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Sample records for machine shows hiv-positive

  1. Cuba shows jump in HIV positives.

    Science.gov (United States)

    Cuba experienced a substantial increase in the number of HIV cases in 1996 due primarily to a growth of foreign tourism and an increase in prostitution, health officials said. The Juventud Rebelde newspaper said that since HIV/AIDS testing began in 1985, government-run hospitals and clinics have detected 1609 HIV-positive cases. In 1995 the total was reported at 1196, meaning that 413 new cases were detected in 1996. This compared with only 97 new cases reported during 1995. HIV infection among the island's 11 million inhabitants has remained relatively low due to a massive testing program and a public health infrastructure that provides universal and free medical treatment. Cuba was a pioneer in the use of interferon on those testing HIV-positive. Cuba produces its own interferon, which prolongs the life expectancy of patients, and also reagents for AIDS testing. There are special sanitariums for AIDS patients in most of Cuba's 12 provinces. Cuban adults who test HIV-positive are required to enter the sanitarium in a policy reminiscent of the way tuberculosis patients were tested in the US earlier in this century. Officials said the isolation of patients in sanitariums has been somewhat relaxed over past years by introducing greater flexibility in allowing persons who are considered reliable to live at home or make prolonged visits.

  2. HIV-Positive-to-HIV-Positive Liver Transplantation

    OpenAIRE

    Calmy, Alexandra; van Delden, Christian; Giostra, Emiliano; Junet, C; Rubbia Brandt, L; Yerly, S; Chave, J-P; Samer, Caroline Flora; Elkrief, Laure; Vionnet, J; Berney, Thierry

    2016-01-01

    Most countries exclude human immunodeficiency virus (HIV)-positive patients from organ donation because of concerns regarding donor-derived HIV transmission. The Swiss Federal Act on Transplantation has allowed organ transplantation between HIV-positive donors and recipients since 2007. We report the successful liver transplantation from an HIV-positive donor to an HIV-positive recipient. Both donor and recipient had been treated for many years with antiretroviral therapy and harbored multidr...

  3. Induced abortion among HIV-positive women in Northern Vietnam

    DEFF Research Database (Denmark)

    Chi, Bui Kim; Hanh, Nguye Thi Thuy; Rasch, Vibeke

    2010-01-01

    an abortion after being diagnosed as HIV-positive, exploring their reflections, concerns and dilemmas. The results show that the HIV-positive pregnant women sought to balance their desires for a child with their worries of being unable to fulfill their responsibilities as mothers. Even while strongly desiring...

  4. Nutrition and HIV-Positive Pregnancy

    Science.gov (United States)

    Montgomery, Kristen S.

    2003-01-01

    When an HIV-positive woman becomes pregnant, additional nutritional considerations are warranted. Compared to routine prenatal nutritional assessment and intervention, pregnant HIV-positive women have increased needs to promote a healthy outcome. This column contains information on HIV and pregnancy, nutrition and infection, and nutrition for HIV-positive pregnancy. This content can be integrated into childbirth education settings to improve care to women who are HIV-positive. PMID:17273329

  5. Nutrition and HIV-Positive Pregnancy

    OpenAIRE

    Montgomery, Kristen S.

    2003-01-01

    When an HIV-positive woman becomes pregnant, additional nutritional considerations are warranted. Compared to routine prenatal nutritional assessment and intervention, pregnant HIV-positive women have increased needs to promote a healthy outcome. This column contains information on HIV and pregnancy, nutrition and infection, and nutrition for HIV-positive pregnancy. This content can be integrated into childbirth education settings to improve care to women who are HIV-positive.

  6. Contraception in HIV-positive female adolescents

    OpenAIRE

    Ananworanich Jintanat; Lakhonphon Sudrak; Kancheva Landolt Nadia T

    2011-01-01

    Abstract Sexual behavior of HIV-positive youths, whether infected perinatally, through risky behavior or other ways, is not substantially different from that of HIV-uninfected peers. Because of highly active antiretroviral therapy, increasing number of children, infected perinatally, are surviving into adolescence and are becoming sexually active and need reproductive health services. The objective of this article is to review the methods of contraception appropriate for HIV-positive adolesce...

  7. Italian Textile Machines on Show at TECHTEXTILE 2009

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    @@ In 2009 edition of Techtextil,which will take place next June in Frankfrut,ACIMIT (Association of Italian Textile Machinery Manufactures)and ICE (Italian Institute for Foreign Trade)have organized a Meeting Point.It will host about 10 Italian machinery manufacturers involved in the production of machines for technical textiles.

  8. 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.

  9. Reproductive tract infections in HIV positive women: A case control study

    Directory of Open Access Journals (Sweden)

    Sharma Archana

    2009-01-01

    Full Text Available Background: Human immunodeficiency virus (HIV infection primarily affects women during their reproductive years, and the coexistence of reproductive tract infections (RTIs is not surprising given the fact that HIV is mainly acquired via heterosexual contact. Aim: The aim of the study was to compare the occurrence of RTIs among infected and noninfected women. Materials and Methods: A case control study of 83 HIV positive women, tested by two enzyme linked immunosorbent assay (ELISA and a matched control of 87 HIV negative women were screened for RTIs. They were submitted to gynecological examination and cervical cytology. Results: The mean age for HIV positive women was 30 years and that for HIV negative women was 27 years. 18% HIV positive women had menstrual irregularities compared to 6% in seronegative group ( P = 0.024. Vaginal infections including sexually transmitted infections (STIs were found in 47 (57% HIV positive women and 30 (34% HIV negative women ( P = 0.0037. Vaginal candidiasis was the most common infection (34% in HIV positive women, followed by trichomoniasis (12%. Human papilloma virus (HPV infection was seen in nine HIV positive women versus none in HIV negative women. Cervical cytology showed inflammation in 53 (64% HIV positive women compared to 27 (31% HIV negative women ( P = 0.000023. Genital neoplasia, including carcinoma in situ was observed in 2 (2.5% HIV positive women and in none of the HIV negative women. Conclusion: It is seen that reproductive tract morbidities are common in HIV positive women. So it is imperative that HIV positive women have a complete gynecological evaluation including a Papanicolaou (PAP smear with aggressive screening of STIs.

  10. Nigerian dental students' willingness to treat HIV-positive patients.

    Science.gov (United States)

    Azodo, Clement Chinedu; Ehigiator, Osarobo; Oboro, Helen Oziofu; Ehizele, Adebola Oluyemisi; Umoh, Agnes; Ezeja, Ejike Bartholomew; Omili, Michael; Ehigiator, Laura

    2010-04-01

    Dental care of HIV-positive individuals plays a vital role in improving their nutritional intake, medication tolerance and effectiveness, treatment success rate, and quality of life. It is therefore important to ensure optimal dental care of this group of people, especially since more of them, with or without knowledge of their serologic status, are now utilizing dental services. The objective of this study was to assess Nigerian dental students' willingness to treat HIV-positive individuals. A descriptive cross-sectional survey of all seventy-six final-year dental students of the University of Benin, Nigeria, was conducted in December 2007 using a self-administered questionnaire that elicited information on the students' demography, self-rated knowledge on HIV/AIDS, attitude towards homosexuals, infection control practices, occupational risk perception, and willingness to provide care for HIV-positive individuals. The response rate was 76.3 percent. Over 77 percent of the respondents were in the twenty-five to thirty years age group. The male-female ratio was approximately 1.6:1. HIV-related knowledge was reported as high by only 31 percent of the respondents. Eighty-one percent showed great interest in HIV-related information, while about half (53.4 percent) exhibited significant worry about occupational contagion. Forty-eight (82.7 percent) desired more knowledge about safety precautions during treatment of HIV patients. Fifty respondents (86.2 percent) reported good infection control practices. About three-fourths (74.2 percent) rated the risk of HIV contagion from patients high, while only one-fourth (25.8 percent) reported having an unsympathetic attitude towards homosexuals. Almost all respondents (98.3 percent) agreed that oral care for HIV-positive individuals improves their quality of life, but only 58.8 percent expressed a willingness to treat HIV-positive patients and only 46.5 percent said they will render volunteer dental services in HIV centers. HIV

  11. Safe abortion for HIV-positive women with unwanted pregnancy: a reproductive right.

    Science.gov (United States)

    de Bruyn, Maria

    2003-11-01

    About 2.5 million women who become pregnant each year worldwide are HIV-positive. UNAIDS recommends that HIV-positive women should be able to control their fertility and to prevent HIV transmission perinatally if they decide to have children. Yet a literature review on these matters found that termination of pregnancy for HIV-positive women receives very little attention. This paper describes the difficulties faced by HIV-positive women in obtaining safe, legal, affordable abortion services. It shows that voluntary HIV counselling and testing for women seeking induced abortions and post-abortion care may not be provided. HIV-positive women want to avoid pregnancy for the same reasons as other women, but they also do not want to infect their partners through unprotected sex, worry about effects of pregnancy and childbirth on their own health, or about infecting a child and the child's future care. Little research has been done on whether HIV-positive women have a greater risk of morbidity following unsafe abortions than HIV-negative women, but evidence suggests they might. Studies in Zimbabwe and Thailand show that when information and access to legal pregnancy termination are lacking, HIV-positive women may be prevented from terminating a pregnancy. The paper concludes that it is essential for women living with HIV/AIDS to be able to exercise their right to decide whether and when to have children.

