaventura

    2009-07-01

    The spectrum of complications emerging in successfully treated HIV-infected patients has dramatically changed since the advent of HAART. Typical AIDS-defining illnesses have been substituted by new comorbid conditions that threaten even those patients who maintain virologic suppression. Proper management of cardiovascular risk, and early diagnosis of AIDS-related and, particularly, non-AIDS-related malignancies (including papilomavirus-related neoplasms) must be introduced into the routine of care. Hot areas of investigation include HIV-associated neurocognitive disorders, hepatitis B and C coinfection, non-alcoholic fatty liver disease, progressive multifocal leukoencephalopathy and tuberculosis. Bone and kidney long-term toxicities and lipoatrophy remain as issues of paramount importance. The identification and early treatment of immune reconstitution disease is also of major interest, specially in those patients starting their antiretroviral treatment with severe CD4 cell depletion. The present review focuses on these twelve areas of increasing interest for physicians currently facing successfully treated HIV+ patients.

  3. Breast-axillary complex in HIV/AIDS patients.

    Science.gov (United States)

    Eni, U E; Naaya, H U; Yawe, K D T; Lawan, M A; Bakari, A A

    2010-01-01

    HIV/AIDS have not only increased the health care burden especially in developing countries, it equally complicates the presentation of many diseases. Some well known disease entities now occur in fulminant complexities not previously described or known as such. The objective of this article is to report an unusual presentation of HIV/AIDS patients to the surgeon with Axillary and ipsilateral breast swelling. This is a report of three cases seen and managed by the authors. Three adult female patients presented with progressively increasing axillary and ipsilateral breast swellings. They also had associated fevers and weight loss. Their main concern had been development of breast cancer. One of the patients was a known retroviral positive on Highly Active Anti-Retroviral Therapy (HAART). Examination revealed axillary abscess and ipsilateral breast oedema in two cases. The patient on HAART had a hard breast-axillary mass complex. Biopsy (FNAB) revealed inflammatory cells and no malignancy in all three cases. HIV screening was positive in all cases. One of the patients had excision of breast-axillary mass complex, and the histology showed features of chronic inflammation, with no malignant cells. The other two had incision and drainage of their axillary abscess. This shows the ubiquitous presentation of HIV/AIDS in our environment and surgeons should be aware of the breast axillary complex in HIV/AIDS. Medical practitioners should be careful to obtain accurate diagnosis before embarking on treatment especially mutilating surgical procedures.

  4. Patient knowledge of HIV and its treatment in South Africa

    Directory of Open Access Journals (Sweden)

    Lauren M. Terblanche

    2014-01-01

    Full Text Available Background: Patients on antiretroviral therapy (ART need to achieve a 90% adherence rate to ART in order to prevent disease progression and drug resistance. The patients’ knowledge of ART and HIV is thus crucial to ensuring good adherence, decreased risk for drug resistance and cost-effective treatment for these patients.Aim: To determine the knowledge of infected patients with regard to HIV and the ART they were receiving.Setting: The study was conducted at a comprehensive community health centre in a developing low socio-economic community near Cape Town, South Africa.Methods: A quantitative descriptive correlative research design was applied. A sample consisting of 200 (8.5% respondents was selected from a population of 2349. A multiple-choice questionnaire, comprising 29 questions, including 14 critical knowledge testing questions, was used in individual interviews conducted by either the researcher or fieldworker who assessed the respondents’ knowledge regarding various key aspects of HIV and ART.Results: Misconceptions regarding HIV and ART were revealed and scores for the 14 critical knowledge testing questions in the questionnaire revealed that 0% of the respondents had good knowledge, 20% had average knowledge and 80% had poor knowledge.Conclusion: The respondents on ART in this particular community health centre had poor knowledge of HIV and ART. This may contribute to poor adherence rates, increased drug resistance, disease progression and increased costs for the government with regard to treating such patients. Increased attention needs to be given to patient education.

  5. Malignant Fibrohisticytoma of the Knee in a Patient with HIV

    Directory of Open Access Journals (Sweden)

    Riccardo Gomes Gobbi

    2012-01-01

    Full Text Available This case report describes a patient presenting with anterior knee pain (extensor mechanism pain, a poorly studied complaint in the HIV population. The final diagnosis was malignant fibrohistiocytoma, a rare condition among knee pathologies, successfully treated with endoprosthesis after tumor resection. This article focuses on what the authors learned after treating this patient, particularly on the difficulty in making a correct diagnosis of this group of patients due to lack of adequate epidemiological characterization. By assuming that the pathology was related to long-term infection and treatment of HIV (knee hoffitis, the authors underestimated the gravity of the case, almost compromising the result of treatment.

  6. Serological diagnosis of Chagas disease in HIV-infected patients

    Directory of Open Access Journals (Sweden)

    Dulce Stauffert

    2015-06-01

    Full Text Available INTRODUCTION: This study assessed the rate of request for the serological diagnosis of Chagas disease among human immunodeficiency virus (HIV-infected patients treated at the Specialized Care Service of Pelotas, Rio Grande do Sul, Brazil. METHODS: This cross-sectional study used secondary data obtained from the medical records of 252 patients aged between 18 and 75 years. RESULTS: The serological diagnosis of Chagas disease was requested only in 3.2% of cases. CONCLUSIONS: The results demonstrate poor adherence to protocols on the part of healthcare professionals, indicating the need to reevaluate the procedures applied to HIV-infected patients from endemic regions for both diseases.

  7. Neurologic emergencies in HIV-negative immunosuppressed patients.

    Science.gov (United States)

    Guzmán-De-Villoria, J A; Fernández-García, P; Borrego-Ruiz, P J

    HIV-negative immunosuppressed patients comprise a heterogeneous group including transplant patients, patients undergoing treatment with immunosuppressors, uremic patients, alcoholics, undernourished patients, diabetics, patients on dialysis, elderly patients, and those diagnosed with severe or neoplastic processes. Epileptic seizures, focal neurologic signs, and meningoencephalitis are neurologic syndromes that require urgent action. In most of these situations, neuroimaging tests are necessary, but the findings can be different from those observed in immunocompetent patients in function of the inflammatory response. Infectious disease is the first diagnostic suspicion, and the identification of an opportunistic pathogen should be oriented in function of the type and degree of immunosuppression. Other neurologic emergencies include ischemic stroke, cerebral hemorrhage, neoplastic processes, and pharmacological neurotoxicity. This article reviews the role of neuroimaging in HIV-negative immunodepressed patients with a neurologic complication that requires urgent management. Copyright © 2016 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. Development of hematopoietic stem cell based gene therapy for HIV-1 infection: considerations for proof of concept studies and translation to standard medical practice.

    Science.gov (United States)

    DiGiusto, David L; Stan, Rodica; Krishnan, Amrita; Li, Haitang; Rossi, John J; Zaia, John A

    2013-11-22

    Over the past 15 years we have been investigating an alternative approach to treating HIV-1/AIDS, based on the creation of a disease-resistant immune system through transplantation of autologous, gene-modified (HIV-1-resistant) hematopoietic stem and progenitor cells (GM-HSPC). We propose that the expression of selected RNA-based HIV-1 inhibitors in the CD4+ cells derived from GM-HSPC will protect them from HIV-1 infection and results in a sufficient immune repertoire to control HIV-1 viremia resulting in a functional cure for HIV-1/AIDS. Additionally, it is possible that the subset of protected T cells will also be able to facilitate the immune-based elimination of latently infected cells if they can be activated to express viral antigens. Thus, a single dose of disease resistant GM-HSPC could provide an effective treatment for HIV-1+ patients who require (or desire) an alternative to lifelong antiretroviral chemotherapy. We describe herein the results from several pilot clinical studies in HIV-1 patients and our strategies to develop second generation vectors and clinical strategies for HIV-1+ patients with malignancy who require ablative chemotherapy as part of treatment and others without malignancy. The important issues related to stem cell source, patient selection, conditioning regimen and post-infusion correlative studies become increasingly complex and are discussed herein.

  9. Evaluation of adhesive properties of Candida albicans isolated from the oral cavity in HIV positive patients.

    Science.gov (United States)

    Macura, A B; Bort, A

    2001-01-01

    The aim of the work was to compare adhesive properties of Candida albicans strains isolated from the oral cavity in HIV+ vs. HIV- persons. The materials were Candida albicans strains and buccal epithelial cells isolated from both HIV+ and HIV- persons. We applied the in vitro adherence test, primarily described by Kimura and Pearsall and modified by Macura. The strongest adherence was found between both fungi and epithelial cells isolated from a HIV+ person. The adherence of C. albicans isolated from HIV+ patients was significantly stronger to epithelium collected from HIV+ than HIV- persons.

  10. Microbial translocation is correlated with HIV evolution in HIV-HCV co-infected patients.

    Directory of Open Access Journals (Sweden)

    Jean-Jacques Tudesq

    Full Text Available Microbial translocation (MT is characterized by bacterial products passing into the blood through the gut barrier and is a key phenomenon in the pathophysiology of Human Immunodeficiency Virus (HIV infection. MT is also associated with liver damage in Hepatitis C Virus (HCV patients. The aim of the study was to assess MT in plasma of HIV-HCV co-infected patients. 16S rDNA (16 S Ribosomal DNA subunit marker and other markers of MT such as Lipopolysaccharide (LPS-binding protein (LBP, soluble CD14 (sCD14, intestinal fatty acid binding protein (I-FABP were used. Clinical, biological and immunological characteristics of the population were studied in order to correlate them with the intensity of the MT. We demonstrate that indirect markers of MT, LBP and CD14s, and a marker of intestinal permeability (I-FABP are significantly higher in HIV-HCV co-infected patients than in healthy controls (17.0 vs 2.6 μg/mL, p < 0.001; 1901.7 vs 1255.0 ng/mL, p = 0.018; 478.3 vs 248.1 pg/mL, p < 0.001, respectively, while a direct marker of MT (16S rDNA copies is not different between these two populations. However, plasma 16S rDNA was significantly higher in co-infected patients with long-standing HIV infections (RGM = 1.47 per 10 years, CI95% = [1.04:2.06], p = 0.03. Our findings show that in HIV-HCV co-infected patients, plasma 16S rDNA levels, directly reflecting MT, seem to be linked to the duration of HIV infection, while elevated levels of LBP and sCD14 reflect only a persistence of immune activation. The levels of these markers were not correlated with HCV evolution.

  11. Helicobacter pylori gastritis in HIV-infected patients: a review.

    Science.gov (United States)

    Nevin, Daniel T; Morgan, Christopher J; Graham, David Y; Genta, Robert M

    2014-10-01

    The risk factors for acquiring Helicobacter pylori and Human Immunodeficiency Virus (HIV) infections are different: H. pylori is transmitted by gastro- or fecal-oral routes and is associated with low socioeconomic conditions, while HIV is transmitted through sexual intercourse, infected body fluids, and transplacentally. If the host responses to these infections were independent, the prevalence of H. pylori should be similar in HIV-infected and non-infected patients. Yet, several studies have detected a lower prevalence of H. pylori in patients with HIV infection, whereas other studies found either no differences or greater rates of H. pylori infection in HIV-positive subjects. To review studies that addressed the issue of these two simultaneous infections and attempt to determine whether reliable conclusions can be drawn from this corpus of often contrasting evidence. Electronic literature search for relevant publications, followed by manual search of additional citations from extracted articles. The initial search yielded 44 publications; after excluding case reports, reviews, narrowly focused articles, and duplicate reports, there remained 29 articles, which are the corpus of this review. With one exception, all studies reported higher rates of H. pylori infection in HIV-negative subjects. Five studies also examined the CD4 lymphocyte counts and found an inverse correlation between the degree of immunosuppression and the prevalence of active H. pylori infection. Current evidence suggests that it is likely that H. pylori needs a functional immune system to successfully and persistently colonize the human gastric mucosa. © 2014 John Wiley & Sons Ltd.

  12. Malarial infection among HIV Patients on Antiretroviral Therapy (ART)

    African Journals Online (AJOL)

    Malarial infection among patients on antiretroviral therapy (ART) attending Federal Medical Centre, Makurdi, Benue State was investigated between April and August 2008 to determine the level of malaria infection in HIV/AIDS patients on ART and those not on ART with respect to CD4+ counts, age and gender. A total of ...

  13. Otorhinolaryngologic Associated Features Of HIV/ AIDS Patients In ...

    African Journals Online (AJOL)

    The pattern of presentation and treatment outcome in HIV / AIDS patients in our centre is presented. Method: ... Otorhinolaryngologists practicing in this environment must be well trained in the act of pre and post screening counseling, while precaution is taken against infecting themselves and their patients. Key Words: ...

  14. Causes for antiretroviral regimen change among HIV/AIDS patients ...

    African Journals Online (AJOL)

    2010-03-01

    This was a retrospective cross-sectional study conducted from January 1 to March 1, 2010 in two primary hospitals and one health centre in central Ethiopia. Information cards of HIV/AIDS patients who have had their antiretroviral regimen switched were reviewed. Data from patients below 18 years old and those who did not ...

  15. HIV sero-prevalence among tuberculosis patients in Kenya | Van ...

    African Journals Online (AJOL)

    Objective: To determine HIV seroprevalence among tuberculosis patients and the burden of HlV attributable tuberculosis among notified patients in Kenya. Design: A cross-sectional anonymous unlinked HlV seroprevalence survey. Setting: Tuberculosis diagnostic clinics of the National Leprosy Tuberculosis Programme in ...

  16. HBV, HCV and HIV among patients with Hemophilia in Khartoum ...

    African Journals Online (AJOL)

    Objectives: The main objective is to determine the screening, vaccination, seroconversion of hepatitis B, C and HIV among Sudanese hemophilic patients registered in Hemophilia Center Khartoum Teaching Hospital. Methods: During the period from July to November 2008, sixty two hemophilic male patients were randomly ...

  17. Prevalence of HIV infection among trauma patients admitted to ...

    African Journals Online (AJOL)

    Trauma health care workers will encounter patients infected with HIV in geographic areas where prevalence is high or in areas where intravenous drug abuse use, high-risk sexual behaviors and penetrating trauma are more common (Kelen et al, 1989). Studies of patients with penetrating trauma in the USA have shown a ...

  18. Pulmonary disease in HIV-infected Patients at the University ...

    African Journals Online (AJOL)

    Esem

    is scarce and variable. Rapid and accurate aetiological diagnosis of pneumonias in HIV-infected patients is thus essential to establishing the local prevalence patterns of disease. However this remains a challenge in developing countries, particularly in patients with sputum smears negative for alcohol acid fast bacilli ...

  19. HIV patients presenting common adverse drug events caused by ...

    African Journals Online (AJOL)

    Antiretroviral (ARV) drug toxicities pose treatment challenges and contribute to poor adherence. This study was carried out to document the commonly reported adverse reactions caused by ARV drugs in HIV patients in Tanzania. Information on drug induced adverse reactions (ADRs) in patients using ARV drugs was ...

  20. Prevalence of HIV seropositivity in paediatric surgical patients at the ...

    African Journals Online (AJOL)

    ... a hernia and severe cachexia. Conclusion: Prevalence of HIV seropositivity is very low among paediatric surgical patients at NAUTH. Routine screening of patients is not necessary and should not form part of the policy. We recommend routine counselling of parents and provision of facilities for precautionary measures as ...

  1. Upper Abdominal Ultra-Sonography Findings in HIV Patients at ...

    African Journals Online (AJOL)

    Design: A descriptive cross-sectional study. Setting: Kenyatta National Hospital and the Defence Forces Memorial Hospital, Nairobi, Kenya. Subjects: HIV infected patients referred for upper abdominal sonography within the study duration of eight months. Results: Two hundred and seventy three (273) patients were ...

  2. Lung fibrosis in deceased HIV-infected patients with Pneumocystis ...

    African Journals Online (AJOL)

    Background. Pneumocystis pneumonia (PcP) is one of the most common opportunistic infections found in patients with HIV. The prognosis if ventilation is required is poor, with mortality of 36 - 80%. Although more recent studies have shown improved survival, our experience has been that close to 100% of such patients die, ...

  3. Independent clinical significance of HIV antigen determination and CD4 counts in anti-HIV positive patients

    DEFF Research Database (Denmark)

    Skinhøj, P; Hofmann, B; Jacobsen, K D

    1989-01-01

    HIV antigenemia was found in 52/243 HIV antibody positive individuals attending 2 AIDS-screening clinics, giving a prevalence of 13, 25 and 76% in CDC groups II, III and IV, respectively. No correlation was found to decreased CD4 lymphocyte values in the individual groups. HIV antigen therefore...... identified a separate subpopulation. For 138 asymptomatic patients followed prospectively both laboratory parameters predicted HIV-related events, the relative risk factor being 4 for low CD4 value and 6 for presence of HIV antigen. Individuals presenting with HIV antigen and decreased CD4 count all...... developed disease within 18 months, the relative risk factor being 24. Thus the 2 markers, when measured together, effectively separated asymptomatic HIV-infected patients into 1 of 3 risk categories....

  4. Rheumatoid arthritis in patients with HIV: management challenges

    Directory of Open Access Journals (Sweden)

    Carroll MB

    2016-04-01

    Full Text Available Matthew B Carroll, Joshua H Fields, Philip G Clerc Department of Rheumatology, Keesler Medical Center, Keesler Air Force Base, Biloxi, MS, USA Abstract: Over the past few decades, HIV has been transformed from a once-uniformly fatal disease to now a manageable but complex multisystem illness. Before highly active antiretroviral therapy (HAART, reports suggested that HIV-infected patients with rheumatoid arthritis (RA would experience remission of their disease. It has now become clear that RA can develop in HIV-infected patients at any time, independent of HAART. Choosing the right medication to treat symptoms related to RA while avoiding excess weakening of the immune system remains a clinical challenge. Agents such as hydroxychloroquine and sulfasalazine might best balance safety with efficacy, making them reasonable first choices for therapy in HIV-infected patients with RA. More immune suppressing agents such as methotrexate may balance safety with efficacy, but data are limited. Corticosteroids such as prednisone may also be reasonable but could increase the risk of osteonecrosis. Among biologic response modifiers, tumor necrosis factor a inhibitors may balance safety with efficacy, but perhaps when HIV replication is controlled with HAART. Monitoring RA disease activity remains challenging as only one retrospective study has been published in this area. Those with HIV infection and RA can experience comorbidities such as accelerated heart disease and osteoporosis, a consequence of the chronic inflammatory state that each illness generates. Although HIV-infected patients are at risk for developing the immune reconstitution inflammatory syndrome when starting HAART, it appears that immune reconstitution inflammatory syndrome has a minimal effect on triggering the onset or the worsening of RA. Keywords: human immunodeficiency virus, rheumatoid arthritis, osteoporosis, cardiovascular disease, immune reconstitution inflammatory syndrome

  5. Impaired distensibility of ascending aorta in patients with HIV infection

    Directory of Open Access Journals (Sweden)

    Zormpala Alexandra

    2012-07-01

    Full Text Available Abstract Background Our aim was to investigate the aortic distensibility (AD of the ascending aorta and carotid artery intima-media thickness (c-IMT in HIV-infected patients compared to healthy controls. Methods One hundred and five HIV-infected patients (86 males [82%], mean age 41 ± 0.92 years, and 124 age and sex matched HIV-1 uninfected controls (104 males [84%], mean age 39.2 ± 1.03 years were evaluated by high-resolution ultrasonography to determine AD and c-IMT. For all patients and controls clinical and laboratory factors associated with atherosclerosis were recorded. Results HIV- infected patients had reduced AD compared to controls: 2.2 ± 0.01 vs. 2.62 ± 0.01 10-6 cm2 dyn-1, respectively (p -6 cm2 dyn-1, p = 0.01]. In multiadjusted analysis, increasing age and exposure to HAART were independently associated with decreased AD. Conclusion HIV infection is independently associated with decreased distensibility of the ascending aorta, a marker of subclinical atherosclerosis. Increasing age and duration of exposure to HAART are factors further contributing to decreased AD.

  6. Screening for alcohol use disorders in HIV patients

    Directory of Open Access Journals (Sweden)

    C Ward

    2012-11-01

    Full Text Available Many chronic health conditions have been linked to alcohol consumption, as well as excess morbidity, mortality and an increased financial burden on the National Health Service (NHS. The British HIV Association (BHIVA recommends that HIV patients be asked about alcohol due to its effect on adherence to antiretroviral therapy. National Institute of Health and Clinical Excellence (NICE guidelines recommend screening for alcohol use disorders in patients attending genitourinary medicine (GUM clinics. In this study we looked at the use of a screening tool for alcohol use disorders in HIV patients in a metropolitan city. We assessed HIV patients over a 6-month period for alcohol use disorders using the AUDIT-C questionnaire. Patients with a score >4 were identified as higher risk and provided with brief advice about alcohol and offered written information and support. Demographic data was collected along with hepatitis B and C status, information on sexually transmitted infection (STI testing and diagnosis. 352 patients were reviewed with a mean age of 41. 297 (84.4% patients were male, 235 (66.8% were white British and 251 (71.3% were men who have sex with men (MSM. 277 (78.7% patients were on antiretroviral therapy with 254 (91.7% of these having an undetectable viral load. Alcohol use disorders were assessed using the AUDIT-C score in 332 (94.3% patients with no patient declining assessment. 166 (50% patients had an AUDIT-C score >4 signifying higher risk. Alcohol advice was provided to 161 (97% of these patients and a Drink Smart guide offering advice on alcohol self help offered to 103 (64% patients and accepted by 45 (43.7%. An opportunistic STI screen was offered to 258 (73.3% patients on that visit in line with best practice guidelines and was accepted by 83 (32.2%. 25 infections were found in 20 patients, of which 13 (65% had AUDIT-C scores >4. There were 8 active hepatitis C co-infected patients of which 3 had an AUDIT-C score >4 and 12

  7. Hyperproinsulinaemia in normoglycaemic lipodystrophic HIV-infected patients

    DEFF Research Database (Denmark)

    Haugaard, Steen B; Andersen, Ove; Hales, CN

    2006-01-01

    BACKGROUND: We aimed to investigate whether the insulin precursors, intact (IP) and 32-33 split proinsulin (SP), which are elevated in states of insulin resistance and predict type 2 diabetes, would be elevated in human immunodeficiency virus (HIV)-infected patients with lipodystrophy (LIPO......). MATERIALS AND METHODS: Forty-three normoglycaemic HIV-infected patients [18 LIPO and 18 without lipodystrophy (NONLIPO) receiving antiretroviral drugs, and seven patients naïve to antiretroviral drugs (NAIVE)] were examined. Insulin precursors were measured during fasting, during an intravenous glucose.......01), but did not differ between study groups. CONCLUSIONS: Proinsulin appeared to be increased in HIV-lipodystrophy, but no more than caused by the increased ISR. Nevertheless, the inverse correlations between SP/insulin ratio versus Si(RD) and incremental total proinsulin/insulin ratio versus DI may argue...

  8. How to address smoking cessation in HIV patients.

    Science.gov (United States)

    Calvo-Sánchez, M; Martinez, E

    2015-04-01

    Tobacco consumption is the modifiable risk factor contributing most to the development of non-AIDS-defining events among persons living with HIV/AIDS (PLWHA). Clinicians' awareness of this problem is critical and not yet adequate. Practical information issued by public health authorities or contained in experts' clinical guidelines regarding how to address smoking cessation in PLWHA is scarce. The aim of this review is to provide physicians with comprehensive and practical information regarding how to identify HIV-positive patients willing to stop smoking and those more likely to succeed, how to choose the most suitable strategy for an individual patient, and how to help the patient during the process. In the light of current evidence on the efficacy and benefits of stopping smoking in PLWHA, physicians must actively pursue smoking cessation as a major objective in the clinical care of PLWHA. © 2014 British HIV Association.

  9. Recurrent pneumococcal meningitis in a splenectomised HIV-infected patient

    Directory of Open Access Journals (Sweden)

    Quesne Gilles

    2003-11-01

    Full Text Available Abstract Background Streptococcus pneumoniae is a major cause of human disease, especially in pre-school children and elderly people, as well as in special risk groups such as asplenic, antibody deficient patients, or presenting disruption of natural barriers. The occurrence of pneumococcal disease has increased with the onset of the HIV epidemic and the emergence of drug-resistance. Case presentation We report the case of an HIV-1-infected patient who experienced three episodes of recurrent pneumococcal meningitis over a 4-year period, despite chemoprophylaxis and capsular vaccination. Conclusions Efficacy of anti-pneumococcal chemoprophylaxis and vaccination in HIV-infected patients are discussed in the light of this particular case.

  10. Hyperproinsulinaemia in normoglycaemic lipodystrophic HIV-infected patients

    DEFF Research Database (Denmark)

    Haugaard, Steen B; Andersen, Ove; Hales, CN

    2006-01-01

    .01), but did not differ between study groups. CONCLUSIONS: Proinsulin appeared to be increased in HIV-lipodystrophy, but no more than caused by the increased ISR. Nevertheless, the inverse correlations between SP/insulin ratio versus Si(RD) and incremental total proinsulin/insulin ratio versus DI may argue......BACKGROUND: We aimed to investigate whether the insulin precursors, intact (IP) and 32-33 split proinsulin (SP), which are elevated in states of insulin resistance and predict type 2 diabetes, would be elevated in human immunodeficiency virus (HIV)-infected patients with lipodystrophy (LIPO......). MATERIALS AND METHODS: Forty-three normoglycaemic HIV-infected patients [18 LIPO and 18 without lipodystrophy (NONLIPO) receiving antiretroviral drugs, and seven patients naïve to antiretroviral drugs (NAIVE)] were examined. Insulin precursors were measured during fasting, during an intravenous glucose...

  11. Effects of nutritional supplementation for HIV patients starting antiretroviral treatment

    DEFF Research Database (Denmark)

    Olsen, Mette Frahm; Abdissa, Alemseged; Kæstel, Pernille

    2014-01-01

    Objectives: To determine the effects of lipid based nutritional supplements with either whey or soy protein in patients with HIV during the first three months of antiretroviral treatment (ART) and to explore effects of timing by comparing supplementation at the start of ART and after three months...... delay. Design: Randomised controlled trial. Setting: Three public ART facilities in Jimma, Oromia region, Ethiopia. Participants: Adults with HIV eligible for ART with body mass index (BMI) >16. Intervention: Daily supplementation with 200 g (4600 kJ) of supplement containing whey or soy during either...... with undetectable viral load at three months. Patients receiving delayed supplementation had higher weight gain but lower gains in functional outcomes. Conclusions: Lipid based nutritional supplements improved gain of weight, lean body mass, and grip strength in patients with HIV starting ART. Supplements...

  12. Cognitive disorders in HIV-infected patients: are they HIV-related?

    Science.gov (United States)

    Bonnet, Fabrice; Amieva, Hélène; Marquant, Fabienne; Bernard, Charlotte; Bruyand, Mathias; Dauchy, Frédéric-Antoine; Mercié, Patrick; Greib, Carine; Richert, Laura; Neau, Didier; Catheline, Gwenaelle; Dehail, Patrick; Dabis, Francois; Morlat, Philippe; Dartigues, Jean-François; Chêne, Geneviève

    2013-01-28

    Large unselected studies on representative samples of HIV-infected patients with a whole battery of neuropsychological tests and cerebral MRI scan are required to assess the frequency of neurocognitive impairment (NCI), the determinants of mild neurocognitive disorders (MNDs), or HIV-associated dementia (HAD) and the relationship between NCI and MRI scan findings. Investigation of 400 consecutively enrolled HIV-1-infected adults from the ANRS CO3 Aquitaine Cohort, using standardized neurocognitive tests chosen to achieve consistency with Frascati's criteria. Half of the patients had a cerebral MRI scan allowing gray and white matter volume measurement. Factors associated with NCI were studied by logistic regression models. Median age of participants was 47 years, 79% were male and 89% received combination antiretroviral treatment (cART), of whom 93% had plasma HIV RNA below 500 copies/ml. Median CD4 cell count was 515 cells/μl. Prevalence of NCI was 59%, including 21% of asymptomatic NCI, 31% of MND, and 7% of HAD. A low level of education, prior neurologic AIDS-defining disorders event, anxiety, depressive symptoms, and prior history of brain damage were independently associated with MND or HAD, but neither HIV nor cART-related variables. The presence of NCI was significantly associated with lower gray matter fraction. In this large unselected cohort, a high prevalence of symptomatic neurocognitive disorders was mainly related to its traditional determinants and associated with gray matter atrophy at early stages of the disease.

  13. Could a Monetary Perk Help Keep HIV Patients on Their Meds?

    Science.gov (United States)

    ... Monetary Perk Help Keep HIV Patients on Their Meds? Study involving $70 gift cards suggests the approach ... infected patients will enter care, and take their meds as directed. The study, conducted at HIV clinics ...

  14. Health care index score and risk of death following tuberculosis diagnosis in HIV-positive patients

    DEFF Research Database (Denmark)

    Podlekareva, D N; Grint, D; Post, F A

    2013-01-01

    To assess health care utilisation for patients co-infected with TB and HIV (TB-HIV), and to develop a weighted health care index (HCI) score based on commonly used interventions and compare it with patient outcome....

  15. Towards a fair consideration of PrEP as part of combination HIV prevention in Latin America

    Science.gov (United States)

    Ravasi, Giovanni; Grinsztejn, Beatriz; Baruch, Ricardo; Guanira, Juan Vicente; Luque, Ricardo; Cáceres, Carlos F; Ghidinelli, Massimo

    2016-01-01

    Introduction Despite progress in scaling up antiretroviral treatment, HIV prevention strategies have not been successful in significantly curbing HIV incidence in Latin America. HIV prevention interventions need to be expanded to target the most affected key populations with a combination approach, including new high impact technologies. Oral pre-exposure prophylaxis (PrEP) is recommended as additional prevention choice for individuals at higher risk of infection and could become a cost-effective prevention tool. We discuss the barriers and solutions for a fair consideration of PrEP as part of combination HIV prevention strategies in Latin America. Discussion Although demonstration projects are ongoing or being planned in a number of countries, to date no Latin American country has implemented a public PrEP programme. The knowledge of policymakers about PrEP implementation needs to be strengthened, and programmatic guidance and cost estimate tools need to be developed to support adequate planning. Despite high levels of awareness among health providers, especially if engaged in HIV or key population care, willingness to prescribe PrEP is still low due to the lack of national policies and guidelines. Key populations, especially men who have sex with men, transgender women and sex workers, have been engaged in demonstration projects, and qualitative research shows high awareness and willingness to use PrEP, especially if accessible in the public sector for free or at affordable price. Concerns of safety, adherence, effectiveness and risk compensation need to be addressed through targeted social communication strategies to improve PrEP knowledge and stimulate demand. Alliance among policymakers, civil society and representatives from key populations, healthcare providers and researchers will be critical for the design and successful implementation of PrEP demonstration projects of locally adapted delivery models. The use of mechanisms of joint negotiation and

  16. Towards a fair consideration of PrEP as part of combination HIV prevention in Latin America.

    Science.gov (United States)

    Ravasi, Giovanni; Grinsztejn, Beatriz; Baruch, Ricardo; Guanira, Juan Vicente; Luque, Ricardo; Cáceres, Carlos F; Ghidinelli, Massimo

    2016-01-01

    Despite progress in scaling up antiretroviral treatment, HIV prevention strategies have not been successful in significantly curbing HIV incidence in Latin America. HIV prevention interventions need to be expanded to target the most affected key populations with a combination approach, including new high impact technologies. Oral pre-exposure prophylaxis (PrEP) is recommended as additional prevention choice for individuals at higher risk of infection and could become a cost-effective prevention tool. We discuss the barriers and solutions for a fair consideration of PrEP as part of combination HIV prevention strategies in Latin America. Although demonstration projects are ongoing or being planned in a number of countries, to date no Latin American country has implemented a public PrEP programme. The knowledge of policymakers about PrEP implementation needs to be strengthened, and programmatic guidance and cost estimate tools need to be developed to support adequate planning. Despite high levels of awareness among health providers, especially if engaged in HIV or key population care, willingness to prescribe PrEP is still low due to the lack of national policies and guidelines. Key populations, especially men who have sex with men, transgender women and sex workers, have been engaged in demonstration projects, and qualitative research shows high awareness and willingness to use PrEP, especially if accessible in the public sector for free or at affordable price. Concerns of safety, adherence, effectiveness and risk compensation need to be addressed through targeted social communication strategies to improve PrEP knowledge and stimulate demand. Alliance among policymakers, civil society and representatives from key populations, healthcare providers and researchers will be critical for the design and successful implementation of PrEP demonstration projects of locally adapted delivery models. The use of mechanisms of joint negotiation and procurement of antiretrovirals

  17. Towards a fair consideration of PrEP as part of combination HIV prevention in Latin America

    Directory of Open Access Journals (Sweden)

    Giovanni Ravasi

    2016-10-01

    Full Text Available Introduction: Despite progress in scaling up antiretroviral treatment, HIV prevention strategies have not been successful in significantly curbing HIV incidence in Latin America. HIV prevention interventions need to be expanded to target the most affected key populations with a combination approach, including new high impact technologies. Oral pre-exposure prophylaxis (PrEP is recommended as additional prevention choice for individuals at higher risk of infection and could become a cost-effective prevention tool. We discuss the barriers and solutions for a fair consideration of PrEP as part of combination HIV prevention strategies in Latin America. Discussion: Although demonstration projects are ongoing or being planned in a number of countries, to date no Latin American country has implemented a public PrEP programme. The knowledge of policymakers about PrEP implementation needs to be strengthened, and programmatic guidance and cost estimate tools need to be developed to support adequate planning. Despite high levels of awareness among health providers, especially if engaged in HIV or key population care, willingness to prescribe PrEP is still low due to the lack of national policies and guidelines. Key populations, especially men who have sex with men, transgender women and sex workers, have been engaged in demonstration projects, and qualitative research shows high awareness and willingness to use PrEP, especially if accessible in the public sector for free or at affordable price. Concerns of safety, adherence, effectiveness and risk compensation need to be addressed through targeted social communication strategies to improve PrEP knowledge and stimulate demand. Alliance among policymakers, civil society and representatives from key populations, healthcare providers and researchers will be critical for the design and successful implementation of PrEP demonstration projects of locally adapted delivery models. The use of mechanisms of joint

  18. HBV and neurological impairment in HIV-infected patients

    Directory of Open Access Journals (Sweden)

    L Manolescu

    2012-11-01

    Full Text Available Objective: HIV can affect CNS in early stages of disease and determine neurological impairment. HBV DNA was found in CSF of HIV co-infected patients, but little is known about the neurotropic character of this virus. Here we assessed the degree of association between HBV infection and neurological impairment in a large cohort of long-term survivors, HIV-infected patients that experienced multiple therapeutic schemes over time. Methods: A total of 462 HIV-1-infected patients were retrospectively followed up for 10 years for HBV infection and neurological impairment. The patients were tested for immune (flow cytometry and virological parameters of HIV infection (Roche Amplicor, version 1.5/ COBAS AmpliPrep/COBAS TaqMan HIV-1 test and for HBV infection markers (HBsAg, anti HBc: Murex Biotech ELISA tests. Many of these patients have experienced between one and six regimens such as: 2 NRTIs, 3 NRTIs, 2 NRTIs+1 NNRTI, 1 NRTI+1 NNRTI+1 PI, 2 NRTIs+2 PIs. Results: After 10 years 29.87% of the patients presented neurological impairment. Out of them 56.52% were HBV-infected. The prevalence of HIV encephalopathy (HE in our studied cohort was 22.7% and 50.4% of these patients were HBV-infected. The median HIV diagnosis age was 7 and the median age of HE diagnosis was 10. In order to establish a possible correlation between HBV infection and HE we first reviewed and excluded the main risk factors associated with HE at the moment of diagnosis: low weight, anemia, constitutional symptoms, low CD4+count, high plasma HIV-RNA load. No patient was infected with HCV. The groups of patients that presented HE and HBsAg and HE without HBsAg were balanced regarding sex, number of deceased patients, number of class C3 patients, but the patients in first group presented lower CD4 values at HE diagnosis vs patients from second group 2: 44.5 vs 95 cells/µL, p=0.3; lower nadir CD4 count: 38 vs 51 cell/µL, p=0.1; and slightly higher HIV viral load: 5.2 vs 5 log10 copies

  19. Sero-prevalance of anti-R7V antibody in HIV infected patients in the ...

    African Journals Online (AJOL)

    STORAGESEVER

    2010-01-25

    Jan 25, 2010 ... immunity against HIV-infection in drug naïve HIV patients and that the synthesis and release of this antibody may decrease with ARD treatment. Key words: HIV, AIDS, anti-R7V ... alcohol and caffeine (Raboud et al., 1995). The anti-R7V antibodies have been linked to non progression of HIV-infected ...