  12. The missed HIV-positive children of Ethiopia.

    Directory of Open Access Journals (Sweden)

    Elisabetta Pegurri

    Full Text Available As elsewhere, due to scarcity of data and limited awareness of HIV infection, especially in older children, the HIV epidemic among Ethiopian children appears neglected in national programs (children ART coverage is of only 12% in 2013. This paper estimates the country burden of HIV in older children and investigates the prevalence of HIV in orphans and vulnerable children (OVC households.We analyzed national HIV data for Ethiopia, using Spectrum/ Estimation and Projection Package (EPP and primary data on children living in households with at least one HIV-positive adult in the Amhara and Tigrai regions. Descriptive analysis of the age and sex distribution of HIV-positive OVC in Ethiopia was performed.Our Spectrum/EPP analysis estimated the population of HIV-positive children under 15 years old to be 160,000 in 2013. The majority of children (81•6% were aged five to 14 years. The estimated number of orphans due to AIDS was 800,000. The empirical data from almost 10,000 OVC under 18 years showed 11•9% were HIV-positive, the majority of whom were between five and 10 years old with no significant difference between males and females.There is a large population of children living with HIV in Ethiopia, the magnitude of which not previously recognized. The majority were vertically infected and never identified nor linked into treatment. OVC represent a reachable group which could account for a substantial proportion of the HIV infected older children. We recommend that HIV programs urgently synergize with social protection sectors and address these children with HIV testing and related services.

  13. Successful treatment of syphilitic uveitis in HIV-positive patients

    Directory of Open Access Journals (Sweden)

    Nurfahzura MJ

    2013-08-01

    Full Text Available Mohd-Jamil Nurfahzura,1–3 Hashim Hanizasurana,1 Embong Zunaina,2,3 Hussein Adil2,3 1Department of Ophthalmology, Hospital Selayang, Lebuhraya Selayang-Kepong, Selangor, Malaysia; 2Department of Ophthalmology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia; 3Hospital Universiti Sains Malaysia, Jalan Raja Perempuan Zainab II, Kelantan, Malaysia Abstract: We report successful treatment of syphilitic uveitis in a case series of three Human immunodeficiency virus (HIV-positive patients at Malaysia's Selayang Hospital eye clinic. All three patients with syphilitic uveitis were male, aged from 23 to 35 years old, with a history of high-risk behaviors. Of the patients, two presented with blurring of vision and only one patient presented with floaters in the affected eye. Ocular examination revealed intermediate uveitis (case 1 and case 3 and panuveitis (case 2. Each patient showed a high Venereal Disease Research Laboratory (VDRL titer at presentation and they were also newly diagnosed as HIV positive with variable CD4 counts. All three patients responded well to a neurosyphilis regimen of intravenous penicillin G. At 3 months posttreatment, there was reduction in VDRL titer with improvement of vision in the affected eye. Diagnosis of syphilis needs to be ruled out in all cases of uveitis. All syphilitic uveitis cases should have HIV screening and vice versa, as syphilis is one of the most common infectious diseases associated with HIV-positive patients. Early detection and treatment are important for a good visual outcome. Keywords: syphilitic uveitis, penicillin, neurosyphilis, HIV-positive patient

  14. Associated Factors of Suicidal Thoughts in HIV-Positive Individuals

    Directory of Open Access Journals (Sweden)

    Fatemeh Dabaghzadeh

    2015-11-01

    Full Text Available  Objective: As a first study, suicidal ideation and its correlates have been evaluated in Iranian HIV positive population .  Methods:One hundred and fifty HIV-positive individuals were recruited in this cross-sectional study. The Hospital Anxiety and Depression Scale (HADS, Positive and Negative Suicide Ideation (PANSI, Pittsburgh Sleep Quality Inventory (PSQI and Somatization subscale of Symptom Checklist 90 (SCL 90 as self- reported questionnaires were used to assess the patients’ anxiety and depression status, suicidal thoughts, sleep quality and physiological factors, respectively . Results:Antiretroviral therapy and efavirenz intake did not show any significant effects on the patients’ suicidal ideation. Anxiety (p<0.001, depression (p<0.001, poor physical activity (P<0.001 and sleep quality (p<0.001 were significantly associated with the patients’ negative suicidal ideation. From the patients’ demographic data, unemployment (p = 0.04, living alone (p = 0.01, and lack of family support (p = 0.01 were correlated with the patients’ negative suicidal thoughts . Conclusion:Although hospitals are the main referral centers for providing care for HIV-positive individuals in Tehran, Iran, conducting a multi-center study with sufficient sample size from different areas of our country that include individuals with different behaviors and cultures is essential to confirm the results of this study.

  15. Microsporidiosis in HIV-positive children in Madrid (Spain).

    Science.gov (United States)

    Del Aguila, C; Navajas, R; Gurbindo, D; Ramos, J T; Mellado, M J; Fenoy, S; Muñoz Fernandez, M A; Subirats, M; Ruiz, J; Pieniazek, N J

    1997-01-01

    A prospective study was carried out to determine the prevalence rates of microsporidiosis and other enteroparasites in HIV-positive children in the Madrid area. HIV-positive pediatric patients from three hospitals were enrolled in the study. A total of 293 samples (158 stool and 127 urine) were collected from 83 children whose mean age was 6.3 years and had a mean CD4 count of 504.7/mm3 (range 1-2,220/mm3), 48 of whom suffered diarrhea at the time of the study. Microsporidia identification was investigated in stool and urine samples using Weber's chromotrope-based stain, IIF and PCR species-specific tests. Enteric parasites were identified in 32.5% of the children. Cryptosporidium sp. was the most common parasite encountered (14.4%), followed by Blastocytis sp. (9.6%) and Giardia duodenalis (8.4%). Microsporidia was only found in the stools of one child (1.2% of total and 2% of those with diarrhea) and Enterocytozoon bieneusi was demonstrated by PCR. The patient was 10 years old, presented non-chronic diarrhea and his CD4 count was 298/mm3. These data differ from those previously reported by us in HIV-positive adults (13.9%) in the same area, although this group showed more severely depressed CD4 lymphocyte counts than children. New epidemiological studies should be carried out to elucidate whether additional risk factors exist between these groups.

  16. Successful treatment of syphilitic uveitis in HIV-positive patients

    Science.gov (United States)

    Nurfahzura, Mohd-Jamil; Hanizasurana, Hashim; Zunaina, Embong; Adil, Hussein

    2013-01-01

    We report successful treatment of syphilitic uveitis in a case series of three Human immunodeficiency virus (HIV)-positive patients at Malaysia’s Selayang Hospital eye clinic. All three patients with syphilitic uveitis were male, aged from 23 to 35 years old, with a history of high-risk behaviors. Of the patients, two presented with blurring of vision and only one patient presented with floaters in the affected eye. Ocular examination revealed intermediate uveitis (case 1 and case 3) and panuveitis (case 2). Each patient showed a high Venereal Disease Research Laboratory (VDRL) titer at presentation and they were also newly diagnosed as HIV positive with variable CD4 counts. All three patients responded well to a neurosyphilis regimen of intravenous penicillin G. At 3 months posttreatment, there was reduction in VDRL titer with improvement of vision in the affected eye. Diagnosis of syphilis needs to be ruled out in all cases of uveitis. All syphilitic uveitis cases should have HIV screening and vice versa, as syphilis is one of the most common infectious diseases associated with HIV-positive patients. Early detection and treatment are important for a good visual outcome. PMID:23986629

  17. The experiences of HIV-positive mothers breastfeeding exclusively ...

    African Journals Online (AJOL)

    The experiences of HIV-positive mothers breastfeeding exclusively in Swaziland. ... African Journal of Food, Agriculture, Nutrition and Development ... Seven exclusive breastfeeding, HIV-positive mothers, aged 21-41 years, married and ...

  18. Contraception in HIV-positive female adolescents

    Directory of Open Access Journals (Sweden)

    Ananworanich Jintanat

    2011-06-01

    Full Text Available Abstract Sexual behavior of HIV-positive youths, whether infected perinatally, through risky behavior or other ways, is not substantially different from that of HIV-uninfected peers. Because of highly active antiretroviral therapy, increasing number of children, infected perinatally, are surviving into adolescence and are becoming sexually active and need reproductive health services. The objective of this article is to review the methods of contraception appropriate for HIV-positive adolescents with a special focus on hormonal contraceptives. Delaying the start of sexual life and the use of two methods thereafter, one of which is the male condom and the other a highly effective contraceptive method such as hormonal contraception or an intrauterine device, is currently the most effective option for those who desire simultaneous protection from both pregnancy and sexually transmitted diseases. Health care providers should be aware of the possible pharmacokinetic interactions between hormonal contraception and antiretrovirals. There is an urgent need for more information regarding metabolic outcomes of hormonal contraceptives, especially the effect of injectable progestins on bone metabolism, in HIV-positive adolescent girls.