  20. CANDIDURIA AMONG HIV- INFECTED PATIENTS ATTENDING A ...

    African Journals Online (AJOL)

    colonization and infection or between upper or lower urinary tract infections. Objective: This study focused on determining the spectrum of Candida species implicated in candiduria among HIV-infected individuals and their susceptibility to .... found in urine of neonates and is usually associated with systemic infection in this ...

  1. CANDIDURIA IN HIV INFECTED PATIENTS IN YAOUNDE,

    African Journals Online (AJOL)

    200 and 499 lymphocytes/mms. The propor- tions were as follows: 62%, 38% and 0%, re- spectively, for CD4 count 499. DISCUSSION. The hospitals chosen for this study were reference hospitals designated for the diagno- sis and management of HIV in Cameroon. The search for Candida in the urine ...

  2. Cryptosporidiosis Among HIV-infected Patients with Diarrhea in Edo State, Midwesten Nigeria

    Directory of Open Access Journals (Sweden)

    Akinbo, F. O.

    2010-01-01

    Full Text Available To determine the prevalence of cryptosporidiosis among HIV infected and HIV non-infected patients with diarrhea in Edo State, Nigeria, as well as the effect of CD4+ lymphocyte count on the prevalence of cryptosporidial infection among the HIV patients. Stool samples were collected from 300 patients consisting of 200 HIV-infected and 100 HIV non-infected patients with diarrhea. Blood samples were collected from the HIV-infected patients. The stool samples were processed to detect Cryptosporidium species using a modified Ziehl-Neelsen stain, as well as other intestinal parasites using saline and iodine preparations. The blood samples were used to determine CD4+ lymphocyte count. The prevalence of intestinal parasites was higher in HIV-infected patients compared with their HIV non-infected counterparts (39% vs 24% respectively, p=0.0097. Cryptosporidiosis was diagnosed only among HIV-infected patients and was the only parasite whose prevalence was significantly different between HIV-infected and HIV non-infected patients. CD4+ lymphocyte count of <200 cells/µL among HIV-infected was a risk factor for acquiring cryptosporidial infection (OR=18.776, 95% CI=6.299, 55.964. A cryptosporidial infection prevalence of 18% among HIV-infected patients was observed and CD4+ count of <200 cells/µL was a risk factor for acquiring the disease. Routine examination of diarrhogenic stools of HIVinfected patients for cryptosporidiosis is advocated.

  3. Acquired epidermodysplasia verruciformis in an HIV-positive patient.

    Science.gov (United States)

    Lau, Carmen; Acharya, Sashi; Arumainayagam, Joseph T; Kasparis, Christos; Dhesi, I

    2016-10-01

    Epidermodysplasia verruciformis (EV) is a rare dermatological manifestation of the human papillomavirus (HPV) infection, which causes distinctive skin lesions in sun-exposed areas. Both inherited and acquired forms exist. Immunocompromised individuals, such as HIV patients, are at risk of acquired EV. EV poses challenges in its management and variable responses are seen in different individuals. In addition, EV carries a significant risk of skin malignancy with certain HPV types that require skin surveillance. A case of acquired EV in a HIV-positive patient is presented in this report. © The Author(s) 2016.

  4. HIV patient with mucous membrane pemphigoid: a case report.

    Science.gov (United States)

    Singh, Anand Pratap; Chaitra, T R; Ravishankar, T L; Singh, Surendra Pratap; Mohapatra, Ashok Kumar

    2014-04-01

    Mucous Membrane Pemphigoid, a new denomination of cicatricial pemphigoid, encompasses a group of chronic subepithelial autoimmune blistering diseases that predominantly affect the oral cavity and the eyes (conjunctivitis and symblepharon). A rare case of Mucous Membrane Pemphigoid (MMP) in a human immunodeficiency virus (HIV) positive patient is discussed with clinicohistopathological presentation. Since our patient was HIV-positive and had lesions restricted to the oral mucosa with ocular involvement, only topical and intralesional steroids were preferred as the first line of treatment. Systemic corticosteroid therapy raises a concern regarding immunosuppression.

  5. Stroke in a patient with tuberculous meningitis and HIV infection

    Directory of Open Access Journals (Sweden)

    Maria Bruna Pasticci

    2013-02-01

    Full Text Available Abstract. Tuberculous meningitis (TBM is a devastating disease. TBM occurs more commonly in HIV infected patients. The influence of HIV co-infection on clinical manifestations and outcome of TBM is not well defined. Yet, some differences have been observed and stroke has been recorded to occur more frequently. This study reports on an HIV infected Caucasian female with lung, meningeal tuberculosis and stroke due to a cortical sub-cortical ischemic lesion.TBM was documented in the absence of neurologic symptoms. At the same time, miliary lung TB caused by multi-susceptible Mycobacterium tuberculosis was diagnosed. Anti-TB therapy consisting of a combination of four drugs was administered. The patient improved and was discharged five weeks later. In conclusion, TBM and multiple underling pathologies including HIV infection, as well as other risk factors can lead to a greater risk of stroke. Moreover, drug interactions and their side effects add levels of complexity. TBM must be included in the differential diagnosis of HIV infected patients with stroke and TBM treatment needs be started as soon as possible before the onset of vasculopathy.

  6. Positron emission tomography in patients suffering from HIV-1 infection

    Energy Technology Data Exchange (ETDEWEB)

    Sathekge, Mike [University Hospital of Pretoria, Department of Nuclear Medicine, Pretoria (South Africa); Goethals, Ingeborg; Wiele, Christophe van de [University Hospital Ghent, Department of Nuclear Medicine, Ghent (Belgium); Maes, Alex [AZ Groening, Department of Nuclear Medicine, Kortrijk (Belgium)

    2009-07-15

    This paper reviews currently available PET studies performed either to improve our understanding of the pathogenesis of HIV-1 infection or to assess the value of PET imaging in the clinical decision making of patients infected with HIV-1 presenting with AIDS-related opportunistic infections and malignancies. FDG PET has shown that HIV-1 infection progresses by distinct anatomical steps, with involvement of the upper torso preceding involvement of the lower part of the torso, and that the degree of FDG uptake relates to viral load. The former finding suggests that lymphoid tissues are engaged in a predictable sequence and that diffusible mediators of activation might be important targets for vaccine or therapeutic intervention strategies. In lipodystrophic HIV-infected patients, limited available data support the hypothesis that stavudine-related lipodystrophy is associated with increased glucose uptake by adipose tissue as a result of the metabolic stress of adipose tissue in response to highly active antiretroviral treatment (HAART). Finally, in early AIDS-related dementia complex (ADC), striatal hypermetabolism is observed, whereas progressive ADC is characterized by a decrease in subcortical and cortical metabolism. In the clinical setting, PET has been shown to allow the differentiation of AIDS-related opportunistic infections and malignancies, and to allow monitoring of side effects of HAART. However, in patients suffering from HIV infection and presenting with extracerebral lymphoma or other human malignancies, knowledge of viraemia is essential when interpreting FDG PET imaging. (orig.)

  7. Clinical Evaluation of Shilajatu Rasayana in patients with HIV Infection.

    Science.gov (United States)

    Gupta, G D; Sujatha, N; Dhanik, Ajay; Rai, N P

    2010-01-01

    AIDS is one of the serious global health concerns caused by Human Immuno Deficiency(HIV) virus and is predominantly a sexually transmitted disease. Currently there is no vaccine or cure for AIDS still Anti Retroviral Therapy (ART) is successful. It reduces both the mortality and the morbidity of HIV infection, but is expensive and inaccessible in many countries. However intense the therapy may be, HIV virus is rarely eliminated, and drug resistance is a major setback during long-term therapy. The development of new drugs and strategies and exploring alternative systems of medicine for antiviral herbs or drugs is the need of the age to improve treatment outcomes. Ayurveda describes many diseases which incorporate HIV like illness e.g. Rajayakshma, Ojo Kshaya, Sannipata jwara etc. HIV infection affects multisystems, chiefly the Immune System which can be correlated to Ojo Kshaya. Rasayana Chikitsa is the frontline therapy employed to treat Ojus disorders. Therefore Shilajatu (Mineral pitch), Centella asiatica (Mandukaparni), Tinospora cordifolia (Guduchi) and Emblica officinalis (Amalaki), well known for their Immuno-modulator and antioxidant properties were selected to evaluate their role on immune system. The study was carried on 20 patients from OPD and IPD of Kayachikitsa, S.S.Hospital, IMS, BHU and was randomly allocated into Treated group (Shilajatu+ART) and Control group (ART). Treated Group responded better to ART both clinically and biochemically. The results show that Shilajatu decreases the recurrent resistance of HIV virus to ART and improves the outcome of the therapy.

  8. HBV/HIV co-infection: the dynamics of HBV in South African patients with AIDS.

    Science.gov (United States)

    Mayaphi, Simnikiwe H; Roussow, Theresa M; Masemola, Difuro P; Olorunju, Steve A S; Mphahlele, M Jeffrey; Martin, Desmond J

    2012-02-23

    As sub-Saharan Africa is highly endemic for hepatitis B virus (HBV) and human immunodeficiency virus (HIV) infections, and their co-infection requires special management, we aimed to assess the serological and molecular characteristics of HBV in patients with AIDS. This was a cross-sectional, case control study, which enrolled 200 patients with AIDS and 200 HIV-negative controls. HBV serology was done in all participants and HCV serology in participants with a hepatitis B core antibody (anti-HBc) only serological pattern. Nested HBV polymerase chain reaction (PCR) and HBV viral load assays were used for HBV molecular detection. Hepatitis B surface antigen (HBsAg) prevalence was 3-fold higher while the 'anti-HBc only' pattern was 6-fold higher in the AIDS group compared with the controls. Mean HBV viral load was significantly higher in HBsAg-positive patients with CD4+ cell counts AIDS group compared with the controls (p=0.002). A significant proportion of AIDS patients with an 'anti-HBc only' pattern had CD4+ cell counts AIDS group compared with 1% in the controls (p=0.092). When occult HBV infection was taken into consideration, the overall HBV prevalence became 10% in the AIDS group and 3% in the control group. We showed an increased HBV prevalence in patients with AIDS and identified a CD4+ cell count HIV co-infection.

  9. iTRAQ based investigation of plasma proteins in HIV infected and HIV/HBV coinfected patients — C9 and KLK are related to HIV/HBV coinfection

    National Research Council Canada - National Science Library

    Tao Sun; Li Liu; Ao Wu; Yujiao Zhang; Xiaofang Jia; Lin Yin; Hongzhou Lu; Lijun Zhang

    2017-01-01

    .... Our main objective was to investigate the molecular mechanism of HIV/HBV coinfections. Methods: We selected HIV infected and HIV/HBV coinfected patients with and without Highly Active Antiretroviral Therapy...

  10. Impact of tuberculosis treatment on CD4 cell count, HIV RNA, and p24 antigen in patients with HIV and tuberculosis

    DEFF Research Database (Denmark)

    Wejse, Christian; Furtado, A.; Camara, C.

    2013-01-01

    To describe HIV RNA levels during tuberculosis (TB) infection in patients co-infected with TB and HIV. Moreover, to examine the p24 antigen profile during TB treatment.......To describe HIV RNA levels during tuberculosis (TB) infection in patients co-infected with TB and HIV. Moreover, to examine the p24 antigen profile during TB treatment....

  11. Lay Counsellor-Based Risk Reduction Intervention with HIV Positive Diagnosed Patients at Public HIV Counselling and Testing Sites in Mpumalanga, South Africa

    Science.gov (United States)

    Peltzer, Karl; Tabane, Cily; Matseke, Gladys; Simbayi, Leickness

    2010-01-01

    Objective: To evaluate the feasibility, fidelity, and effect of a human immunodeficiency virus (HIV) risk reduction intervention delivered to HIV-infected patients by lay counsellors during routine HIV counselling and testing (HCT) public service in Mpumalanga, South Africa. Methods: A total of 488 HIV-infected patients, aged 18 years and older,…

  12. Use of electronic personal health record systems to encourage HIV screening: an exploratory study of patient and provider perspectives

    Directory of Open Access Journals (Sweden)

    McInnes D Keith

    2011-08-01

    methods to smooth the flow of patients getting screened. When provided a choice between unsecured emails versus PHRs as the delivery mechanism for disease screening messages, both patients and providers preferred PHRs. Conclusions There is considerable potential to use PHR systems for electronic outreach and social marketing to communicate to patients about, and increase rates of, disease screening, including for HIV. Planning for direct-to-patient communications through PHRs should include providers and address provider reservations, especially about workload increases.

  13. Use of electronic personal health record systems to encourage HIV screening: an exploratory study of patient and provider perspectives.

    Science.gov (United States)

    McInnes, D Keith; Solomon, Jeffrey L; Bokhour, Barbara G; Asch, Steven M; Ross, David; Nazi, Kim M; Gifford, Allen L

    2011-08-15

    screened. When provided a choice between unsecured emails versus PHRs as the delivery mechanism for disease screening messages, both patients and providers preferred PHRs. There is considerable potential to use PHR systems for electronic outreach and social marketing to communicate to patients about, and increase rates of, disease screening, including for HIV. Planning for direct-to-patient communications through PHRs should include providers and address provider reservations, especially about workload increases.

  14. Considerations and development of topical microbicides to inhibit the sexual transmission of HIV.

    Science.gov (United States)

    Turpin, Jim A

    2002-08-01

    The increased incidence of HIV/AIDS disease in women aged 15 - 49 years has identified the urgent need for a female-controlled, efficacious and safe vaginal topical microbicide. To meet this challenge, new topical microbicide candidates consisting of molecules or formulations that modify the genital environment (BufferGel, engineered Lactobacillus, over-the-counter lubricants), surfactants (C31D/Savvy, sodium dodecyl sulfate, sodium lauryl sulfate), polyanionic polymers (PRO 2000, beta-cyclodextrin, Carraguard, CAP, D2S, SPL-7013), proteins (cyanovirin-N, monoclonal antibodies, thromspondin-1 peptides, Pokeweed antiviral protein and others), reverse transcription inhibitors (PMPA [Tenofovir ]), UC-781, SJ-3366, DABO and thiourea) and other molecules (NCp7-specific virucides, chemokine receptor agonists/antagonists, WHI-05 and WHI-07) are currently being investigated for activity, safety and efficacy. This review will assess the development of these molecules in the context of cervicovaginal defences and the clinical failure of nonoxynol-9.

  15. Compromiso renal en pacientes HIV+ Renal abnormalities in HIV infected patients

    Directory of Open Access Journals (Sweden)

    María Marta Pernasetti

    2010-06-01

    agents and/or drugs. Little is known about the prevalence of renal diseases that may occur as a complication of or related to HIV infection in asymptomatic patients. This is a single center cross-sectional study of asymptomatic HIV+ patients referred to a nefrology care service at an Argentine hospital to look for the presence of renal abnormalities. Fifty two consecutive patients were studied between April and November 2008. Patients underwent plasma and urine analysis, ultrasound, and kidney biopsy as needed. Mean age was 39.9 ± 10.6 years, 88% were male, time from HIV diagnosis 53.2 ± 41.2 months (2-127; 71% had HIV-disease and 77% were on antiretroviral therapy. Mean plasma HIV-RNA copies number was 7.043 ± 3.322 and CD4+ cell count: 484 ± 39. Pathologic findings in urine analysis were present in 30.7% of patients: albuminuria 16.6%, microscopic hematuria 11.5%, hypercalciuria 10.8% and crystalluria 6%. Mean glomerular filtration rate was 102.2 ± 22.95 ml/min (34-149 and 41% of patients could be classified in stages 1 to 3 of chronic kidney disease. Renal abnormalities prevaled in older patients without relationship with presence of HIV-disease. Two patients were biopsied and the findings included: tubulointerstitial nephritis with presence of crystal deposition in one and IgA nephropathy in the other. No HIV-associated nephropathy was detected. The broad spectrum and the high prevalence of lesions found in this series suggest that asymptomatic HIV-infected patients should routinely undergo renal evaluation.

  16. Ophthalmological profile of patients living with HIV/AIDS

    Directory of Open Access Journals (Sweden)

    Janković-Terzić Katarina

    2010-01-01

    Full Text Available Introduction. Serbia has 2.287 registered HIV positive persons. A certain number has ocular complications which are mainly the result of opportunistic infections accompanying this illness. Due to a highly stigmatizing environment for people living with HIV/AIDS in Serbia, they do not always seek doctors assistance despite the fear of losing their sight. Case report. We presented ophthalmologic status of nine HIV positive persons, all at the different phases of the illness. The decrease in the visual acuity was the first symptom which led to the diagnosis of HIV infection in two of our patients. Conclusion. Ophthalmologist has an important role in the multidisciplinary approach to patients with HIV/AIDS from introducing the diagnosis to the follow-up and the treatment of ocular complications which may accompany this chronic illness. With the active involvement of eye professionals serious consequences can be prevented, which have not only medical but also social and economic implications on the individual and the society as a whole.

  17. Pseudogout Associated Hip Pain in a Patient with HIV Infection

    Directory of Open Access Journals (Sweden)

    Benan M. Dala-Ali

    2010-01-01

    Full Text Available HIV infection is a global pandemic, currently affecting approximately 77,000 people in the UK and 33 million people around the world. The infection has widespread effects on the body and can involve the musculoskeletal system. It is therefore important that orthopaedic surgeons are aware of the condition and its sequelae. We present the case of a 46-year-old man with a 10-year history of HIV who presented with acute hip pain, difficulty weight-bearing, and constitutional symptoms. Following radiological, microbiological, and serological tests a diagnosis of pseudogout was established following microscopic analysis of the hip joint aspirate. The patient's symptoms resolved completely following the joint aspiration and NSAID therapy. Studies have shown a relationship between HIV infection and gout. The virus has also been linked to osteonecrosis, osteopenia, bone and joint tuberculosis, and septic arthritis from rare pathogens. However, it is difficult to fully ascertain whether these conditions are related to the HIV infection itself or the HAART (highly active antiretroviral therapy. There are no previously reported cases of HIV-infected patients with pseudogout. The case is discussed with reference to the literature.

  18. Clinical features of HIV/AIDS patients with digestive diseases

    Directory of Open Access Journals (Sweden)

    YIN Fei

    2016-07-01

    Full Text Available ObjectiveTo analyze the clinical data of patients admitted with an initial diagnosis of digestive diseases who have human immunodeficiency virus (HIV/acquired immune deficiency syndrome (AIDS, and to guide clinical diagnosis. MethodsThe clinical data of HIV/AIDS patients who were hospitalized due to digestive system symptoms from January 1, 2013 to December 31, 2014 were collected, including epidemiological data, clinical symptoms and signs, auxiliary examinations, and complications. The features of each parameter were observed. The t-test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. ResultsA total of 95 HIV/AIDS patients with digestive diseases were enrolled, and the male/female ratio was 1.4∶1. Among these patients, 57 (60% were aged 30-50 years, 85 (89.47% were Yi people, and 86 (90.53% were farmers. Of all patients, 46 (48.42% were infected via sexual transmission and 44 (46.32% were infected via intravenous drug use. In these patients, common clinical symptoms included abdominal pain (71.58%, pyrexia (43.16%, and diarrhea (17.89%, and common signs included ascites (28.42%, superficial lymphadenectasis (21.05%, and hepatosplenomegaly (16.84%. The auxiliary examination showed a significant increase in globulin. The proportion of patients with opportunistic infection reached 83.16%, mainly lung and digestive tract infections. Among the patients who underwent gastroscopy, 31.58% had mycotic esophagitis. Chronic non-atrophic gastritis, electrolyte disturbance, and intestinal obstruction were commonly seen in patients with noninfectious complications. Of all HIV/AIDS patients, 5474% (52/95 were complicated by HBV and/or HCV infection, and the liver function parameters globulin, total bilirubin, aspartate aminotransferase, alanine aminotransferase, and A/G showed significant differences between these patients and the patients with HIV infection

  19. Oral Human Papillomavirus Infection and Oral Lesions in HIV-Positive and HIV-Negative Dental Patients.

    Science.gov (United States)

    Muller, Katia; Kazimiroff, Julie; Fatahzadeh, Mahnaz; Smith, Richard V; Wiltz, Mauricio; Polanco, Jacqueline; Grossberg, Robert M; Belbin, Thomas J; Strickler, Howard D; Burk, Robert D; Schlecht, Nicolas F

    2015-09-01

    We evaluated the risk factors associated with oral human papillomavirus (HPV) infection and oral lesions in 161 human immunodeficiency virus (HIV)-positive patients and 128 HIV-negative patients presenting for oral examination at 2 urban healthcare centers. Patients were interviewed on risk factors and provided oral-rinse samples for HPV DNA typing by polymerase chain reaction. Statistical associations were assessed by logistic regression. Oral HPV was prevalent in 32% and 16% of HIV-positive patients and HIV-negative patients, respectively, including high-risk HPV type 16 (8% and 2%, respectively; P = .049) and uncommon HPV types 32/42 (6% and 5%, respectively; P = .715). Among HIV-negative patients, significant risk factors for oral HPV included multiple sex partners (≥21 vs ≤5; odds ratio [OR], 9.1; 95% confidence interval [CI], 1.7-49.3), heavy tobacco smoking (>20 pack-years vs none; OR, 9.2; 95% CI, 1.4-59.4), and marijuana use (OR, 4.0; 95% CI, 1.3-12.4). Among HIV-positive patients, lower CD4(+) T-cell count only was associated with oral HPV detection (≤200 vs ≥500 cells/mm(3); OR, 4.5; 95% CI, 1.3-15.5). Detection of high-risk HPV was also associated with concurrent detection of potentially cancerous oral lesions among HIV-negative patients but not among HIV-positive patients. The observed risk factor associations with oral HPV in HIV-negative patients are consistent with sexual transmission and local immunity, whereas in HIV-positive patients, oral HPV detection is strongly associated with low CD4(+) T-cell counts. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  20. Incentives for HIV testing at the workplace in the automotive industry in the Nelson Mandela Bay Municipality: Ethical considerations

    OpenAIRE

    Martin Weihs; Anna Meyer-Weitz; Friederike Baasner-Weihs

    2017-01-01

    Comprehensive HIV and AIDS workplace programmes made use of substantial lottery incentives in HIV counselling and testing drives to promote HIV testing at four companies in the automotive industry in the Nelson Mandela Bay Municipality. The main aim was to use lottery incentives to increase uptake for HIV testing. This would help to define company HIV prevalence and ensure timely support, care and treatment of employees. In total, 1 324 employees, making up about 90% of the total staff, were ...

  1. TB in HIV Patients: Strengthening Control Measures | Saleh ...

    African Journals Online (AJOL)

    This review, discusses the importance of streghthening different TB control measures both in the community and hos[pital environment to be able to reduce the increases in cases of TB seen in HIV patients and further prevent the emergence of drug resistant TB. Keywords: Human immunodeficiency virus, tuberculosis, ...

  2. Experiences of newly diagnosed HIV and AIDS patients at ...

    African Journals Online (AJOL)

    Experiences of newly diagnosed HIV and AIDS patients at Mankweng tertiary hospital campus in Limpopo Province, South Africa. ... The following themes emerged from the data analysis: lack of acceptance, lack of health care services and support, lack of financial support, lack of confidentiality and stigmatisation. The study ...

  3. Testicular tuberculosis in an HIV positive patient mimicking ...

    African Journals Online (AJOL)

    B.A. Ojo

    Abstract. With the upsurge of tuberculosis infection compounded by the pandemic Human Immune Deficiency Virus. (HIV), isolated testicular tuberculosis though a rarity, should be a differential diagnosis especially in the atypical age group of patients presenting with testicular swelling and in areas with high prevalence rate ...

  4. Dyslipidaemia and dysglycaemia in HIV- infected patients on highly ...

    African Journals Online (AJOL)

    Background: Diet and genetic predisposition significantly affect lipid metabolism in the individual. This metabolic effect is further challenged in patients infected with HIV and on HAART. The prolonged use of HAART is associated with lipodystrophy, dyslipidemia, and insulin resistance. Objective: To determine the ...

  5. Survival analysis of HIV-infected patients under antiretroviral ...

    African Journals Online (AJOL)

    admin

    Abstract. Background: The introduction of ART dramatically improved the survival and health quality of HIV-infected patients in the industrialized world; and the survival benefit of ART has been well studied too. However, in resource-poor settings, where such treatment was started only recently, limited data exist on treatment ...

  6. The behaviourally disturbed patient with HIV / AIDS : case study

    African Journals Online (AJOL)

    HIV was confirmed by a doctor at a tertiary level psy- chiatric unit. The recommendation was to wean the patient off haloperidol and replace it with risperidone. Risperidone is not available at level 1 district hospi- tals, so haloperidol 2.5 mg 3 times daily was continued. Nevirapine was introduced after 10 days. She was dis-.

  7. Dyslipidemia among HIV-infected patients | Wiwanitkit | Annals of ...

    African Journals Online (AJOL)

    Annals of African Medicine. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 13, No 3 (2014) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. Dyslipidemia among HIV-infected patients. S Wiwanitkit, V ...

  8. HIV Seroprevalence in Patients Undergoing Ophthalmic Surgery in ...

    African Journals Online (AJOL)

    Aim: The aim of this study was to determine the number of HIV positive cases undergoing ophthalmic surgery at two centres in Nigeria and to assess if routine testing is clinically or economically effective. Methods: All patients listed for ophthalmic surgery in two eye units in southern Nigeria during a six-month period in 2005,

  9. Pulmonary disease in HIV-infected Patients at the University ...

    African Journals Online (AJOL)

    Esem

    1Department of Internal Medicine, University Teaching Hospital, Lusaka,. 2University of Alabama, Birmingham, ... adult HIV prevalence estimated at 14.3%, and AIDS and. AIDS-related illnesses have contributed to the high. 3 .... Additionally, Kaposi's sarcoma was diagnosed in three (2.7%) patients on visual inspection at.

  10. cryptococcus meningitis in a cohort of hiv positive kenyan patients

    African Journals Online (AJOL)

    East African Medical Journal Vol. 90 No. 12 (Supplement) December 2013. CRYPTOCOCCUS MENINGITIS IN A COHORT OF HIV POSITIVE KENYAN PATIENTS : OUTCOME AFTER TWO. WEEKS OF THERAPY. A. E. O. Otedo, MBChB, MMed (Int.Med.); Cert. Gastroenterology, Consultant Physician/ Gastroenterologist, ...

  11. Ovarian pregnancy in an HIV positive patient: Case report ...

    African Journals Online (AJOL)

    Ovarian pregnancy in an HIV positive patient: Case report. A Mohammed, AG Adesiyun, AA Mayun, CA Ameh. Abstract. No Abstract. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians ...

  12. Thrombocytopenia in Haart naive HIV infected patients attending the ...

    African Journals Online (AJOL)

    Background: Haematological abnormalities are common in HIV infected patients. Thrombocytopenia has been associated with progression of disease. The presence of thrombocytopenia is significantly associated with decreased survival and is a predictor of mortality. Objective: To determine the prevalence of ...

  13. Purulent pelvic collections in HIV infected female patients: bacterial ...

    African Journals Online (AJOL)

    This study was designed to compare the bacterial flora in purulent pelvic collections obtained from HIV infected and noninfected female patients treated over a period of two years. Samples of pus were collected from both groups during laparotomy that was carried out by the same trained surgeon and sent for culture and ...

  14. cryptococcus meningitis in a cohort of hiv positive kenyan patients

    African Journals Online (AJOL)

    In sub-. Saharan Africa with the highest prevalence of HIV/AIDS, response to treatment of cryptococcal meningitis has seldom been assessed. Objective: To describe the clinical features, laboratory findings, CD4+ cell counts and clinical outcome after a two-week treatment course of patients having cryptococcal meningitis.

  15. Prevalence of HIV/Sputum AFB positivity among patients attending ...

    African Journals Online (AJOL)

    Key words: prevalence, TB, HIV, co-infection, Nigeria. LA PREVALENCE DE LA POSITIVITE DU VIH/EXPECTORATIONS AFB CHEZ LES PATIENTS QUI FREQUENT L'UNIVERSITE HOPITAL D'ENSEIGNEMENT DE BENIN (UBTH), BENIN CITY, NIGERIA. Le virus de l'immunodéficience humaine(VIH) et la tuberculose ...

  16. burden of intestinal parasites amongst hiv/aids patients attending

    African Journals Online (AJOL)

    boaz

    diarrhea, especially in AIDS patients, although they are thought to cause self limiting diarrhea in immunocompetent individuals. These are referred to as opportunistic parasites [6]. Different species of protozoa have been associated with acute and chronic diarrhea in. HIV infection and AIDS. They include Cryptosporidium.

  17. Urinary tract candidiasis in HIV+ patients and sensitivity patterns of ...

    African Journals Online (AJOL)

    The incidence of Candida urinary tract infections is gradually on the rise and is an important public health problem. The aim of our study was to determine the prevalence of urinary tract candidiasis (candiduria) in HIV positive patients in Dschang District Hospital and the antifungal susceptibility test of isolates. A total of.

  18. Oral candida infection among HIV patients at Kilimanjaro Christian ...

    African Journals Online (AJOL)

    Background: Oral candidiasis has been a global health challenge especially in immunocompromised patients particularly with HIV infection. Though the incidence and prevalence of opportunistic infections have been reduced due to the use of anti-retroviral therapy (ART), oral candidiasis remains the most frequently ...

  19. Urinary tract candidiasis in HIV+ patients and sensitivity patterns of ...

    African Journals Online (AJOL)

    The incidence of Candida urinary tract infections is gradually on the rise and is an important public health problem. The aim of our study was to determine the prevalence of urinary tract candidiasis (candiduria) in HIV positive patients in Dschang District Hospital and the antifungal susceptibility test of isolates. A total of 285 ...

  20. Intestinal Protozoan Infection in HIV Patients in Jimeta, Yola ...

    African Journals Online (AJOL)

    The incriminated protozoan parasites were Giardia lamblia, Entamoeba histolitica, Trichomonas hominis and Entamoeba coli. Helminthes parasites were mainly present in HIV negative patients who constituted the control group. Potential risk factors for intestinal parasite infection revealed that though occupation played ...

  1. Epidemiology of hepatitis C virus in HIV-infected patients

    DEFF Research Database (Denmark)

    Peters, Lars; Klein, Marina B

    2015-01-01

    PURPOSE OF REVIEW: This review will give an update on the prevalence of HIV/hepatitis C virus (HCV) coinfection, and describe recent trends in all-cause and cause-specific mortality. The focus is mainly on patients followed in clinics in high-income countries and their heterogeneity in terms...

  2. Hypertension and obesity among HIV patients in a care programme ...

    African Journals Online (AJOL)

    Objective: To determine the prevalence of hypertension and obesity among HIV patients enrolled in the Sex Worker Outreach Programme (SWOP), Nairobi, Kenya. Design: A retrospective a study. Setting: SWOP managed by the University of Manitoba, Nairobi team. Subjects: We selected clinic visit records from HIV ...

  3. Prevalence of pulmonary cryptococcosis in hiv/aids patients | Junaid ...

    African Journals Online (AJOL)

    Cryptococcus neoformans causes both pulmonary and meninges infection in healthy and immunocompromised hosts. The objective of this study was to determine the prevalence of pulmonary cryptococcosis in HIV/AIDS patients and assess the clinical presentations due to the infection. The subjects recruited for this study ...

  4. Immunological profiles in HIV positive patients following Haart ...

    African Journals Online (AJOL)

    ... in and correlation between CD4 count, viral load, IL-10, IL-2 and IFN-γ before HAART and at six months of HAART among HIV positive patients in Kigali; with a view to understand cytokine networks particularly in relation to HAART ; and to see whether they can be used as alternative markers of the disease progression.

  5. 17 Smear positive pulmonary tuberculosis among HIV patients ...

    African Journals Online (AJOL)

    HIV positive (Badri et al., 2002; Corbett et al., 2003; WHO, 2008; Williams & Dye, 2003). * Correspondence: Dr. Veneranda Bwana; E-mail: vbwana@nimr.or.tz ... count compared with other AIDS-related diseases conditions. In Cote d'Ivoire, smear-positive TB patients presented with a median CD4 lymphocyte count of.

  6. HIV infection in elderly medical patients | Mtei | East African Medical ...

    African Journals Online (AJOL)

    HIV infection in elderly medical patients. L. N. Mtei, P. Pallangyo. Abstract. (East African Medical Journal: 2001 78(3): 144-147). Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · http://dx.doi.org/10.4314/eamj.v78i3.9081 · AJOL African Journals Online.

  7. Malignant syphilis (Leus maligna in a HIV infected patient

    Directory of Open Access Journals (Sweden)

    Prasad P

    2001-01-01

    Full Text Available A 40-year-old promiscuous man presented with nodulo ulcerative lesions all over the body and a healing genital ulcer. Blood VDRL was reactive in 64 dilutions and HIV (Elisa was positive. Patient was diagnosed to have malignant syphilis (leas inaligna and was given appropriate treatment. Lesions healed with hypopigmented macules suggestive of ′Icukoderma colli′.

  8. Feelings of hopelessness in stable HIV-positive patients on ...

    African Journals Online (AJOL)

    ... were single (p<0.05). Conclusion. Hopelessness is a psychological distress reaction that is common but largely undetected in stable HIV-positive patients on antiretrovirals. Feelings of hopelessness may result in increase in risk-taking behaviour (e.g. unprotected sex, drug use, sharing needles) and attempted suicide.

  9. Evaluation of liver function tests of HIV positive patients on ...

    African Journals Online (AJOL)

    Liver enzymes-alanine and aspartate aminotransferases and alkaline phosphatase (AST, ALT and ALP), bilirubin and serum proteins were determined using standard laboratory methods and these parameters were used to evaluate the liver function of human immunodeficiency virus (HIV)- positive patients receiving ...

  10. Pattern of pericardial diseases in HIV positive patients at University ...

    African Journals Online (AJOL)

    Rationale. Pericarditis has been reported as the most common cardiac complication of HIV disease, followed by pericardial effusion. Methods. A retrospective review was conducted of all 68 patients treated for pericardial diseases between August 2003 and July 2008 at University College Hospital, Ibadan, Nigeria.

  11. Frequency of Cryptococcal Meningitis in HIV-1 Infected Patients in ...

    African Journals Online (AJOL)

    Methods: A cross sectional study was carried out at the Jos University Teaching Hospital (JUTH), A total of 100 HIV-1 infected patients suspected of having meningitis or meningoencephalitis were subjected to cerebrospinal fluid (CSF) analysis (including Indian ink preparation and fungal culture by conventional methods) ...

  12. Ocular diseases among HIV/AIDS patients in Jakarta, Indonesia.

    Science.gov (United States)

    Lestari, Yeni Dwi; Sitompul, Ratna; Edwar, Lukman; Djoerban, Zubairi

    2013-01-01

    We conducted a survey of ocular diseases among HIV/AIDS outpatients in Jakarta, Indonesia. This cross sectional study was conducted among 311 HIV/ AIDS patients presenting to three referral hospitals in Jakarta, Indonesia from September 2008 to May 2009. All subjects underwent ophthalmological examination, including visual acuity, intraocular pressure, eye movement, Schirmer's test and anterior and posterior segment evaluation. Most subjects (86%) were aged 20-40 years; and 77% were male. Intravenous drug use was the most common risk factor (48.9%) for HIV infection. At the time of enrollment, 85% of subjects were receiving anti-retroviral therapy (ART); the median CD4+ T cell count prior to ART was 56 (0-757) cells/microl. The most common ocular manifestations were dry eye syndrome (54%), followed by toxoplasma retinochoroiditis (8.4%) and cytomegalovirus (CMV) retinitis (5.8%). Risk factors associated with ocular diseases were late HIV clinical stage (OR = 4.35 for clinical stage 4 vs 1; p = 0.001), co-infection (OR = 2.67 for 2 co-infections vs no co-infection; p = 0.009) and low CD4+ T cell count prior to ART ( or = 200 cells/microl; p = 0.003). The CD4+ count at the first visit (p = 0.041) and clinical stage (p = 0.049) were associated with dry eyes. This study shows dry eyes were the most prevalent ocular disease among HIV/ AIDS patients in Jakarta. HIV clinical stage 3 or 4, co-infection with tuberculosis and hepatitis C infection and a CD4+ T cell count of AIDS patients.