  19. Targeted destruction of HIV-positive cells

    Directory of Open Access Journals (Sweden)

    Jyoti R Sharma

    2014-11-01

    Full Text Available Introduction: HIV/AIDS is now a global epidemic that has become the leading infectious killer of adults worldwide. Although antiretroviral (ARV therapy has dramatically improved the quality of life and increased the life expectancy of those infected with HIV but frequency of dosing and drug toxicity as well as the development of viral resistance pose additional limitations. The rapidly expanding field of nanotechnology has vast potential to radically advance the treatment and prevention of HIV/AIDS. Nanoparticles can provide improved drug delivery, by virtue of their small size, robustness, safety, multimodality or multifunctionality. Aims and objectives: Since HIV primarily infects CD4+ cells; we aim to use CD4 as a selectable target to deliver a pro-apoptotic protein to HIV-infected cells using nanoparticles as carriers. The aim of study was to develop a nanotechnology-based death inducing delivery system for the destruction of CD4+HIV infected cells through the activation of caspase-3. Methodology: A modified caspase-3 protein (Mut-3 was engineered, which is cleavable only by HIV-1 protease. Mut-3 can activate apoptosis in the presence of HIV-1 protease, consequently killing HIV-positive cells. Mut-3 protein was conjugated to gold nanoparticles together with a CD4-targeting peptide. The efficacy of the gold nanoparticles was tested on CHO cells that were genetically engineered to express GFP labelled CD4 and HIV-1 protease. Results: Mut-3 was expressed in bacterial cells and purified. CHO cells that stably over express CD4-GFP and HIV-1 protease were selected using Fluorescence Activated Cell Sorting. Dose response cell culture experiments showed that gold nanoparticles without Mut-3 and CD4-targeting peptide did not induce cell death in CHO cells, while gold nanoparticles that was conjugated with Mut-3 and the CD4-targeting peptide rapidly induced cell death in CHO cells. Conclusions: Our results suggest that gold nanoparticles conjugated

  20. Nursing Care of HIV-Positive Women

    DEFF Research Database (Denmark)

    Nielsen, Ben; Martinsen, Bente

    2015-01-01

    to improve quality of life after being diagnosed with HIV, a sharp distinction between HIV and AIDS and a religious and spiritually coping. Identifying the emotional challenges women living with HIV face in their daily lives may help nurses obtain a clearer understanding and greater knowledge of how...... to provide HIV-positive women with effective care that empower and support these women in managing their chronic disease. However to ensure that nurses have the proper tools for effective care for women living with HIV European studies are essentials in relation to what emotional challenges these women...

  1. Porokeratosis of Mibelli in an HIV-positive patient*

    Science.gov (United States)

    Ottoni, Luiza de Queiroz; Kakizaki, Priscila; Pinheiro, Rafael Ribeiro; Sittart, José Alexandre de Souza; Valente, Neusa Yuriko Sakai

    2016-01-01

    Porokeratosis represents a group of disorders of epidermal keratinization that are characterized by one or more annular plaques surrounded by a histologically distinctive hyperkeratotic ridge-like border called the cornoid lamella. Many studies showed that organ transplantation and immunosuppression were associated in a significant number of cases. Furthermore, an association with squamous cell carcinoma and basal cell carcinoma has been noted in all variants of porokeratosis. The rarity of this disorder and its atypical clinical presentation – a single lesion on the thumb of an HIV-positive male patient – motivated this report.

  2. Oral manifestations of HIV positive children.

    Science.gov (United States)

    Magalhães, M G; Bueno, D F; Serra, E; Gonçalves, R

    2001-01-01

    Oral manifestations in HIV positive children were observed in thirty-eight HIV infected children that have received care at the Special Care Dentistry Center (SCDC) of the School of Dentistry, University of Sao Paulo. Results have shown that 52.63% of the children presented at least one oral manifestation related with HIV/AIDS. Angular cheilitis occurred in 28.94%, parotid gland bilateral enlargement, pseudomembranous candidiasis and erythematous candidiasis in 18.42%, conventional gingivitis in 13.15%, herpes simplex in 5.26%, hairy leukoplakia, recurrent aphthous ulcer and condyloma acuminatum in 2.63%. Although enamel hypoplasia occurred in 23.68%, this could not be attributed specifically to HIV infection.

  3. Contribution of Common Infections to Cardiovascular risk in HIV Positive Individuals.

    Science.gov (United States)

    Berquist, Victoria; Hoy, Jennifer F; Trevillyan, Janine M

    HIV-positive individuals are at increased risk for cardiovascular disease due to complex interactions between the increased incidence of traditional cardiovascular risk factors and HIV and antiretroviral-associated inflammation and dyslipidemia. Increasing evidence suggests that a number of important co-pathogens, including cytomegalovirus, hepatitis C virus, and periodontal disease, are likely to also be contributing. Mechanisms such as molecular mimicry and modification of lipids play a role; however, induction of systemic inflammation is the likely key pathogenic link by which this occurs. Treatments to reduce the presence of infection, such as antibiotics, antivirals, or dental hygiene, show potential as modifiers of cardiovascular risk in HIV-positive individuals. This review will discuss the evidence regarding the contribution of these key co-pathogens, Chlamydia pneumoniae, cytomegalovirus, and hepatitis C virus, to cardiovascular risk in HIV-positive individuals. It will also review the roles that inflammation, microbial translocation, and periodontal infection play in promoting cardiovascular disease. The potential cardiovascular benefits of treating these infections with antimicrobials (such as valganciclovir) or improvements in dental hygiene (in the setting of periodontal disease) will be explored. As the life expectancy of HIV-positive individuals increases and the HIV-positive population thus ages, reducing the impact of age-related comorbidities, and particularly cardiovascular disease, will be of increasing importance at both an individual and population level.

  4. Ramifications of ostracism as a consequence of revelation of HIV positive status: its effect o individuals and families in Botswana

    Directory of Open Access Journals (Sweden)

    Langeni, Tabitha T.

    2003-01-01

    Full Text Available Using primary data and a combination of qualitative and quantitative methods the study looks into ramifications of ostracism as a factor influencing people’s behavior towards the spread of HIV/AIDS, which have devastating effects on the structure and composition of the family in Botswana. The study showed that the highest proportion of respondents who would abandon an HIV positive partner (58.4% occurs among young people aged 15 to 19 years; and that the propensity to abandon an HIV positive partner diminishes with advancement in age. In-depth inquiries on why HIV positive partners would be abandoned produced responses that revolved around fear of exposure, vulnerability and association with an HIV positive individual. The study showed that the highest proportion of respondents who would not reveal their HIV positive status occurs among those who have lost a relative or a friend to AIDS. Fear of being isolated, rejected, stigmatized and unwanted featured among the top reasons why respondents would not reveal their HIV positive status. Society’s reaction towards HIV positive individuals and families with HIV/AIDS patients appeared strong enough to drive individuals to hide their positive status and to go ahead and take the risk of onward transmission of the virus.

  5. 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....

  6. Family Status and Dilemma of HIV Positive Subjects

    Institute of Scientific and Technical Information of China (English)

    Jun-qing WU; Ying YANG; Wen-ying LI; Yu-yan LI; Rui-ping WANG

    2007-01-01

    Objective To understand the family status and dilemma of HIV positive subjects and provide some related suggestions.Methods Constructured questionnaire and in-depth interview were used to survey their psychological needs of the 111 HIV positive subjects and AIDS patients from 4 provinces in China.Results HIV positive subjects and AIDS patients had strong mental stress. All of them hope to get support from their families; the most difficulty the subjects faced was economic poor.Conclusion It is a highlight to promote AIDS education to establish a good social environment in which HIV positive subjects and AIDS patients can live quietly and happily. And psychological support from their families and the society is very important to HIV positive subjects and AIDS patients.

  7. [Stigma and discrimination: the experiences of HIV-positive women in poor neighborhoods of Maputo, Mozambique].

    Science.gov (United States)

    Andrade, Rosário Gregório; Iriart, Jorge Alberto Bernstein

    2015-03-01

    The HIV/AIDS epidemic is a serious public health problem in Mozambique. The country has high prevalence rates, and the epidemic's impact is aggravated by the stigma affecting HIV-positive persons. This study takes a socio-anthropological perspective to analyze the experience of HIV-positive women in poor neighborhoods of Maputo and the ways they cope with stigma and discrimination. Semi-structured interviews were conducted with 10 HIV-positive women. The results show how gender inequalities increase women's vulnerability to HIV and contribute to their stigmatization and discrimination. In dealing with stigma, women try to keep their diagnosis confidential, seeking support in group meetings with others living with HIV. Public policies should focus on women's empowerment and the reduction of HIV/AIDS-related stigma.