  13. Special Considerations for Endoscopists on PEG Indications in Older Patients

    National Research Council Canada - National Science Library

    Cardin, Fabrizio

    2012-01-01

    .... Tube feeding is an important resource for facilitating metabolic recovery in cachectic patients and is particularly successful in "bridging" and stabilizing therapies prior to major treatment able to cure the patient...

  14. iTRAQ based investigation of plasma proteins in HIV infected and HIV/HBV coinfected patients - C9 and KLK are related to HIV/HBV coinfection.

    Science.gov (United States)

    Sun, Tao; Liu, Li; Wu, Ao; Zhang, Yujiao; Jia, Xiaofang; Yin, Lin; Lu, Hongzhou; Zhang, Lijun

    2017-10-01

    Human immunodeficiency virus (HIV) and hepatitis B virus (HBV) share similar routes of transmission, and rapid progression of hepatic and immunodeficiency diseases has been observed in coinfected individuals. Our main objective was to investigate the molecular mechanism of HIV/HBV coinfections. We selected HIV infected and HIV/HBV coinfected patients with and without Highly Active Antiretroviral Therapy (HAART). Low abundance proteins enriched using a multiple affinity removal system (MARS) were labeled with isobaric tags for relative and absolute quantitation (iTRAQ) kits and analyzed using liquid chromatography-mass spectrometry (LC-MS). The differential proteins were analyzed by Gene Ontology (GO) database. A total of 41 differential proteins were found in HIV/HBV coinfected patients as compared to HIV mono-infected patients with or without HAART treatment, including 7 common HBV-regulated proteins. The proteins involved in complement and coagulation pathways were significantly enriched, including plasma kallikrein (KLK) and complement component C9 (C9). C9 and KLK were verified to be down-regulated in HIV/HBV coinfected patients through ELISA analysis. The present iTRAQ based proteomic analyses identified 7 proteins that are related to HIV/HBV coinfection. HBV might influence hepatic and immune functions by deregulating complement and coagulation pathways. C9 and KLK could potentially be used as targets for the treatment of HIV/HBV coinfections. Copyright © 2017. Published by Elsevier Ltd.

  15. [Metabolic abnormalities, lipodystrophy and cardiovascular risk in HIV-infected patients].

    Science.gov (United States)

    Leclercq, Pascale; Blanc, Myriam

    2006-05-15

    Life expectancy of HIV-infected patients has improved considerably with HAART. However long term use of HAART is linked with lipodystrophy syndrom (subcutaneous lipoatrophy and central fat accumulation) associated with dyslipemia (hypoHDL, hyperLDL and hypertriglyceridemia) and insulin resistance. It is also linked with mitochondrial toxicity clinically expressed by chronic fatigue syndrom and premature aging. The induced metabolic syndrom has cardiovascular consequences and myocardial infarction is the cause of 7% of the HIV-infected deaths in 2000. Assessment of these complications should be done at least every year. Treatment options concern antiretroviral therapy with the search for the least toxic drug (but with equal antiviral efficacy), symptomatic treatment (statin, fibrates, thiazolidinediones, metformin) and lifestyle modifications (first of all, stopping cigarette smoking!)

  16. Testosterone Replacement Therapy and Polycythemia in HIV-infected Patients

    Science.gov (United States)

    Vorkas, Charles Kyriakos; Vaamonde, Carlos M.; Glesby, Marshall J.

    2013-01-01

    We conducted a case-control study to assess testosterone use as a primary risk factor for polycythemia in 21 HIV-infected men. Any testosterone use within two months of first elevated hemoglobin was associated with polycythemia (matched odds ratio 6.55; 95% CI 1.83-23.4; P=0.004) and intramuscular administration demonstrated a stronger association than topical use. No adverse cardiovascular or thrombotic events were observed. HIV-infected patients taking testosterone should undergo routine hematologic monitoring with adjustment of therapy when appropriate. PMID:22008652

  17. HIV testing among patients infected with Neisseria gonorrhoeae: STD Surveillance Network, United States, 2009-2010.

    Science.gov (United States)

    Bradley, Heather; Asbel, Lenore; Bernstein, Kyle; Mattson, Melanie; Pathela, Preeti; Mohamed, Mukhtar; Samuel, Michael C; Schwebke, Jane; Stenger, Mark; Tabidze, Irina; Zenilman, Jonathan; Dowell, Deborah; Weinstock, Hillard

    2013-03-01

    We used data from the STD Surveillance Network to estimate HIV testing among patients being tested or treated for gonorrhea. Of 1,845 gonorrhea-infected patients identified through nationally notifiable disease data, only 51% were tested for HIV when they were tested or treated for gonorrhea. Among the 10 geographic sites in this analysis, the percentage of patients tested for HIV ranged from 22-63% for men and 20-79% for women. Nearly 33% of the un-tested patients had never been previously HIV-tested. STD clinic patients were more likely to be HIV-tested than those in other practice settings.

  18. Inflammation in HIV-infected patients: impact of HIV, lifestyle, body composition, and demography - a cross sectional cohort study.

    Directory of Open Access Journals (Sweden)

    Anne Langkilde

    Full Text Available To examine mechanisms underlying the increased inflammatory state of HIV-infected patients, by investigating the association of HIV-related factors, demography, lifestyle, and body composition with the inflammatory marker soluble urokinase plasminogen activator receptor (suPAR.suPAR was measured in EDTA-plasma and associated with HIV-related factors (HIV-duration, combination antiretroviral treatment (cART, nadir CD4+ cell count, CD4+ cell count, and HIV RNA; demography; lifestyle; and body composition determined by Dual energy X-ray Absorptiometry (DXA scan, in multiple linear regression analyses adjusted for biological relevant covariates, in a cross-sectional study of 1142 HIV-infected patients.Increased suPAR levels were significantly associated with age, female sex, daily smoking, metabolic syndrome and waist circumference. cART was associated with 17% lower suPAR levels. In cART-treated patients 10-fold higher HIV RNA was associated with 15% higher suPAR, whereas there was no association in untreated patients. Patients with CD4+ cell count <350 cells/µL had higher suPAR levels than patients with CD4+ cell count ≥350 cells/µL , though not significantly. We found no association with nadir CD4+ cell count or with duration of HIV-infection [corrected]. Finally, suPAR was not associated with adipose tissue distribution, but strongly associated with low leg muscle mass [corrected].In patients infected through intravenous drug use (IDU, CD4+ cell counts ≥350 cells/µL were associated with 27% lower suPAR (p = 0.03, andsuPAR was 4% lower pr. year during treatment (p = 0.05; however, there was no association with HIV RNA, duration of HIV-infection, nor cART [corrected].We found elevated suPAR levels in untreated patients compared to patients on cART. Moreover, we observed a significant positive association between suPAR and HIV RNA levels in cART-treated patients. Age, HIV-transmission through IDU, metabolic syndrome, smoking, and low leg

  19. Efavirenz Plasma Concentrations and HIV Viral Load in HIV/AIDS-tuberculosis Infection Patients Treated with Rifampicin

    Directory of Open Access Journals (Sweden)

    Nina Mariana

    2016-09-01

    Full Text Available Aim:to determine the effect of a rifampicin-containing tuberculosis regimen on efavirenz plasma concentrations and viral load in HIV/AIDS-Tuberculosis infection patients who received efavirenz-based antiretroviral therapy. Methods:plasma efavirenz concentrations and HIV viral load were measured in HIV/AIDS patients treated with 600 mg efavirenz-based antiretroviral for 3 to 6 months and in HIV/AIDS-Tuberculosis infection patients treated with similar antiretroviral regimen plus rifampicin-containing antituberculosis in Sulianti Saroso Infectious disease Hospital, Jakarta. Plasma efavirenz concentration in both groups were compared using Mann-Whitney test, while proportion of patients with viral load >40 copy/mL were analyzed with chi-square test. Results:forty five patients (27 with HIV/AIDS and 18 with HIV/AIDS-Tuberculosis infections were recruited during the period of February to May 2015. The median efavirenz plasma concentration obtained from HIV/AIDS group was 0,680 mg/L(range 0,24 to 5,67 mg/L and that obtained from HIV/AIDS-Tuberculosis group was 0.685 mg/L (0.12 -2.23 mg/L which was not significantly different statistically. The proportion of patients with viral load ≥40 copies/mL after 3-6 months of ARV treatment in the HIV/AIDS group was 51.9%, and in the HIV/AIDS-Tuberculosis group was 72.2%, which was not significantly different statistically (Chi Square test, p=0.291. Conclusion:plasma efavirenz concentration in HIV/AIDS-tuberculosis patients receiving antiretroviral and rifampicin is not significantly different from that on HIV/AIDS patients without tuberculosis. Proportion of patients with viral load of >40 copy/mL is higher in HIV/AIDS-tuberculosis patients receiving rifampicin compared to HIV/AIDS patients that not receive rifampicin. However, this difference did not reach statistical significance. Confirmatory studies with bigger sample size are needed to clarify the influence of rifampicin on plasma level ofefavirenzand and

  20. Frequency of EBV Infection in HIV Positives Patients

    Directory of Open Access Journals (Sweden)

    alireza Abdollahi

    2014-12-01

    Full Text Available Background and aim: An opportunist infection in patients diagnosed with human immunodeficiency virus (HIV is the Epstein-Barr virus (EBV which causes serious complications. This study is conducted to examine the frequency of EBV in HIV/AIDS sufferers and compare it with non-sufferers and examine its correlation with the number of CD4+ lymphocytes. Methods: In a case-control, prospective study, two 114-member groups (patients with and without human immunodeficiency virus of equal sex and age – one group suffering from HIV – were assessed for the presence of IgG antibody against EBV capsid virus and the number of CD4+ lymphocytes and the results were analyzed based on the objectives of the study. Results: A total of 103 (90.4% of HIV-positives and 37 (32.5% of control group were tested positive for EBV-VCA IgG (p value = 0.001. The amount of antibody and the number of CD4+ lymphocytes were in a meaningful and reverse relationship (p value = 0.0003. There was no meaningless difference between the presence of EBV-VCA IgG antibody and the age and sex of patients, transmission of virus and receiving HAART anti-virus treatment (p value>0.05 Conclusion: Due to complications of acute EBV virus and its high frequency in HIV patients, these patients are strongly recommended to be examined for EBV infection after diagnosis in a bid to prevent more mortality and morbidity. Preventive actions and periodical checkups must be done for EBV-positives.

  1. Neuropsychological functioning in methadone maintenance patients with HIV

    Directory of Open Access Journals (Sweden)

    Enrique Vázquez-Justo

    2016-09-01

    Full Text Available Although highly active antiretroviral therapy (HAART has improved survival rates of HIV patients, HIV-associated neurocognitive disorders (HAND still exist in a highly prevalent group of persons with this disease. In this study we seek to evaluate the influence of drug use in the neuropsychological performance of seropositive drug users. We carried out an extensive neuropsychological evaluation and compared the performance of seropositive drug users (n = 90 with that of a control group of seronegative drug users (n = 48. The results reveal that methadone maintenance programmes can make the seropositive subject neuropsychologically vulnerable. Likewise, we found that giving up drugs have a protective effect in the presence of neuropsychological alterations associated with HIV. These findings lead us to suggest that seropositivity is not sufficient to explain the neuropsychological alterations of seropositive drug users, noting that these alterations are multifactorial.

  2. Avascular necrosis in HIV patients: a case-control study.

    Science.gov (United States)

    Whitlock, G G; Herbert, S; Copas, A; Gilson, R; Ainsworth, J G

    2013-10-01

    This study investigates the association of avascular necrosis (AVN) in human immunodeficiency virus (HIV)-positive individuals with possible risk factors, including antiretroviral therapy. Clinic records of all AVN cases diagnosed up to July 2009 in HIV-positive patients attending North Middlesex Hospital, London, UK were retrospectively reviewed. For each case, one control was randomly selected, matched for gender, age, nadir CD4 count and date of HIV diagnosis. Of 15 symptomatic AVN cases identified, eight were in women. Univariate analysis demonstrated significant associations between AVN and a history of systemic steroid use (p = 0.004) and cumulative exposure to protease inhibitor (p = 0.03). Physicians should be aware of the risk of AVN with steroid use, the importance of early diagnosis and avoidance of other risk factors in order to prevent further joint involvement if possible.

  3. Oral candidiasis and immune status of HIV-infected patients.

    Science.gov (United States)

    Nielsen, H; Bentsen, K D; Højtved, L; Willemoes, E H; Scheutz, F; Schiødt, M; Stoltze, K; Pindborg, J J

    1994-03-01

    A total of 84 HIV-infected homosexual men having either normal oral mucosa (NOM), erythematous candidiasis (EC) or pseudomembranous candidiasis (PsC) were included in the study. The patients were evaluated by median number of peripheral CD4+ cells, CD8+ cells and by lymphocyte function assessed by poke-weed mitogen test. There was a significant difference between CD4+ counts among patients with the two subtypes of candidiasis (95% CI of median difference: 10-240/mm3; P = 0.03), but not for pokeweed mitogen response. Survival analysis showed that after 2 y there was no significant difference in development of AIDS between patients with EC and PsC (P = 0.29). If patients with both types of oral candidiasis were pooled and compared with patients with NOM, a significant difference in development of AIDS was found (P = 0.04). It is concluded that HIV-infected patients with oral candidiasis of any subtype (EC or PsC) are significantly more immune suppressed and show a faster development of AIDS than HIV-infected patients with NOM. However, in this cohort, EC and PsC are of equal importance as predictors for immune suppression and AIDS development.

  4. Group psychotherapy for HIV-seropositive patients with major depression.

    Science.gov (United States)

    Levine, S H; Bystritsky, A; Baron, D; Jones, L D

    1991-07-01

    Patients were recruited from the UCLA AIDS Research Center who had previously been referred to psychiatry for participation in an open-label pilot treating patients with major depression with fluoxetine. They chose to participate in group therapy for continuing distress in coping with their HIV-seropositive status, dissolution of their support system, "accepting patienthood," and on being placed on an experimental medical protocol. The group was a closed, twenty-session, homogeneous (for patient characteristics), psychoeducational, supportive, and cognitively oriented psychotherapy group. We found this to be a successful intervention in helping patients manage HIV illness and in providing the coping skills and social support necessary to function at home, work, and in their interaction with their health care providers.

  5. Nondaily hormonal contraception: considerations in contraceptive choice and patient counseling.

    Science.gov (United States)

    Freeman, Sarah

    2004-06-01

    To review currently available choices for non-daily hormonal contraception, considering efficacy, safety, patient counseling issues, and appropriate patient selection. Worldwide medical literature and the individual products' prescribing information. Patients and clinicians have many nondaily hormonal contraceptive options available--from Depo-Provera quarterly injection, which has been available in the United States for over 10 years, to several new entries (Mirena 5-year intrauterine system, Lunelle monthly injection, NuvaRing monthly intravaginal ring, and Ortho Evra weekly transdermal patch). All these options offer high efficacy and enhanced convenience for many patients over daily oral contraceptives (OCs). Barriers to use of these agents may include patients' lack of information as well as fear or misconceptions regarding the hormones and methods. All of these can be addressed with adequate patient counseling and open dialogue. The clinician and patient need to be well-informed regarding these options so that they can work together and identify the best contraceptive fit for the patient---with the ultimate goal being to increase patient satisfaction and adherence and, thus, avoid unintended pregnancy. Despite the efficacy of OCs, missed pills are quite common and contribute to unintended pregnancy. Many women in all population categories would benefit from the convenience and reliability of nondaily hormonal contraceptives. The highest efficacy rates with typical use are associated with agents that require minimal user participation (i.e., Depo-Provera, Mirena). Compared to daily regimens, all nondaily options offer increased convenience and may contribute to improved patient adherence. However, barriers to use may exist. Patient fears regarding use of hormones can be minimized by discussing the long-term safety of hormonal contraceptives. (The data are predominantly derived from Depo-Provera and OCs because these agents have been available in the United

  6. Medicine use among HIV/Aids patients in public hospitals, Kwara State

    African Journals Online (AJOL)

    Background: The prognosis of HIV/AIDS and HIV-related comorbidities has been revolutionized by the use of medicines. However, World Health Organization reported that 50% of patients do not use their medicines as prescribed. Objective: To assess HIV/AIDS patients' knowledge of the use of medicines dispensed to ...

  7. Patient and provider perspectives on improving the linkage of HIV-positive pregnant women to long-term HIV care and treatment in eastern Uganda.

    Science.gov (United States)

    Saleem, Haneefa; Kyeyagalire, Robert; Lunsford, Sarah Smith

    2014-01-01

    Despite strong evidence that antiretroviral therapy (ART) reduces the risk of mother-to-child transmission of HIV and improves the health of HIV-positive mothers, many HIV-positive pregnant women do not enrol into long-term HIV care and treatment. This study examined barriers and facilitators to the linkage of HIV-positive pregnant women from antenatal care (ANC) to long-term HIV care from patient and provider perspectives, following the implementation of a collaborative quality improvement project in Eastern Uganda. It also solicited recommendations for improving linkages to HIV care. Structured interviews were conducted with 11 health providers and 48 HIV-positive mothers enrolled in HIV care. Facilitators to linking HIV-positive pregnant women to long-term HIV care identified included support from expert clients, escorted referrals, same-day HIV care registration, and coordination between ANC and HIV services. Barriers reported included shortages in HIV testing kits and fear of social, physical and medical consequences. Participants recommended integration of ANC and HIV services, reduction in waiting times, HIV counselling by expert clients, and community-based approaches for improving linkages to HIV care. Linking HIV-positive pregnant women to HIV care can be improved through deliberate implementation of quality improvement interventions in facilities to address barriers to access and provide stronger support and community mobilisation.

  8. Patient preferences for HIV/AIDS therapy - a discrete choice experiment.

    Science.gov (United States)

    Mühlbacher, Axel C; Stoll, Matthias; Mahlich, Jörg; Nübling, Matthias

    2013-05-11

    An increasing emphasis on patient-centred health care and shared decision making requires an intensive consideration of patient preferences. In the present study, patient preferences regarding treatment of HIV/AIDS were explored using direct assessment and discrete choice experiment (DCE). Based on literature research about preferences of HIV/AIDS patients we conducted a qualitative pre-study. The results were used to compose a questionnaire on relevant aspects of HIV/AIDS treatment which underwent a pre-test. In the subsequent quantitative study phase presented here, the following data were collected online or on paper including socio-demographic data, SF12v2, data on HIV/AIDS, antiretroviral treatment and patient preferences for therapy characteristics using direct measurement, as well as a discrete choice experiment. 218 patients completed the quantitative main study, 82% of these on paper. 86% were male and the most frequent age group was between 45 and 54 years (37.6%). The SF12v2 showed a mean value of 43 points for the "mental health" component sum score. In the direct measurement the most relevant therapy characteristics were "Self-application of the drug (at home or on-the-go) possible", "Drug has very high efficacy (reduction of viral load)" and "Long term (hidden) damage (e.g. organ damage) is unlikely". Based on a factor analysis, six treatment characteristics were selected and used to generate eight virtual therapies. To evaluate the patient assessments a random effect logit model was employed. All of the characteristics were statistically significant predictors of the model of patient preference. The most important therapy characteristic was that the disease is not obvious for others. The main result is the high impact of quality of life, in particular the emotional quality of life on patient preferences on the selection of treatments. Thus, the selection of particular treatment options should be accompanied by a deliberate consideration of

  9. Causes of Death in HIV Patients and the Evolution of an AIDS Hospice: 1988–2008

    Directory of Open Access Journals (Sweden)

    Ann Stewart

    2012-01-01

    Full Text Available This paper reports on the transformation that has occurred in the care of people living with HIV/AIDS in a Toronto Hospice. Casey House opened in the pre-HAART era to care exclusively for people with HIV/AIDS, an incurable disease. At the time, all patients were admitted for palliative care and all deaths were due to AIDS-defining conditions. AIDS-defining malignancies accounted for 22 percent of deaths, mainly, Kaposi sarcoma and lymphoma. In the post-HAART era, AIDS-defining malignancies dropped dramatically and non-AIDS-defining malignancies became a significant cause of death, including liver cancer, lung cancer and gastric cancers. In the post-HAART era, people living with HIV/AIDS served at Casey House have changed considerably, with increasing numbers of patients facing homelessness and mental health issues, including substance use. Casey House offers a picture of the evolving epidemic and provides insight into changes and improvements made in the care of these patients.

  10. Endoscopic bronchial valve treatment: patient selection and special considerations

    Directory of Open Access Journals (Sweden)

    Eberhardt R

    2015-10-01

    Full Text Available Ralf Eberhardt,1,2 Daniela Gompelmann,1,2 Felix JF Herth,1,2 Maren Schuhmann1 1Pneumology and Critical Care Medicine, Thoraxklinik at the University of Heidelberg, 2Translational Lung Research Center, Member of the German Center for Lung Research, Heidelberg, Germany Abstract: As well as lung volume reduction surgery, different minimally invasive endoscopic techniques are available to achieve lung volume reduction in patients with severe emphysema and significant hyperinflation. Lung function parameters and comorbidities of the patient, as well as the extent and distribution of the emphysema are factors to be considered when choosing the patient and the intervention. Endoscopic bronchial valve placement with complete occlusion of one lobe in patients with heterogeneous emphysema is the preferred technique because of its reversibility. The presence of high interlobar collateral ventilation will hinder successful treatment; therefore, endoscopic coil placement, polymeric lung volume reduction, or bronchoscopic thermal vapor ablation as well as lung volume reduction surgery can be used for treating patients with incomplete fissures. The effect of endoscopic lung volume reduction in patients with a homogeneous distribution of emphysema is still unclear and this subgroup should be treated only in clinical trials. Precise patient selection is necessary for interventions and to improve the outcome and reduce the risk and possible complications. Therefore, the patients should be discussed in a multidisciplinary approach prior to determining the most appropriate treatment for lung volume reduction. Keywords: lung emphysema, valve treatment, collateral ventilation, patient selection, outcome

  11. HIV and Hepatitis B seroprevalence in trauma patients in

    African Journals Online (AJOL)

    workers. Key-words: HIV/Hepatitis B ser0prevalence, Trauma patients, Social class, Occupational hazards. Résumé. Introduction: Avec la fréquence élevée du taux du VIH et de l'infection du virus hépatite B au sous Sahara de l'Afrique, des patients chirurgicalment infectés, en particulier ceux avec des plaies récentes, pose ...

  12. Increased incidence of cancer observed in HIV/hepatitis C virus-coinfected patients versus HIV-monoinfected.

    Science.gov (United States)

    Meijide, Héctor; Pértega, Sonia; Rodríguez-Osorio, Iria; Castro-Iglesias, Ángeles; Baliñas, Josefa; Rodríguez-Martínez, Guillermo; Mena, Álvaro; Poveda, Eva

    2017-05-15

    Cancer is a growing problem in persons living with HIV infection (PLWH) and hepatitis C virus (HCV) coinfection could play an additional role in carcinogenesis. Herein, all cancers in an HIV-mono and HIV/HCV-coinfected cohort were evaluated and compared to identify any differences between these two populations. A retrospective cohort study was conducted including all cancers in PLWH between 1993 and 2014. Cancers were classified in two groups: AIDS-defining cancer (ADC) and non-AIDS-defining cancer (NADC). Cancer incidence rates were calculated and compared with that observed in the Spanish general population (GLOBOCAN, 2012), computing the standardized incidence ratios (SIRs). A competing risk approach was used to estimate the probability of cancer after HIV diagnosis. Cumulative incidence in HIV-monoinfected and HIV/HCV-coinfected patients was also compared using multivariable analysis. A total of 185 patients (117 HIV-monoinfected and 68 HIV/HCV) developed cancer in the 26 580 patient-years cohort, with an incidence rate of 696 cancers per 100 000 person-years, higher than in the general population (SIR = 3.8). The incidence rate of NADC in HIV/HCV-coinfected patients was 415.0 (SIR = 3.4), significantly higher than in monoinfected (377.3; SIR = 1.8). After adjustments, HIV/HCV-coinfected patients had a higher cumulative incidence of NADC than HIV-monoinfected (adjusted hazard ratio = 1.80), even when excluding hepatocellular carcinomas (adjusted hazard ratio = 1.26). PLWH have a higher incidence of NADC than the general population and HCV-coinfection is associated with a higher incidence of NADC. These data justify the need for prevention strategies in these two populations and the importance of eradicating HCV.

  13. Alterations of growth and nutritional status in HIV-infected pediatric patients

    Directory of Open Access Journals (Sweden)

    Lizbeth López-Mejía

    2014-08-01

    Conclusions: This study demonstrates the importance of nutritional intervention in patients with HIV. The HIV Clinic of Instituto Nacional de Pediatría should consider including a nutritionist as part of the multidisciplinary team.

  14. Cognitive dysfunction in HIV patients despite long-standing suppression of viremia

    National Research Council Canada - National Science Library

    Simioni, Samanta; Cavassini, Matthias; Annoni, Jean-Marie; Rimbault Abraham, Aline; Bourquin, Isabelle; Schiffer, Véronique; Calmy, Alexandra; Chave, Jean-Philippe; Giacobini, Ezio; Hirschel, Bernard; Du Pasquier, Renaud A

    .... Assessment of HANDs with neuropsychological tests. Two hundred HIV-infected patients with undetectable HIV-1 RNA concentrations in the plasma, no history of major opportunistic infection of the central nervous system in the past 3 years, no current...

  15. Socio-technical considerations in epilepsy electronic patient record implementation.

    LENUS (Irish Health Repository)

    Mc Quaid, Louise

    2010-05-01

    Examination of electronic patient record (EPR) implementation at the socio-technical interface. This study was based on the introduction of an anti-epileptic drug (AED) management module of an EPR in an epilepsy out-patient clinic. The objective was to introduce the module to a live clinical setting within strictly controlled conditions to evaluate its usability and usefulness.

  16. Health care students' reactions towards HIV patients: examining prejudice, emotions, attribution of blame and willingness to interact with HIV/AIDS patients.

    Science.gov (United States)

    Philip, Jannel; Chadee, Derek; Yearwood, Rosana Patricia

    2014-01-01

    One of the most pervasive stigmatising conditions in society today is HIV/AIDS. In Trinidad and Tobago, stigma and discrimination are still pervasive especially against persons living with HIV/AIDS (PLHIV) and at-risk groups. HIV stigmatisation takes place at all levels including health care institutions, and is a major obstacle to effective HIV/AIDS prevention and care. This study examined health care students' reactions towards HIV patients. A stratified random sample of 339 health care students from Trinidad was used. A 2 × 2 factorial design using vignettes manipulated a male patient's sexual orientation (heterosexual/homosexual) and HIV onset controllability (high/low). Multivariate analysis of variance and discriminant function analysis were used to analyse the data. There was a significant main effect of HIV onset controllability on participants' attribution of blame, emotions, prejudicial evaluation and willingness to interact with PLHIV, Λ (.64) F(6, 330) = 31.44, p towards PLHIV.

  17. Educational attainment and risk of HIV infection, response to antiretroviral treatment, and mortality in HIV-infected patients

    DEFF Research Database (Denmark)

    Legarth, Rebecca; Omland, Lars H; Kronborg, Gitte

    2014-01-01

    identified. All-cause MRRs were 1.8 (95% CI 1.0-3.2) and 1.8 (1.1-2.8) for HIV-infected patients and population controls with low educational attainment compared with medium and high educational attainment. MRRs for smoking and alcohol-related deaths were 3.6 (95% CI 1.5-8.9) for HIV-infected patients and 2......OBJECTIVE: To estimate association between educational attainment and risk of HIV diagnosis, response to HAART, all-cause, and cause-specific mortality in Denmark in 1998-2009. DESIGN: Prospective, population-based cohort study including 1277 incident HIV-infected patients without hepatitis C virus...... or intravenous drug abuse identified in the Danish HIV Cohort Study and 5108 individually matched population controls. METHODS: Data on educational attainment, categorized as low, medium, or high, were identified in The Danish Attainment Register. Logistic and Poisson regression were used to estimate odds ratios...

  18. Left ventricular mass in HIV-infected patients.

    Science.gov (United States)

    Olalla, J; Pombo, M; Del Arco, A; de la Torre, J; Urdiales, D; García-Alegría, J

    2013-01-01

    The HIV infection has been associated with an increased incidence of vascular events. Left ventricular mass (LVM) is independently associated with greater overall mortality. Various studies have shown that patients with HIV infection have higher LVM than the uninfected population. We aim to describe the distribution of LVM in an extensive series of patients with HIV infection, and the factors associated with its increase. A cross-sectional study was performed in HIV-infected patients followed in our center from 1 December 2009 to 28 February 2011. A transthoracic echocardiography (TTE) was performed in all patients who gave their consent. Demographic variables, viroimmunological status, cardiovascular risk factors, vascular risk at 10 years (VR10) and history of exposure to antiretroviral drugs were collected. LVM was considered to be the quantitative dependent variable. A univariate analysis was performed, including in the multivariate analysis those variables with P<,05. A TTE was performed in 400 patients, and the LVM was calculated in 388. Mean age was 45 years, 75.5 males. Mean LVM was 39.54g/m(2.7)(95% CI: 38.35-40.73). Age, height, body mass index, VR10, hypertension, dyslipidemia, different medications within the cardiovascular area and having taken nevirapine have been used in the history of the patient were associated to greater LVM. In the multivariate analysis, use of nevirapine in the history of the patient and VR10 remained in the model. VR10 may be associated with greater LVM. The relationship with nevirapine may respond to an indication bias. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  19. HIV and antiretroviral therapy: lipid abnormalities and associated cardiovascular risk in HIV-infected patients.

    Science.gov (United States)

    Kotler, Donald P

    2008-09-01

    It has been demonstrated that patients on highly active antiretroviral therapy are at increased risk for developing metabolic abnormalities that include elevated levels of serum triglycerides and low-density lipoprotein cholesterol and reduced levels of high-density lipoprotein cholesterol. This dyslipidemia is similar to that seen in the metabolic syndrome, raising the concern that highly active antiretroviral therapy also potentially increases the risk for cardiovascular complications. This paper reviews the contribution of both HIV infection and the different components of highly active antiretroviral therapy to dyslipidemia and the role of these abnormalities toward increasing the risk of cardiovascular disease in HIV-infected patients; therapeutic strategies to manage these risks are also considered.

  20. Technical Considerations in Rehabilitation of an Edentulous Total Glossectomy Patient

    Directory of Open Access Journals (Sweden)

    Pravin Bhirangi

    2012-01-01

    Full Text Available The technician by virtue of his profession plays an important role in fabricating silicone tongue prosthesis for a total glossectomy patient. The technician, with his skills and specialized knowledge in handling material, plays a valuable role as a member of the oncology team. A patient with total glossectomy can be rehabilitated by silicone tongue prosthesis as an aid to improve his speech and swallowing. This paper describes the technical steps involved in fabricating a silicone tongue prosthesis for an edentulous total glossectomy patient.

  1. Prosthodontic considerations concerning the abutment teeth of the irradiated patient

    Energy Technology Data Exchange (ETDEWEB)

    Nitta, Eiji; Taniguchi, Hisashi; Ohyama, Takashi; Takeda, Masamune (Tokyo Medical and Dental Univ. (Japan). School of Dentistry)

    1984-06-01

    There still remain several prosthodontic problems for the patient who has received radiation therapy for oral cancer because of radiation injury. We have experienced these in applying a tooth-borne denture to such a patient. Subsequently, it has been recognized that the longevity of the abutment teeth in such a denture is extremely short, compared with the ordinary case. Therefore, when designing the prosthesis for the irradiated patients, it is imperative that we pay special attention to the decreased vitality of the supporting bones of the abutment teeth, as well as to the weakened mucous membrane and rampant caries.

  2. Assessment of nutritional status of HIV-infected patients at a tertiary centre in North India.

    Science.gov (United States)

    Malhotra, Sunita; Wanchu, Ajay; Khurana, Sudha

    2007-07-01

    Infection with HIV has an adverse effect on nutritional status, and can result in progressive involuntary weight loss. We assessed the nutritional status of our patients with HIV infection and found that HIV-infected patients had significantly low nutrient intake and body mass index as compared with controls. Involuntary weight loss, altered body composition and reduced nutritional status were present throughout the stages of HIV infection.

  3. Imported Plasmodium falciparum malaria in HIV-infected patients: A report of two cases

    OpenAIRE

    García-Bujalance Silvia; Francisco Carolina; Rubio José M; Arribas José R; Gutierrez Avelino

    2012-01-01

    Abstract As HIV becomes a chronic infection, an increasing number of HIV-infected patients are travelling to malaria-endemic areas. Association of malaria with HIV/AIDS can be clinically severe. Severe falciparum malaria is a medical emergency that is associated with a high mortality, even when treated in an Intensive Care Unit. This article describes two cases of HIV-positive patients, who returned from malaria-endemic areas and presented a parasitaemia > 5% of erythrocytes and clinical sign...

  4. Impact of HIV care facility characteristics on the cascade of care in HIV-infected patients in the Netherlands

    NARCIS (Netherlands)

    Engelhard, Esther A. N.; Smit, Colette; van Sighem, Ard; Reiss, Peter; Nieuwkerk, Pythia T.; Kroon, Frank P.; Brinkman, Kees; Geerlings, Suzanne E.

    2016-01-01

    Successful treatment of people infected with HIV requires that patients are retained in HIV care, use combination antiretroviral therapy (cART) and ultimately reach and sustain viral suppression. Our aim was to identify health facility characteristics associated with these steps in the cascade of

  5. [Pneumocystosis in non-HIV-infected immunocompromised patients].

    Science.gov (United States)

    Fillâtre, P; Revest, M; Belaz, S; Robert-Gangneux, F; Zahar, J-R; Roblot, F; Tattevin, P

    2016-05-01

    Pneumocystis jiroveci (formerly P. carinii) is an opportunistic fungus responsible for pneumonia in immunocompromised patients. Pneumocystosis in non-HIV-infected patients differs from AIDS-associated pneumocystosis in mostly two aspects: diagnosis is more difficult, and prognosis is worse. Hence, efforts should be made to target immunocompromised patients at higher risk of pneumocystosis, so that they are prescribed long-term, low-dose, trimethoprime-sulfamethoxazole, highly effective for pneumocystosis prophylaxis. Patients at highest risk include those with medium and small vessels vasculitis, lymphoproliferative B disorders (chronic or acute lymphocytic leukaemia, non-Hodgkin lymphoma), and solid cancer on long-term corticosteroids. Conversely, widespread use of prophylaxis in all patients carrier of inflammatory diseases on long-term corticosteroids is not warranted. The management of pneumocystosis in non-AIDS immunocompromised patients follows the rules established for AIDS patients. The diagnosis relies on the detection of P. jiroveci cyst on respiratory samples, while PCR does not reliably discriminate infection from colonization, in 2015. High-doses trimethoprim-sulfamethoxazole is, by far, the treatment of choice. The benefit of adjuvant corticosteroid therapy for hypoxic patients, well documented in AIDS patients, has a much lower level of evidence in non-HIV-infected patients, most of them being already on corticosteroid by the time of pneumocystosis diagnosis anyway. However, based on its striking impact on morbi-mortality in AIDS patients, adjuvant corticosteroid is recommended in hypoxic, non-HIV-infected patients with pneumocystosis by many experts and scientific societies. Copyright © 2015 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  6. Volasertib for AML: clinical use and patient consideration

    Directory of Open Access Journals (Sweden)

    Hao Z

    2015-07-01

    Full Text Available Zhonglin Hao,1 Vamsi Kota2 1Cancer Center, Medical College of Georgia, Georgia Regents University, Augusta, GA, USA; 2Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA, USA Abstract: Acute myeloid leukemia (AML is a disease diagnosed mostly in patients >65 years of age. Despite its heterogeneous nature, the different types of AMLs are still managed by standard induction chemotherapy for those who can tolerate it in the beginning. For the elderly and infirm patients, however, this approach leads to unacceptably high induction mortality rate. This article reviews past and current efforts searching for low-intensiveness treatments for the elderly and infirm patients who cannot tolerate the standard induction regimen. Volasertib, currently in Phase III clinical trials in combination with cytarabine, is reviewed as a promising agent for this patient population with AML, from the viewpoints of potential compliance and efficacy. Keywords: volasertib, acute myeloid leukemia, management, induction

  7. Examining the link between patient satisfaction and adherence to HIV care: a structural equation model.

    Directory of Open Access Journals (Sweden)

    Bich N Dang

    Full Text Available INTRODUCTION: Analogous to the business model of customer satisfaction and retention, patient satisfaction could serve as an innovative, patient-centered focus for increasing retention in HIV care and adherence to HAART, and ultimately HIV suppression. OBJECTIVE: To test, through structural equation modeling (SEM, a model of HIV suppression in which patient satisfaction influences HIV suppression indirectly through retention in HIV care and adherence to HAART. METHODS: We conducted a cross-sectional study of adults receiving HIV care at two clinics in Texas. Patient satisfaction was based on two validated items, one adapted from the Consumer Assessment of Healthcare Providers and Systems survey ("Would you recommend this clinic to other patients with HIV? and one adapted from the Delighted-Terrible Scale, ("Overall, how do you feel about the care you got at this clinic in the last 12 months?". A validated, single-item question measured adherence to HAART over the past 4 weeks. Retention in HIV care was based on visit constancy in the year prior to the survey. HIV suppression was defined as plasma HIV RNA <48 copies/mL at the time of the survey. We used SEM to test hypothesized relationships. RESULTS: The analyses included 489 patients (94% of eligible patients. The patient satisfaction score had a mean of 8.5 (median 9.2 on a 0- to 10- point scale. A total of 46% reported "excellent" adherence, 76% had adequate retention, and 70% had HIV suppression. In SEM analyses, patient satisfaction with care influences retention in HIV care and adherence to HAART, which in turn serve as key determinants of HIV suppression (all p<.0001. CONCLUSIONS: Patient satisfaction may have direct effects on retention in HIV care and adherence to HAART. Interventions to improve the care experience, without necessarily targeting objective clinical performance measures, could serve as an innovative method for optimizing HIV outcomes.

  8. Avascular necrosis of the femoral head in HIV infected patients

    Directory of Open Access Journals (Sweden)

    Marcos Almeida Matos

    Full Text Available Avascular necrosis (AVN of the femoral head is an emerging complication in HIV infected patients. It has been suggested that the increased incidence of AVN in this population may be caused by an increased prevalence of predisposing factors for osteonecrosis, including protease inhibitors, hyperlipidemia, corticosteroid use, alcohol and intravenous drug abuse. The aim of this study was to assess the risk factors for avascular necrosis developing in the femoral head of HIV infected individuals. This study consisted of meta-analysis of the secondary data extracted from current literature. The selected articles allowed two study groups to be drawn up for comparison. Group 1 comprised 324 individuals infected by the HIV virus, who did not present femoral head AVN. Group 2 comprised 32 HIV positive patients, who presented femoral head AVN. The parameters used for analysis were as follows: age, gender, sexual preference, use of intravenous drugs, time of diagnosis, CD4+ cell count, use of antiretroviral agents and duration, serum cholesterol and serum triglycerides. The present study found a statistically significant association between hypertriglyceridemia, hypercholesterolemia, sexual preference and intravenous drug abuse. The authors concluded that femoral head osteonecrosis is associated with hyperlipidemia (hypercholesterolemia and hypertriglyceridemia and intravenous drug abuse. This study supports the hypothesis that protease inhibitors play a role in the development of osteonecrosis through a tendency to cause hyperlipidemia.

  9. Modern approaches to parodontitis therapy in HIV patients

    Directory of Open Access Journals (Sweden)

    Shuldyakov A.A.

    2011-12-01

    Full Text Available The research goal is to determine the clinical pathogenetic efficacy of Cycloferon liniment in the combined therapy of periodontitis in patients with subclinical stage of HIV-infection. Medical examination and treatment of 40 patients has been carried out. It is established that use of liniment Cycloferon in the combined treatment of patients with subclinical stage of HIV-infection allows to accelerate process of normalization of lipid peroxidation parameters and antioxidant potential of blood and to decrease infection (herpes symplex virus I, Candida albicans, staphylococcus aureus in par-odontal recess and evidence of local inflammation. The considered method of therapy has been proved to improve convalescence period and to decrease frequency of parodontitis recurrences

  10. Various patterns of oral mucosa candidiasis treatment in HIV patients.

    Science.gov (United States)

    Macura, Anna B; Bort, Artur; Postawa-Kłosińska, Barbara; Mach, Tomasz

    2002-01-01

    Oral cavity is the site of numerous HIV infection manifestations. Oral mucosa candidiasis is the most common one. It may be the earliest sign of the underlying disease. Long lasting observations give evidence that antiretroviral therapy is beneficial also in the cases of this opportunistic infection because it reduces both the number and severity of relapses, however, the prolongation of the patients' survival time creates the need of antifungal therapy prolongation, and thorough observation of its effectiveness and methods. We decided to analyze the influence of antiretroviral therapy with at least three drugs on the development of oral mucosa candidiasis in the out- and inpatients of the Jagiellonian University Medical College Clinic of Infectious Diseases (or Outpatient Clinic) in Cracow. The study was carried out in 75 patients with confirmed HIV infection. We have shown a decrease in the number of fungi present in the oral cavity in patients under antiretroviral treatment as well as higher susceptibility to fluconazole.

  11. Association of osteonecrosis and osteoporosis in HIV-1-infected patients.

    Science.gov (United States)

    Fessel, W Jeffrey; Chau, Quyen; Leong, Davis

    2011-09-24

    We questioned whether heightened impairment of regenerative capacity of osteoblasts might account for the excess of osteonecrosis and osteoporosis seen in HIV-infected patients. Were that the case, patients with osteonecrosis would have more osteoporosis than the patients without osteonecrosis. Eleven thousand, five hundred and six patients with HIV infection were studied for the presence of osteonecrosis and osteoporosis and for confounding factors. Depending upon whether dual-energy X-ray absorptiometry (DEXA) was before or after the diagnosis of osteonecrosis, osteoporosis was between 6.3 and 18 times more frequent in those with than in those without osteonecrosis. Those who received DEXA were similar to those who did not in median CD4 level at the time of DEXA or at a comparable time after their first recorded CD4 cell count in our system; in nadir CD4 level; and in use and amount of corticosteroids. Those with osteonecrosis and osteoporosis did not use more corticosteroids than those with osteoporosis without osteonecrosis. Alcohol abuse had not been diagnosed more often before the occurrence of osteonecrosis than in those without osteonecrosis. Tenofovir was not more used by those with than by those without osteoporosis. Osteonecrosis and osteoporosis in HIV-infected patients were concurrent more often than expected.

  12. Endocarditis in burn patients: clinical and diagnostic considerations.

    Science.gov (United States)

    Regules, Jason A; Glasser, Jessie S; Wolf, Steven E; Hospenthal, Duane R; Murray, Clinton K

    2008-08-01

    Burned patients are at high risk for invasive procedures, bacteremia, and other infectious complications. Previous publications describe high incidence, delayed diagnosis, and high mortality for endocarditis in burned patients, but do not address use of contemporary diagnostic criteria. Further analysis of the clinical presentation and diagnosis may aid in the earlier recognition and decreased mortality of endocarditis in burned patients. At a 40 bed burn center, during the period from 1 January 2003 to 1 August 2006, blood culture, electronic inpatient, echocardiographic, and autopsy records were reviewed for cases of endocarditis and persistent bacteremia (blood culture positivity for the same organism separated by 24h). In addition, we reviewed cases of burn-related bacterial endocarditis published in the English language. We compared the clinical and diagnostic aspects of our identified cases with those in the published literature. There were 90 episodes of persistent bacteremia or fungemia in 56 of 1250 patients admitted during the study period. Echocardiography was performed on 19, identifying 4 cases of endocarditis. One additional case of endocarditis was identified post-mortem. Time until echocardiography ranged from 6 to 176 days after onset of bacteremia. Case patient age ranged from 31 to 64 years, and total burn surface area ranged from 34 to 80%. Endocarditis occurred in 0.4% of burn unit admissions and in 8.9% of these patients with persistent bacteremia. Sites involved included the mitral valve (3), tricuspid valve (2), aortic valve (1), and pulmonic valve (1). Pathogens included Staphylococcus aureus, Pseudomonas aeruginosa, and one case of Enterococcus faecium. Diagnostic clues were minimal. Case mortality was 100%. A literature review revealed 17 publications describing confirmed bacterial endocarditis in burned patients. These cases revealed a predilection for infection by S. aureus and P. aeruginosa, a relative paucity of diagnostic clues prior

  13. Pharmacologic Considerations during the Preoperative Evaluation of Neurologic Patients.

    Science.gov (United States)

    Mabry, Christian

    2017-08-28

    Optimizing a patient for surgery is a central goal during the preoperative period. Patients with common neurological disorders, such as Alzheimer's disease, epilepsy, Parkinson's disease, and multiple sclerosis, may require special attention on the perioperative management of their neurologic medications. This review aims to organize the most current recommendations for neurologic medication management during the perioperative period to minimize the risk of postoperative neurologic decline. A review of current literature present on Pubmed and Medline of peer-reviewed research papers was conducted. The quality of the papers was assessed by their research methodology and many of their sources were further analyzed in the same manner. A focused review question for each disease type was used, and, at times, inclusion and exclusion criteria were applied. Manuscripts covered a wide range of medical subspecialties with the most common sources being anesthetic, neurologic, and pharmacologic journals. The systemic inflammation that occurs in the perioperative period is detrimental to a patient's neurologic status. It is important to recognize that the proper management of neurologic medications can limit the negative effects of these stresses on a patient. Most medications appear safe to continue until the morning of surgery. Consultation of a neurologist regarding continuation of specific medications may be necessary to ensure patient safety. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  14. The HIV care cascade in Switzerland: reaching the UNAIDS/WHO targets for patients diagnosed with HIV.

    Science.gov (United States)

    Kohler, Philipp; Schmidt, Axel J; Cavassini, Matthias; Furrer, Hansjakob; Calmy, Alexandra; Battegay, Manuel; Bernasconi, Enos; Ledergerber, Bruno; Vernazza, Pietro

    2015-11-28

    To describe the HIV care cascade for Switzerland in the year 2012. Six levels were defined: (i) HIV-infected, (ii) HIV-diagnosed, (iii) linked to care, (iv) retained in care, (v) on antiretroviral treatment (ART), and (vi) with suppressed viral load. We used data from the Swiss HIV Cohort Study (SHCS) complemented by a nationwide survey among SHCS physicians to estimate the number of HIV-patients not registered in the cohort. We also used Swiss ART sales data to estimate the number of patients treated outside the SHCS network. Based on the number of patients retained in care, we inferred the estimates for levels (i) to (iii) from previously published data. We estimate that (i) 15 200 HIV-infected individuals lived in Switzerland in 2012 (margins of uncertainty, 13 400-19 300). Of those, (ii) 12 300 (81%) were diagnosed, (iii) 12 200 (80%) linked, and (iv) 11 900 (79%) retained in care. Broadly based on SHCS network data, (v) 10 800 (71%) patients were receiving ART, and (vi) 10 400 (68%) had suppressed (Switzerland is substantially lower than previously reported, halving previous national HIV prevalence estimates to 0.2%. In Switzerland in 2012, 91% of patients in care were receiving ART, and 96% of patients on ART had suppressed viral load, meeting recent UNAIDS/WHO targets.

  15. Special Anesthetic Consideration for the Fragility Fracture Patient

    Science.gov (United States)

    Ouanes, Jean-Pierre P.; Tomas, Vicente Garcia; Sieber, Frederick

    2014-01-01

    Synopsis This article presents an overview of perioperative management of the fragility fracture patient including, pre-operative risk stratification and optimization, anesthesia risks and anesthesia options as well as post-operative pain management. It is the intent of this manuscript to communicate the issues of preoperative evaluation which are of concern for the anesthesiologist because of their direct effect on intraoperative care. A team interdisciplinary approach and good communication between specialties involved in care of the elderly surgical patients is important for optimal patient outcomes and to avoid perioperative complications. Cooperation between anesthesiology and medicine is indispensable in reaching a reasonable consensus regarding preoperative evaluation, and should occur on a case-by-case basis. PMID:24721364

  16. Hemophilia A. Considerations for dental management of pediatric patients.

    Directory of Open Access Journals (Sweden)

    Sonia López-Villareal

    2016-12-01

    Full Text Available It comes to consulting the Faculty of Dentistry at the University of Nuevo León pediatric male patient of 9 years 10 months, who was admitted with a presumptive diagnosis of hemophilia due to a subsequent persistent bleeding to treatment with steel crowns made in an earlier appointment. Interconsultation is performed with the hematologist who by laboratory examinations notice decreased coagulation factor VIII confirming the diagnosis of hemophilia A. It plans and conducts comprehensive treatment dental team with the hematologist who said that patients in hospitals with the replacement of missing clotting factor is prepared by cryo precipitates or with concentrated factor VIII intravenously before and after his dental intervention. The aim of the article is to highlight that hemophilia can be a disease detected during dental surgery in some patients and for it to be successfully treated with multidisciplinary management protocol is required between hematologists and dentists.

  17. Buccal Dosage Forms: General Considerations for Pediatric Patients.

    Science.gov (United States)

    Montero-Padilla, Soledad; Velaga, Sitaram; Morales, Javier O

    2017-02-01

    The development of an appropriate dosage form for pediatric patients needs to take into account several aspects, since adult drug biodistribution differs from that of pediatrics. In recent years, buccal administration has become an attractive route, having different dosage forms under development including tablets, lozenges, films, and solutions among others. Furthermore, the buccal epithelium can allow quick access to systemic circulation, which could be used for a rapid onset of action. For pediatric patients, dosage forms to be placed in the oral cavity have higher requirements for palatability to increase acceptance and therapy compliance. Therefore, an understanding of the excipients required and their functions and properties needs to be particularly addressed. This review is focused on the differences and requirements relevant to buccal administration for pediatric patients (compared to adults) and how novel dosage forms can be less invasive and more acceptable alternatives.

  18. HIV/AIDS patients' medical and psychosocial needs in the era of HAART: a cross-sectional study among HIV/AIDS patients receiving HAART in Yunnan, China.

    Science.gov (United States)

    Wen, Yi; Shi, Yun; Jiang, Chengqin; Detels, Roger; Wu, Di

    2013-01-01

    Since the launch of China's Free Antiretroviral Therapy (ART) Program in 2002, more than 100,000 HIV/AIDS patients have been treated with highly actively antiretroviral therapy (HAART). However, the current evaluation system for this program mainly focused on its medical outcomes. This study aims to evaluate the medical and psychosocial needs of HIV/AIDS patients after initiating HAART. A cross-sectional study was conducted among 499 HIV/AIDS patients who were currently being treated with HAART in three designated hospitals in Luxi City, Yunnan Province. A questionnaire was used to collect information about participants' demographic characteristics, perceived HIV-related stigma, physician-patient relationship, quality of life, family functioning, etc. Patients' medical records in the National HIV Information System were linked with their questionnaire by their ART identification number. Patients on HAART who were infected with HIV through injection drug use and were current smokers typically had poorer physical health than other participants on HAART. Better financial status and better physician-patient relationship were associated with both physical and psychological well-being. Family awareness of the patient's HIV status was negatively associated with the patient's psychological well-being. Higher levels of perceived HIV-related stigma were associated with poorer psychological health and poorer family functioning. This study emphasizes the importance of assuring a caring environment in China's AIDS treatment program and re-enforces the need to combat the stigma encountered with health providers and the public.

  19. Ocular surface squamous neoplasia in HIV-positive and HIV-negative patients and response to 5-fluorouracil in Angola

    Directory of Open Access Journals (Sweden)

    Nutt RJ

    2014-12-01

    Full Text Available Robert J Nutt,1 John L Clements,2 William H Dean3 1Faculty of Medicine and Dentistry, University of Bristol, Bristol, UK; 2Boa Vista Eye Clinic, Benguela, Angola; 3Bristol Eye Hospital, Bristol, UK Background: Ocular surface squamous neoplasia (OSSN is becoming increasingly prevalent and aggressive in Sub-Saharan Africa. It is a phenomenon linked with human immunodeficiency virus (HIV infection, although association rates in Angola are currently unknown. A topical treatment that is effective in HIV-positive and HIV-negative individuals may be preferable to surgery in some contexts. We aimed to estimate the proportion of OSSN associated with HIV in Angola and to report on the success of topical 5-fluorouracil as a primary treatment in HIV-positive and HIV-negative patients.Methods: Photographs of OSSNs taken at presentation and following treatment with 5-fluorouracil in patients presenting to Boa Vista Eye Clinic, Angola, between October 2011 and July 2013 were grouped into HIV-positive and HIV-negative groups and analyzed to compare presenting features and treatment response. Eighty-one OSSNs were analyzed for clinical features and 24 met the inclusion criteria for analysis of treatment response.Results: Eighty-two patients presented with OSSN between October 2011 and July 2013. Twenty-one (26% were HIV-positive and typically had OSSNs that exhibited more pathological features than those in HIV-negative patients. Twenty-four (29% patients met the inclusion criteria for analysis of treatment response; of these, 26 (91% OSSNs in both groups displayed at least partial resolution after one treatment course. In the HIV-positive group, five of eight patients displayed complete resolution, two showed partial resolution, and one failed. In the HIV-negative group, five of 16 showed complete resolution, ten of 16 had partial resolution, and one failed.Conclusion: Individuals presenting with OSSN in Angola are more likely to have HIV infection compared

  20. Increased incidence of cancer observed in HIV/HCV-coinfected patients versus HIV-monoinfected, 1993-2014.

    Science.gov (United States)

    Meijide, Héctor; Pértega, Sonia; Rodríguez-Osorio, Iria; Castro-Iglesias, Ángeles; Baliñas, Josefa; Rodríguez-Martínez, Guillermo; Mena, Álvaro; Poveda, Eva

    2017-03-21

    Cancer is a growing problem in persons living with HIV infection (PLWH) and hepatitis C virus (HCV) coinfection could play an additional role in carcinogenesis. Herein, all cancers in an HIV-mono and HIV/HCV-coinfected cohort were evaluated and compared to identify any differences between these two populations. A retrospective cohort study was conducted including all cancers in PLWH between 1993 and 2014. Cancers were classified in two groups, AIDS-defining cancer (ADC) and non AIDS-defining cancer (NADC). Cancer incidence rates were calculated and compared with that observed in the Spanish general population (GLOBOCAN, 2012), computing the standardized incidence ratios (SIR). A competing risk approach was used to estimate the probability of cancer after HIV diagnosis. Cumulative incidence in HIV-monoinfected and HIV/HCV-coinfected was also compared using multivariable analysis. A total of 185 patients (117 HIV-monoinfected and 68 HIV/HCV) developed cancer in the 26,580 patient-years cohort; with an incidence rate of 696 cancers per 100,000 person-years, higher than in the general population (SIR = 3.8). The incidence rate of NADC in HIV/HCV-coinfected was 415.0 (SIR = 3.4), significantly higher than in monoinfected (377.3; SIR = 1.8). After adjustments, HIV/HCV-coinfected patients had a higher cumulative incidence of NADC than HIV-monoinfected (adjusted hazard ratio = 1.80), even when excluding hepatocellular carcinomas (adjusted hazard ratio = 1.26). PLWH have a higher incidence of NADC than the general population and HCV-coinfection is associated with a higher incidence of NADC. This data justifies the need for prevention strategies in these two populations and the importance of eradicating HCV.

  1. Treatment considerations for patient with Amelogenesis Imperfecta: a review.

    Science.gov (United States)

    Chen, Chiung-Fen; Hu, Jan Cc; Bresciani, Eduardo; Peters, Mathilde C; Estrella, Maria Regina

    Amelogenesis imperfecta (AI) is a group of inherited disorders primary affecting the structural of enamel. Patients with AI experience poor esthetic, excessive tooth sensitivity and compromised chewing function that dental treatments are frequently required at early age. This review describes the non-enamel implications, stage-specific management strategies and outcomes of selected restorative materials based on literature evidence.

  2. Patient considerations in the management of mental stress in psoriasis

    Directory of Open Access Journals (Sweden)

    Schmid-Ott G

    2012-06-01

    Full Text Available Gerhard Schmid-Ott,1,2 Dana Böhm,1,3 Scott Stock Gissendanner1,21Hospital Management and Stress Medicine, IREHA Institute for Innovative Rehabilitation, Loehne, Germany; 2Berolina Klinik, Loehne, Germany; 3Saale Reha-Klinikum, Bad Koesen, GermanyAbstract: Psoriasis is an incurable, inflammatory disease of the skin with a complex etiology. The disease has serious negative repercussions for patients' quality of life, but quality of life does not depend on physical symptoms alone. The impact of somatic symptoms on life quality is mitigated by various forms of mental stress. Through a discussion of the physical and mental burdens of psoriasis, the psychosocial determinants of life quality, common treatment options, and issues of adherence and resilience, this paper seeks to identify common sources of mental stress and appropriate strategies for stress management for psoriasis patients. The paper argues that a sustained and successful management of psoriasis depends on patients playing an active role in the prevention and reduction of their own personal sources of mental stress. Health-care professionals can and should assist patients in doing so.Keywords: psoriasis, shared decision-making, treatment, adherence, resilience

  3. ANAESTHETIC CONSIDERATION IN PATIENTS OF DOWN’S SYNDROME

    OpenAIRE

    Sanjeev; Verma; De, Arun; Bibha; Nidhi; Raghwendra; Sangeeta

    2014-01-01

    Down’s syndrome is one of the commonest chromosomal disorders which are associated with several congenital anomalies. Such patients frequently need surgical interference under anesthesia as correction of cardiac anomalies, dental deformities, urological problems and facial deformities etc. But due to associated risk like relative macroglossia, microcephaly, hypoplastic mandible, atlantoaxial instability & supraglottic stenosis make them difficult for endotracheal intubatio...

  4. Cardiovascular impact in patients undergoing maintenance hemodialysis: Clinical management considerations.

    Science.gov (United States)

    Chirakarnjanakorn, Srisakul; Navaneethan, Sankar D; Francis, Gary S; Tang, W H Wilson

    2017-04-01

    Patients undergoing maintenance hemodialysis develop both structural and functional cardiovascular abnormalities. Despite improvement of dialysis technology, cardiovascular mortality of this population remains high. The pathophysiological mechanisms of these changes are complex and not well understood. It has been postulated that several non-traditional, uremic-related risk factors, especially the long-term uremic state, which may affect the cardiovascular system. There are many cardiovascular changes that occur in chronic kidney disease including left ventricular hypertrophy, myocardial fibrosis, microvascular disease, accelerated atherosclerosis and arteriosclerosis. These structural and functional changes in patients receiving chronic dialysis make them more susceptible to myocardial ischemia. Hemodialysis itself may adversely affect the cardiovascular system due to non-physiologic fluid removal, leading to hemodynamic instability and initiation of systemic inflammation. In the past decade there has been growing awareness that pathophysiological mechanisms cause cardiovascular dysfunction in patients on chronic dialysis, and there are now pharmacological and non-pharmacological therapies that may improve the poor quality of life and high mortality rate that these patients experience. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Anesthetic considerations for patients with acute cervical spinal cord injury

    Directory of Open Access Journals (Sweden)

    Fang-ping Bao

    2017-01-01

    Full Text Available Anesthesiologists work to prevent or minimize secondary injury of the nervous system and improve the outcome of medical procedures. To this end, anesthesiologists must have a thorough understanding of pathophysiology and optimize their skills and equipment to make an anesthesia plan. Anesthesiologists should conduct careful physical examinations of patients and consider neuroprotection at preoperative interviews, consider cervical spinal cord movement and compression during airway management, and suggest awake fiberoptic bronchoscope intubation for stable patients and direct laryngoscopy with manual in-line immobilization in emergency situations. During induction, anesthesiologists should avoid hypotension and depolarizing muscle relaxants. Mean artery pressure should be maintained within 85–90 mmHg (1 mmHg = 0.133 kPa; vasoactive drug selection and fluid management. Normal arterial carbon dioxide pressure and normal blood glucose levels should be maintained. Intraoperative neurophysiological monitoring is a useful option. Anesthesiologists should be attentive to postoperative respiratory insufficiency (carefully considering postoperative extubation, thrombus, and infection. In conclusion, anesthesiologists should carefully plan the treatment of patients with acute cervical spinal cord injuries to protect the nervous system and improve patient outcome.

  6. Carotid intima-media thickness in HIV patients treated with antiretroviral therapy

    DEFF Research Database (Denmark)

    Lebech, Anne-Mette; Wiinberg, Niels; Kristoffersen, Ulrik Sloth

    2007-01-01

    INTRODUCTION: Increased cardiovascular risk in HIV patients in antiretroviral therapy (ART) may be due to HIV infection, direct effect of ART or dyslipidaemia induced by ART. Our aim was to study the relative importance of HIV, ART and dyslipidaemia on atherosclerosis, assessed by the comparison...... of carotid artery intima-media thickness (IMT) in non-smoking HIV patients with high or low serum cholesterol levels as well as in healthy volunteers. METHODS: HIV patients in ART with normal cholesterol (or=6 x 5 mmol l(-1); n=12) as well as healthy controls (n=14) were included. All were non...... no correlation was found with total cholesterol or LDL cholesterol. CONCLUSIONS: In non-smoking HIV patients receiving ART no sign of accelerated atherosclerosis was found as assessed by IMT even not in hypercholesterolaemic HIV patients. IMT correlated with HDL cholesterol but not with LDL cholesterol. Based...

  7. SLEEVE GASTRECTOMY IN PATIENTS WITH MORBID OBESITY AND HIV.

    Science.gov (United States)

    Pinto, José Máximo Costa; Lima, Marianna Gomes Cavalcanti Leite de; Almeida, Ana Luiza Melo Cavalcanti de; Sousa, Marcelo Gonçalves

    It is estimated that there are nearly 40 million people with the human immunodeficiency virus (HIV) worldwide. Due to the advent of antiretroviral drugs, it has been observed increasing in obesity and metabolic rates among patients undergoing treatment. Thus, numerous surgical therapies for weight loss are proposed for continuous improvement in health of patients with HIV, being the vertical gastrectomy an option for intact intestinal transit. To evaluate the applicability of the vertical gastrectomy in patients with morbid obesity and HIV. Was conducted a systematic review of the literature, in the electronic databases Scopus, Pubmed, Cinahl, Scielo, Cochrane and Lilacs, from 1998 to 2015. MeSH headings used in data collection were "Gastrectomy" and "Morbid obesity" being combined with the descriptor "HIV". Were found 2148 articles in Scopus, 1234 in PubMed and 784 in Cinahl. The articles were analyzed by the Jadad Quality Scale, being reduced to 40 articles, subsequently reassessed using an elaborated form by the Critical Appraisal Skills Programme (CASP), reaching 12 articles in the end. It was found that vertical gastrectomy constitutes a safe and effective method, with low mortality and low rate of postoperative complications, being recommended as surgical technique in patients with obesity, HIV and comorbidities. Estima-se que haja quase 40 milhões de pessoas com o vírus da imunodeficiência adquirida (HIV) no mundo. Com o advento dos antirretrovirais, observou-se aumento da obesidade e de taxas metabólicas nos pacientes em tratamento. Assim, inúmeras terapias cirúrgicas para a perda de peso estão sendo estudadas para a melhoria contínua da saúde dos pacientes com HIV, sendo a gastrectomia vertical uma opção de trânsito íntegro. Avaliar a aplicabilidade da gastrectomia vertical em pacientes com obesidade mórbida e HIV. Foi realizada revisão sistemática de literatura, de artigos publicados nas bases eletrônicas de dados Scopus, Pubmed, Cinahl

  8. Are routine tuberculosis programme data suitable to report on antiretroviral therapy use of HIV-infected tuberculosis patients?

    NARCIS (Netherlands)

    Brouwer, Miranda; Gudo, Paula Samo; Simbe, Chalice Mage; Perdigão, Paula; van Leth, Frank

    2013-01-01

    Antiretroviral therapy (ART) is lifesaving for HIV-infected tuberculosis (TB) patients. ART-use by these patients lag behind compared to HIV-testing and co-trimoxazole preventive therapy. TB programmes provide the data on ART-use by HIV-infected TB patients, however often the HIV services provide

  9. Clinicopathological study of itchy folliculitis in HIV-infected patients

    Directory of Open Access Journals (Sweden)

    Annam Vamseedhar

    2010-01-01

    Full Text Available Background: Itchy folliculitis are pruritic, folliculo-papular lesions seen in human immunodeficiency virus (HIV-infected patients. Previous studies have shown that it was impossible to clinically differentiate between eosinophilic folliculitis (EF and infective folliculitis (IF. Also, attempts to suppress the intense itch of EF were ineffective. Aims: The present study is aimed at correlating clinical, histopathological and immunological features of itchy folliculitis in HIV patients along with their treatment. Methods: The present prospective study lasted for 36 months (September, 2005 to August, 2008 after informed consent, data on skin disorders, HIV status and CD4 count were obtained by physical examination, histopathological examination and laboratory methods. Results: Of 51 HIV-positive patients with itchy folliculitis, the predominant lesion was EF in 23 (45.1% followed by bacterial folliculitis in 21 (41.2%, Pityrosporum folliculitis in five (9.8% and Demodex folliculitis in two (3.9% patients. The diagnosis was based on characteristic histopathological features and was also associated with microbiology confirmation wherever required. EF was associated with a lower mean CD4 count (180.58 ± 48.07 cells/mm 3 , P-value < 0.05, higher mean CD8 count (1675.42 ± 407.62 cells/mm3 and CD8/CD4 ratio of 9.27:1. There was significant reduction in lesions following specific treatment for the specific lesion identified. Conclusion: Clinically, it is impossible to differentiate itchy folliculitis and therefore it requires histopathological confirmation. Appropriate antimicrobial treatment for IF can be rapidly beneficial. The highly active antiretroviral therapy along with Isotretinoin therapy has shown marked reduction in the lesions of EF. Familiarity with these lesions may help in improving the quality of lives of the patients.

  10. [Enteropathogens relating to diarrhea in HIV patients on antiretroviral therapy].

    Science.gov (United States)

    Pupulin, Aurea Regina Telles; Carvalho, Paula Galdino; Nishi, Letícia; Nakamura, Celso Vataru; Guilherme, Ana Lucia Falavigna

    2009-01-01

    The etiology of the diarrheic process in AIDS may be caused by viruses, bacteria, fungi, protozoa or helminths, as well as HIV itself. This study evaluated enteropathogens relating to diarrhea in HIV patients who were on antiretroviral therapy. The parasitological methods used were Faust, Hoffmann and Kinyoun. Isolation and culturing of fungi were carried out in accordance with the methodology recommended by the NCCLS M27-A standard. The yeast species were identified using the polymerase chain reaction (PCR). Bacteria were isolated on MacConkey and SS agar and the species were identified using Enterokit B (Probac do Brasil) and biochemical methods. Forty-nine patients were evaluated: 44.89% presented enteroparasites and 48.1% presented Candida sp, of which 61.5% were Candida albicans, 7.6% were Candida sp and 30.7% were Candida non-albicans. Bacteria were isolated from 72% of the patients, of which 49% were Escherichia coli, 13% Salmonella parathyphi, Klebsiella sp or Proteus and 6% Citrobacter freundii or Yersinia sp. There was high prevalence of Candida sp in HIV patients with diarrhea and non-albicans species were isolated. Their presence could be taken to mean that they were accomplices in or causes of the infection.

  11. Extracutaneous atypical syphilis in HIV-infected patients.

    Science.gov (United States)

    Prieto, Paula; Imaz, Arkaitz; Calatayud, Laura; García, Olga; Saumoy, María; Podzamczer, Daniel

    2017-12-07

    We describe a series of cases of syphilis with atypical extracutaneous clinical presentation diagnosed in HIV-infected patients. Retrospective observational study. All cases of syphilis diagnosed in HIV-infected patients during the period between June 2013 and June 2016 in a tertiary hospital of the Barcelona metropolitan area were analysed. A total of 71 cases of syphilis were diagnosed, 32 of them presenting with clinical signs or symptoms. Seven of these cases (9.8% of the total and 21.8% of the symptomatic cases) had atypical presentations with extracutaneous involvement: ocular (4), gastric (1), multiple hepatic abscesses (1) and generalised adenopathies (1). Patients were treated with intramuscular or intravenous penicillin and the clinical and serological evolution was good in all of them. Extracutaneous atypical clinical presentations were observed in 21.8% of symptomatic cases of syphilis in HIV+ patients with ocular involvement being the most freqent. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  12. Critical care monitoring considerations for the diabetic patient.

    Science.gov (United States)

    Connally, Heather E

    2002-05-01

    Diabetes mellitus (DM) is a common endocrine disease encountered in the emergency and critical care setting. The diabetic Ketoacidotic (DKA) animal represents an extreme of the DM patient with regard to hyperglycemia and acid-base and electrolyte derangements. Prompt diagnosis of DKA in a critical patient and rapid initiation of appropriate therapy are necessary for a positive outcome. The steps of treatment, in order of importance, include initiation of intravenous fluid therapy, insulin therapy, electrolyte replacement, and reversal of the metabolic acidosis. The main goals of therapy--including correction of dehydration, electrolyte abnormalities and acidosis via aggressive fluid therapy with electrolyte supplementation and correction of ketoacidosis and hyperglycemia via initiation of insulin therapy--can be achieved if these steps are followed. Because of the severity of metabolic alterations in the DKA animal, frequent and careful monitoring are paramount because they will allow the clinician to tailor treatment to each case.

  13. The prevalence and associated factors for delayed presentation for HIV care among tuberculosis/HIV co-infected patients in Southwest Ethiopia: a retrospective observational cohort.

    Science.gov (United States)

    Gesesew, Hailay; Tsehaineh, Birtukan; Massa, Desalegn; Tesfay, Amanuel; Kahsay, Hafte; Mwanri, Lillian

    2016-11-02

    A delay presentation for human immunodeficiency virus (HIV) patient's care (that is late engagement to HIV care due to delayed HIV testing or delayed linkage for HIV care after the diagnosis of HIV positive) is a critical step in the series of HIV patient care continuum. In Ethiopia, delayed presentation (DP) for HIV care among vulnerable groups such as tuberculosis (Tb) /HIV co-infected patients has not been assessed. We aimed to assess the prevalence of and factors associated with DP (CD4 prevalence of DP among Tb/HIV co-infected patients was 59.9 %. Tb/HIV co-infected patients who had a house with at least two rooms were less likely (AOR, 0.5; 95 % CI: 0.3-1.0) to present late than those having only single room. Tobacco non-users of Tb/HIV co-infected participants were also 50 % less likely (AOR, 0.5; 95 % CI: 0.3-0.8) to present late for HIV care compared to tobacco users. The relative odds of DP among Tb/HIV co-infected patients with ambulatory (AOR, 1.8; 95 % CI, 1.0-3.1) and bedridden (AOR, 8.3; 95 % CI, 2.8-25.1) functional status was higher than with working status. Three out of five Tb/HIV co-infected patients presented late for HIV care. Higher proportions of DP were observed in bedridden patients, tobacco smokers, and those who had a single room residence. These findings have intervention implications and call for effective management strategies for Tb/HIV co-infection including early HIV diagnosis and early linkage to HIV care services.

  14. Subclinical atherosclerosis in low Framingham risk HIV patients.

    Science.gov (United States)

    León, Rafael; Reus, Sergio; López, Nicolás; Portilla, Irene; Sánchez-Payá, José; Giner, Livia; Boix, Vicente; Merino, Esperanza; Torrús, Diego; Moreno-Pérez, Óscar; Portilla, Joaquín

    2017-08-01

    Pathogenesis of atherosclerosis is complex, and differences between HIV-infected patients and general population cannot be completely explained by the higher prevalence of traditional cardiovascular risk factors. We aimed to analyse the association between inflammation and subclinical atherosclerosis in HIV patients with low Framingham risk score. Case-control study. Outpatient Infectious Diseases clinic in a university hospital. HIV-1-infected patients aged > 35 years receiving antiretroviral treatment with viral load  5 cigarettes/day; diabetes; hypertension; vascular diseases. subclinical atherosclerosis determined by ultrasonography: common carotid intima-media thickness greater than 0·8 mm or carotid plaque presence. Explanatory variables: ribosomal bacterial DNA (rDNA), sCD14, interleukin-6 (IL-6) and TNF-α. Eighty-four patients were included, 75% male, mean age 42 years and mean CD4+ cells 657 ± 215/mm(3) . Median Framingham risk score was 1% at 10 years (percentile 25-75: 0·5-4%). Eighteen patients (21%) had subclinical atherosclerosis; the associated factors were older age (P = 0·001), waist-hip ratio (P = 0·01), time from HIV diagnosis (P = 0·02), rDNA (P = 0·04) and IL-6 (P = 0·01). In multivariate analysis, OR for subclinical atherosclerosis was 7 (95% CI, 1.3-40, P = 0.02) and 9 (95% CI, 1.0-85, P = 0.04) for patients older than 44 years and IL-6 > 6·6 pg/mL, respectively. Well-controlled HIV patients with low Framingham risk score have a high prevalence of subclinical carotid atherosclerosis, and the main risk factors are age and inflammation. These patients are not receiving primary prophylaxis for cardiovascular events according to current guidelines. © 2017 Stichting European Society for Clinical Investigation Journal Foundation.