  8. Mycobacterium tuberculosis infection in a HIV-positive patient

    Directory of Open Access Journals (Sweden)

    Maria Theresa Montales

    2015-01-01

    Full Text Available Mycobacterium tuberculosis (MTB and human immunodeficiency virus (HIV coinfection remains a global public health challenge. We report a 40 year old African American male who is a known HIV-positive patient, non-compliant with his antiretrovirals and developed pulmonary tuberculosis. His chief complaints were chronic cough, fever, night sweats and undocumented weight loss. He had a prior positive T-SPOT-TB test; however, chest radiograph and sputum smear examination revealed normal results. PCR-based GeneXPERT MTB/RIF assay was ordered and confirmed MTB infection. The sputum cultures grew MTB and sensitivities showed susceptibility to all primary anti-tuberculosis medications. A delay in diagnosis and initiation of MTB therapy, in the setting of HIV or AIDS, may result in rapid disease progression and worse clinical outcome.

  9. HIV-positive migrants’ encounters with the Swedish health care system

    DEFF Research Database (Denmark)

    Mehdiyar, Manijeh; Andersson, Rune; Hjelm, Katarina;

    2016-01-01

    that participants experienced frustration and discrimination because they were required to provide sexual partners with information about their HIV status, which is compulsory under the Swedish Disease Act. The study also showed that the bias or fear regarding HIV infection among general health care professionals...... outside of the infectious diseases clinics limited the access to the general health care system for HIV-positive migrants. Conclusions: The HIV-positive migrants appreciated the free access to antiviral therapy, but wished to have more time for patient–physician communications. The participants...

  10. A Case of Respiratory Syncytial Virus Infection in an HIV-Positive Adult

    Directory of Open Access Journals (Sweden)

    Aakriti Gupta

    2012-01-01

    Full Text Available Respiratory syncytial virus (RSV is commonly known to cause an influenza-like illness. However, it can also cause more severe disease in young children and older adults comprising of organ transplant patients with immunocompromised status. Till date, only four cases of RSV infections have been reported in HIV-positive adults. We describe here a case of HIV-positive female with relatively preserved immune function who presented with RSV infection requiring ventilation and showed improvement after prompt treatment with intravenous immunoglobulin.

  11. Rosacea-like demodicosis in an HIV-positive child.

    Science.gov (United States)

    Barrio, J; Lecona, M; Hernanz, J M; Sánchez, M; Gurbindo, M D; Lázaro, P; Barrio, J L

    1996-01-01

    A second case of rosacea-like demodicosis in an HIV-positive child was seen at our center. No such cases have previously been published. The present case is a 2-year-old boy, the son of an HIV-positive mother, who responded well to oral erythromycin and topical metronidazole. The frequency of rosacea-like eruptions in HIV-negative children is very low. However, the incidence of these eruptions in HIV-positive children may have been underestimated. The pathogenic role of Demodex mites is discussed as well as the possible mechanisms for an exaggerated reaction.

  12. Two Cases of Neisseria meningitidis Proctitis in HIV-Positive Men Who Have Sex with Men

    Science.gov (United States)

    Gutierrez-Fernandez, José; Medina, Verónica; Hidalgo-Tenorio, Carmen

    2017-01-01

    We report 2 cases from Spain of infectious proctitis caused by Neisseria meningitidis in HIV-positive men who have sex with men. Genetic characterization of the isolates showed that they are unusual strains not found in other more frequent meningococcal locations. This finding suggests an association between specific strains and anogenital tract colonization. PMID:28221124

  13. First Canadian Case Report of Kidney Transplantation From an HIV-Positive Donor to an HIV-Positive Recipient

    Science.gov (United States)

    Ambaraghassi, Georges; Cardinal, Héloïse; Corsilli, Daniel; Fortin, Claude; Fortin, Marie-Chantal; Martel-Laferrière, Valérie; Malaise, Jacques; Pâquet, Michel R.; Rouleau, Danielle

    2017-01-01

    Rationale: Kidney transplantation has become standard of care for carefully selected patients living with human immunodeficiency virus (HIV) and end-stage renal disease (ESRD) in the highly active antiretroviral therapy (HAART) era. American and European prospective cohort studies have reported similar patient and graft survival compared with HIV-negative kidney transplant recipients. Despite an increased rate of acute rejection, partially due to drug interactions, HIV immunovirologic parameter generally remains under control during immunosuppression. A few cases of kidney transplantation between HIV-infected patients were done in South Africa and showed favorable results. No cases of kidney transplantation from an HIV-positive donor in Canada have previously been reported. Presenting concerns of the patient: A 60-year-old Canadian man with HIV infection presented in 2007 with symptoms compatible with acute renal failure secondary to IgA nephropathy. Chronic kidney disease resulted after the acute episode. Diagnoses: Hemodialysis was started in 2012. The patient was referred for a kidney transplantation evaluation. Interventions: The patient underwent kidney transplantation from an HIV-positive donor in January 2016. The recipient’s antiretroviral regimen consisted of abacavir, lamivudine, and dolutegravir. No drug interactions have been reported between these antiretrovirals and the maintenance immunosuppressive regimen used. Outcomes: The outcome at 7 months post transplantation was excellent, with good graft function and adequate control of HIV replication, in the absence of opportunistic infections at a time when immunosuppression is at its highest intensity. No acute rejection was reported. An episode of bacteremic graft pyelonephritis due to Enterococcus faecalis was successfully treated after transplantation. Novel finding: With careful selection of patient, kidney transplantation between HIV-infected patients is a viable option. The use of antiretroviral

  14. Sexual risk behavior among HIV-positive persons in Jamaica.

    African Journals Online (AJOL)

    program based on the social cognitive theory.19 The pro- gram assists people living ... among HIV-positive people in order to develop risk re- duction interventions; ... defined as adults. 19 years and older who attended HIV treatment sites and.

  15. Renal transplantation between HIV-positive donors and recipients justified.

    Science.gov (United States)

    Muller, Elmi; Barday, Zunaid; Mendelson, Marc; Kahn, Delawir

    2012-03-02

    HIV infection was previously an absolute contraindication to renal transplantation. However, with the advent of highly active antiretroviral therapy (HAART), renal transplantation using HIV-negative donor kidneys has successfully been employed for HIV-infected patients with end-stage renal failure. In resource-limited countries, places on dialysis programmes are severely restricted; HIV-infected patients, like many others with co-morbidity, are often denied treatment. Kidneys (and other organs) from HIV-infected deceased donors are discarded. The transplantation of HIV-positive donor kidneys to HIV-infected recipients is now a viable alternative to chronic dialysis or transplantation of HIV-negative donor kidneys. This significantly increases the pool of donor kidneys to the advantage of HIV-positive and -negative patients. Arguments are presented that led to our initiation of renal transplantation from HIV-positive deceased donors to HIV-positive recipients at Groote Schuur Hospital, Cape Town.

  16. Ethnographic experiences of HIV-positive nurses in managing ...

    African Journals Online (AJOL)

    An ethnographic study with HIV-positive nurses was conducted from August 2005 to ... This process provided the nurses with a solid foundation for developing ... perceived stigma, psychosocial support, qualitative research, sub-Saharan Africa

  17. Prevalence and clinical presentation of HIV positive female ...

    African Journals Online (AJOL)

    Ten of the 19 HIV positive patients (53%) had an Axis I diagnosis of a psychiatric disorder secondary to HIV, most ... These disorders include delirium, HIV associated dementia ... study participation was obtained by the investigator once the.

  18. Coinfection with Hepatitis B and C Viruses among HIV Positive ...

    African Journals Online (AJOL)

    Coinfection with Hepatitis B and C Viruses among HIV Positive Pregnant Women in Enugu South East, Nigeria. ... PROMOTING ACCESS TO AFRICAN RESEARCH. AFRICAN JOURNALS ONLINE (AJOL) · Journals · Advanced Search ...

  19. HIV Positive Men Five Times that of Women

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    According to the latest statis-tics, China’s HIV positive men and women are in the ratio of 5.2:1. This sharp increase in the number of HIV positive men can be attributed to intravenous drug use and unprotected sex. The survey reveals that youth between the ages of 20 and 29, some of whom are college and technical school students, account for as

  20. Diversity management: the treatment of HIV-positive employees.

    Science.gov (United States)

    Yap, Matthew H T; Ineson, Elizabeth M

    2012-01-01

    Socio-demographic dimensions such as age, gender, sexual orientation, race and ethnicity are commonly included in diversity studies. With a view to helping Asian hospitality managers to manage HIV-positive employees in their workplaces through diversity management (DM) theory, this research extends the boundaries of previous diversity studies by considering Human Immunodeficiency Virus (HIV) infection as a diverse characteristic. Both quantitative and qualitative primary data were collected from purposively selected Asian hospitality managers through postal questionnaire and follow-up telephone interviews. Transformed raw data were analysed using summary statistics and template analysis. Asian hospitality managers agreed that DM would be appropriate in the management of HIV-positive employees and that it could generate substantial benefits for employees and employers. However, they believe that the successful adoption and implementation of DM is not easy; it requires training and, ideally, the recruitment of experienced directors. Nevertheless, Asian hospitality managers are confident that implementing DM to manage HIV-positive employees can enhance tolerance, improve understanding and promote equality. The purposive sampling technique and the small number of respondents have impacted the external validity of the study. However, this exploratory study initiates an equality discussion to include HIV-positive employees in DM discourse beyond antidiscrimination legislation. It also supplements the sparse literature addressing HIV-positive employees in the Asian hospitality workplace. Asian hospitality managers are advised to understand and employ DM to treat HIV-positive employees fairly to overcome hospitality workplace marginalisation, discrimination and stigmatisation.