  15. Clinical, virological and immunological responses in Danish HIV patients receiving raltegravir as part of a salvage regimen

    Directory of Open Access Journals (Sweden)

    Frederik N Engsig

    2010-05-01

    Full Text Available Frederik N Engsig1, Jan Gerstoft1, Gitte Kronborg2, Carsten S Larsen3, Gitte Pedersen4, Anne M Audelin5, Louise B Jørgensen5, Niels Obel11Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Denmark; 2Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark; 3Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark; 4Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark; 5Department of Virology, Statens Serum Institute, Copenhagen, DenmarkBackground: Raltegravir is the first integrase inhibitor approved for treatment of HIV-infected patients harboring multiresistant viruses.Methods: From a Danish population-based nationwide cohort of HIV patients we identified the individuals who initiated a salvage regimen including raltegravir and a matched cohort of HIV-infected patients initiating HAART for the first time. We compared these two cohorts for virological suppression, gain in CD4 count, and time to first change of initial regimen.Results: We identified 32 raltegravir patients and 64 HIV patients who initiated HAART for the first time in the period 1 January 2006 to 1 July 2009. The virological and immunological responses in the raltegravir patients were comparable to those seen in the control cohort. No patients in the two cohorts died and no patients terminated raltegravir treatment in the observation period. Time to first change of initial regimen was considerably shorter for HAART-naïve patients.Conclusion: We conclude that salvage regimens including raltegravir have high effectiveness in the everyday clinical setting. The effectiveness of the regimens is comparable to that observed for patients initiating HAART for the first time. The risk of change in the salvage regimens after initiation of raltegravir is low.Keywords: HIV, raltegravir, salvage regime, efficacy, matched cohort

  16. 9G4 autoreactivity is increased in HIV-infected patients and correlates with HIV broadly neutralizing serum activity.

    Directory of Open Access Journals (Sweden)

    James J Kobie

    Full Text Available The induction of a broadly neutralizing antibody (BNAb response against HIV-1 would be a desirable feature of a protective vaccine. Vaccine strategies thus far have failed to elicit broadly neutralizing antibody responses; however a minority of HIV-infected patients do develop circulating BNAbs, from which several potent broadly neutralizing monoclonal antibodies (mAbs have been isolated. The findings that several BNmAbs exhibit autoreactivity and that autoreactive serum antibodies are observed in some HIV patients have advanced the possibility that enforcement of self-tolerance may contribute to the rarity of BNAbs. To examine the possible breakdown of tolerance in HIV patients, we utilized the 9G4 anti-idiotype antibody system, enabling resolution of both autoreactive VH4-34 gene-expressing B cells and serum antibodies. Compared with healthy controls, HIV patients had significantly elevated 9G4+ serum IgG antibody concentrations and frequencies of 9G4+ B cells, a finding characteristic of systemic lupus erythematosus (SLE patients, both of which positively correlated with HIV viral load. Compared to the global 9G4-IgD--memory B cell population, the 9G4+IgD--memory fraction in HIV patients was dominated by isotype switched IgG+ B cells, but had a more prominent bias toward "IgM only" memory. HIV envelope reactivity was observed both in the 9G4+ serum antibody and 9G4+ B cell population. 9G4+ IgG serum antibody levels positively correlated (r = 0.403, p = 0.0019 with the serum HIV BNAbs. Interestingly, other serum autoantibodies commonly found in SLE (anti-dsDNA, ANA, anti-CL did not correlate with serum HIV BNAbs. 9G4-associated autoreactivity is preferentially expanded in chronic HIV infection as compared to other SLE autoreactivities. Therefore, the 9G4 system provides an effective tool to examine autoreactivity in HIV patients. Our results suggest that the development of HIV BNAbs is not merely a consequence of a general breakdown in

  17. Usefulness of the HIV dementia scale in nigerian patients with HIV ...

    African Journals Online (AJOL)

    Saharan Africa, where statistics on HIV are alarming, is sparse because of lack of validated cognitive tools. This study assessed the usefulness and predictive validity of the HIV Dementia Scale (HDS) as a screening tool in HIV-positive Nigerians.

  18. JCL roundtable: Managing lipid disorders in patients with HIV.

    Science.gov (United States)

    Brown, W Virgil; Aberg, Judith A; Aspry, Karen E; Longenecker, Chris T; Myerson, Merle

    The HIV-AIDS epidemic has provided one of the more challenging problems in treatment of infectious diseases. As antiretroviral drugs made a very marked improvement in controlling the immunodeficiency state and patients gained in their longevity, the concern with lipid abnormalities came to the fore. The initial drugs produced a form of metabolic syndrome accompanied by very elevated plasma triglyceride concentrations. Furthermore, the drugs used to control the virus were often metabolized in a manner that interfered with lipid lowering drug therapy. The antiviral agents have improved in many respects and the experience in managing the lipid disorders has added greatly to our ability to control these problems as well. This roundtable discussion has been conducted with 4 physicians who have been involved in management of large cohorts of patients with HIV infection and who have had a special interest in reduction of vascular disease risk. Copyright © 2016 National Lipid Association. Published by Elsevier Inc. All rights reserved.

  19. Lipodystrophy in HIV patients: its challenges and management approaches

    Directory of Open Access Journals (Sweden)

    Singhania R

    2011-12-01

    Full Text Available Rohit Singhania, Donald P KotlerDepartment of Medicine, St Luke's-Roosevelt Hospital Center, New York, NY, USAAbstract: HIV-associated lipodystrophy is a term used to describe a constellation of body composition (lipoatrophy and lipohypertrophy and metabolic (dyslipidemia and insulin resistance alterations that accompany highly active antiretroviral therapy. These changes, which resemble metabolic syndrome, have been associated with a variety of adverse outcomes including accelerated cardiovascular disease. The body composition and metabolic changes appear to cluster in HIV infection, although they are distinct alterations and do not necessarily coexist. Epidemiological studies have demonstrated multiple pathogenic influences associated with host, disease, and treatment-related factors. The adverse treatment effects were more prominent in early regimens; continued drug development has led to the application of metabolically safer regimens with equal or greater potency than the regimens being replaced. Disease-related factors include HIV infection as well as inflammation, immune activation, and immune depletion. The body composition changes promote anxiety and depression in patients and may affect treatment adherence. Treatment of dyslipidemia and alterations in glucose metabolism is the same as in non-HIV-infected individuals. Lipoatrophy is managed by strategic choice of antivirals or by antiviral switching, and in some cases by plastic/reconstructive surgery. Lipohypertrophy has been managed mainly by lifestyle modification, ie, a hypocaloric diet and increased exercise. A growth hormone releasing factor, which reduces central fat, has recently become available for clinical use.Keywords: lipoatrophy, lipohypertrophy, body composition, dyslipidemia, insulin resistance

  20. Lipodystrophy in HIV patients: its challenges and management approaches.

    Science.gov (United States)

    Singhania, Rohit; Kotler, Donald P

    2011-01-01

    HIV-associated lipodystrophy is a term used to describe a constellation of body composition (lipoatrophy and lipohypertrophy) and metabolic (dyslipidemia and insulin resistance) alterations that accompany highly active antiretroviral therapy. These changes, which resemble metabolic syndrome, have been associated with a variety of adverse outcomes including accelerated cardiovascular disease. The body composition and metabolic changes appear to cluster in HIV infection, although they are distinct alterations and do not necessarily coexist. Epidemiological studies have demonstrated multiple pathogenic influences associated with host, disease, and treatment-related factors. The adverse treatment effects were more prominent in early regimens; continued drug development has led to the application of metabolically safer regimens with equal or greater potency than the regimens being replaced. Disease-related factors include HIV infection as well as inflammation, immune activation, and immune depletion. The body composition changes promote anxiety and depression in patients and may affect treatment adherence. Treatment of dyslipidemia and alterations in glucose metabolism is the same as in non-HIV-infected individuals. Lipoatrophy is managed by strategic choice of antivirals or by antiviral switching, and in some cases by plastic/reconstructive surgery. Lipohypertrophy has been managed mainly by lifestyle modification, ie, a hypocaloric diet and increased exercise. A growth hormone releasing factor, which reduces central fat, has recently become available for clinical use.

  1. Burden of respiratory diseasw among paediatric patients infected with HIV

    Directory of Open Access Journals (Sweden)

    N. C.P. da Cunha

    2013-01-01

    Full Text Available The effects of paediatric HIV on the respiratory system are seen daily in paediatric wards. The nature of respiratory disease and the needs of HIV-positive patients have changed subsequent to the introduction of anti-retrovirals to South Africa in 2004. One hundred and twenty-five children admitted to the paediatric wards under the age of seven years were recruited for this study. The purpose of this study was to understand the disease profile of children with HIV/AIDS, their health status, presenting respiratory conditions, and need for chest physiotherapy. The most common respiratory conditions included bacterial pneumonia (66.4%, tuberculosis (48% and pneumocystis jirovecii pneumonia (23.2% (n=125. Two thirds of the children (68.8% presented with a high burden of disease. Forty percent (40.8% of the children were taking anti-retrovirals with an average length of use of 9.81 months (±SD=11.61. Analysis of immune status revealed a mean CD4 percentage of 17.33% (±SD=10.96, CD4 absolute 631.36 cell/mm3 (±SD=610.36 and viral load 2.6 million copies /ml (±SD=9.08 million copies/ml. This study highlights the characteristics and prevalence of respiratory disease burden among children with HIV in a South African setting in a post highly active antiretroviral era.

  2. Patients with HIV/AIDS: physicians' knowledge, attitudes, and referral practices.

    Science.gov (United States)

    Fournier, P O; Baldor, R A; Warfield, M E; Frazier, B

    1997-01-01

    This study investigated Massachusetts family physicians' current care and referral practices with respect to HIV/AIDS patients and examined actors that might influence family physicians in referring these patients to specialists. Educational opportunities for physicians with regard to HIV were also examined. In 1994, a 2-page survey was mailed to the 468 members of the Massachusetts Academy of Family Physicians. The survey questionnaire examined such factors as whether the respondents were teaching or nonteaching, rural or urban; number of years since medical school or residency training; and knowledge and attitudes with regard to HIV/AIDS patients. The data were analyzed using Student's t test, chi-square, and correlation analysis. Usable responses were returned by 281 (60%) of the physicians surveyed. Of these, 65% reported having HIV patients in their practice, and 46% reported having AIDS patients was being managed alone by 53% of these physicians, and 11% managed their patients with AIDS. Physicians providing care for HIV/AIDS patients were more likely to be practicing in urban locations, have three or more HIV/AIDS patients in their practice, or recently graduated from residency. Additionally, they were more likely to be involved in residency teaching programs. Those who did not care for HIV/AIDS patients felt less knowledgeable about HIV/AIDS care, and felt that they had no time in their practice to care for this population of patients. Physicians with HIV patients learn more about HIV care from their colleagues than those without HIV patients. Family physicians are increasingly seeing HIV/AIDS patients in their offices. The majority are continually caring for these patients, either by themselves or co-managing their care with a specialist. Local CME programs relying on colleagues and community resources to discuss management of these patients may be one of the best ways of ensuring that increasing numbers of family physicians obtain the appropriate

  3. Impairment of colour contrast sensitivity and neuroretinal dysfunction in patients with symptomatic HIV infection or AIDS.

    OpenAIRE

    Geier, S A; Kronawitter, U.; Bogner, J. R.; Hammel, G; Berninger, T; Klauss, V; Goebel, F D

    1993-01-01

    Ophthalmic and neurological complications are frequent findings in patients with AIDS. Little is known about neuroretinal dysfunction in patients with HIV infection. The purpose of this study was to measure and evaluate colour vision in patients with HIV infection or AIDS. Colour contrast sensitivity tests were performed on 75 patients (150 eyes) in different stages of HIV infection. A highly sensitive computer graphics system was used to measure tritan, deutan, and protan colour contrast thr...

  4. HIV testing of patients diagnosed with tuberculosis increased in Denmark during the period from 2007 to 2009

    DEFF Research Database (Denmark)

    Perch, M; Andersen, PH; Kok-Jensen, A

    2013-01-01

    We examined the trends of HIV testing among patients notified with TB in Denmark during a 3-year period from 2007 to 2009. We were able to obtain HIV testing status for 96%. There was a significant increase of patients examined for HIV infection during the 3-year period. HIV prevalence among HIV-......-tested TB patients in Denmark is much higher than in the average population. It seems there is an increasing awareness in Denmark towards testing TB cases for HIV co-infection.......We examined the trends of HIV testing among patients notified with TB in Denmark during a 3-year period from 2007 to 2009. We were able to obtain HIV testing status for 96%. There was a significant increase of patients examined for HIV infection during the 3-year period. HIV prevalence among HIV...

  5. Analysis of Hepatitis B Transmission Risk Factors in HIV Patients

    Directory of Open Access Journals (Sweden)

    Iman Ghasemzadeh

    2016-09-01

    Full Text Available Co-infection with Hepatitis B (HBV virus and HIV is common due to similarity of their transmission methods. However, the prevalence of concurrent infection in different societies, shows the crucial role of various risk factors in different populations. Therefore, the present study was performed to examine risk factors of transmission of HBV in patients with HIV in a care center for AIDS patients in Rasht City. This case-control study was carried out on 60 HIV positive patients, who visited the Infectious Diseases Center of Razi Hospital of Rasht from November, 2015 to March, 2016. Participants were assigned to two 30-member experiment and control groups. They were adjusted in terms of age group (18-30, 30-40, 40-50, and 50-60, gender (male and female, and marital status (married, single, divorced, and widowed and visited by an infectious diseases specialist according to routine examinations. Data was recorded in a questionnaire for each subject. The mean age for the experimental group was 35±6.1, and for control group was 36.6± 5.7 years. Both univariate and multivariate analyses of development of HBV infection and variables including Illegitimate sexual intercourse, use of intravenous injection drugs, positive history of imprisonment, and tattooing (p value < 0.05 showed existence of significant relationships. Injection of illegal intravenous drugs, history of imprisonment, illegitimate sexual intercourse, and tattooing are four important risk factors for transmission of HBV infection to HIV patients. In addition, the master risk reduction program may include provision of clean disposable tools for intravenous injection of drugs and tattooing.

  6. Adherence and neurocognitive screening in Romanian HIV patients

    Directory of Open Access Journals (Sweden)

    M Arbune

    2012-11-01

    Full Text Available Background: Adherence is critical for the effectiveness of antiretroviral HIV therapy (ART, accordingly decreasing the opportunistic diseases and increasing the quality of life. Neurocognitive disorders (NCD are still frequent in ART era and could impair the adherence, but how ethical is to refer ART in patients with NCD? Objective: To assess the relation between NCD and adherence in HIV Romanian patients. Material and methods: Cross-sectional screening study on 151 patients under ART, no drug users, from HIV Clinic - Galati, assessed by HIV-Associated Dementia Scale (HDS, Hospital Anxiety and Depression Scale (HADS [1], ART CNS-effectiveness Letendre scores [2] and adherence assessment questionnaire CNLAS- Romania. Normal values: HDS >10; anxiety/ depression <8. Statistical analysis performed: Chi-square test and Mann-Whitney test, with 5% significance level. Results: Characteristics of the patients: median age 22 [20; 56] years old; sex ratio F/M 1.17; median educational level 8 [0; >12] years; HBV co-infection 27.8%; AIDS stage 85.3%; current median CD4 526/mm3 [8; 1605] and 65% undetectable HIV-RNA levels. 49.6% (75/151 patients attain HDS scores <10 and imply probable NCD. Scores below 8 for anxiety are more frequent than for depression: 24% vs 13%. The median ART CNS penetration score is 8 [5; 12]. Adherence is considered for 66% patients and is correlating with CD4 number (p=0.001, educational level >4 years (p=0.001; OR=4.2, HDS >10 (p=0.01; OR=2.4 and ART-CNS penetration score >7 (p=0.023; OR=2.4. Low HDS are influenced by old age (p=0.003, depression (p=0.02 and ART-CNS penetration scores <7 (p=0.01. Anxiety is related neither with adherence nor with NCD by HDS, but females are obvious anxious than males (p<0.001. Conclusions: Basic educational level is sufficient for developing ART adherence. High scores of HDS screening should be predictors for ART adherence. Referring ART as well to patients with low HDS scores is rational and

  7. Differential effects of sex in a West African cohort of HIV-1, HIV-2 and HIV-1/2 dually infected patients: men are worse off.

    Science.gov (United States)

    Jespersen, Sanne; Hønge, Bo Langhoff; Esbjörnsson, Joakim; Medina, Candida; da Silva Té, David; Correira, Faustino Gomes; Laursen, Alex Lund; Østergaard, Lars; Andersen, Andreas; Aaby, Peter; Erikstrup, Christian; Wejse, Christian

    2016-02-01

    Several studies have reported conflicting effects of sex on HIV-1 infection. We describe differences in baseline characteristics and assess the impact of sex on HIV progression among patients at a clinic with many HIV-2 and HIV-1/2 dually infected patients. This study utilised a retrospective cohort of treatment-naïve adults at the largest HIV clinic in Guinea-Bissau from 6 June 2005 to 1 December 2013. Baseline characteristics were assessed and the patients followed until death, transfer, loss to follow-up, or 1 June 2014. We estimated the time from the first clinic visit until initiation of ART, death or loss to follow-up using Cox proportional hazard models. A total of 5694 patients were included in the study, 3702 women (65%) and 1992 men (35%). Women were more likely than men to be infected with HIV-2 (19% vs. 15%, P < 0.01) or dually infected with HIV-1/2 (11% vs. 9%, P = 0.02). For all HIV types, women were younger (median 35 vs. 40 years), less likely to have schooling (55% vs. 77%) or to be married (46% vs. 67%), and had higher baseline CD4 cell counts (median 214 vs. 178 cells/μl). Men had a higher age-adjusted mortality rate (hazard rate ratio (HRR) 1.29, 95% confidence interval (CI) 1.09-1.52) and were more often lost to follow-up (HRR 1.27, 95% CI 1.17-1.39). Significant differences exist between HIV-infected men and women regardless of HIV type. Men seek treatment at a later stage and, despite better socio-economic status, have higher mortality and loss to follow-up than women. © 2015 John Wiley & Sons Ltd.

  8. Colagenoma eruptivo em paciente HIV+ Eruptive collagenoma in an HIV-positive patient

    Directory of Open Access Journals (Sweden)

    Daniel Dal'Asta Coimbra

    2008-04-01

    Full Text Available Colagenomas são hamartomas do tecido conjuntivo gerados por aumento anormal do colágeno dérmico. O colagenoma eruptivo caracteriza-se por pequenos nódulos duros, assintomáticos, sem relato de trauma ou processo inflamatório prévios. Descreve-se caso de paciente do sexo masculino, de 28 anos, que há 10 anos notou surgimento espontâneo de lesões papulosas no tronco, nos membros superiores e abdômen, e há três anos descobriu ser soropositivo para HIV. O diagnóstico diferencial, a classificação da doença como entidade própria e a associação casual com o HIV são discutidos, bem como a necessidade da realização da coloração vermelho Picrosirius/luz polarizada para confirmação diagnóstica dos colagenomas.Collagenomas are connective tissue nevi predominantly composed of excessive dense and coarse collagen in the dermis. Eruptive collagenoma is a rare disorder occurring in young adults as asymptomatic dermal nodules, with no previous history of injury or inflammation and usually localized on the back. We describe the case of a 28-year-old male patient who was examined for numerous asymptomatic little nodules on the trunk and upper arms, which appeared ten years ago with no previous inflammation or injury. Three years ago the patient was diagnosed HIV-positive. Differential diagnoses, classification of the disease as an autonomous entity, its casual association with HIV, as well as the real need for picrosirius red staining to confirm diagnosis of collagenoma are discussed.

  9. Cerebral FDG-PET scanning abnormalities in optimally treated HIV patients

    DEFF Research Database (Denmark)

    Andersen, Åse Bengård; Law, Ian; Krabbe, Karen Suarez

    2010-01-01

    The long-term neurological consequences of HIV infection and treatment are not yet completely understood. In this study we examined the prevalence of cerebral metabolic abnormalities among a cohort of neurologically intact HIV patients with fully suppressed HIV viral loads. Concomitant analyses...

  10. HIV infection among tuberculosis patients in Vietnam: prevalence and impact on tuberculosis notification rates

    NARCIS (Netherlands)

    Thanh, D. H.; Sy, D. N.; Linh, N. D.; Hoan, T. M.; Dien, H. T.; Thuy, T. B.; Hoa, N. P.; Tung, L. B.; Cobelens, F.

    2010-01-01

    Vietnam has an emerging human immunodeficiency virus (HIV) epidemic (estimated population prevalence 0.5%), but valid data on HIV prevalence among tuberculosis (TB) patients are limited. Recent increases in TB notification rates among young adults may be related to HIV. To assess the prevalence of

  11. The prevalence of HIV among patients admitted with stroke at the ...

    African Journals Online (AJOL)

    Stroke and HIV infection are both common medical problems in the day to day clinical practice. Although data from developed countries confirm HIV infection as a risk for stroke the exact underlying mechanism is still unclear. Little data exist on the magnitude of HIV among patients with stroke in Tanzania.

  12. Canadian Consensus Recommendations for the Optimal Use of Enfuvirtide in HIV/AIDS Patients

    Directory of Open Access Journals (Sweden)

    Anita Rachlis

    2006-01-01

    Full Text Available BACKGROUND AND OBJECTIVES: An eight-member group consisting of Canadian infectious disease and immunology specialists and a family physician with significant experience in HIV management was convened to update existing recommendations, specifically intended for use by Canadian HIV-treating physicians, on the appropriate use of enfuvirtide in HIV/AIDS patients with resistance to other antiretroviral drugs.

  13. Heat shock protein of Mycoplasma salivarium and Mycoplasma orale strains isolated from HIV-seropositive patients.

    Science.gov (United States)

    Chattin-Kacouris, Blanca Rosa; Ishihara, Kazuyuki; Miura, Tadashi; Okuda, Katsuji; Ikeda, Masakazu; Ishikawa, Tatsuya; Rowland, Randal

    2002-11-01

    It has been suggested that infection by some mycoplasma species can act as possible cofactors in the acceleration of immunodeficiency in HIV-infected patients. The present study was designed to examine infections by oral mycoplasma species in HIV-seropositive (HIV(+)) patients. Mycoplasma salivarium and Mycoplasma orale were isolated from 59.5% and 16.7% of 42 HIV(+) patients, respectively. Non-M. salivarium and non-M. orale species were isolated from 40.5% of saliva samples from the HIV(+) group and 20.8% of those from 24 HIV-seronegative (HIV(-)) subjects, respectively. Although the production of superantigen by human peripheral lymphocytes in the isolated mycoplasma species from HIV(+) and HIV(-) subjects was evaluated, none of the examined mycoplasma strains, including ATCC strains of M. salivarium, M. orale, Mycoplasma buccae and Mycoplasma penetrans, were found to produce superantigen. Production of heat shock proteins (HSPs) by isolated mycoplasma strains was examined by immunoblotting using monoclonal antibodies against Helicobacter pylori HSP60. It was found that all the strains of M. salivarium, M. orale, and unidentified mycoplasma species isolated from HIV(+) and HIV(-) groups produced heat shock proteins. HSP production by oral mycoplasma may play a role in the immunomodulation of HIV(+) patients.

  14. Neuroretinal Degeneration in HIV Patients Without Opportunistic Ocular Infections in the cART Era

    NARCIS (Netherlands)

    Demirkaya, Nazli; Wit, Ferdinand; Schlingemann, Reinier; Verbraak, Franciscus

    2015-01-01

    Subtle structural and functional retinal abnormalities, termed 'HIV-associated Neuroretinal Disorder (HIV-NRD)', have been reported in HIV patients receiving combination antiretroviral therapy (cART), without infectious retinitis or any apparent fundus abnormalities otherwise. In this review, we

  15. Steep increase in HIV prevalence among tuberculosis patients in Ho Chi Minh City

    NARCIS (Netherlands)

    Quy, Hoang T.; Nhien, Dang T. T.; Lan, Nguyen T. N.; Borgdorff, Martien W.; Broekmans, Jaap F.

    2002-01-01

    In Vietnam the spread of HIV infection is thought to be limited. In 12 urban districts of Ho Chi Minh City representative samples of tuberculosis patients have undergone HIV testing since 1995. HIV prevalence increased steeply from 0.5% in 1995 to 4% in 2000, with a doubling time of approximately 21

  16. Mortality in siblings of patients coinfected with HIV and hepatitis C virus

    DEFF Research Database (Denmark)

    Hansen, Ann-Brit Eg; Gerstoft, Jan; Kronborg, Gitte

    2007-01-01

    had had at least 1 HCV test were included (n=3531). In addition, 336,652 population control subjects matched for sex, age, and residency were identified from the Danish Civil Registration System. For both HIV-infected patients and population control subjects, we identified all siblings born after 1951......, with dates of death or emigration. Siblings of HIV-infected patients were classified according to the patients' HCV serostatus. Survival after age 20 years was compared among the groups of siblings. RESULTS: We identified 437 siblings of HIV/HCV-coinfected patients, 1856 siblings of HIV-monoinfected patients......, and 285,509 siblings of population control subjects. Mortality was substantially higher in siblings of HIV/HCV-coinfected patients than in either siblings of HIV-monoinfected patients (mortality rate ratio [MRR], 2.97 [95% confidence interval {CI}, 1.98-4.45]) or siblings of control subjects (MRR, 4...

  17. Efavirenz Plasma Concentrations and HIV Viral Load in HIV/AIDS-tuberculosis Infection Patients Treated with Rifampicin

    National Research Council Canada - National Science Library

    Mariana, Nina; Purwantyastuti; Instiaty; Rusli, Adria

    2016-01-01

    to determine the effect of a rifampicin-containing tuberculosis regimen on efavirenz plasma concentrations and viral load in HIV/AIDS-Tuberculosis infection patients who received efavirenz-based antiretroviral therapy...

  18. Altered brain functions in HIV positive patients free of HIV- associated neurocognitive disorders: A MRI study during unilateral hand movements

    Directory of Open Access Journals (Sweden)

    Jing Zhao

    2015-03-01

    Full Text Available This paper aimed to investigate the brain activity of human immunodeficiency virus (HIV positive patients with normal cognition during unilateral hand movement and whether highly active antiretroviral therapy (HAART could affect the brain function. Functional magnetic resonance imaging (fMRI was performed for 60 HIV positive (HIV+ subjects and −42 healthy age-matched right-handed control subjects. Each subject was evaluated by the neuropsychological test and examined with fMRI during left and right hand movement tasks. HIV+ subjects showed greater activation in anterior cingulum, precuneus, occipital lobes, ipsilateral postcentral gyrus and contralateral cerebellum compared with control group during right hand movement task. However, during left hand movement no statistically significant difference was detected between these two groups. HAART medication for HIV+ subjects lowered the increased activity to normal level. Meanwhile patients receiving the regimen of zidovudine, lamivudine and efavirenz showed lower activity at bilateral caudate and ipsilateral inferior frontal gyrus in comparison with subjects receiving other HAART regimens. Therefore, HIV+ subjects demonstrated brain asymmetry in motor cortex, with increased activity present during right hand movement but absent during left hand movement. HAART proves effective in HIV+ subjects even with normal cognition and the specific regimen of HAART could prevent cerebral abnormal functions. Meanwhile, this study validates that during motor tasks, fMRI can detect the brain signal changes prior to the occurrences of other HIV- associated dysfunctions.

  19. Securing and sustaining employment: concerns of HIV patients in Singapore.

    Science.gov (United States)

    Tan, Si Ying; Ow Yong, Lai Meng; Foong, Jasmin Yuet Ee; Wong, Nicole Huay Sze; Chew, Li Ling; Koh, Yin Ling

    2013-01-01

    Employment sustainability is one of the most pressing issues inflicting people living with HIV (PLHIV). A qualitative approach was used to elucidate the perceived challenges in sustaining their employment and the perceived barriers in re-entering the workforce for HIV patients. In-depth interviews were conducted with 16 patients from an acute hospital in Singapore. The main challenges raised in sustaining employment were: (1) ability to ensure secrecy of diagnosis from employers, (2) ability to secure financial resources for treatment and sustenance, (3) ability to ensure stable health to meet job requirements, (4) ability to cognitively sit with the concerns of uncertainty and limitations in career, and (5) ability to work through discriminatory workplace practices. The perceived barriers in gaining workforce re-entry were: (1) fear of pre-employment medical screening and potential discriminatory practices at workplace, (2) concerns over health (frequent hospital admissions, physical weakness, and existing medical co-morbidities), and (3) psychosocial challenges (unstable accommodation, older age, financial issues, and trade skills limitation). The overarching factor that influences the success of sustaining and securing an employment among HIV patients is secrecy of the diagnosis. The individuals' health status, financial status and access to healthcare, and other psychosocial challenges further compound the issue.

  20. The Infectiousness of Tuberculosis Patients Coinfected with HIV

    Science.gov (United States)

    Escombe, A. Roderick; Moore, David A. J; Gilman, Robert H; Pan, William; Navincopa, Marcos; Ticona, Eduardo; Martínez, Carlos; Caviedes, Luz; Sheen, Patricia; Gonzalez, Armando; Noakes, Catherine J; Friedland, Jon S; Evans, Carlton A

    2008-01-01

    Background The current understanding of airborne tuberculosis (TB) transmission is based on classic 1950s studies in which guinea pigs were exposed to air from a tuberculosis ward. Recently we recreated this model in Lima, Perú, and in this paper we report the use of molecular fingerprinting to investigate patient infectiousness in the current era of HIV infection and multidrug-resistant (MDR) TB. Methods and Findings All air from a mechanically ventilated negative-pressure HIV-TB ward was exhausted over guinea pigs housed in an airborne transmission study facility on the roof. Animals had monthly tuberculin skin tests, and positive reactors were removed for autopsy and organ culture for M. tuberculosis. Temporal exposure patterns, drug susceptibility testing, and DNA fingerprinting of patient and animal TB strains defined infectious TB patients. Relative patient infectiousness was calculated using the Wells-Riley model of airborne infection. Over 505 study days there were 118 ward admissions of 97 HIV-positive pulmonary TB patients. Of 292 exposed guinea pigs, 144 had evidence of TB disease; a further 30 were tuberculin skin test positive only. There was marked variability in patient infectiousness; only 8.5% of 118 ward admissions by TB patients were shown by DNA fingerprinting to have caused 98% of the 125 characterised cases of secondary animal TB. 90% of TB transmission occurred from inadequately treated MDR TB patients. Three highly infectious MDR TB patients produced 226, 52, and 40 airborne infectious units (quanta) per hour. Conclusions A small number of inadequately treated MDR TB patients coinfected with HIV were responsible for almost all TB transmission, and some patients were highly infectious. This result highlights the importance of rapid TB drug-susceptibility testing to allow prompt initiation of effective treatment, and environmental control measures to reduce ongoing TB transmission in crowded health care settings. TB infection control must be

  1. Stimulation of the primary anti-HIV antibody response by IFN-{alpha} in patients with acute HIV-1 infection

    OpenAIRE

    Adalid-Peralta, Laura; Godot, Véronique; Colin, Céline; Krzysiek, Roman; Tran, Thi; Poignard, Pascal; Venet, Alain; Hosmalin, Anne; Lebon, Pierre; Rouzioux, Christine; Chêne, Geneviève; Emilie, Dominique; The Interprim Anrs 112 Study Group,

    2008-01-01

    International audience; Type I IFNs are needed for the production of antiviral antibodies in mice; whether they also stimulate primary antibody responses in vivo during human viral infections is unknown. This was assessed in patients acutely infected with HIV-1 and treated with IFN-alpha2b. Patients with acute HIV-1 infection were randomized to receive antiretroviral therapy alone (Group A, n=60) or combined for 14 weeks with pegylated-IFN-alpha2b (Group B, n=30). Emergence of anti-HIV antibo...

  2. Ocular complications and loss of vision due to herpes zoster ophthalmicus in patients with HIV infection and a comparison with HIV-negative patients.

    Science.gov (United States)

    Nithyanandam, S; Joseph, M; Stephen, J

    2013-02-01

    The aim of the work is to describe the occurrence of ocular complications and loss of vision due to herpes zoster ophthalmicus (HZO) in HIV-positive patients who received early antiviral therapy for HZO.This is a post hoc analysis of prospectively collected data.Twenty-four HIV-positive patients with HZO were included in this report; male to female ratio was 3.8:1; mean age was 33.5 (±14.9) years. The visual outcome was good, with 14/24 patients having 6/6 vision; severe vision loss (≤6/60) occurred in only 2/24. There was no statistical difference in the visual outcome between the HIV-positive and -negative patients (P = 0.69), although severe vision loss was more likely in HIV-infected patients. The ocular complications of HZO in HIV-infected patients were: reduced corneal sensation (17/24), corneal epithelial lesions (14/24), uveitis (12/24), elevated intraocular pressure (10/24) and extra-ocular muscle palsy (3/24). The severity of rash was similar in the two groups but multidermatomal rash occurred only in HIV-infected patients (4/24). There was no difference in the occurrence of ocular complications of HZO between HIV-positive and HIV-negative patients. HZO associated ocular complications and visual loss is low in HIV-infected patients if treated with HZO antiviral therapy and was comparable with HIV-negative patients. Early institution of HZO antiviral therapy is recommended to reduce ocular complication and vision loss.

  3. Examining the link between patient satisfaction and adherence to HIV care: a structural equation model.

    Science.gov (United States)

    Dang, Bich N; Westbrook, Robert A; Black, William C; Rodriguez-Barradas, Maria C; Giordano, Thomas P

    2013-01-01

    Analogous to the business model of customer satisfaction and retention, patient satisfaction could serve as an innovative, patient-centered focus for increasing retention in HIV care and adherence to HAART, and ultimately HIV suppression. To test, through structural equation modeling (SEM), a model of HIV suppression in which patient satisfaction influences HIV suppression indirectly through retention in HIV care and adherence to HAART. We conducted a cross-sectional study of adults receiving HIV care at two clinics in Texas. Patient satisfaction was based on two validated items, one adapted from the Consumer Assessment of Healthcare Providers and Systems survey ("Would you recommend this clinic to other patients with HIV?) and one adapted from the Delighted-Terrible Scale, ("Overall, how do you feel about the care you got at this clinic in the last 12 months?"). A validated, single-item question measured adherence to HAART over the past 4 weeks. Retention in HIV care was based on visit constancy in the year prior to the survey. HIV suppression was defined as plasma HIV RNA satisfaction score had a mean of 8.5 (median 9.2) on a 0- to 10- point scale. A total of 46% reported "excellent" adherence, 76% had adequate retention, and 70% had HIV suppression. In SEM analyses, patient satisfaction with care influences retention in HIV care and adherence to HAART, which in turn serve as key determinants of HIV suppression (all psatisfaction may have direct effects on retention in HIV care and adherence to HAART. Interventions to improve the care experience, without necessarily targeting objective clinical performance measures, could serve as an innovative method for optimizing HIV outcomes.

  4. Patients with discordant responses to antiretroviral therapy have impaired killing of HIV-infected T cells.

    Directory of Open Access Journals (Sweden)

    Sekar Natesampillai

    2010-11-01

    Full Text Available In medicine, understanding the pathophysiologic basis of exceptional circumstances has led to an enhanced understanding of biology. We have studied the circumstance of HIV-infected patients in whom antiretroviral therapy results in immunologic benefit, despite virologic failure. In such patients, two protease mutations, I54V and V82A, occur more frequently. Expressing HIV protease containing these mutations resulted in less cell death, caspase activation, and nuclear fragmentation than wild type (WT HIV protease or HIV protease containing other mutations. The impaired induction of cell death was also associated with impaired cleavage of procaspase 8, a requisite event for HIV protease mediated cell death. Primary CD4 T cells expressing I54V or V82A protease underwent less cell death than with WT or other mutant proteases. Human T cells infected with HIV containing these mutations underwent less cell death and less Casp8p41 production than WT or HIV containing other protease mutations, despite similar degrees of viral replication. The reductions in cell death occurred both within infected cells, as well as in uninfected bystander cells. These data indicate that single point mutations within HIV protease which are selected in vivo can significantly impact the ability of HIV to kill CD4 T cells, while not impacting viral replication. Therefore, HIV protease regulates both HIV replication as well as HIV induced T cell depletion, the hallmark of HIV pathogenesis.