  1. Kaposi's Sarcoma-Associated Herpesvirus Infection of Neurons in HIV-Positive Patients.

    Science.gov (United States)

    Tso, For Yue; Sawyer, Ashley; Kwon, Eun Hee; Mudenda, Victor; Langford, Dianne; Zhou, You; West, John; Wood, Charles

    2017-06-15

    Kaposi's sarcoma-associated herpesvirus (KSHV) is the causative agent of Kaposi sarcoma (KS), one of the leading cancers in human immunodeficiency virus (HIV)-infected patients in Zambia. KSHV was detected in the human central nervous system (CNS) by polymerase chain reaction (PCR) analysis, but tissue location and cell tropism for KSHV infection has not been established. Given the neurotropism exhibited by other herpesviruses and the frequent coinfection of HIV-positive individuals by KSHV, we sought to determine whether the central nervous system (CNS) can be infected by KSHV in HIV-positive Zambian individuals. Postmortem brain tissue specimens were collected from individuals coinfected with KSHV and HIV. PCR and Southern blots were performed on DNA extracted from the brain tissue specimens to verify KSHV infection. Immunohistochemical analysis and immunofluorescent microscopy were used to localize and identify KSHV-infected cells. Tropism was further established by in vitro infection of primary human neurons with rKSHV.219. KSHV DNA was detected in the CNS from 4 of 11 HIV-positive individuals. Immunohistochemical analysis and immunofluorescent microscopy demonstrated that KSHV infected neurons and oligodendrocytes in parenchymal brain tissues. KSHV infection of neurons was confirmed by in vitro infection of primary human neurons with rKSHV.219. Our study showed that KSHV infects human CNS-resident cells, primarily neurons, in HIV-positive Zambian individuals.

  2. HIV-positive migrants’ encounters with the Swedish health care system

    Directory of Open Access Journals (Sweden)

    Manijeh Mehdiyar

    2016-11-01

    Full Text Available Background: There is limited knowledge about human immunodeficiency virus (HIV-positive migrants and their experiences in the Swedish health care system. It is necessary to increase our knowledge in this field to improve the quality of care and social support for this vulnerable group of patients. Objective: The aim of this study was to describe the experiences of HIV-positive migrants and their encounters with the health care system in Sweden. Design: This is a Grounded Theory study based on qualitative interviews with 14 HIV-positive migrants living in Sweden, aged 29–55 years. Results: ‘A hybrid of access and adversity’ was identified as the core category of the study. Three additional categories were ‘appreciation of free access to treatment’, ‘the impact of the Swedish Disease Act on everyday life’, and ‘encountering discrimination in the general health care system’. The main finding indicated that participants experienced frustration and discrimination because they were required to provide sexual partners with information about their HIV status, which is compulsory under the Swedish Disease Act. The study also showed that the bias or fear regarding HIV infection among general health care professionals outside of the infectious diseases clinics limited the access to the general health care system for HIV-positive migrants. Conclusions: The HIV-positive migrants appreciated the free access to antiviral therapy, but wished to have more time for patient–physician communications. The participants of this study felt discrimination in health care settings outside of the infectious diseases clinics. There is a need to reduce the discrimination in general health care services and to optimize the social support system and social network of this vulnerable group.

  3. Pattern of neuropsychological performance among HIV positive patients in Uganda

    Directory of Open Access Journals (Sweden)

    Parsons Thomas D

    2007-04-01

    Full Text Available Abstract Background Few studies have examined cognitive functioning of HIV positive patients in sub-Saharan Africa. It cannot be assumed that HIV positive patients in Africa exhibit the same declines as patients in high-resource settings, since there are differences that may influence cognitive functioning including nutrition, history of concomitant disease, and varying HIV strains, among other possibilities. Part of the difficulty of specifying abnormalities in neuropsychological functioning among African HIV positive patients is that there are no readily available African normative databases. The purpose of the current study was to evaluate the pattern of neuropsychological performance in a sample of HIV positive patients in comparison to HIV negative control subjects in Uganda. Methods The neuropsychological test scores of 110 HIV positive patients (WHO Stage 2, n = 21; WHO Stage 3, n = 69; WHO Stage 4, n = 20 were contrasted with those of 100 control subjects on measures of attention/concentration, mental flexibility, learning/memory, and motor functioning. Results Analysis of covariance (ANCOVA revealed significant group differences on measures of verbal learning and memory, speed of processing, attention and executive functioning between HIV seropositive and seronegative subjects. Conclusion Ugandan patients with HIV demonstrated relative deficits on measures of verbal learning and memory, speed of processing, attention, and executive functioning compared to HIV negative controls. These results from a resource limited region where clades A and D are prevalent are consistent with previous findings in the developed world where clade B predominates.

  4. Pregnancy in HIV-Positive Patients: Effects on Vaginal Flora

    Directory of Open Access Journals (Sweden)

    Cristina Vallone

    2012-01-01

    Full Text Available A high proportion of HIV-infected pregnant women present pathogenic organisms in their lower genital tract. This has been associated with the development of postpartum morbility, HIV transmission to the partner and offspring, and other gynaecological conditions, such as cervical dysplasia or cancer. Vaginal flora alterations can range from 47% in Western countries to 89% in Africa in pregnant HIV-positive patients, much higher than about 20% of the general population. Pathogen organism retrieval is high. As peripartum complications due to vaginal infections seem higher in HIV-positive patients, accurate investigation and treatment of such infections are strongly mandatory.

  5. HIV-positive people, HIV-negative partners.

    Science.gov (United States)

    Harmon, L; Volker, M

    1995-01-01

    More relationships exist today between HIV-positive and HIV-negative partners. This article explores the underlying dynamics that might account for this phenomenon. Codependency theories may explain these relationships for some couples. For other couples, it is suggested that positive-negative homosexual relationships may be influenced by both unhealthy and healthy gay developmental experiences as well as by a sense of compassion. The article addresses both HIV-positive people choosing HIV-negative partners and vice versa. Treatment issues for the various theories are discussed and recommendations are made.

  6. Impulsivity, Sensation Seeking, and Risk-Taking Behaviors among HIV-Positive and HIV-Negative Heroin Dependent Persons

    Directory of Open Access Journals (Sweden)

    Koosha Paydary

    2016-01-01

    Full Text Available Objective. The aim of this study was to compare impulsivity and risky decision making among HIV-positive and negative heroin dependent persons. Methods. We compared different dimensions of impulsivity and risky decision making in two groups of 60 HIV-positive and 60 HIV-negative male heroin dependent persons. Each group was comprised of equal numbers of current (treatment seeker and former (abstinent heroin addicts. Data collection tools included Balloon Analogue Risk Task (BART, Iowa Gambling Task (IGT, Barratt Impulsiveness Scale (BIS, and Zuckerman Sensation Seeking Scale (SSS. Results. In SSS, comprised of four subscales including thrill and adventure seeking (TAS, experience seeking (ES, disinhibition (DIS, and boredom susceptibility (BS, there was a borderline difference in DIS (P=0.08 as HIV-positive group scored higher than HIV-negative group. Also, ES and total score were significantly higher among HIV-positive patients. In BART, HIV-positive subjects scored higher in risk taking than HIV-negative subjects as reflected in higher Average Number of puffs in Successful Balloons (ANSB. In BIS, HIV-positive group scored significantly higher in cognitive impulsivity (CI (P=0.03 and nonplanning impulsivity (NPI (P=0.05 in comparison to HIV-negative group. Also, current heroin addicts scored significantly higher in NPI compared to former addict HIV-negative participants (P=0.015. IGT did not show any significant difference between groups. Conclusion. Higher levels of impulsivity and risk taking behaviors among HIV-positive heroin addicts will increase serious concerns regarding HIV transmission from this group to other opiate dependents and healthy people.

  7. Treating depression in HIV-positive patients affects adherence

    African Journals Online (AJOL)

    2012-09-02

    19,20-22 maintain CD4 cell counts; prevent clinical ... affecting ART adherence in HIV-positive patients,32-35 ... 99.5%, and of those who received psychotherapy increased .... children (chi2=5.022; p=0.285); past history.

  8. HIV-positive status among surgeons - an ethical dilemma

    African Journals Online (AJOL)

    2006-08-11

    Aug 11, 2006 ... HIV I AIDS is a manageable disease with a reasonable expectation that affected ... the potential risk of an HIV-positive surgeon transmitting .... much-publicised Florida (USA) dentist transmitting HIV to a patient,? There has ...

  9. Diabetes Risk May Be Higher for HIV-Positive Adults

    Science.gov (United States)

    ... Español You Are Here: Home → Latest Health News → Article URL of this page: https://medlineplus.gov/news/fullstory_163344.html Diabetes Risk May Be Higher for HIV-Positive Adults Longer survival with the virus might ...

  10. Preventive cancer screening practices in HIV-positive patients.

    Science.gov (United States)

    Momplaisir, Florence; Mounzer, Karam; Long, Judith A

    2014-01-01

    As patients with HIV age, they are at risk of developing non-AIDS defining malignancies. We performed a questionnaire study to evaluate colorectal and breast cancer screening among HIV-positive and HIV-negative patients seeking care from either an integrated (HIV/primary care), nonintegrated (specialized HIV), or general internal medicine clinic between August 2010 and July 2011. We performed a logistic regression to determine the odds of cancer screening. A total of 813 surveys were collected, and 762 were included in the analysis. As much as 401 were from HIV-positive patients. Patients with HIV were less likely to be current with their colorectal cancer screening (CRCS) (54.4% versus 65.0%, p=0.009); mammography rates were 24.3% versus 62.3% if done during the past year (pscreening in HIV-positive patients compared to negative controls was not statistically significant (OR 0.8; 95% CI 0.5-1.3); however, HIV-positive women remained significantly less likely to be current with breast cancer screening (BCS) whether their mammogram was completed within 1 year (OR 0.1, 95% CI 0.1-0.2) or within 5 years (OR 0.1, 95% CI 0.0-0.2). Integrated care was not associated with improved screening; however, having frequent visits to a primary care physician (PCP) increased the likelihood of getting screened. BCS was lower in HIV-positive compared to HIV-negative women. Frequent visits to a PCPs improved cancer screening.

  11. The relative frequency of Mycobacterium tuberculosis and Mycobacterium avium infections in HIV positive patients, Ahvaz, Iran

    Institute of Scientific and Technical Information of China (English)

    Khosravi AD; Alavi SM; Hashemzade M; Abasi E; Seghatoleslami S

    2012-01-01

    Objective:To estimate the prevalence of Mycobacterium tuberculosis (M. tuberculosis) and Mycobacterium avium (M. avium) infections in HIV-positive patients suspected to have pulmonary and extrapulmonary mycobacterial co-infection using PCR technique. Methods:Totally 50 samples comprising sputum, pleural fluid and CSF taken from HIV positive patients suspected to have mycobacterial infection, were processed. The demographic information and results of acid fast staining and culture were recorded for each patient. The PCR for detecting of M. tuberculosis comprised of specific primers targeting IS6110 gene sequence. For detecting of M. avium, PCR with primers that amplifies the mig gene were used. Results:From 50 samples processed, 45 were sputum (90%), 3 pleural fluid (6%) and 2 CSF (4%). In total, 8 (16%) were culture positive, 7 had positive acid fast staining (14%) and 13 samples (26%) were positive using PCR technique. All the positive samples were sputum and belonged to patients with pulmonary infection. Of these, 9 were positive for M. tuberculosis (69.2%) and 4 were identified as M. avium (30.8%), which 2 out of 13 positive samples showed mixed infections by both mycobacteria. Conclusions:The PCR shows the highest detection rate (26%) of mycobacteria compared with culture and acid fast staining. The majority of infections were with M. tuberculosis (18%) and this shows the importance of this mycobacterial co-infection in HIV positive patients in the region of study.

  12. Production of nanodrug for Bacillus cereus isolated from HIV positive patient using Mallotus philippensis

    Directory of Open Access Journals (Sweden)

    R. Bhuvaneswari

    2016-04-01

    Full Text Available The present investigation was aimed to synthesis of silver nanoparticles (AgNPs using Mallotus philippensis leaf extract and their antibacterial potential against Bacillus cereus isolated from HIV positive patient. In this, UV- Visible spectroscopy showed the high peak of absorption band at 450 nm. Based on XRD analysis, face centered cubic structure and average size of the AgNPs was around 16 nm. FTIR spectroscopy study revealed the seventeen functional groups of the AgNPs was observed. The morphology of AgNPs was spherical, oval shapes and diameter of the particle size ranges between 9 and 24 nm was measured using transmission electron microscopy (TEM. In addition to these green synthesized AgNPs were found to express the higher efficacy in inhibiting the growth of Bacillus cereus (B. cereus isolated from the HIV-positive patient.

  13. Contraceptive use among HIV-positive women in Quang Ninh province, Vietnam

    DEFF Research Database (Denmark)

    Chi, Bui Kim; Gammeltoft, Tine; Hanh, Nguyen Thi Thuy

    2012-01-01

    Objective  To investigate contraceptive use among HIV-positive women in Ha long city and Cam Pha town of Quang Ninh, a Northern province of Vietnam. Methods  Cross-sectional questionnaire study among HIV-positive women identified through the district HIV/AIDS register. Information on socioeconomic...... characteristics and contraceptive use before and after HIV diagnosis was obtained through structured questionnaires. Chi-square testing was used to assess whether the included women differed from the target population in terms of age. Crude Odds ratios (ORs) were calculated to show the association between...... contraceptive use and the women's socioeconomic characteristics. Logistic regression analyses were applied to adjust for possible confounding. The women's contraceptive use before HIV testing and after HIV testing was described and compared by Chi-square testing, and the association between post...

  14. Tinea capitis in the form of concentric rings in an HIV positive adult on antiretroviral treatment

    Directory of Open Access Journals (Sweden)

    Kirti Narang

    2012-01-01

    Full Text Available Dermatophyte infection may present in the form of concentric rings caused by Trichophyton concentricum, known as Tinea Imbricata. In immunosuppressed patients, there are reports of lesions in the form of concentric rings caused by dermatophytes other than Trichophyton concentricum too, mostly by Trichophyton tonsurans, known as Tinea indesiciva or Tinea pseudoimbricata. We report a case of tinea capitis in a HIV-positive adult woman on antiretroviral therapy, who presented with concentric rings of papules and pustules with slight scaling on the scalp along with diffuse thinning of hair. Both Potassium hydroxide mount and culture showed the presence of Dermatophytes. Tinea capitis is considered rare in adults, but new cases are being reported in immunocompromised as well as in immunocompetent patients. The pertinent features of this case are: HIV-positive adult female on antiretroviral therapy, presenting with tinea capitis in the form of concentric rings; culture from the lesion grew Microsporum audouinii; responding to oral Terbinafine.

  15. Orofacial manifestations of histoplasmosis in HIV-positive patients: a case report.

    Science.gov (United States)

    Gomes Ferreira, O; Vieira Fernandes, A; Sebastião Borges, A; Simão Ferreira, M; Mota Loyola, A

    2001-01-01

    Amongst the main opportunistic diseases that affect the HIV-positive patient, histoplasmosis is found. This systemic mycosis caused by the fungus Histoplasma capsulatum has the capacity to disseminate from the lung to the skin and oral mucosa. Oral lesions of histoplasmosis can be found with ulcerated or nodular aspect, being always very painful and infiltrating the mucosa. When they are present in the mouth, they strongly indicate the presence of some kind of immunosuppression. This study shows the disease's evolution in an HIV-positive patient, who presented several ulcerated lesions in the oral cavity and facial skin. The symptomatology and clinical aspects of the lesions were not specific for the disease, and due to this, the diagnosis was obtained by cytological smear and oral biopsy. The results of the exams defined the disseminated picture of the infection. The treatment plan involved the use of amphotericin B for the lesions' remission, and, following this, itraconazole was administered in the maintenance phase.

  16. Brain viral burden, neuroinflammation and neurodegeneration in HAART-treated HIV positive injecting drug users.

    Science.gov (United States)

    Smith, Donald B; Simmonds, Peter; Bell, Jeanne E

    2014-02-01

    The long-term impact of chronic human immunodeficiency virus (HIV) infection on brain status in injecting drug users (IDU) treated with highly active antiretroviral therapy (HAART) is unknown. Viral persistence in the brain with ongoing neuroinflammation may predispose to Alzheimer-like neurodegeneration. In this study, we investigated the brains of ten HAART-treated individuals (six IDU and four non-DU), compared with ten HIV negative controls (six IDU and four non-DU). HIV DNA levels in brain tissue were correlated with plasma and lymphoid tissue viral loads, cognitive status, microglial activation and Tau protein and amyloid deposition. Brain HIV proviral DNA levels were low in most cases but higher in HIV encephalitis (n = 2) and correlated significantly with levels in lymphoid tissue (p = 0.0075), but not with those in plasma. HIV positive subjects expressed more Tau protein and amyloid than HIV negative controls (highest in a 58 year old), as did IDU, but brain viral loads showed no relation to Tau and amyloid. Microglial activation linked significantly to HIV positivity (p = 0.001) and opiate abuse accentuated these microglial changes (p = 0.05). This study confirms that HIV DNA persists in brains despite HAART and that opiate abuse adds to the risk of brain damage in HIV positive subjects. Novel findings in this study show that (1) plasma levels are not a good surrogate indicator of brain status, (2) viral burden in brain and lymphoid tissues is related, and (3) while Tau and amyloid deposition is increased in HIV positive IDU, this is not specifically related to increased HIV burden within the brain.