  5. Oral non-Hodgkin′s lymphoma as an initial diagnosis in a HIV positive patient

    Directory of Open Access Journals (Sweden)

    Elluru Venkatesh

    2008-01-01

    Full Text Available Patients with the acquired immunodeficiency syndrome (AIDS present unique diagnostic challenges because of a propensity to develop unusual infections and neoplasms. Since the beginning of the AIDS epidemic, the number of documented clinical manifestations has considerably increased. Current estimates are that 40% of patients with AIDS have a malignant tumor at the time of initial diagnosis, and the percentage may increase to 70% over the course of the disease. It is generally recognized that Kaposi′s sarcoma is the most common of these malignant conditions, but non-Hodgkin′s lymphoma (NHL is also being diagnosed in greater numbers. The purpose of this paper is to present one such case of oral NHL as initial diagnosis in a HIV positive patient.

  6. Hepatitis B and C Co-Infection in HIV Patients from the TREAT Asia HIV Observational Database: Analysis of Risk Factors and Survival.

    Science.gov (United States)

    Chen, Marcelo; Wong, Wing-Wai; Law, Matthew G; Kiertiburanakul, Sasisopin; Yunihastuti, Evy; Merati, Tuti Parwati; Lim, Poh Lian; Chaiwarith, Romanee; Phanuphak, Praphan; Lee, Man Po; Kumarasamy, Nagalingeswaran; Saphonn, Vonthanak; Ditangco, Rossana; Sim, Benedict L H; Nguyen, Kinh Van; Pujari, Sanjay; Kamarulzaman, Adeeba; Zhang, Fujie; Pham, Thuy Thanh; Choi, Jun Yong; Oka, Shinichi; Kantipong, Pacharee; Mustafa, Mahiran; Ratanasuwan, Winai; Durier, Nicolas; Chen, Yi-Ming Arthur

    2016-01-01

    We assessed the effects of hepatitis B (HBV) or hepatitis C (HCV) co-infection on outcomes of antiretroviral therapy (ART) in HIV-infected patients enrolled in the TREAT Asia HIV Observational Database (TAHOD), a multi-center cohort of HIV-infected patients in the Asia-Pacific region. Patients testing HBs antigen (Ag) or HCV antibody (Ab) positive within enrollment into TAHOD were considered HBV or HCV co-infected. Factors associated with HBV and/or HCV co-infection were assessed by logistic regression models. Factors associated with post-ART HIV immunological response (CD4 change after six months) and virological response (HIV RNA infection, age, route of HIV infection, baseline CD4 count, baseline HIV RNA, and HIV-1 subtype were associated with immunological recovery. Age, route of HIV infection, baseline CD4 count, baseline HIV RNA, ART regimen, prior ART and HIV-1 subtype, but not HBV or HCV co-infection, affected HIV RNA suppression. Risk factors affecting mortality included HCV co-infection, age, CDC stage, baseline CD4 count, baseline HIV RNA and prior mono/dual ART. Shortest survival was seen in subjects who were both HBV- and HCV-positive. In this Asian cohort of HIV-infected patients, HCV co-infection, but not HBV co-infection, was associated with lower CD4 cell recovery after ART and increased mortality.

  7. Anesthetic considerations in patients with previous thoracic surgery.

    Science.gov (United States)

    Kozian, Alf; Schilling, T; Strang, C; Hachenberg, T

    2006-02-01

    This review presents an overview of the different problems and challenges after thoracic surgery. It covers the pathophysiological changes that may occur regularly in the early and late period following surgery. In addition, surgical complications with anesthesiological implications for diagnosis, treatment and prevention are discussed, and consequences for anesthesia in further major and thoracic surgical procedures are shown. During the last decade, complications in the early period following surgery after thoracotomy have increasingly moved into the focus caused by their high morbidity and mortality. These problems, such as hemorrhagia and bronchopleural fistulas, are important because they call for a prompt revision or even an emergency operation. The therapy of acute bleeding follows general anesthesiological guidelines whereas the bronchopleural fistula demands methods to prevent aspiration pneumonia as a first priority. In the late period following surgery, typical cardiac and pulmonary modifications can be described that persist and have anesthesiological implications in the case of further surgery. Recent literature, however, lacks clear recommendations regarding anesthesiological management and practice for these cases. Current literature presents no general recommendations on how to manage patients after recent thoracic surgery. Therefore it is necessary to find an individual strategy to handle possible complications and well known pathophysiological changes. Knowledge and understanding of the etiology, the pathophysiology and the risk factors of the perioperative period, allows prevention and target intervention aimed at reducing morbidity and mortality following surgery.

  8. Medication absorption considerations in patients with postpyloric enteral feeding tubes.

    Science.gov (United States)

    McIntyre, Chelsey M; Monk, Heather M

    2014-04-01

    The gastrointestinal absorption sites of medications administered via postpyloric enteral feeding tubes were examined. Many issues must be considered when administering medications via the postpyloric route, including interactions with enteral feeds, additional toxicities, and the concern of whether the medication will be absorbed. Despite the potential clinical significance of this information, data regarding the gastrointestinal site of absorption for most medications are lacking. Gastrointestinal absorption sites for all drugs for which requests for information on absorption sites were received at our institution since 2008 (n = 124) were evaluated by reviewing the package insert, consulting tertiary references, conducting primary literature searches, or contacting the drug manufacturer. Seventy (56.5%) of the 124 drugs reviewed had information available regarding the site of absorption. Just 2 drugs required acid for absorption and thus should be administered only through the stomach, while 2 other drugs were found to bind extensively to tubing and should not be administered in this manner. For 3 drugs, increased absorption may occur when they are administered directly into the small bowel. Seven medications had decreased absorption when administered directly to the small bowel, and 10 drugs were clearly not absorbed when administered through either the duodenal or the jejunal route. The implications of absorption site should be considered for all patients receiving medications via postpyloric feeding tubes. Several medications cannot be administered through alternative routes because gastric acid is needed for their absorption, the medications may bind to the tubing, or drug absorption is altered at the intestinal site.

  9. Considerations for Culturally Competent Cognitive-Behavioral Therapy for Depression with Hispanic Patients

    Science.gov (United States)

    Interian, Alejandro; Diaz-Martinez, Angelica M.

    2007-01-01

    The purpose of this paper is to outline considerations for adapting cognitive-behavioral therapy (CBT) to Hispanic patients who have recently immigrated, particularly those presenting with depressive symptoms. Culturally competent CBT is framed within a model originally proposed by Rogler and his colleagues (1987). The considerations outlined by…

  10. Restricting access of human immunodeficiency virus (HIV)-seropositive patients to infertility services: a legal analysis of the rights of reproductive endocrinologists and of HIV-seropositive patients.

    Science.gov (United States)

    Phelps, John Y

    2007-12-01

    To discuss the legal rights of reproductive endocrinologists and HIV-seropositive patients seeking infertility services. Westlaw and LexisNexis commercial legal search engines were used to perform a legal review of statutes and cases pertaining to HIV-seropositive patients seeking health care services. Human immunodeficiency virus antidiscrimination laws apply to healthcare providers whether they practice in private clinics or a university setting. Patients infected with HIV cannot be denied access to health services solely on the basis of their HIV status. If proof exists that HIV-seropositive patients will medically benefit by a referral to another provider with more expertise, it is legally permissible to refer these patients to another provider who has more expertise in providing infertility services to HIV-seropositive patients. However, the burden will be on the reproductive endocrinologist to demonstrate that he or she lacks the capability to care for HIV-seropositive patients and that the referral was for the medical benefit of the patient and of the patient's potential offspring.

  11. Oral manifestations of anemia in HIV/AIDS patients without ARV treatment

    Directory of Open Access Journals (Sweden)

    Wahyu Hidayat

    2017-03-01

    Full Text Available Abstract Introduction: Acquired immunodeficiency syndrome (AIDS is  a set of symptoms caused by decreases of the immune system that was infected by human immunodeficiency virus (HIV. Blood disorders often found in patient with HIV and associated with HIV infection. Mostly found disorders is anemia of chronic disease. The prevalence of anemia in HIV/AIDS patients reaches 70%. Oral manifestations of anemia are atrophy of the papillae on tongue, glossodynia, pallor, angular cheilitis, glossitis, aphthous ulcers/erosive lesions, candidiasis, and geographic tongue. There are many publications that uses anemia as indicator to determine the prognosis of HIV infection, thus the description of oral manifestation of anemia in the non-ARV HIV/AIDS patients is a necessity. The purpose of this study was to describe the oral manifestation of anemia in the non-ARV HIV/AIDS patients. Methods: The methods used were purposive random sampling. Samples were new HIV/AIDS patients who have not got antiretroviral (ARV treatment. The study included 40 patients in Teratai Clinic Hasan Sadikin Hospital Bandung. Results: Oral manifestations of anemia were found amongst non-ARV HIV/AIDS patients, which were candidiasis in  37 patients, glossodynia in 28 patients, glossitis in 10 patients, and angular cheilitis in 1 patient. Conclusion: From the study found that oral manifestations of anemia that found in non-ARV HIV/AIDS patients were candidiasis, glossodynia, glossitis and angular cheilitis. HIV/AIDS patients with anemia needed to treat more intensive for better prognosis and quality of life. Keywords: Anemia, HIV/AIDS, Candidiasis, Glossitis, Glossodynia

  12. Approach to the patient: transgender youth: endocrine considerations.

    Science.gov (United States)

    Rosenthal, Stephen M

    2014-12-01

    Compelling studies have demonstrated that "gender identity"--a person's inner sense of self as male, female, or occasionally a category other than male or female--is not simply a psychosocial construct, but likely reflects a complex interplay of biological, environmental, and cultural factors. An increasing number of preadolescents and adolescents, identifying as "transgender" (a transient or persistent identification with a gender different from their "natal gender"--ie, the gender that is assumed based on the physical sex characteristics present at birth), are seeking medical services to enable the development of physical characteristics consistent with their affirmed gender. Such services, including the use of agents to block endogenous puberty at Tanner stage 2 and subsequent use of cross-sex hormones, are based on longitudinal studies demonstrating that those individuals who were first identified as gender-dysphoric in early or middle childhood and who still meet the mental health criteria for being transgender at early puberty are likely to be transgender as adults. Furthermore, onset of puberty in transgender youth is often accompanied by increased "gender dysphoria"--clinically significant distress related to the incongruence between one's affirmed gender and one's "assigned (or natal) gender." Studies have shown that such distress may be ameliorated by a "gender-affirming" model of care. Although endocrinologists are familiar with concerns surrounding gender identity in patients with disorders of sex development, many providers are unfamiliar with the approach to the evaluation and management of transgender youth without a disorder of sex development. The goals of this article are to review studies that shed light on the biological underpinnings of gender identity, the epidemiology and natural history of transgenderism, current clinical practice guidelines for transgender youth, and limitations and challenges to optimal care. Prospective cohort studies

  13. Clinical utility and patient consideration in the use of lenalidomide for multiple myeloma in Chinese patients

    Directory of Open Access Journals (Sweden)

    Wang J

    2015-06-01

    Full Text Available Jing Wang, Hongfeng Guo, Xin Zhou Department of Hematology, Wuxi People’s Hospital, Nanjing Medical University, Wuxi, People’s Republic of China Abstract: Multiple myeloma (MM is an incurable hematologic malignancy caused by the autonomous growth of malignant plasma cells. In the last decade, the introduction of novel targeted agents such as thalidomide, bortezomib, and lenalidomide has dramatically improved the clinical outcome of MM patients in both the frontline and recurrent settings. Lenalidomide is a synthetic derivative of thalidomide, which has been shown to significantly improve overall survival, time to progression, and overall response rates in patients with MM. The China Food and Drug Administration approved the use of lenalidomide in patients with MM in 2013. In a Phase II trial, lenalidomide plus low-dose dexamethasone was associated with a high response rate and acceptable safety profile in heavily pretreated Chinese patients with relapsed/refractory MM, including those with renal impairment and IgD subtype. However, lenalidomide will remain as a second-line antimyeloma drug in the near future because of its high price and the policy of health insurance reimbursement in People’s Republic of China. In this review, we summarize the clinical utility and patient considerations in the use of lenalidomide for MM in Chinese patients. Further studies with larger sample sizes are required to investigate the better quality, longer duration, and more clinically meaningful outcomes of lenalidomide in the treatment of MM in Chinese patients. Keywords: lenalidomide, multiple myeloma, clinical efficacy, Chinese patients

  14. Predictors of HIV/AIDS Related Ocular Manifestations among HIV/AIDS Patients in Felege Hiwot Referral Hospital, Northwest Ethiopia

    Directory of Open Access Journals (Sweden)

    Guadie Sharew

    2015-01-01

    Full Text Available Background. Ocular manifestations in people living with HIV/AIDS are varied and affect almost all the structures of eye leading to visual impairment or blindness. Therefore, the aim of this study was to identify the predictors of HIV related ocular manifestation among ART clinic clients. Methods. Institution based cross-sectional study was employed among ART clients at Felege Hiwot referral hospital, northwest Ethiopia. The study was conducted from 1 January 2013 to 30 January 2013. A total of 369 systematically and randomly selected clients were included in the study. Data were collected using structured questionnaires and ophthalmologic clinical examination. Data were entered and analyzed using SPSS version 16.0. Binary and multivariable logistic regression analyses were computed to identify independent predictors of HIV related ocular manifestation. Results. Twenty-five percent (25.7% of HIV patients had ocular manifestations. The three most frequent signs were Squamoid Conjuctival growth (26.9%, ophthalmic herpes zoster (22.1%, and Bacterial Conjuctivitis (17.2%. History of eye problem, CD4 count, and visual acuity of the eye were the predictors of HIV related ocular manifestation. Conclusion. In this study, a higher proportion of ocular manifestations were detected in HIV/AIDS patients. Visual acuity and CD4 counts were the independent predictors of ocular manifestations. This finding gives an insight for policy makers and concerned body to integrate ophthalmic examination in ART clinics to improve the health condition of HIV/ADIS patients.

  15. Incentives for HIV testing at the workplace in the automotive industry in the Nelson Mandela Bay Municipality: Ethical considerations

    Directory of Open Access Journals (Sweden)

    Martin Weihs

    2017-07-01

    Full Text Available Comprehensive HIV and AIDS workplace programmes made use of substantial lottery incentives in HIV counselling and testing drives to promote HIV testing at four companies in the automotive industry in the Nelson Mandela Bay Municipality. The main aim was to use lottery incentives to increase uptake for HIV testing. This would help to define company HIV prevalence and ensure timely support, care and treatment of employees. In total, 1 324 employees, making up about 90% of the total staff, were tested for HIV in the four companies during wellness testing days. In order to gain an understanding of employees’ experiences of the lotteries as part of the HIV counselling and testing drive, quantitative data were collected among a total of 414 employees, and 17 interviews were conducted in the four companies. In this article, we investigate the issue of whether the lotteries unduly influenced the employees’ participation in workplace HIV testing, and an approach to resolving an identified ethical dilemma is presented. The ethical question as to whether lottery incentives contribute to undue coercion was explored using both a utilitarian and a deontological approach. The analysis concluded that the use of lotteries to encourage HIV testing in the workplaces of the automotive industry in the Nelson Mandela Bay Municipality can be deemed morally acceptable.

  16. Prevention and treatment of HIV addicted patients: a biopsychosocial approach.

    Science.gov (United States)

    Iskandar, Shelly; van Crevel, Reinout; Siregar, I M P; Achmad, T H; van der Ven, A J A M; de Jong, C A J

    2009-07-01

    Injecting drug use is the main route of HIV transmission in many parts of Indonesia. Efforts to prevent HIV-transmission through injecting drug use mostly focus on subjects who actively inject. In scientific publications, the term 'injecting drug users' tends to be used without a clear definition and without specifying the pattern of drug use as current or former drug use, frequency, duration, type of injected drug(s) or context (e.g. imprisonment). Actually, injecting drug users (IDUs) have different drug use patterns, risk behavior, somatic co-morbidity, psychiatric co-morbidity, and psychosocial problems. In fact, these patients are suffering from addiction as a chronic brain disease in co-occurrence with somatic and psychiatric disorder and many social problems. Failing in addressing the problems comprehensively will lead to the failure of drug treatment. This is why addiction can be best studied and treated from a biopsychosocial perspective. Accordingly, treatment goals can be differentiated in crisis intervention, cure or recovery (detoxification, relapse prevention), and care or partial remission (stabilization and harm reduction). In summary, injecting drug use in Indonesia is not a single entity and patient oriented prevention and care for IDUs, especially focusing on their addiction, should be addressed to prevent the transmission of HIV/AIDS.

  17. [Urinary lithiasis secondary to medication in HIV+ patients receiving Indinavir].

    Science.gov (United States)

    Juan Escudero, Joaquín Ulises; López Alcina, Emilio; Ordoño Domínguez, Felipe; Fabuel Deltoro, Milagros; Serrano de la Cruz Torrijos, Francisco; Montoliu García, Ana; Ramada Benlloch, Francisco; Marqués Vidal, Emilio

    2008-01-01

    Therapy with protease inhibitors is commonly used in patients infected by human inmunodeficency virus (HIV). 20% of the administered dose is excreted by the kidney, and when alkaline urine is present, indinavir may crystallize forming stones and patients may experience renal colic due to this fact. Between January 1998 and June 2005, 26 patients receiving antiretroviral treatment with protease inhibitors received care at our hospital because of renal colic or flank pain. All of them underwent physical examination, echography and urography as well as blood and urine analysis. Patients were treated ambulatory excepting those in whom oral analgesics were insufficient to control the pain. All patients had been treated with indinavir for longer than 12 months. They represented 4% of all patients treated with the recommended dose of Crivixan. Most of them presented flank pain, associated in most cases to microhaematuria. Five of them required hospitalization because of persistent pain in spite of endovenous analgesia. Imaging tests (echography and urography) showed functional delay of the kidney (2 cases), ureteral stasis (4 cases) and little lithiasic concretions of mild radiologic density (5 cases). Urinalysis revealed suggestive christaluria and alkaline pH. All patients required hidratation and analgesic treatment. In 3 patients indinavir dose was reduced, it was retired in another one, and 100 mg of rito-navir were added in another one. Unsuccesfuly ureteral cateterization was tried in one patient. All of them presented symptomatic improvement. We ought to know the capability of indinavir to form urolithiasis in HIV patients treated with protease inhibitors, although its use is decreasing along time. Prevalence of urolithiasis in these patients seems to be higher as length of treatment becomes longer. Metabolic alterations in urine have been proved in these patients, contributing to a higher incidence of lithiasis than in general population.

  18. Nutritional status in patients with HIV infection and AIDS.

    Science.gov (United States)

    Stambullian, Marcela; Feliu, Susana; Slobodianik, Nora H

    2007-10-01

    The aim of this study was to evaluate the nutritional status of adults with HIV infection or with AIDS through the use of biochemical parameters. The study was performed on 43 patients (19 HIV+ and 24 AIDS patients), between 26 and 44 years of age, from low and medium socioeconomic status, with access to health care services; 35 patients were under highly active antiretroviral therapy (HAART) treatment. Body weight and height were determined, and the Body Mass Index calculated (kg/m2). Blood samples were collected from fasting patients. Plasma cholesterol (total, HDL and LDL), triacylglycerol, total protein, apolipoproteins A-I and B, albumin, transthyretin, retinol binding protein, and ceruloplasmin concentrations were determined. Plasma levels of zinc, copper, and selenium were determined in a haemolysis-free sample by flame atomic absorption spectrometry. Statistical analyses were performed with the Student's t-test. AIDS patients showed changes in biochemical parameters, particularly an increase in fibrinogen and a trend to decreased transthyretin levels. These findings stress the importance of the inclusion of functional biochemical parameters in the periodic evaluation of these patients. This would allow an early assessment of the need for appropriate nutritional support, implemented along with the specific retroviral treatment. This would aim at delaying the progression of the disease, and might improve the prospects of survival and quality of life.

  19. Self-efficacy analysis among HIV positive patients in Jimma University Specialized Hospital: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Netsanet Fentahun

    2014-07-01

    Conclusions: The HIV patients had high self-efficacy on disclosure, safe sex and treatment adherence. This good practice should be promoted and enhanced in different part of Ethiopia. The HIV patients had low awareness about their parents' HIV status. Future effort should be made on awareness level about their parents' HIV status.

  20. HealthCall for the smartphone: technology enhancement of brief intervention in HIV alcohol dependent patients

    OpenAIRE

    Hasin, Deborah S; Aharonovich, Efrat; Greenstein, Eliana

    2014-01-01

    Background Heavy drinking jeopardizes the health of patients in HIV primary care. In alcohol dependent patients in HIV primary care, a technological enhancement of brief intervention, HealthCall administered via interactive voice response (HealthCall-IVR) was effective at reducing heavy drinking. The smartphone offered a technology platform to improve HealthCall. Methods Working with input from patients, technology experts, and HIV clinic personnel, we further developed HealthCall, harnessing...

  1. Mycobacterium simiae pulmonary infection unmasked during immune reconstitution in an HIV patient.

    Science.gov (United States)

    Vitoria, María Asunción; González-Domínguez, María; Salvo, Soledad; Crusells, María José; Letona, Santiago; Samper, Sofía; Sanjoaquín, Isabel

    2013-01-01

    Highly active antiretroviral therapy in human immunodeficiency virus (HIV) patients may trigger the onset of immune reconstitution inflammatory syndrome (IRIS). Among HIV patients with IRIS, infections are commonly due to Mycobacterium tuberculosis and nontuberculous mycobacteria. We report the first case in Spain and the second in Europe of Mycobacterium simiae pulmonary infection unmasked during immune reconstitution in an HIV patient. Copyright © 2013 Elsevier Inc. All rights reserved.

  2. Intraosseous fibrosarcoma of maxilla in an HIV patient.

    Science.gov (United States)

    Kotrashetti, Vijayalakshmi S; Kale, Alka D; Hallikeremath, Seema R; Mane, Deepa R; V Angadi, Punnya; Bhatt, Pooja

    2012-01-01

    Fibrosarcoma is a malignant mesenchymal neoplasm of fibroblasts that rarely affects the oral cavity and can cause local recurrences or metastasis. Fibrosarcomas account for 15% of all soft tissue sarcomas, which represent only 1% of all malignant tumors of the head and neck region. The clinical behavior of the fibrosarcoma is characterized by a high local recurrence rate, and low incidence of loco regional lymph node and/or distant hematogenous metastasis. The etiology for fibrosarcoma has no definite cause but is thought to occur from preexisting lesions or in previously irradiated areas of bone lesions. Immunosuppression associated with HIV infection and acquired immune deficiency syndrome (AIDS) has been consistently linked to various cancers, including Kaposi's sarcoma, non-Hodgkin's lymphoma, and invasive cervical cancer. Rare neoplasms like Hodgkin's disease, anal cancer, leukemia, basal cell carcinoma, and squamous cell carcinoma have also been demonstrated. This paper presents one such a rare incidence of an intraosseous fibrosarcoma occurring in an HIV-positive patient.

  3. Cotrimoxazole-Induced Hypoglycemia in an HIV-Infected Patient

    Directory of Open Access Journals (Sweden)

    Christine A Hughes

    2001-01-01

    Full Text Available A case of cotrimoxazole-induced hypoglycemia is described in a male patient infected with HIV. Ten days after initiating high dose cotrimoxazole for suspected Pneumocystis carinii pneumonia, the patient developed neuroglycopenic symptoms and diaphoresis. Blood glucose levels were repeatedly low, with elevated insulin and C-peptide levels despite multiple intravenous bolus doses and infusions of dextrose. Hypoglycemia resolved after approximately 36 h of treatment with dextrose and discontinuation of cotrimoxazole. A review of reported cases of hypoglycemia associated with cotrimoxazole is provided, including information about onset, risk factors and possible mechanism.

  4. HIV-1 Continues To Replicate and Evolve in Patients with Natural Control of HIV Infection

    DEFF Research Database (Denmark)

    Mens, Helene; Kearney, Mary; Wiegand, Ann

    2010-01-01

    Elucidating mechanisms leading to the natural control of HIV-1 infection is of great importance for vaccine design and for understanding viral pathogenesis. Rare HIV-1-infected individuals, termed HIV-1 controllers, have plasma HIV-1 RNA levels below the limit of detection by standard clinical...

  5. The Spectrum of Pulmonary Disease in Patients with HIV Infection

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    Julio Sg Montaner

    1994-01-01

    bacterial pneumonia secondary to Streptococcus pneumoniae. Haemophilus influenzae or Staphylococcus aureus. Among the noninfectious causes of pulmonary disease. the most common are Kaposi's sarcoma. airways hyper-reactive disease (asthma and emphysema. Respiratory involvement in HIV-infected individuals is not always related to the HIV infection. These patients often present with pulmonary disorders that are common in the genernal population. Differential diagnosis of respiratory conditions is significantly facilitated by the prior knowledge of the degree of immunodeficiency present as measured by the CD4 count. In particular, most episodes of PCP occur in patients with absolute CD4 counts below 200 cells/mm3. On the other hand. bacterial pneumonias and tuberculosis tend to occur at any time during the natural history of HIV disease. History and physical examination can help in the differential diagnosis; however. they are rclatively nonspecific in this setting. The same can be said of radiographic findings as well as laboratory and physiological abnormalities. Of note, the lactate dehydrogenase (LDH serum level has proved to be extremely useful in ruling out PCP. Even mild PCP is usually accompanied by a significant elevation of LDH. Furthermore, the degree of LDH elevalion generally correlates wilh the severity of the PCP episode. Also, changes in LDH parallel the clinical course of the underlying PCP. Often LDH level has been useful in discriminating worsening PCP following the initiation of therapy from worsening respiratory symptoms due to superimposed disease. It must be emphasized, however. thal LDH level. although a very sensitive marker for PCP. is also nonspecific. Of note, hemolysis, lymphomas, pulmonary embolism, liver disease and dapsone therapy can be associated with elevated LDH in the context of HIV disease. Given the high frequency of respiratory involvement in this patient populalion. it is generally recommended thal preventive therapies be used

  6. Can socio-economic differences explain low expectation of health services among HIV patients compared to non-HIV counterparts?

    Science.gov (United States)

    Li, Jing; Assanangkornchai, Sawitri; Lu, Lin; Cai, Le; You, Jing; McNeil, Edward B; Chongsuvivatwong, Virasakdi

    2016-09-09

    The health service of China has encountered significant challenges due to inequalities in socio-economic determinants of health. HIV patients are known to suffer from social stigma, and may receive inadequate responsiveness from health providers. Before assessing the responsiveness they receive, it is important to know their expectations. We aimed to compare levels of expectation towards the healthcare service among HIV and non-HIV patients with adjustment for socio-economic factors. A cross-sectional study was conducted during January and February, 2015 among two consecutive groups of HIV positive and non-HIV patients in two hospitals in Kunming, China. Patients' expectation towards eight domains of health system responsiveness was measured using 40 vignettes; five per domain. Each vignette was ranked from 1 "very good" to 5 "very bad", and the responses were summed to obtain a total score for each domain. Differences in total scores were compared between the two groups and adjusted for other factors using multiple linear regression. The three domains with the highest scores, reflecting high expectation, were prompt attention, basic amenities and choice. Adjusted for other factors, HIV patients had significantly lower levels of expectation in all domains compared to the non-HIV group. Age was associated with the basic amenities domain, with young adults having higher expectations than other age groups. Minority ethnic groups had lower expectation towards dignity, prompt attention and autonomy domains compared to Han ethnicity. Those who lived in a home with 2-4 family members had higher expectations towards confidentiality than those who lived alone. Patients with HIV have significantly lower levels of expectations even after adjusting for socio-economic factors. Assessment of health system responsiveness based on their judgments above may give biased results toward favorable service quality.

  7. Clinical characteristics of HIV-infected patients with adjudicated heart failure.

    Science.gov (United States)

    Steverson, Alexandra B; Pawlowski, Anna E; Schneider, Daniel; Nannapaneni, Prasanth; Sanders, Jes M; Achenbach, Chad J; Shah, Sanjiv J; Lloyd-Jones, Donald M; Feinstein, Matthew J

    2017-11-01

    Aims HIV-infected persons may have elevated risks for heart failure, but factors associated with heart failure in the modern era of HIV therapy are insufficiently understood. Despite substantial disagreement between physician-adjudicated heart failure and heart failure diagnosis codes, few studies of HIV cohorts have evaluated adjudicated heart failure. We evaluated associations of HIV viremia, immunosuppression, and cardiovascular risk factors with physician-adjudicated heart failure. Methods and results We analyzed clinical characteristics associated with heart failure in a cohort of 5041 HIV-infected patients receiving care at an urban hospital system between 2000 and 2016. We also evaluated characteristics of HIV-infected patients who screened negative for heart failure, screened positive for possible heart failure but did not have heart failure after adjudication, and had adjudicated heart failure. HIV-infected patients with heart failure ( N = 216) were older and more likely to be black, hypertensive, and have diabetes than HIV-infected patients without heart failure; heart failure with reduced ejection fraction was more common than heart failure with preserved ejection fraction. In our primary analyses restricted to HIV-infected patients whose heart failure diagnoses did not precede their HIV diagnoses ( N = 149), peak HIV viral load ≥100,000 copies/mL (odds ratio (OR) 2.12, 1.28-3.52) and nadir CD4 T-cell count failure. Overall, 30.6% of patients with any diagnosis code of heart failure had adjudicated heart failure. Conclusion Higher peak HIV viremia and lower CD4 cell nadir are associated with significantly elevated odds of heart failure for HIV-infected persons. Physician adjudication of heart failure may be helpful in HIV cohorts.

  8. Drug resistance mutations in HIV-2 patients failing raltegravir and influence on dolutegravir response.

    Science.gov (United States)

    Requena, Silvia; Treviño, Ana; Cabezas, Teresa; Garcia-Delgado, Rosa; Amengual, María José; Lozano, Ana Belén; Peñaranda, María; Fernández, Juan Manuel; Soriano, Vicente; de Mendoza, Carmen

    2017-07-01

    A broader extent of amino acid substitutions in the integrase of HIV-2 compared with HIV-1 might enable greater cross-resistance between raltegravir and dolutegravir in HIV-2 infection. Few studies have examined the virological response to dolutegravir in HIV-2 patients that failed raltegravir. All patients recorded in the HIV-2 Spanish cohort were examined. The integrase coding region was sequenced in viraemic patients. Changes associated with resistance to raltegravir and dolutegravir in HIV-1 were recorded. From 319 HIV-2-infected patients recorded in the HIV-2 Spanish cohort, 53 integrase sequences from 30 individuals were obtained (20 raltegravir naive and 10 raltegravir experienced). Only one secondary mutation (E138A) was found in one of the 20 raltegravir-naive HIV-2 patients. For raltegravir-experienced individuals, the resistance mutation profile in 9 of 10 viraemic patients was as follows: N155H + A153G/S (four); Y143G + A153S (two); Q148R + G140A/S (two); and Y143C + Q91R (one). Of note, all patients with Y143G and N155H developed a rare non-polymorphic mutation at codon 153. Rescue therapy with dolutegravir was given to 5 of these 10 patients. After >6 months on dolutegravir therapy, three patients with baseline N155H experienced viral rebound. In two of them N155H was replaced by Q148K/R and in another by G118R. A wide repertoire of resistance mutations in the integrase gene occur in HIV-2-infected patients failing on raltegravir. Although dolutegravir may allow successful rescue in most HIV-2 raltegravir failures, we report and characterize three cases of dolutegravir resistance in HIV-2 patients, emerging variants Q148K and Q148R and a novel change G118R.

  9. Disseminated cryptococcosis in a patient with HIV/AIDS at a teaching hospital in Ghana

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    KP Akakpo

    2015-01-01

    Full Text Available Objective: To raise awareness of the existence of cryptococcal infections in HIV/AIDS patients in Ghana. Method: Detailed postmortem gross and histopathological analysis of an HIV/AIDS patient suspected to have cryptococcal meningitis was carried out and histopathological findings correlated with clinical findings. Results: showed disseminated Cryptococcosis in an HIV/AIDS patient which was confirmed with special stains. Conclusion: cryptococcal infection occurs in HIV /AIDS patients in Ghanaian and when clinically suspected the diagnosis should be pursued vigorously.

  10. Mycobacterium tuberculosis and non-tuberculous mycobacteria isolates from HIV-infected patients in Guangxi, China.

    Science.gov (United States)

    Lan, R; Yang, C; Lan, L; Ou, J; Qiao, K; Liu, F; Gao, Q

    2011-12-01

    Tuberculosis (TB) remains the leading cause of death among human immunodeficiency virus (HIV) infected persons. The prevalence of infection with Mycobacterium tuberculosis and non-tuberculous mycobacteria (NTM) in HIV-infected patients in China is unknown. To estimate the prevalence of M. tuberculosis and NTM in HIV-infected patients in Guangxi Province, determine their drug resistance profiles, and evaluate the genotype patterns of M. tuberculosis strains. Samples were collected from two HIV designated hospitals in Guangxi Province between 2005 and 2008. HIV-infected patients who were culture-positive for mycobacteria were included. Drug susceptibility testing was performed for mycobacterial isolates. NTM species was identified by sequencing, and M. tuberculosis isolates were genotyped using the variable number of tandem repeats method. M. tuberculosis and NTM were identified in respectively 117 (53%) and 102 (47%) HIV-infected patients. Drug resistance was found in 27% and multi-drug-resistant TB (MDR-TB) in 11% of the patients with TB. Previous treatment for TB was significantly associated with MDR-TB. Twenty (17%) TB patients belonged to eight VNTR-defined clusters. The high frequency of NTM among HIV-infected patients raises concerns about accurate species identification before the determination of appropriate treatment. The potential for TB transmission exists among HIV-infected patients. Intensified screening and effective treatment of TB-HIV co-infected patients is urgently needed.

  11. The effect of different combination therapies on oxidative stress markers in HIV infected patients in cameroon

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    Etame Lucten

    2006-07-01

    Full Text Available Abstract The study assessed the effect of some highly active antiretroviral therapies (HAART, used in the management of HIV/AIDS in Cameroon, on oxidative stress markers such as malondialdehyde (as TBARs, albumin, protein carbonyl content and protein sulfhydryls groups. 85 HIV positive patients (34.8 ± 9.3 years were on three different highly active antiretroviral therapies (HAART patients. 65 HIV positive patients (32.2 ± 10.9 years on no treatment (Pre-HAART patients, and 90 non-HIV infected patients (32.6 ± 9.3 years, were the control groups. Plasma TBARs as well as carbonyl levels were significantly higher in HIV patients on HAART compared to pre-HAART patients or non-HIV infected controls. On the other hand, the protein sulfhydryl group content was not different for patients on HAART compared to pre-HAART patients, but both were significantly lower than non-HIV infected controls (P HIV infection therefore increases the oxidative stress process, while antiretroviral combination therapy increased protein oxidation as well as the level of oxidative stress already present in HIV infection.

  12. High prevalence and low cure rate of tuberculosis among patients with HIV in Xinjiang, China.

    Science.gov (United States)

    Maimaiti, Rena; Zhang, Yuexin; Pan, Kejun; Mijiti, Peierdun; Wubili, Maimaitiali; Musa, Maimaitijiang; Andersson, Rune

    2017-01-05

    Tuberculosis and HIV co-epidemics are problems in many parts of the world. Xinjiang is a high tuberculosis and HIV prevalence area in China. We aimed to investigate the prevalence and cure rate of tuberculosis among HIV positive patients in Xinjiang. In a retrospective study between 2006 and 2011, clinical and laboratory data on 333 patients with HIV and tuberculosis were compared to 2668 patients with HIV only. There were 31 HIV positive patients with no data on tuberculosis. The prevalence of tuberculosis co-infection among the HIV positive patients was 11% (95% CI 10-12%), significantly higher than the national figure in China of 2%. In most cases HIV was diagnosed late, with advanced immunodeficiency. The use of isoniazid preventive therapy was only 57.9% in patients without tuberculosis who fulfilled the criteria for receiving this prevention. The cure rate one year after diagnosis was 69.2%, which was lower than the officially reported 91.4% in all tuberculosis cases in Xinjiang in 2011. The hazard of not surviving over the five years was significantly higher in patients with HIV + tuberculosis compared to HIV only after adjusting for sex and Intravenous drug use with HR = 1.84 (95% CI 1.43-2.35; p prevalence of tuberculosis among HIV positive patients in Xinjiang was higher than in China taken as a whole, and HIV was diagnosed late, with underuse of isoniazid preventive therapy. The low cure rate and reduced survival can be due to late diagnosis of HIV and no testing for antibiotic resistance, together with insufficient control of adherence to the treatment regimens for tuberculosis and HIV.