  17. Early-developed hand osteoarthritis in treated HIV-positive patients: Four cases.

    Science.gov (United States)

    Larcher, Romaric; Mauboussin, Jean-Marc; Rouanet, Isabelle; Sotto, Albert

    2015-10-01

    We describe four cases of hand osteoarthritis in patients with HIV infection under antiretroviral treatment. A 36-year-old HIV-infected man came for consultation in 2007 with hand osteoarthritis. He was diagnosed HIV positive by sexual transmission in 1997. A 52-year-old HIV-infected woman came for consultation with hand osteoarthritis started in 2006. She was diagnosed HIV positive in 1986 by sexual transmission. A 57-year-old man presented hand osteoarthritis. This former IV drug user was diagnosed HIV positive in 1989. A 61-year-old HIV-infected man presented with hand osteoarthritis started in 2010. He had been contaminated with HIV in 1990 by sexual transmission. For all patients, there were neither clinical nor biological manifestations suggesting inflammatory arthritis. X-rays showed signs of hand osteoarthritis. CD4 cell count was over 500/mm(3) and the viral load was below 20 copies/mL under treatments. These four cases show osteoarthritis in HIV-infected patients. Hand osteoarthritis did not seem to be linked to aging or to an antiretroviral treatment's side effect, but rather to the HIV infection itself, and it may pass through a metabolic syndrome. We described a possible association between early-developed hand osteoarthritis and HIV-infected patients. Clinicians should consider osteoarthritis when they are confronted with HIV-infected patients with chronic hand pain.

  18. Periodontal disease in HIV-positive individuals: association of periodontal indices with stages of HIV disease.

    Science.gov (United States)

    Vastardis, Sotirios A; Yukna, Raymond A; Fidel, Paul L; Leigh, Janet E; Mercante, Donald E

    2003-09-01

    Periodontal disease has been previously associated with human immunodeficiency virus (HIV) infection, and HIV infection has been considered a modifier of periodontal disease. The aim of this study was to report the prevalence and severity of periodontal disease in a population of HIV-positive individuals and to investigate the association between clinical periodontal indices and the stage of HIV disease, as expressed by CD4 cell counts. Thirty-nine male HIV-positive patients were recruited and a medical history was taken. To evaluate periodontal disease, probing depth (PD), attachment level loss (AL), bleeding index (BI), and modified gingival index (MGI) were recorded. Associations between the above indices and CD4 counts were examined. Immunocompromised patients (with CD4 cell counts 4 mm compared to patients with CD4 cell counts > 200 cells/microl. When patients with CD4 counts 4 mm (r2 = 0.1469, P = 0.056). Severely immunocompromised HIV-positive patients showed less severe gingival inflammation than expected. Patients with CD4 cell counts > 500 cells/microl showed no association between CD4 cell count and periodontal indices.

  19. Anti-glomerular basement membrane glomerulonephritis in an HIV positive patient: case report

    Directory of Open Access Journals (Sweden)

    Eduardo José Bellotto Monteiro

    Full Text Available We report on a case of a patient with HIV infection, diagnosed 18 months prior to the development of an anti-glomerular basement membrane (anti-GBM rapidly progressive glomerulonephritis; this is probably the first report of such an association. A 30-year-old white man presented with elevation of serum creatinine (1.3 - 13.5 mg/dL within one month. At admission, the urinalysis showed proteinuria of 7.2 g/L and 8,000,000 erythrocytes/mL. Renal biopsy corresponded to a crescentic diffuse proliferative glomerulonephritis mediated by anti-GBM, and serum testing for anti-GBM antibodies was positive; antinuclear antibodies (ANA and anti-neutrophilic cytoplasmic antibodies (ANCA were also positive. The patient underwent hemodyalisis and was treated with plasmapheresis, cyclophosphamide and prednisone. The association described here is not casual, as crescentic glomerulonephritis is not common in HIV-positive patients, anti-GBM glomerulonephritis is rare and anti-GBM antibodies are frequently observed in HIV-positive subjects when compared to the overall population. Based on the current case and on the elevated frequency of the positivity for such antibodies in this group of patients, it is advisable to be aware of the eventual association between these two conditions and to promote an active search for anti-GBM antibodies and early diagnosis of eventual urinary abnormalities in HIV-positive subjects, considering the severity of anti-GBM glomerulonephritis.

  20. Coping with discrimination among HIV-positive Black men who have sex with men.

    Science.gov (United States)

    Bogart, Laura M; Dale, Sannisha K; Christian, Jana; Patel, Kinjal; Daffin, Gary K; Mayer, Kenneth H; Pantalone, David W

    2017-07-01

    In the USA, HIV-positive Black men who have sex with men show large disparities in disease outcomes compared to other racial/ethnic and risk groups. This study examined the strategies that HIV-positive Black men who have sex with men use to cope with different types of discrimination. A total of 27 HIV-positive Black men who have sex with men participated in semi-structured interviews, which were transcribed verbatim and coded using thematic analysis by multiple raters. Major coping themes included reactive avoidance (using behaviours, cognitions and emotions to escape from discrimination), a common reaction to racism; proactive avoidance (avoiding situations in which discrimination is anticipated), manifested as selective disclosure of HIV-serostatus; external attribution for discrimination (versus self-blame), used more for sexual orientation and HIV discrimination; and social support-seeking, which most often emerged in response to racism. Active coping strategies, such as self-advocacy (countering discrimination directly or indirectly), were infrequently reported. Findings suggest a need for structural anti-discrimination interventions, in tandem with culturally congruent individual- or group-level interventions that aim to enhance men's existing adaptive coping strategies.

  1. Anti-glomerular basement membrane glomerulonephritis in an HIV positive patient: case report

    Directory of Open Access Journals (Sweden)

    Eduardo José Bellotto Monteiro

    2006-02-01

    Full Text Available We report on a case of a patient with HIV infection, diagnosed 18 months prior to the development of an anti-glomerular basement membrane (anti-GBM rapidly progressive glomerulonephritis; this is probably the first report of such an association. A 30-year-old white man presented with elevation of serum creatinine (1.3 - 13.5 mg/dL within one month. At admission, the urinalysis showed proteinuria of 7.2 g/L and 8,000,000 erythrocytes/mL. Renal biopsy corresponded to a crescentic diffuse proliferative glomerulonephritis mediated by anti-GBM, and serum testing for anti-GBM antibodies was positive; antinuclear antibodies (ANA and anti-neutrophilic cytoplasmic antibodies (ANCA were also positive. The patient underwent hemodyalisis and was treated with plasmapheresis, cyclophosphamide and prednisone. The association described here is not casual, as crescentic glomerulonephritis is not common in HIV-positive patients, anti-GBM glomerulonephritis is rare and anti-GBM antibodies are frequently observed in HIV-positive subjects when compared to the overall population. Based on the current case and on the elevated frequency of the positivity for such antibodies in this group of patients, it is advisable to be aware of the eventual association between these two conditions and to promote an active search for anti-GBM antibodies and early diagnosis of eventual urinary abnormalities in HIV-positive subjects, considering the severity of anti-GBM glomerulonephritis.

  2. Differential temperature Carnot heat analysis shows that computing machines are thermodynamically irreversible

    Science.gov (United States)

    Parker, Michael C.; Walker, Stuart D.

    2008-07-01

    We perform a differential temperature Carnot analysis of the changes in energy and entropy (degrees of freedom) associated with an ideal classical computing machine. Assuming that Carnot's maximum efficiency law is as equally applicable to a computing machine as to a mechanical machine, we find that useful computation is necessarily dissipative and thermodynamically irreversible. In addition, we find that copying or cloning of information is as dissipative as the original process employed to create the information (through a computation) in the first place. We prove minimum heat dissipation kT ln 2 per output calculation bit, where T is the thermodynamic temperature of unavoidable by-product bits (i.e. not the output calculation bits) rather than a generally assumed 'surrounding environment' temperature. Overall, this places computers into the same category as conventional machines, obeying the second law of thermodynamics and always operating below 100% efficiency, such that a perpetual calculating machine cannot exist.