  13. Parthenium dermatitis in a HIV patient

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    Shanmuga Sekar

    2009-01-01

    Full Text Available Parthenium dermatitis is a distressing problem in India. Both type 1 (immediate and late phase reaction and type 4 hypersensitivity phenomenon play a role in pathogenesis. We prick tested the patient after administering various drugs to assess the best agent to prevent late phase reaction.

  14. Mortality in siblings of patients coinfected with HIV and hepatitis C virus

    DEFF Research Database (Denmark)

    Hansen, Ann-Brit Eg; Gerstoft, Jan; Kronborg, Gitte

    2007-01-01

    BACKGROUND: Coinfection with hepatitis C virus (HCV) is a poor prognostic factor for human immunodeficiency virus (HIV)-infected patients. We examined whether the increased mortality in these patients is partly explained by a familial excess risk of death. METHODS: Danish HIV-infected patients who...

  15. Can socio-economic differences explain low expectation of health services among HIV patients compared to non-HIV counterparts?

    Directory of Open Access Journals (Sweden)

    Jing Li

    2016-09-01

    Full Text Available Abstract Background The health service of China has encountered significant challenges due to inequalities in socio-economic determinants of health. HIV patients are known to suffer from social stigma, and may receive inadequate responsiveness from health providers. Before assessing the responsiveness they receive, it is important to know their expectations. We aimed to compare levels of expectation towards the healthcare service among HIV and non-HIV patients with adjustment for socio-economic factors. Methods A cross-sectional study was conducted during January and February, 2015 among two consecutive groups of HIV positive and non-HIV patients in two hospitals in Kunming, China. Patients’ expectation towards eight domains of health system responsiveness was measured using 40 vignettes; five per domain. Each vignette was ranked from 1 “very good” to 5 “very bad”, and the responses were summed to obtain a total score for each domain. Differences in total scores were compared between the two groups and adjusted for other factors using multiple linear regression. Results The three domains with the highest scores, reflecting high expectation, were prompt attention, basic amenities and choice. Adjusted for other factors, HIV patients had significantly lower levels of expectation in all domains compared to the non-HIV group. Age was associated with the basic amenities domain, with young adults having higher expectations than other age groups. Minority ethnic groups had lower expectation towards dignity, prompt attention and autonomy domains compared to Han ethnicity. Those who lived in a home with 2–4 family members had higher expectations towards confidentiality than those who lived alone. Conclusion Patients with HIV have significantly lower levels of expectations even after adjusting for socio-economic factors. Assessment of health system responsiveness based on their judgments above may give biased results toward favorable service

  16. What are the reasons for poor uptake of HIV testing among patients with TB in an Eastern India District?

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    Bipra Bishnu

    Full Text Available BACKGROUND: National policy in India recommends HIV testing of all patients with TB. In West Bengal state, only 28% of patients with TB were tested for HIV between April-June, 2010. We conducted a cross-sectional survey to understand patient, provider and health system related factors associated with low uptake of HIV testing among patients with TB. METHODS: We reviewed TB and HIV program records to assess the HIV testing status of patients registered for anti-TB treatment from July-September 2010 in South-24-Parganas district, West Bengal, assessed availability of HIV testing kits and interviewed a random sample of patients with TB and providers. RESULTS: Among 1633 patients with TB with unknown HIV status at the time of diagnosis, 435 (26% were tested for HIV within the intensive phase of TB treatment. Patients diagnosed with and treated for TB at facilities with co-located HIV testing services were more likely to get tested for HIV than at facilities without [RR = 1.27, (95% CI 1.20-3.35]. Among 169 patients interviewed, 67 reported they were referred for HIV testing, among whom 47 were tested. During interviews, providers attributed the low proportion of patients with TB being referred and tested for HIV to inadequate knowledge among providers about the national policy, belief that patients will not test for HIV even if they are referred, shortage of HIV testing kits, and inadequate supervision by both programs. DISCUSSION: In West Bengal, poor uptake of HIV testing among patients with TB was associated with absence of HIV testing services at sites providing TB care services and to poor referral practices among providers. Comprehensive strategies to change providers' beliefs and practices, decentralization of HIV testing to all TB care centers, and improved HIV test kit supply chain management may increase the proportion of patients with TB who are tested for HIV.

  17. What are the reasons for poor uptake of HIV testing among patients with TB in an Eastern India District?

    Science.gov (United States)

    Bishnu, Bipra; Bhaduri, Sudipto; Kumar, Ajay M V; Click, Eleanor S; Chadha, Vineet Kumar; Satyanarayana, Srinath; Nair, Sreenivas Achutan; Gupta, Devesh; Ahmed, Quazi T; Sarkar, Silajit; Paul, Durba; Dewan, Puneet

    2013-01-01

    National policy in India recommends HIV testing of all patients with TB. In West Bengal state, only 28% of patients with TB were tested for HIV between April-June, 2010. We conducted a cross-sectional survey to understand patient, provider and health system related factors associated with low uptake of HIV testing among patients with TB. We reviewed TB and HIV program records to assess the HIV testing status of patients registered for anti-TB treatment from July-September 2010 in South-24-Parganas district, West Bengal, assessed availability of HIV testing kits and interviewed a random sample of patients with TB and providers. Among 1633 patients with TB with unknown HIV status at the time of diagnosis, 435 (26%) were tested for HIV within the intensive phase of TB treatment. Patients diagnosed with and treated for TB at facilities with co-located HIV testing services were more likely to get tested for HIV than at facilities without [RR = 1.27, (95% CI 1.20-3.35)]. Among 169 patients interviewed, 67 reported they were referred for HIV testing, among whom 47 were tested. During interviews, providers attributed the low proportion of patients with TB being referred and tested for HIV to inadequate knowledge among providers about the national policy, belief that patients will not test for HIV even if they are referred, shortage of HIV testing kits, and inadequate supervision by both programs. In West Bengal, poor uptake of HIV testing among patients with TB was associated with absence of HIV testing services at sites providing TB care services and to poor referral practices among providers. Comprehensive strategies to change providers' beliefs and practices, decentralization of HIV testing to all TB care centers, and improved HIV test kit supply chain management may increase the proportion of patients with TB who are tested for HIV.

  18. Adequacy of Mental Health Services for HIV-Positive Patients with Depression: Ontario HIV Treatment Network Cohort Study.

    Science.gov (United States)

    Choi, Stephanie K Y; Boyle, Eleanor; Cairney, John; Gardner, Sandra; Collins, Evan J; Bacon, Jean; Rourke, Sean B

    2016-01-01

    Major depression can profoundly impact clinical and quality-of-life outcomes of people living with HIV, and this disease is underdiagnosed and undertreated in many HIV-positive individuals. Here, we describe the prevalence of publicly funded primary and secondary mental health service use and antidepressant use, as well as mental health care for depression in accordance with existing Canadian guidelines for HIV-positive patients with depression in Ontario, Canada. We conducted a prospective cohort study linking data from the Ontario HIV Treatment Network Cohort Study with administrative health databases in the province of Ontario, Canada. Current depression was assessed using the Center for Epidemiologic Depression Scale or the Kessler Psychological Distress Scale. Multivariable regressions were used to characterize prevalence outcomes. Of 990 HIV-positive patients with depression, 493 (50%) patients used mental health services; 182 (18%) used primary services (general practitioners); 176 (18%) used secondary services (psychiatrists); and 135 (14%) used both. Antidepressants were used by 407 (39%) patients. Patients who identified as gay, lesbian, or bisexual, as having low income or educational attainment, or as non-native English speakers or immigrants to Canada were less likely to obtain care. Of 493 patients using mental health services, 250 (51%) received mental health care for depression in accordance with existing Canadian guidelines. Our results showed gaps in delivering publicly funded mental health services to depressed HIV-positive patients and identified unequal access to these services, particularly among vulnerable groups. More effective mental health policies and better access to mental health services are required to address HIV-positive patient needs and reduce depression's impact on their lives.

  19. Contribution of HIV infection to mortality among cancer patients in Uganda

    Science.gov (United States)

    Coghill, Anna E.; Newcomb, Polly A.; Madeleine, Margaret M.; Richardson, Barbra A.; Mutyaba, Innocent; Okuku, Fred; Phipps, Warren; Wabinga, Henry; Orem, Jackson; Casper, Corey

    2015-01-01

    Objective HIV infection is associated with cancer risk. This relationship has resulted in a growing cancer burden, especially in resource-limited countries where HIV is highly prevalent. Little is known, however, about how HIV affects cancer survival in these settings. We therefore investigated the role of HIV in cancer survival in Uganda. Design Retrospective cohort (N = 802). Methods Eligible cancer patients were residents of Kyadondo County, at least 18 years of age at cancer diagnosis, and diagnosed between 2003 and 2010 with one of the following: breast cancer, cervical cancer, non-Hodgkin’s lymphoma, Hodgkin’s lymphoma, or esophageal cancer. Patients were classified as HIV-infected at cancer diagnosis based on a documented positive HIV antibody test, medical history indicating HIV infection, or an HIV clinic referral letter. The primary outcome, vital status at 1 year following cancer diagnosis, was abstracted from the medical record or determined through linkage to the national hospice database. The risk of death during the year after cancer diagnosis was compared between cancer patients with and without evidence of HIV infection using Cox proportional hazards regression. Results HIV-infected cancer patients in Uganda experienced a more than two-fold increased risk of death during the year following cancer diagnosis compared to HIV-uninfected cancer patients [hazard ratio 2.28; 95% confidence interval (CI) 1.61–3.23]. This association between HIV and 1-year cancer survival was observed for both cancers with (hazard ratio 1.56; 95% CI 1.04–2.34) and without (hazard ratio 2.68; 95% CI 1.20–5.99) an infectious cause. Conclusion This study demonstrates the role of HIV in cancer survival for both cancers with and without an infectious cause in a resource-limited, HIV-endemic setting. PMID:23921614

  20. Estomatologic manifestations in HIV/AIDS patients

    OpenAIRE

    Garibay Rodríguez, Lorena Elvira; CD. Práctica privada.; Cisneros Zárate, Luis; Departamento Académico Médico Quirúrgico. Facultad de Odontología, UNMSM.

    2014-01-01

    The study was carried out at Hospital Nacional Guillermo Almenara Irigoyen, on 128 patients infected by the human inmunodefense virus. The aim of the investigation was to study the frecuency, and location of oral lesions, in relation with age and sex, also to establish the relationship between CD4 cells counts with oral lesions detected. The sample were selected in a probabilistic way; the data was recorded in a special designed format. 74 subjects of the sample were male and 57 female. Oral ...

  1. CLINICAL AND LABORATORY PROFILE OF SPUTUM POSITIVE PULMONARY TUBERCULOSIS AMONG HIV SEROPOSITIVE AND HIV SERONEGATIVE PATIENTS- A CROSS-SECTIONAL STUDY

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    Amit Govind Kamat

    2017-05-01

    Full Text Available BACKGROUND The global impact of the converging dual epidemics of TB and HIV is one of the major public health challenges. The increasing rate of HIV infection in many countries has had an impact on TB epidemiology. As the prevalence of pulmonary tuberculosis is increasing among HIV seropositive patients with a wide range of immune status and clinical presentations, the present study was undertaken to assess the clinical and laboratory profile of sputum positive pulmonary tuberculosis among HIV seropositive and HIV seronegative patients. MATERIALS AND METHODS The present one year cross-sectional study was conducted in the Department of Medicine, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum on 104 patients with sputum positive pulmonary tuberculosis patients during the period of January 2009 to December 2009. Routine investigations such as blood group, haemogram that is haemoglobin, total count, differential count, erythrocyte sedimentation rate, sputum smears for AFB and chest x-ray were done. RESULTS Seroprevalence of HIV among pulmonary tuberculosis patients was 23.08%. On examination anaemia, undernourishment, lymphadenopathy and the presence of opportunistic infections like oral candidiasis, herpes zoster stain and genital lesions were more predominant among HIV seropositives compared to HIV seronegatives. Mean Hb and TLC were significantly low among HIV seropositives compared to HIV seronegatives. Chest x-ray showed varied presentation. Upper zone infiltration, cavitation and fibrosis were more commonly involved among HIV seronegatives compared to HIV seropositives. CONCLUSION HIV seropositive PTB patients commonly present with fever, weight loss and loss of appetite, while cough with expectoration, haemoptysis, breathlessness were more common with HIV seronegative patients. Cavitation, fibrosis and fibrocavitary lesions were predominantly seen among HIV seronegatives, while infiltration and miliary mottling was

  2. A CASE OF RENAL DISEASE IN HIV INFECTED PATIENT

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    Ni Made Vina Septiani

    2013-11-01

    Full Text Available Normal 0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4 Kidney diseases in human immunodeficiency virus (HIV infected patients has been been fourth leading cause of death after sepsis, pneumonia, and liver disease. HIV-associated nephropathy (HIVAN is the most common. We report a case, a male patient, 48 years, who experienced shortness of breath, cough and intermittent fever and has been reported as HIV positive, without previous antiretroviral treatment and last CD4+ count is 89 cells/mm3. There are elevated BUN and SC from day to day during treatment and proteinuria +2 as a sign of kidney disease with normal blood pressure and there was no edema. Patients given an antibiotic and ACE inhibitors as antiproteinuria. Patients with suspicion of HIVAN in this case can progress very rapidly and causes progressive decline in renal function. Prognosis of patients with HIVAN if not handled properly will develop end stage renal disease (ESRD in 1-4 months and had a mortality rate 4.7 times higher than HIV patients without renal impairment. /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

  3. HIV and anaesthesia

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    S Parthasarathy

    2007-01-01

    Full Text Available The pandemic of AIDS (Acquired Immuno Deficiency Syndrome is virtually creating a panic among health workers which include and medical and paramedical staff. Out of the global 40 million Human immunodeficiency virus (HIV infections, an estimated 5.2 millions are in India. With the advancement of the management techniques, the life span of infected patients is on the increase so that more patients will come for surgical procedures in the future. There is little information on the risk of anaesthesia in HIV infected patients. A detailed preoperative examination and investigations to unmask multisystem disorders caused either by HIV or drugs is essential. General anaesthesia is acceptable but drug interactions and multisystem disease caused by HIV should be considered preoperatively. Regional anaesthesia is safe but one must take into consideration the presence of local infections, bleeding problems and neuropathies. Routine preoperative testing for HIV is acceptable but strict adherence to universal precautions is mandatory.

  4. Characterization of Candida albicans isolates from the oral cavity of HIV-positive patients.

    Science.gov (United States)

    Woldeamanuel, Y; Abate, D

    1998-10-01

    Characterization of Candida albicans isolates from the oral cavity of Ethiopian Human Immunodeficiency Virus (HIV)-positive patients and HIV-negative individuals was undertaken. After identification of isolates using conventional methods and determination of carbohydrate assimilation profiles, serotyping was performed by slide agglutination with the Iatron IF6 serotyping system. Sensitivity of the isolates to 5-Fluorocytosine (5-FC) was assessed using the broth macrodilution method. There was no difference in phenotype, by any of the three methods used, between the HIV-positive and HIV-negative individuals. Serotype A was found to be dominant in strains isolated from both HIV-positive (34/40 = 85%) and HIV-negative (17/20 = 85%) study subjects. These data suggest that the C. albicans strains causing oral candidiasis in patients with HIV infection are identical to the commensal ones found in healthy individuals.

  5. Design Considerations for Post-Acute Care mHealth: Patient Perspectives.

    Science.gov (United States)

    Sanger, Patrick; Hartzler, Andrea; Lober, William B; Evans, Heather L; Pratt, Wanda

    2014-01-01

    Many current mobile health applications ("apps") and most previous research have been directed at management of chronic illnesses. However, little is known about patient preferences and design considerations for apps intended to help in a post-acute setting. Our team is developing an mHealth platform to engage patients in wound tracking to identify and manage surgical site infections (SSI) after hospital discharge. Post-discharge SSIs are a major source of morbidity and expense, and occur at a critical care transition when patients are physically and emotionally stressed. Through interviews with surgical patients who experienced SSI, we derived design considerations for such a post-acute care app. Key design qualities include: meeting basic accessibility, usability and security needs; encouraging patient-centeredness; facilitating better, more predictable communication; and supporting personalized management by providers. We illustrate our application of these guiding design considerations and propose a new framework for mHealth design based on illness duration and intensity.

  6. Social stigma and knowledge of tuberculosis and HIV among patients with both diseases in Thailand.

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    Sirinapha X Jittimanee

    Full Text Available INTRODUCTION: Disease-related stigma and knowledge are believed to be associated with patients' willingness to seek treatment and adherence to treatment. HIV-associated tuberculosis (TB presents unique challenges, because TB and HIV are both medically complex and stigmatizing diseases. In Thailand, we assessed knowledge and beliefs about these diseases among HIV-infected TB patients. METHODS: We prospectively interviewed and examined HIV-infected TB patients from three provinces and one national referral hospital in Thailand from 2005-2006. At the beginning of TB treatment, we asked patients standardized questions about TB stigma, TB knowledge, and HIV knowledge. Responses were grouped into scores; scores equal to or greater than the median score of study population were considered high. Multiple logistic regression analysis was used to identify factors associated with scores. RESULTS: Of 769 patients enrolled, 500 (65% reported high TB stigma, 177 (23% low TB knowledge, and 379 (49% low HIV knowledge. Patients reporting high TB stigma were more likely to have taken antibiotics before TB treatment, to have first visited a traditional healer or private provider, to not know that monogamy can reduce the risk of acquiring HIV infection, and to have been hospitalized at enrollment. Patients with low TB knowledge were more likely to have severe TB disease, to be hospitalized at enrollment, to be treated at the national infectious diseases referral hospital, and to have low HIV knowledge. Patients with low HIV knowledge were more likely to know a TB patient and to have low TB knowledge. DISCUSSION: We found that stigma and low disease-specific knowledge were common among HIV-infected TB patients and associated with similar factors. Further research is needed to determine whether reducing stigma and increasing TB and HIV knowledge among the general community and patients reduces diagnostic delay and improves patient outcomes.

  7. HIV patients' willingness to share personal health information electronically.

    Science.gov (United States)

    Teixeira, Paul A; Gordon, Peter; Camhi, Eli; Bakken, Suzanne

    2011-08-01

    To assess the attitudes of persons living with HIV/AIDS (PLWH) towards having their personal health information (PHI) stored and shared electronically. PLWH (n = 93) in New York City completed surveys using audio computer-assisted self-interview (ACASI) that assessed willingness to share their PHI with various people and entities via a secure electronic network. The survey also included questions on satisfaction with and trust of health care providers, current health, HIV-associated stigma, and frequency of internet access. Data were analyzed with descriptive and multivariate statistical methods. The majority (84%) of individuals were willing to share their PHI with clinicians involved in their care. Fewer individuals (39%) were as willing to share with non-clinical staff. Willingness to share PHI was positively associated with trust and respect of clinicians. PLWH accepted clinicians' need for access to accurate information. Patients' trust in their primary care providers highlights the importance of the clinician-patient relationship which can be used to engage patients support for health information exchange initiatives. As electronic storage and sharing of PHI is increasing, clinicians and PLWH should discuss patients' attitudes towards sharing PHI electronically. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  8. Lipidomic dataset of plasma from patients infected with wild type and nef-deficient HIV-1 strain

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    Peter Meikle

    2016-03-01

    Full Text Available Previous in vitro and in vivo studies demonstrated that HIV protein nef plays a key role in impairing cellular and systemic cholesterol metabolism in HIV disease, but clinical support for these findings is lacking. Here we present the data of comparative lipidomic analysis (330 lipid species of plasma samples from HIV-negative subjects, patients infected with WT HIV-1 strain and patients infected with nef-deficient strain of HIV-1. We determine which effects of HIV on plasma lipidome are explained by the presence of nef. The data can be used to evaluate cardiovascular risk in HIV disease and to assess the role of nef in HIV-induced disturbances in systemic lipid metabolism. The full impact of nef deficiency on lipid and lipoprotein metabolism in HIV-infected patients is presented in the accompanying study “Lipid Metabolism in Patients Infected with Nef-deficient HIV-1 Strain” [1].

  9. A cohort pilot study on HIV-associated neuropsychological impairments in haemophilia patients

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    Silvia eRiva

    2015-06-01

    Full Text Available Despite advances in the management of HIV infection with the introduction of combination antiretroviral therapy (cART, it is well known that HIV can directly infect the central nervous system (CNS and, as a result of such infection, neuropsychological impairments can be manifested. In this study we tried to determine whether seropositivity was associated with a poor neuropsychological performance in patients with hemophilia and HIV. Such a cohort of patients is very often underrepresented and understudied in the HIV literature. To amend such a gap, we carried out an extensive neuropsychological evaluation on these patients, and compared their performance with that of a group of seronegative hemophilia patients. The results revealed that HIV infection in HIV seropositive (HIV+ hemophilia patients was associated with deficits in attention, short-term memory, abstraction and visual recognition. Such results are still preliminary and explorative due to the small cohort of patients enrolled. However, the results do seem to have some important implications for day-to-day functioning, as the level of impairment detected may cause difficulties in completing common everyday tasks such as maintaining adherence to complex medication regimens, or maintaining social life activities. Continued research into the mechanisms related to HIV and neurocognitive dysfunction may provide targets for interventions that could have meaningful consequences in the real world for HIV hemophilia patients.

  10. Effciency of HIV-infected patients detection in neurological hospitals of large industrial center

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    Shmelev V.V.

    2012-06-01

    Full Text Available

    Aim of the study: to evaluate the effciency of detection for HIV-infection in patients of neurological departments of Saratov. Materials and methods. We retrospectively analyzed 25 250 medical histories of patients hospitalized into neurological departments of Saratov hospitals between January 2007 and April 2012. Results. Blood samples of 2010 patients (7,96 % were tested for the presence of HIV-antibodies. 37 patients were HIV-positive (1,84 % of examined patients and 0,15 % of the total number of patients. Conclusion. Increasing popularity and variety of clinical manifestations of HIV-infection requires the expansion of neurological patients whom serum test for antibodies against HIV is needed.

  11. Barriers for introducing HIV testing among tuberculosis patients in Jogjakarta, Indonesia: a qualitative study.

    Science.gov (United States)

    Mahendradhata, Yodi; Ahmad, Riris Andono; Lefèvre, Pierre; Boelaert, Marleen; Van der Stuyft, Patrick

    2008-11-12

    HIV and HIV-TB co-infection are slowly increasing in Indonesia. WHO recommends HIV testing among TB patients as a key response to the dual HIV-TB epidemic. Concerns over potential negative impacts to TB control and lack of operational clarity have hindered progress. We investigated the barriers and opportunities for introducing HIV testing perceived by TB patients and providers in Jogjakarta, Indonesia. We offered Voluntary Counselling and Testing (VCT) to TB patients in parallel to a HIV prevalence survey. We conducted in-depth interviews with 33 TB patients, 3 specialist physicians and 3 disease control managers. We also conducted 4 Focus Group Discussions (FGDs) with nurses. All interviews and FGDs were recorded and data analysis was supported by the QSR N6 software. Patients' and providers' knowledge regarding HIV was poor. The main barriers perceived by patients were: burden for accessing VCT and fear of knowing the test results. Stigma caused concerns among providers, but did not play much role in patients' attitude towards VCT. The main barriers perceived by providers were communication, patients feeling offended, stigmatization and additional burden. Introduction of HIV testing among TB patients in Indonesia should be accompanied by patient and provider education as well as providing conditions for effective communication.

  12. The innate immune response in HIV/AIDS septic shock patients: a comparative study.

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    Rodrigo T Amancio

    Full Text Available INTRODUCTION: In recent years, the incidence of sepsis has increased in critically ill HIV/AIDS patients, and the presence of severe sepsis emerged as a major determinant of outcomes in this population. The inflammatory response and deregulated cytokine production play key roles in the pathophysiology of sepsis; however, these mechanisms have not been fully characterized in HIV/AIDS septic patients. METHODS: We conducted a prospective cohort study that included HIV/AIDS and non-HIV patients with septic shock. We measured clinical parameters and biomarkers (C-reactive protein and cytokine levels on the first day of septic shock and compared these parameters between HIV/AIDS and non-HIV patients. RESULTS: We included 30 HIV/AIDS septic shock patients and 30 non-HIV septic shock patients. The HIV/AIDS patients presented low CD4 cell counts (72 [7-268] cells/mm(3, and 17 (57% patients were on HAART before hospital admission. Both groups were similar according to the acute severity scores and hospital mortality. The IL-6, IL-10 and G-CSF levels were associated with hospital mortality in the HIV/AIDS septic group; however, the CRP levels and the surrogates of innate immune activation (cytokines were similar among HIV/AIDS and non-HIV septic patients. Age (odds ratio 1.05, CI 95% 1.02-1.09, p=0.002 and the IL-6 levels (odds ratio 1.00, CI 95% 1.00-1.01, p=0.05 were independent risk factors for hospital mortality. CONCLUSIONS: IL-6, IL-10 and G-CSF are biomarkers that can be used to predict prognosis and outcomes in HIV/AIDS septic patients. Although HIV/AIDS patients are immunocompromised, an innate immune response can be activated in these patients, which is similar to that in the non-HIV septic population. In addition, age and the IL-6 levels are independent risk factors for hospital mortality irrespective of HIV/AIDS disease.

  13. Anal carcinoma in HIV-infected patients in the period 1995-2009

    DEFF Research Database (Denmark)

    Legarth, Rebecca Asbjørn; Helleberg, Marie; Kronborg, Gitte

    2013-01-01

    of anal carcinoma. Methods: We used Poisson regression to estimate the incidence rate ratios (IRR) of anal carcinoma in (1) a population of HIV patients identified from the Danish HIV Cohort Study (n = 4993) compared with a population control cohort matched on age and gender (n = 59,916) for the period...... 1995-2009, and (2) parents of HIV patients compared with parents of controls for the period 1978-2009. Cancer diagnoses were identified from The Danish Cancer Registry. We further estimated the mortality rate ratios (MRR) of HIV patients compared with controls after the diagnosis of anal carcinoma...

  14. Genetic variability of Candida albicans in HIV/AIDS patient with and without ARV therapy and non HIV/AIDS

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    Retno Puji Rahayu

    2012-03-01

    Full Text Available Background: Oral candidiasis is the mostly found oral manifestation in HIV/AIDS infected patient caused by immunocompromised especially immunodeficiency. Clinical symptoms is severe pain in oral cavity and dry mouth because of xerostomia which cause the loss of appetite. Candida albicans (C. albicans is normal flora in oral cavity which plays as opportunistic pathogen and also the cause of oral candidiasis. Almost 90% of HIV–infected patient have oral candidiasis. This condition is clinical problem which has not been well-managed yet. C. albicans colonized oral mucous cavity has different genetic variability for each strain. Phenotype of C. albicans has been determined by genetic factor and environtment. This condition stimulate differences of genotype among various strain of C. albicans in the world. Purpose: The purpose of this research is to analyze the genetic variability of C.albicans which colonized in the mucous oral cavity of HIV/AIDS patient in Surabaya in the treatment with and without ARV therapy and non HIV/AIDS. Methods: This research has been identify and characterize the prevalent strain of C. albicans isolat in Surabaya (East Java in HIV/AIDS infected patient with oral candidiasis by method of Iatron candidal check. The highlight of this research including cytology examination by Papanicoloau staining, C. albicans culture, spheroplast making, DNA isolation and genetic variability checking by randomly amplyfied polymorphism DNA (RAPD. Results: C. albicans colonizing oral mucosa of non-HIV patients had a predisposition of farther genetic relationship (genetic distance of 0.452 with C. albicans colonizing oral mucosa of HIV ARV and HIV non-ARV patients. The genetic distance was ranging between 0 and 1, where 9 was long genetic distance and 1 was short genetic distance. In contrast, C. albicans colonizing oral mucosa of HIV ARV have predisposition of closer genetic relationship (genetic distance of 0.762 with C. albicans colonizing

  15. Spirituality and religion in patients with HIV/AIDS.

    Science.gov (United States)

    Cotton, Sian; Puchalski, Christina M; Sherman, Susan N; Mrus, Joseph M; Peterman, Amy H; Feinberg, Judith; Pargament, Kenneth I; Justice, Amy C; Leonard, Anthony C; Tsevat, Joel

    2006-12-01

    Spirituality and religion are often central issues for patients dealing with chronic illness. The purpose of this study is to characterize spirituality/religion in a large and diverse sample of patients with HIV/AIDS by using several measures of spirituality/religion, to examine associations between spirituality/religion and a number of demographic, clinical, and psychosocial variables, and to assess changes in levels of spirituality over 12 to 18 months. We interviewed 450 patients from 4 clinical sites. Spirituality/religion was assessed by using 8 measures: the Functional Assessment of Chronic Illness Therapy-Spirituality-Expanded scale (meaning/peace, faith, and overall spirituality); the Duke Religion Index (organized and nonorganized religious activities, and intrinsic religiosity); and the Brief RCOPE scale (positive and negative religious coping). Covariates included demographics and clinical characteristics, HIV symptoms, health status, social support, self-esteem, optimism, and depressive symptoms. The patients' mean (SD) age was 43.3 (8.4) years; 387 (86%) were male; 246 (55%) were minorities; and 358 (80%) indicated a specific religious preference. Ninety-five (23%) participants attended religious services weekly, and 143 (32%) engaged in prayer or meditation at least daily. Three hundred thirty-nine (75%) patients said that their illness had strengthened their faith at least a little, and patients used positive religious coping strategies (e.g., sought God's love and care) more often than negative ones (e.g., wondered whether God has abandoned me; Pspirituality/religion included ethnic and racial minority status, greater optimism, less alcohol use, having a religion, greater self-esteem, greater life satisfaction, and lower overall functioning (R2=.16 to .74). Mean levels of spirituality did not change significantly over 12 to 18 months. Most patients with HIV/AIDS belonged to an organized religion and use their religion to cope with their illness

  16. Treating depression in HIV-positive patients affects adherence

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    M Y H Moosa

    2012-09-01

    Full Text Available Aim. To determine changes in adherence to antiretroviral therapy (ART in HIV-positive patients with depression, following treatment with an antidepressant or psychotherapy. Methods. The study was prospective, randomised and controlled. Consenting volunteers aged ≥18 years and stable on ART for ≥6 months were included in the study. Sociodemographic data were obtained, and a clinical diagnostic evaluation and the Hamilton Depression rating scale (HAMD were performed on all subjects at entry to and at the end of the study. Participants found to be depressed were randomly assigned antidepressant treatment (20 mg citalopram or interpersonal psychotherapy (IPT (5 sessions. Medication was dispensed at each visit and patients were asked to return all unused medication to determine ART adherence. The study was approved by the University of the Witwatersrand. Results. Sixty-two HIV-positive persons receiving ART participated; 30 were not depressed (control group and 32 were depressed (patient group. No significant differences in demographic characteristics existed between the control and patient groups. Mean ART adherence at the start of the study was 99.5% (standard error (SE ±0.46 and 92.1% (SE ±1.69 in the control and patients groups, respectively. Mean ART adherence at the end of the study changed marginally in the control group (99.7%; SE ±0.46 and increased significantly in the patient group (99.5%; SE± 0.13 (p>0.05. The mean ART adherence rate of patients who received pharmacotherapy increased from 92.8% to 99.5%, and of those who received psychotherapy increased from 91.1% to 99.6% (p>0.05. There was no significant association between the increased adherence in the patient group and baseline demographic and clinical characteristics, irrespective of antidepressant therapy or IPT (p>0.05. Conclusion. Successful treatment of depression with an antidepressant or psychotherapy was associated with improved ART adherence, independent of the type

  17. High frequency of diarrheagenic Escherichia coli in human immunodeficiency virus (HIV) patients with and without diarrhea in Lima, Peru.

    Science.gov (United States)

    Garcia, Coralith; Chincha, Omayra; Leon, Mey; Iglesias, David; Barletta, Francesca; Mercado, Erik; Ochoa, Theresa

    2010-06-01

    Diarrhea is still a prevalent health issue in HIV patients. Our objective was to characterize the different diarrheagenic E. coli (DEC) groups in stools from adult HIV patients. Cross sectional study: We enrolled HIV-positive and -negative patients with and without diarrhea from a tertiary-care center of Lima, Peru. Clinical data was recorded and a stool sample per patient was cultured. Multiplex PCR was used to detect different DECs. One hundred eighty-four participants were enrolled. The frequency of having at least one DEC was more common in HIV-positive than HIV-negative patients with diarrhea (42% versus 20%, P < 0.05). The enterotoxigenic E. coli (ETEC) was the most common DEC in patients with diarrhea, 13% in HIV patients. The diffusely adherent E. coli (DAEC) was only present in HIV positive patients with diarrhea (10.1%). Different types of DEC are frequent in stools from HIV-positive patients.

  18. Routine HIV Testing of Family Members of Hospitalized Patients in Nigeria

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    Olusegun Busari

    2012-04-01

    Full Text Available Background: HIV testing for family members of HIV-positive patients may enhance disclosure of status of spouses, encourage family social support and improve access to HIV services. Objective was to employ the approach of routine HIV testing to determine the prevalence of HIV among family members of both HIV positive and negative patients on admission in a federal HIV treatment designated hospital in Western Nigeria Methodology: This prospective study was conducted between January 2006 and June 2009. Ethical clearance was obtained from the Research and Ethics committee of the hospital prior to the study. Informed consent was obtained from each participant. HIV testing was offered to consenting family members of HIV positive and negative patients on admission. The family members included spouses, children of patients, parents of paediatric patients and other family members. Analysis was done in frequencies and percentages Results: 162 family members of 184 patients were tested. Spouses were, 81 (50.0%; fathers, 14 (8.6%; mothers, 20 (12.3%; children, 19 (11.7% and others family members, 28 (17.3%. 151 (93.2% of testers were first timers. Majority of those tested (82.1% had post-test counseling. The overall HIV prevalence was 12.3% (20/162. HIV prevalence within different family members was 14.8% (12/81, 20% (4/20, 7.1% (1/14, 10.5% (2/19 and 3.6% (1/28 for spouses, mothers, fathers, children and others respectively.In addition, the prevalence of HIV among family members of HIV positive and negative patients was 15.6% (14/90 and 8.3% (6/72 respectively. Of 12 spouses that were positive, 7 (13.5% were HIV-discordant; and in 71.4% (5/7 of discordant couples, the spouse was positive while the patient on admission was negative. Conclusion: The results indicate that routine HIV testing of family members of patients on admission is a strategy for identification of vast number of HIV infected persons. This method is not only innovative, but also a novel

  19. Symptom Status Predicts Patient Outcomes in Persons with HIV and Comorbid Liver Disease

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    Wendy A. Henderson

    2012-01-01

    Full Text Available Persons living with human immunodeficiency virus (HIV are living longer; therefore, they are more likely to suffer significant morbidity due to potentially treatable liver diseases. Clinical evidence suggests that the growing number of individuals living with HIV and liver disease may have a poorer health-related quality of life (HRQOL than persons living with HIV who do not have comorbid liver disease. Thus, this study examined the multiple components of HRQOL by testing Wilson and Cleary’s model in a sample of 532 individuals (305 persons with HIV and 227 persons living with HIV and liver disease using structural equation modeling. The model components include biological/physiological factors (HIV viral load, CD4 counts, symptom status (Beck Depression Inventory II and the Medical Outcomes Study HIV Health Survey (MOS-HIV mental function, functional status (missed appointments and MOS-HIV physical function, general health perceptions (perceived burden visual analogue scale and MOS-HIV health transition, and overall quality of life (QOL (Satisfaction with Life Scale and MOS-HIV overall QOL. The Wilson and Cleary model was found to be useful in linking clinical indicators to patient-related outcomes. The findings provide the foundation for development and future testing of targeted biobehavioral nursing interventions to improve HRQOL in persons living with HIV and liver disease.

  20. Routine HIV testing among hospitalized patients in Argentina. is it time for a policy change?

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    María Eugenia Socías

    Full Text Available INTRODUCTION: The Argentinean AIDS Program estimates that 110,000 persons are living with HIV/AIDS in Argentina. Of those, approximately 40% are unaware of their status, and 30% are diagnosed in advanced stages of immunosuppression. Though studies show that universal HIV screening is cost-effective in settings with HIV prevalence greater than 0.1%, in Argentina, with the exception of antenatal care, HIV testing is always client-initiated. OBJECTIVE: We performed a pilot study to assess the acceptability of a universal HIV screening program among inpatients of an urban public hospital in Buenos Aires. METHODS: Over a six-month period, all eligible adult patients admitted to the internal medicine ward were offered HIV testing. Demographics, uptake rates, reasons for refusal and new HIV diagnoses were analyzed. RESULTS: Of the 350 admissions during this period, 249 were eligible and subsequently enrolled. The enrolled population was relatively old compared to the general population, was balanced on gender, and did not report traditional high risk factors for HIV infection. Only 88 (39% reported prior HIV testing. One hundred and ninety (76% patients accepted HIV testing. In multivariable analysis only younger age (OR 1.02; 95%CI 1.003-1.05 was independently associated with test uptake. Three new HIV diagnoses were made (undiagnosed HIV prevalence: 1.58%; none belonged to a most-at-risk population. CONCLUSIONS: Our findings suggest that universal HIV screening in this setting is acceptable and potentially effective in identifying undiagnosed HIV-infected individuals. If confirmed in a larger study, our findings may inform changes in the Argentinean HIV testing policy.

  1. Routine HIV testing among hospitalized patients in Argentina. is it time for a policy change?

    Science.gov (United States)

    Socías, María Eugenia; Hermida, Laura; Singman, Mariana; Kulgis, Gisela; Díaz Armas, Andrés; Cando, Osvaldo; Sued, Omar; Pérez, Héctor; Hermes, Ricardo; Presas, José Luis; Cahn, Pedro

    2013-01-01

    The Argentinean AIDS Program estimates that 110,000 persons are living with HIV/AIDS in Argentina. Of those, approximately 40% are unaware of their status, and 30% are diagnosed in advanced stages of immunosuppression. Though studies show that universal HIV screening is cost-effective in settings with HIV prevalence greater than 0.1%, in Argentina, with the exception of antenatal care, HIV testing is always client-initiated. We performed a pilot study to assess the acceptability of a universal HIV screening program among inpatients of an urban public hospital in Buenos Aires. Over a six-month period, all eligible adult patients admitted to the internal medicine ward were offered HIV testing. Demographics, uptake rates, reasons for refusal and new HIV diagnoses were analyzed. Of the 350 admissions during this period, 249 were eligible and subsequently enrolled. The enrolled population was relatively old compared to the general population, was balanced on gender, and did not report traditional high risk factors for HIV infection. Only 88 (39%) reported prior HIV testing. One hundred and ninety (76%) patients accepted HIV testing. In multivariable analysis only younger age (OR 1.02; 95%CI 1.003-1.05) was independently associated with test uptake. Three new HIV diagnoses were made (undiagnosed HIV prevalence: 1.58%); none belonged to a most-at-risk population. Our findings suggest that universal HIV screening in this setting is acceptable and potentially effective in identifying undiagnosed HIV-infected individuals. If confirmed in a larger study, our findings may inform changes in the Argentinean HIV testing policy.

  2. [Benefits of routine psychological counselling for patients living with HIV].

    Science.gov (United States)

    Toma, S; Sartori, M; Moayedoddin, B; Weber, K; Toutous Trellu, L; Canuto, A; Calmy, A

    2013-02-13

    Despite improvement of life expectancy of human immunodeficiency virus (HIV) infected people since the implementation of antiretroviral treatment, psychological suffering prevails and needs to be considered as part of the treatment to guarantee its efficiency. Mental disorders and social stigmatization substantially affect patients' quality of life and their adherence to treatment. The article details the benefits of a routine screening for mental disorders within this population, who is often reluctant to consult psychiatric services. The different treatments provided by the Geneva University Hospital (HUG) are introduced. A clinical case report illustrates the relevance of a multidisciplinary care program and the role of the liaison psychiatry in this field.

  3. Periprocedural Considerations During Implantation of ICD In A Patient With Dextrocardia

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    Farid Aliyev

    2010-01-01

    Full Text Available In this case report we present a patient with dextrocardia, who undergone implantation of dual chamber implantable cardioverter-defibrillator (ICD. Here we aimed to underline several specific considerations which must be noted when one considers to implant an ICD in a patient with dextrocardia.

  4. Investigation of Small Bowel Abnormalities in HIV-Infected Patients Using Capsule Endoscopy

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    Eiji Sakai

    2017-01-01

    Full Text Available HIV infection is reportedly associated with an increased permeability of the intestinal epithelium and can cause HIV enteropathy, which occurs independently of opportunistic infections. However, the characteristics of small bowel abnormalities attributable to HIV infection are rarely investigated. In the present study, we assessed the intestinal mucosal changes found in HIV-infected patients and compared them with the mucosa of healthy control subjects using capsule endoscopy (CE. Three of the 27 HIV-infected patients harbored gastrointestinal opportunistic infections and were thus excluded from subsequent analyses. The endoscopic findings of CE in HIV-infected patients were significantly higher than those in control subjects (55% versus 10%, P=0.002; however, most lesions, such as red spots or tiny erosions, were unlikely to cause abdominal symptoms. After validating the efficacy of CE for the diagnosis of villous atrophy, we found that the prevalence of villous atrophy was 54% (13/24 among HIV-infected patients. Interestingly, villous atrophy persisted in patients receiving long-term antiretroviral therapy, though most of them exhibited reconstituted peripheral blood CD4+ T cells. Although we could not draw any conclusions regarding the development of small bowel abnormalities in HIV-infected patients, our results may provide some insight regarding the pathogenesis of HIV enteropathy.

  5. Prevalence, intensity and complications of Microsporidium spores amongst HIV-positive hospital patients in Ilorin, Nigeria

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    Amase Nyamngee

    2013-03-01

    Full Text Available Background: Microsporidiasis, which is of great concern for immunocompromised patients, is poorly studied in developing countries.Objectives: A study was carried out amongst HIV-positive hospital patients and HIV-negative hospital controls in Ilorin, Nigeria, between January 2009 and July 2010 to determine the prevalence and intensity of Microsporidium spores and the complications associated with their presence.Method: Stool samples from 750 HIV-positive patients and 375 HIV-negative patients were studied using the Chromotrope-2R staining technique. Determination of CD4+ count was performed on the Partec Cyflow SL-3 CD4/8 instrument. Intensity of spores was determined by counting the total number of the spores in a 10 μl stained smear of stool. Images were captured with Phenix Microimage Analysis Software and data obtained were analysed using the Statistical Package for the Social Sciences.Results: The prevalence of Microsporidium isolates amongst the HIV-positive hospital patients was significantly higher (42.4% than amongst the HIV-negative controls (19.2%(p < 0.05. The intensity of microsporidial spores amongst HIV-positive hospital patients was also significantly higher than amongst the controls (p < 0.05. However, the difference in the intensity of spores amongst HIV-positive patients who were on antiretroviral therapy(n = 411 and those who were not (n = 339 was not significant (p = 0.236. Microsporidiasis in HIV infection infection was common amongst patients with with low CD4+ counts, diarrhoea, body rashes and cough.Conclusion: Both the prevalence and intensity of Microsporidiasis are high amongst HIV-positive hospital patients; campaigns to promote awareness, prevention and control are required. Laboratory testing for microsporidia in HIV patients should be performed routinely so as to identify the organism for prompt medical attention.

  6. Retrivability in The Danish National Hospital Registry of HIV and hepatitis B and C coinfection diagnoses of patients managed in HIV centers 1995-2004

    DEFF Research Database (Denmark)

    Obel, N.; Reinholdt, H.; Omland, L.H.

    2008-01-01

    ,006 (99%) were registered with HIV in DNHR. Of these, 1,888 (93%) were registered in DNHR within one year of their first positive HIV test. A CD4 or = 100,000 copies/ml and being diagnosed after 1 January 2000, were associated with earlier registration in DNHR, both......BACKGROUND: Hospital-based discharge registries are used increasingly for longitudinal epidemiological studies of HIV. We examined completeness of registration of HIV infections and of chronic hepatitis B (HBV) and hepatitis C (HCV) coinfections in the Danish National Hospital Registry (DNHR......) covering all Danish hospitals. METHODS: The Danish HIV Cohort Study (DHCS) encompasses all HIV-infected patients treated in Danish HIV clinics since 1 January 1995. All 2,033 Danish patients in DHCS diagnosed with HIV-1 during the 10-year period from 1 January 1995 to 31 December 2004 were included...

  7. [Serologic cross-reactions to Leishmania infantum using indirect immunofluorescence in HIV+ and HIV- patients with active tuberculosis].

    Science.gov (United States)

    López-Vélez, R; Turientes, M C; Gómez-Mampaso, E

    1998-03-01

    Clinical presentation of disseminated tuberculosis and visceral leishmaniosis can be very similar, mainly in those infected with HIV, being serology a useful tool in making a differential diagnosis. Cross-reactions of IFAT serodiagnosis of visceral leishmaniosis with other diseases are well known, but few data is available with tuberculosis. Detection of serum antibodies against Leishmania, using a commercial IFAT kit, was attempted in sera of 51 patients with active pulmonar and/or extrapulmonar tuberculosis (25 HIV+ and 26 HIV-). Overall cross-reactions was found in 19.6% patients without significative differences in between 2 groups, but differences in positive serum titres was observed: one at 1/256, three at 1/160, and one at 1/80 dilution, in the HIV+ group, whereas all 5 patients in HIV- group cross-reacted at 1/80 dilution. Recognition of specific leishmanial antigenic bands by serum antibodies of patients with tuberculosis were not clearly defined by Western-blot. IFAT technique for leishmaniosis cross-react in 20% of patients with tuberculosis.

  8. The Effect of GBV-C Infection on CD4 Count and Viral Loads in Patients Infected With HIV

    OpenAIRE

    Hossein Keyvani; Avid Mohammadi; Masoud Sabouri Ghannad; Mahboobeh Hajabdolbaghi

    2012-01-01

    Background: The picture that has emerged from studies investigating HIV infected people with GBV-C viremia is that they have lower plasma HIV viral loads in comparison with HIV-positive people who did not have the GBV-C viremia.Objectives: Since GBV-C HIV coinfection has not been studied in Iran, we have designed a survey to study the outcomes of GBV-C infection on HIV infected individuals.Patients and Methods: We analyzed 78 serum samples from HIV-positive patients in Tehran. The HIV positiv...

  9. Clinical, virological and immunological responses in Danish HIV patients receiving raltegravir as part of a salvage regimen

    DEFF Research Database (Denmark)

    2010-01-01

    Raltegravir is the first integrase inhibitor approved for treatment of HIV-infected patients harboring multiresistant viruses.......Raltegravir is the first integrase inhibitor approved for treatment of HIV-infected patients harboring multiresistant viruses....

  10. Metreleptin Treatment in Patients with Non-HIV Associated Lipodystrophy.

    Science.gov (United States)

    Akinci, Gulcin; Akinci, Baris

    2015-01-01

    Lipodystrophies are a heterogeneous group of disorders characterized by congenital or acquired loss of adipose tissue. Recently, metreleptin, a recombinant human leptin analog, has been approved for the treatment of patients with generalized lipodystrophy. Leptin is an adipokine which has a fundamental role in glucose and lipid homeostasis. Metreleptin treatment has been demonstrated to improve metabolic abnormalities such as hyperglycemia, hypertriglyceridemia, increased hepatic fat content and elevated liver enzymes alanine transaminase and aspartate transaminase in patients with generalized lipodystrophy, and to correct hyperphagia that likely occurs as a result of leptin deficiency. Limited data has also suggested that metreleptin treatment might be beneficial on metabolic abnormalities in patients with partial lipodystrophy. This review focuses on potential benefits of metreleptin in various forms of non-HIV associated lipodystrophy. Safety issues have been discussed. Recent patent submissions have also been reviewed.

  11. Hepatitis C virus coinfection independently increases the risk of cardiovascular disease in HIV-positive patients.

    Science.gov (United States)

    Fernández-Montero, J V; Barreiro, P; de Mendoza, C; Labarga, P; Soriano, V

    2016-01-01

    Patients infected with HIV are at increased risk for cardiovascular disease despite successful antiretroviral therapy. Likewise, chronic hepatitis C virus (HCV) infection is associated with extrahepatic complications, including cardiovascular disease. However the risk of cardiovascular disease has not been formally examined in HIV/HCV-coinfected patients. A retrospective study was carried out to assess the influence of HCV coinfection on the risk of cardiovascular events in a large cohort of HIV-infected patients recruited since year 2004. A composite event of cardiovascular disease was used as an endpoint, including myocardial infarction, angina pectoris, stroke or death due to any of them. A total of 1136 patients (567 HIV-monoinfected, 70 HCV-monoinfected and 499 HIV/HCV-coinfected) were analysed. Mean age was 42.7 years, 79% were males, and 46% were former injection drug users. Over a mean follow-up of 79.4 ± 21 months, 3 patients died due to cardiovascular disease, whereas 29 suffered a first episode of coronary ischaemia or stroke. HIV/HCV-coinfected patients had a greater incidence of cardiovascular disease events and/or death than HIV-monoinfected individuals (4% vs 1.2%, P = 0.004) and HCV-monoinfected persons (4% vs 1.4%, P = 0.5). After adjusting for demographics, virological parameters and classical cardiovascular disease risk factors (smoking, hypertension, diabetes, high LDL cholesterol), both HIV/HCV coinfection (HR 2.91; CI 95%: 1.19-7.12; P = 0.02) and hypertension (HR 3.65; CI 95%: 1.34-9.94; P = 0.01) were independently associated with cardiovascular disease events and/or death in HIV-infected patients. Chronic hepatitis C and hypertension are independently associated with increased cardiovascular disease risk in HIV-infected patients. Therefore, treatment of chronic hepatitis C should be prioritized in HIV/HCV-coinfected patients regardless of any liver fibrosis staging. © 2015 John Wiley & Sons Ltd.

  12. Barriers to care and current medical and social needs of HIV-positive patients in Albania.

    Science.gov (United States)

    Morrison, Shane D; Banushi, Vilson H; Sarnquist, Clea; Gashi, Valbona H; Osterberg, Lars; Maldonado, Yvonne; Harxhi, Arjan

    2011-06-01

    As HIV/AIDS prevalence rises in Eastern Europe, assessment of local epidemics in the bordering Central European region, especially South Eastern Europe, is vital in order to meet treatment and prevention needs. Understanding current medical and social needs and barriers to care experienced by HIV-positive patients in these regions may provide insight into how to best respond to the local epidemics, increase patients' access to treatment, and reduce loss to follow-up. This study assesses the patient characteristics, barriers to care, and current medical and social needs of HIV-positive patients in Albania. Semi-structured interviews were used in this cross-sectional study. We interviewed 79 of 85 patients (93% response rate) followed at the University Hospital Center of Tirana (UHCT) HIV/AIDS Ambulatory Clinic, which represented the majority of patients under HIV care in Albania during 2009. The local HIV epidemic seems to be comprised mainly of heterosexual men who have spent an average of 3.6 years abroad. The vast majority of patients under care at UHCT HIV/AIDS Ambulatory Clinic had experienced barriers to care associated with social stigma (97.4%), lack of knowledge of HIV medical care (76.6%), and medical provider's lack of knowledge of HIV (70.9%). Social needs of the patients were also overwhelmingly unmet (90.0-95.7%). In addressing HIV/AIDS in Albania, it will be crucial to educate the healthcare sector in ways to identify and address barriers to care and current medical and social needs of HIV-positive patients.

  13. Factors Associated with Survival of HIV/HBV Co-infected Patients in ...

    African Journals Online (AJOL)

    Patients who were educated had a reduced death rate as compared to the uneducated ones. Therefore, emphasis should be on designing Information Education Communication (IEC) materials to sensitize the uneducated HIV/HBV co-infected patients on effects of non compliance and unbalanced diets. Keywords: HIV/HBV ...

  14. Lipid profile in HIV/AIDS patients in Nigeria | Adewole | African ...

    African Journals Online (AJOL)

    Introduction: Alterations of serum lipid profiles have been reported widely among Human Immuno deficiency Virus (HIV) positive patients on Highly Active Anti Retroviral Therapy (HAART). However, there are few data on serum lipid profile among treatment naïve HIV positive patients in our environment. Objectives: To ...

  15. Management of MDR-TB in HIV co-infected patients in eastern europe

    DEFF Research Database (Denmark)

    Efsen, A M W; Schultze, A; Miller, R F

    2017-01-01

    OBJECTIVES: Mortality among HIV patients with tuberculosis (TB) remains high in Eastern Europe (EE), but details of TB and HIV management remain scarce. METHODS: In this prospective study, we describe the TB treatment regimens of patients with multi-drug resistant (MDR) TB and use of antiretrovir...

  16. Syphilitic periostitis of the skull and ribs in a HIV positive patient.

    Science.gov (United States)

    Samarkos, Michael; Giannopoulou, Charis; Karantoni, Eleni; Papastamopoulos, Vassileios; Baraboutis, Ioannis; Skoutelis, Athanassios

    2011-02-01

    We report the case of a HIV and syphilis co-infected patient who presented with headache and rash and was found to have syphilitic periostitis. Our case illustrates a rare manifestation of early syphilis and presents the diagnostic dilemmas that can arise in HIV and syphilis co-infected patients.

  17. Outcomes of TB/HIV co-infected patients presenting with ...

    African Journals Online (AJOL)

    8% mortality at 6 months among the general population of patients with TB/HIV co-infection treated at the hospital.[9]. The aim of this article is to describe patient characteristics of an SA adult HIV-infected population presenting with TB DILI, determine the factors that impact on the reintroduction of a standard or modified TBT ...

  18. Immune Dysfunction in HIV infected stroke patients: Role of low CD ...

    African Journals Online (AJOL)

    Whether or not low CD4 count directly contributes to stroke among HIV infected stroke patients is yet to be elucidated. This study aimed to ascertain the role of low CD4 count in the pathophysiology of stroke in HIV infection. This was a hospital-based, case-control study. Sixty five (65) consecutive stroke patients (36 males ...

  19. Are Nigerian dentists willing to treat patients with HIV infection ? | Uti ...

    African Journals Online (AJOL)

    Objective: HIV/AIDS is a modern day plague, which is a challenge to dentistry. The willingness of dentists to treat HIV positive patients is crucial in the provision of oral health care to this increasing population of patients. The purpose of this study was to assess the willingness of dentists and factors that influence willingness ...

  20. HIV-related mortality among tuberculosis patients in The Netherlands, 1993-2001

    NARCIS (Netherlands)

    Haar, C. H.; Cobelens, F. G. J.; Kalisvaart, N. A.; van Gerven, P. J. H. J.; van der Have, J. J.

    2007-01-01

    Human immunodeficiency virus (HIV) infection in tuberculosis (TB) patients in The Netherlands during the period 1993-2001 was associated with an increased risk of death (adjusted odds ratio 4.71, P < 0.002). Age and sex-standardised mortality rates among HIV-infected TB patients decreased

  1. Clinical evolution of chronic renal patients with HIV infection in replacement therapy

    Directory of Open Access Journals (Sweden)

    Ramón Saracho

    2015-09-01

    Despite the use of HAART, the incidence of HIV+ patients on dialysis has increased; their mortality still exceeds non-HIV patients, and they have a very low rate of transplantation. It is necessary to further our knowledge of this disease in order to improve results.

  2. Evaluation of the clinical management of HIV-infected patients by ...

    African Journals Online (AJOL)

    Background: Although private sector doctors are the backbone of treatment service in many countries, caring for patients with HIV entails a whole new set of challenges and difficulties. The few studies done on the quality of care of HIV patients, in the private sector in developing countries, have highlighted some problems ...

  3. How Patient Interactions with a Computer-Based Video Intervention Affect Decisions to Test for HIV

    Science.gov (United States)

    Aronson, Ian David; Rajan, Sonali; Marsch, Lisa A.; Bania, Theodore C.

    2014-01-01

    The current study examines predictors of HIV test acceptance among emergency department patients who received an educational video intervention designed to increase HIV testing. A total of 202 patients in the main treatment areas of a high-volume, urban hospital emergency department used inexpensive netbook computers to watch brief educational…

  4. Rates of cardiovascular disease following smoking cessation in patients with HIV infection

    DEFF Research Database (Denmark)

    Petoumenos, K; Worm, S; Reiss, P

    2011-01-01

    The aim of the study was to estimate the rates of cardiovascular disease (CVD) events after stopping smoking in patients with HIV infection.......The aim of the study was to estimate the rates of cardiovascular disease (CVD) events after stopping smoking in patients with HIV infection....

  5. Persistent Inflammation and Endothelial Activation in HIV-1 Infected Patients after 12 Years of Antiretroviral Therapy

    DEFF Research Database (Denmark)

    Rönsholt, Frederikke F; Ullum, Henrik; Katzenstein, Terese L

    2013-01-01

    The study investigated markers of inflammation and endothelial activation in HIV infected patients after 12 years of successful combination antiretroviral treatment (cART).......The study investigated markers of inflammation and endothelial activation in HIV infected patients after 12 years of successful combination antiretroviral treatment (cART)....

  6. Hepatitis B co-infection in HIV-infected patients receiving ...

    African Journals Online (AJOL)

    2016-05-20

    May 20, 2016 ... almost 8% confirms the need for testing of HIV-positive patients for hepatitis B. Hepatitis B co-infection in HIV-infected patients receiving antiretroviral therapy at the. TC Newman Anti Retroviral Treatment Clinic in Paarl, Western Cape. Read online: Scan this QR code with your smart phone or mobile device.

  7. HIV/AIDS patient satisfaction with a food assistance programme in ...

    African Journals Online (AJOL)

    We measured the satisfaction of HIV/AIDS patients with a food assistance programme in Sofala province in Mozambique. This was an observational study that used a combination of qualitative and quantitative methods. HIV/AIDS patients receiving food assistance took part in focus group discussions (FDGs) and completed ...

  8. Prevalence of intestinal parasites in HIV-infected adult patients in ...

    African Journals Online (AJOL)

    Background: Parasitic infection of the intestinal tract is a major source of disease in patients with HIV particularly in the tropics, where diarrhea is a common complaint with variable severity and specific pathogens are be identified in more than half of the HIV/AIDS patients with persistent diarrhea. Objective: The objective of ...

  9. How HIV patients construct liveable identities in a shame based culture: the case of Singapore.

    Science.gov (United States)

    Ho, Lai Peng; Goh, Esther C L

    2017-12-01

    This article interrogates the mainstream healthcare narrative that frames human immunodeficiency virus (HIV) as a chronic disease, and triangulates it with the lived experiences of people with HIV in Singapore. It also examines how HIV patients reconstruct their identities after the diagnosis of HIV. Four HIV patients (two males and two females) were interviewed in depth by an experienced medical social worker. Findings revealed that even as the illness trajectory of HIV has shifted from a terminal condition to a chronic one, living with HIV continues to be fraught with difficulty as society, especially in the Asian context, perceives HIV with much fear and disapproval. The participants had an overwhelming sense of shame when they were initially diagnosed with HIV and they had to reconstruct a liveable identity by containing the shroud of shame, reinforcing their normative identities and constructing new ones. These strategies help them to keep their shame at bay. This paper also unpacks nuanced insights of shame experienced by Chinese HIV patients in an Asian city dominated by Confucian values.

  10. Risk of high-level viraemia in HIV-infected patients on successful antiretroviral treatment for more than 6 months

    DEFF Research Database (Denmark)

    Engsig, F N; Omland, Lars Haukali Hvass; Larsen, M V

    2010-01-01

    According to the Swiss Federal Commission for HIV/AIDS, HIV-infected patients on successful antiretroviral treatment have a negligible risk of transmitting HIV sexually. We estimated the risk that patients considered to have an undetectable viral load (VL) are actually viraemic.......According to the Swiss Federal Commission for HIV/AIDS, HIV-infected patients on successful antiretroviral treatment have a negligible risk of transmitting HIV sexually. We estimated the risk that patients considered to have an undetectable viral load (VL) are actually viraemic....

  11. Magnetic resonance imaging findings in spinal tuberculosis: Comparison of HIV positive and negative patients

    Directory of Open Access Journals (Sweden)

    Cameron Michael Anley

    2012-01-01

    Full Text Available Background: There is an increasing incidence of Human immunodeficiency virus (HIV and tuberculosis (TB co-infection. This has led to an increasing number of atypical features on magnetic resonance imaging (MRI. We postulated that the type 4 hypersensitivity response causing granulomatous inflammation may be disrupted by the HIV resulting in less vertebral body destruction. This study compares the MRI features of spinal tuberculosis in HIV positive and negative patients. Materials and Methods: Fifty patients with confirmed spinal tuberculosis, HIV status and available MRI scans at a single institution from 2003-2009 were identified. HIV status was positive in 20 and negative in 30. Females were predominant (34:16. The HIV positive group was younger at 32.4 versus 46 years (P=0.008. Blood parameters (WCC, ESR, Hb, Lymphocyte count were not significantly different between the HIV groups. MRI scans were reviewed by a radiologist who was blinded to the HIV status. Site, extent of disease, body collapse, abscess location and volume, kyphotic deformity and cord signal were reported. Results: There was no difference between the number of vertebral bodies affection with TB involvement, presence of cord signal or incidence of non-contiguous lesions. The HIV negative group had significantly more total vertebral collapse (P=0.036 and greater kyphosis (P=0.002. The HIV positive group had a trend to larger anterior epidural pus collection (P=0.2. Conclusion: HIV negative patients demonstrate greater tuberculous destruction in terms of total percentage body collapse and resultant kyphosis. There is no difference in the incidence of cord signal or presence of non-contiguous lesions. HIV positive patients show a trend to a greater epidural abscess volume. This difference may be explained by the reduced autoimmune response of the type 4 hypersensitivity reaction caused by the HIV infection.

  12. Comparative transcriptome analysis of PBMC from HIV patients pre- and post-antiretroviral therapy

    DEFF Research Database (Denmark)

    Zhao, Fang-Jie; Ma, Jinmin; Huang, Lihua

    2017-01-01

    . To understand HIV interactions with host immune cells during HAART, the transcriptomes of peripheral blood mononuclear cells (PBMC) from HIV patients and HIV negative volunteers before and two weeks after HAART initiation were analyzed using RNA sequencing (RNA-Seq) technology. Differentially expressed genes......-associated hypertensions, providing new insights into HIV pathology and novel strategies for developing anti-HIV target. More importantly, we demonstrated that comparative transcriptome analysis is a very powerful tool to identify infection related DEGs using a very small number of samples. This approach could be easily...... to HIV infections in the literature, which demonstrates the credibility of the method. The newly identified HIV-related genes (up-regulated: ACSL1, GPR84, GPR97, ADM, LRG1; down-regulated: RASSF1, PATL2) were empirically validated using qRT-PCR. The Gene Set Enrichment Analysis (GSEA) was also used...

  13. Prevalence of intestinal parasitic infections among HIV patients in Benin City, Nigeria

    Directory of Open Access Journals (Sweden)

    Frederick Olusegun Akinbo

    2010-10-01

    Full Text Available This study was carried out to determine the presence of intestinal parasites and their correlation with CD4+ T-cell counts and demographics among human immunodeficiency virus (HIV-positive patients in Benin City, Nigeria. Stool specimens from 2,000 HIV-positive patients and 500 controls (HIV-negative individuals were examined for ova, cysts, or parasites, using standard procedures. In addition, patient's blood samples were analyzed for CD4 counts by flow cytometry. An overall prevalence rate of 15.3% was observed among HIV-positive patients while 6.2% was noted among non-HIV subjects. HIV status was a significant (P<0.0001 risk factor for acquiring intestinal parasitic infections. Male gender, CD4 count <200cell/µl, and diarrhea were significantly associated with an increased prevalence of intestinal parasitic infections among HIV-positive patients. The level of education, occupation, and source of water among HIV patients significantly (P<0.0001 affected the prevalence of intestinal parasitic infections. Ascaris lumbricoides was the most predominant parasite in both HIV-positive patients and controls. A CD4 count <200 cells/µl was significantly associated with only Isospora belli and Cryptosporidium infections. The presence of pathogenic intestinal parasites such as A. lumbricoides, hookworm, Giardia intestinalis, Entamoeba histolytica, Trichuris trichiura, and Taenia species among HIV-infected persons should not be neglected. Cryptosporidium species and I. belli were the opportunistic parasites observed in this study. Routine screening for intestinal parasites in HIV-positive patients is advocated.

  14. Incidence, risk factors and mortality of tuberculosis in Danish HIV patients 1995-2007

    DEFF Research Database (Denmark)

    Taarnhøj, Gry A.; Engsig, Frederik N; Ravn, Pernille

    2011-01-01

    Human Immunodeficiency Virus (HIV) infection predisposes to tuberculosis (TB). We described incidence, risk factors and prognosis of TB in HIV-1 infected patients during pre (1995-1996), early (1997-1999), and late Highly Active Antiretroviral Therapy (HAART) (2000-2007) periods.......Human Immunodeficiency Virus (HIV) infection predisposes to tuberculosis (TB). We described incidence, risk factors and prognosis of TB in HIV-1 infected patients during pre (1995-1996), early (1997-1999), and late Highly Active Antiretroviral Therapy (HAART) (2000-2007) periods....

  15. Predicting the short-term risk of diabetes in HIV-positive patients

    DEFF Research Database (Denmark)

    Petoumenos, Kathy; Worm, Signe Westring; Fontas, Eric

    2012-01-01

    HIV-positive patients receiving combination antiretroviral therapy (cART) frequently experience metabolic complications such as dyslipidemia and insulin resistance, as well as lipodystrophy, increasing the risk of cardiovascular disease (CVD) and diabetes mellitus (DM). Rates of DM and other...... glucose-associated disorders among HIV-positive patients have been reported to range between 2 and 14%, and in an ageing HIV-positive population, the prevalence of DM is expected to continue to increase. This study aims to develop a model to predict the short-term (six-month) risk of DM in HIV...

  16. Retrivability in The Danish National Hospital Registry of HIV and hepatitis B and C coinfection diagnoses of patients managed in HIV centers 1995–2004

    Directory of Open Access Journals (Sweden)

    Sørensen Henrik T

    2008-04-01

    Full Text Available Abstract Background Hospital-based discharge registries are used increasingly for longitudinal epidemiological studies of HIV. We examined completeness of registration of HIV infections and of chronic hepatitis B (HBV and hepatitis C (HCV coinfections in the Danish National Hospital Registry (DNHR covering all Danish hospitals. Methods The Danish HIV Cohort Study (DHCS encompasses all HIV-infected patients treated in Danish HIV clinics since 1 January 1995. All 2,033 Danish patients in DHCS diagnosed with HIV-1 during the 10-year period from 1 January 1995 to 31 December 2004 were included in the current analysis. We used the DHCS as a reference to examine the completeness of HIV and of HBV and HCV coinfections recorded in DNHR. Cox regression analysis was used to estimate hazard ratios of time to diagnosis of HIV in DNHR compared to DHCS. Results Of the 2,033 HIV patients in DHCS, a total of 2,006 (99% were registered with HIV in DNHR. Of these, 1,888 (93% were registered in DNHR within one year of their first positive HIV test. A CD4 = 100,000 copies/ml and being diagnosed after 1 January 2000, were associated with earlier registration in DNHR, both in crude and adjusted analyses. Thirty (23% HIV patients registered with chronic HBV (n = 129 in DHCS and 126 (48% of HIV patients with HCV (n = 264 in DHCS were registered with these diagnoses in the DNHR. Further 17 and 8 patients were registered with HBV and HCV respectively in DNHR, but not in DHCS. The positive predictive values of being registered with HBV and HCV in DHCS were thereby estimated to 0.88 and 0.97 and in DNHR to 0.32 and 0.54. Conclusion The study demonstrates that secondary data from national hospital databases may be reliable for identification of patients diagnosed with HIV infection. However, the predictive value of co-morbidity data may be low.

  17. Darunavir-based dual therapy in HIV experienced patients

    Directory of Open Access Journals (Sweden)

    Gaetana Sterrantino

    2014-11-01

    Full Text Available Background: We assessed the virological response of DRV/r-based dual therapy in drug-experienced patients included in the Italian antiretroviral resistance database (ARCA. Materials and Methods: Patients included in the study were treated with DRV/r in association with raltegravir (RAL, etravirine (ETV or maraviroc (MAR following treatment failure(s and with a resistance test and at least one follow-up visit available. Observation was censored at last visit under dual therapy and survival analysis and proportional hazard models were used, taking virological failure (confirmed >50 c/mL HIV-RNA as the end-point. Results: Of the total 221 patients included, 149 (67.4% started DRV/r with RAL, 45 (20.4% with ETV, 27 (12.2% with MAR. Patients characteristics at the start of dual regimen were as follows: mean number of previous regimens, nine (IQR: 5–13; non-B subtype, 17 (7.7%; median CD4 count, 347 (IQR: 246–544; undetectable viral load, 74 (33.5%. Full DRV/r resistance was detected in one (0.5%, HIV-DB interpretation system, 13 (5.9%, ANRS and 17 patients (7.7%, Rega. 69 virological failures (31.2% were observed during follow-up. At survival analysis, the overall proportion of failure was 29.2% at one year and 33.8% at two years. The proportion of failure was lower in patients starting with undetectable versus detectable viral load (13.3% and 25.2% versus 37.4% and 38.8% at one and two years, respectively, p=0.001 for both analyses and in patients treated with DRV 600 BID versus 800 QD (HR: 0, 56; 95% CI 0.31–0.99; p<0.05. By regimen, patients treated with DRV/r-RAL showed a non-significant lower proportion of failure (27.7% at one year, 32.0% at two years if compared with DRV/r-MAR (35.9%, 47.1% and DRV/r-ETV (34.1%, 34.1% at one and two years. In the adjusted proportional model, no significant difference among the three regimens was detected. A significant lower risk of failure was associated with higher overall GSS (HIV-DB HR: 0.53, 95% CI

  18. HIV

    African Journals Online (AJOL)

    Introduction. The·human immunodeficiency virus (HIV) can be transmiHed from one person to onother through the use of non-sterile nee- dles, syringes, and other skin-piercing and invasive instruments. Proper .sterilization of all such instruments is therefore important to prevent its transmission. HIV is very sensitive to ...

  19. hiv

    African Journals Online (AJOL)

    2016-03-31

    Mar 31, 2016 ... Indexed By: African Journal Online (AJOL); Texila American University; Genamics; Scholarsteer; EIJASR; CAS-American Chemical. Society; and IRMS Informatics India (J-Gate). ABSTRACT. This study evaluated the effect of HIV infection on CD4 T-lymphocyte depletion in people living with HIV/AIDS.

  20. Oral Candida spp carriage and periodontal diseases in HIV-infected patients in Ribeirão Preto, Brazil.

    Science.gov (United States)

    Lourenço, Alan Grupioni; Ribeiro, Ana Elisa Rodrigues Alves; Nakao, Cristiano; Motta, Ana Carolina Fragoso; Antonio, Luana Grupioni Lourenço; Machado, Alcyone Artioli; Komesu, Marilena Chinali

    2017-06-01

    The majority of HIV-infected patients develop Candida spp-associated clinical oral lesions. Studies have shown that asymptomatic oral colonization of Candida spp may lead to oral lesions or become a source of disseminated infections. The aim of this study was to verify the effects of periodontal conditions on Candida spp prevalence and Candida spp carriage in the oral cavity of HIV-infected patients compared to non-infected patients. Twenty-five patients not infected with HIV and 48 HIV-infected patients were classified according to periodontal conditions as being periodontal healthy or with periodontal disease. Candida spp carriage and classification were performed in oral rinse samples. Viral load and CD4+ T lymphocyte (CD4+L) counts were performed in blood samples from HIV-infected patients. No differences in Candida spp prevalence related to HIV status or periodontal condition were detected. However, Candida spp carriage was increased in periodontally affected HIV-infected patients when compared to periodontally healthy HIV-infected patients (p= 0.04). Periodontally healthy HIV-infected patients presented Candida spp carriage in similar levels as healthy or periodontally affected non-HIV-infected patients. Candida spp carriage was correlated with CD4+L counting in HIV-infected patients. We concluded that periodontal disease is associated with increased Candida spp carriage in HIV-infected patients and may be a predisposing factor to clinical manifestations of candidiasis.