  3. Recommendations for amniocentesis in HIV-positive women.

    Science.gov (United States)

    Constantatos, S N; Boutall, A H; Stewart, C J

    2014-12-01

    There is limited literature on the known risk of HIV transmission during amniocentesis. Before the introduction of highly active antiretroviral therapy (HAART), amniocentesis was avoided owing to the increased risk of HIV transmission. Recent literature suggests that it is safe to perform amniocentesis in women on HAART with undetectable viral loads. In South Africa (SA), many women access antenatal care late in pregnancy and there is often insufficient time to attain undetectable viral loads within a pre-viability period. Guidelines and recommendations for invasive testing in HIV-positive women in the SA setting are lacking. This article provides recommendations to healthcare practitioners who are faced with an HIV-positive patient requiring amniocentesis.

  4. Osseous Kaposi sarcoma in an HIV-positive patient

    Energy Technology Data Exchange (ETDEWEB)

    Thanos, Loukas; Mylona, Sofia; Kalioras, Vasilios; Pomoni, Maria; Batakis, Nikolaos [Radiology Department, ' ' Korgialeneio-Benakeio' ' , Red Cross Hospital of Athens, 1 Athanasaki Street, 11526, Athens (Greece)

    2004-04-01

    A case of osseous Kaposi sarcoma in a 35-year-old man is described. The patient (HIV-positive for 8 years) suffered from cutaneous Kaposi sarcoma and presented with right-sided chest pain. He underwent a chest CT scan that revealed three osteolytic lesions involving rib and vertebra with large soft tissue masses, without cutaneous lesions at these sites. CT-guided core needle biopsy led to a histological diagnosis of Kaposi sarcoma. (orig.)

  5. Treating depression in HIV-positive patients affects adherence

    OpenAIRE

    M Y H Moosa; F Y Jeenah

    2012-01-01

    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 en...

  6. Seroprevalence of Epstein-Barr virus among HIV positive patients moreover and its association with CD4 positive lymphocyte count.

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    Alireza Abdollahi

    2014-12-01

    Full Text Available Opportunistic infections are the leading cause of hospitalization and morbidity in human immunodeficiency virus (HIV positive patients and are the most common cause of death between them. We aimed to measure IgG antibody against EBV viral capsid antigen (EBV-VCA IgG to determine the seroprevalence of this infection in HIV-positive population. A case-control study between September 2011 and October 2012 was conducted in a teaching hospital enrolling 114 HIV-positive patients as case group and 114 healthy individuals as control with similar age and sex. Enzyme-linked immunosurbant assay (ELISA technique was used for determination of EBV-VAC IgG in obtained samples. Of 114 serum samples obtained from HIV-positive patients, 103 (90.4% samples were found positive for EBV-VCA IgG antibody. There was no significant difference in seroprevalence of EBV VCA IgG antibody between patients received antiretroviral therapy and naive patients (91.5% vs. 87.5%, P>0.05. There was no statistically significant difference in EBV-VCA IgG seroprevalence between three groups of CD4+ in HIV positive group. In conclusion current study showed that seroprevalence of EBV in HIV-positive patients is higher than HIV-negative healthy participants; however, administration of HAART and CD4+ lymphocyte count did not reveal a significant effect in seroprevalence of EBV. Due to the significance of this virus in mortality and morbidity and causing certain malignancies in patients with AIDS, these patients are strongly recommended to be tested for this virus.

  7. Seroprevalence of Epstein-Barr virus among HIV positive patients moreover and its association with CD4 positive lymphocyte count.

    Science.gov (United States)

    Abdollahi, Alireza; Shoar, Saeed; Rasoulinejad, Mehrnaz; Sheikhbahaei, Sara

    2014-01-01

    Opportunistic infections are the leading cause of hospitalization and morbidity in human immunodeficiency virus (HIV) positive patients and are the most common cause of death between them. We aimed to measure IgG antibody against EBV viral capsid antigen (EBV-VCA IgG) to determine the seroprevalence of this infection in HIV-positive population. A case-control study between September 2011 and October 2012 was conducted in a teaching hospital enrolling 114 HIV-positive patients as case group and 114 healthy individuals as control with similar age and sex. Enzyme-linked immunosurbant assay (ELISA) technique was used for determination of EBV-VAC IgG in obtained samples. Of 114 serum samples obtained from HIV-positive patients, 103 (90.4%) samples were found positive for EBV-VCA IgG antibody. There was no significant difference in seroprevalence of EBV VCA IgG antibody between patients received antiretroviral therapy and naive patients (91.5% vs. 87.5%, P>0.05). There was no statistically significant difference in EBV-VCA IgG seroprevalence between three groups of CD4+ in HIV positive group. In conclusion current study showed that seroprevalence of EBV in HIV-positive patients is higher than HIV-negative healthy participants; however, administration of HAART and CD4+ lymphocyte count did not reveal a significant effect in seroprevalence of EBV. Due to the significance of this virus in mortality and morbidity and causing certain malignancies in patients with AIDS, these patients are strongly recommended to be tested for this virus.

  8. Intimate partner violence and correlates in pregnant HIV positive Nigerians.

    Science.gov (United States)

    Ezechi, Oliver Chukwujekwu; Gab-Okafor, Chidinma; Onwujekwe, Dan I; Adu, Rosemary A; Amadi, Eva; Herbertson, Ebiere

    2009-11-01

    To determine the prevalence, types and correlates of intimate partner violence (IPV) in pregnant Nigerian living with HIV. Cross sectional study. HIV positive pregnant women. A large HIV comprehensive treatment centre. A cross sectional study of 652 HIV positive pregnant Nigerians seen at Nigerian Institute of Medical Research, Lagos, Nigeria over a 24 months period. Prevalence of intimate partner violence after HIV diagnosis. Among the women interviewed, 423 (65.8%) reported abuse. In 74.0% of abused women, the abuse started after HIV diagnosis. Though having a HIV negative spouse and disclosure of HIV status were associated with abuse, only having a HIV negative partner retained its association with IPV (OR 3.1; CI 2.4-5.3) after controlling for confounding variables. Sixty-two (9.6%) women have not disclosed their HIV status because of fear of rejection. Verbal abuse (51.7%), threat of violence in 97 (22.9%) and sexual deprivation in 91 (21.5%) were the common forms of abuse reported. IPV is common among HIV positive pregnant Nigerians; with a threefold increased risk in women in HIV serodiscordant relationship.

  9. EVALUATION OF PROTOZOAN PARASITES CAUSING DIARRHOEA IN HIV POSITIVE PATIENTS

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    Uday Shankar

    2016-07-01

    Full Text Available BACKGROUND Opportunistic parasitic infections are among the most serious infections in Human Immunodeficiency Virus (HIV positive patients and claim a number of lives every year. The present study was conducted to determine the prevalence of intestinal parasites and to elucidate the association between intestinal opportunistic parasitic infection and CD4 (CD4+ T lymphocyte counts in HIV positive patients. METHODS The study was carried out at Department of Microbiology, on 50 HIV positive patients admitted to or attending the OPD of a tertiary healthcare centre in Kolhapur during the period from June 2013 to June 2015. Air dried smears from stool samples were stained by modified Acid fast stain, directly and after formol ether concentration technique for demonstrating oocysts of Cryptosporidium parvum, I. belli and C. cayetanensis. RESULTS Intestinal parasitic pathogens were detected in 54% patients and the major pathogens included Cryptosporidium parvum (18%, the most common followed by Entamoeba histolytica (14%, Giardia lamblia (10%, Ascaris lumbricoides (6% and 4% each of Isospora belli, Ancylostoma duodenale, Trichuris trichiura and Strongyloides stercoralis. CONCLUSION Intestinal parasitic infections caused diarrhoea in fifty four percent of patients, which was much more than the control group (16%. Proportion of opportunistic pathogens in patients with CD4 count 200-499 and > 500 cells/mm3 .

  10. Gynaecological morbidity among HIV positive pregnant women in Cameroon

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    Nana Philip N

    2008-07-01

    Full Text Available Abstract Objective To compare the prevalence of gynaecological conditions among HIV infected and non-infected pregnant women. Methods Two thousand and eight (2008 pregnant women were screened for HIV, lower genital tract infections and lower genital tract neoplasia at booking antenatal visit. Results About 10% (198/2008 were HIV positive. All lower genital tract infections except candidiasis were more prevalent among HIV positive compared to HIV negative women: vaginal candidiasis (36.9% vs 35.4%; p = 0.678, Trichomoniasis (21.2% vs 10.6%; p p p = 0.026, syphilis (35.9% vs 10.6%; p Chlamydia trachomatis (38.4% vs 7.1%; p p p Conclusion We conclude that (i sexually transmitted infections (STIs are common in both HIV positive and HIV negative pregnant women in Cameroon, and (ii STIs and preinvasive cervical lesions are more prevalent in HIV-infected pregnant women compared to their non-infected compatriots. We recommend routine screening and treatment of STIs during antenatal care in Cameroon and other countries with similar social profiles.

  11. Perceived discrimination and stigma toward children affected by HIV/AIDS and their HIV-positive caregivers in central Haiti.

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    Surkan, Pamela J; Mukherjee, Joia S; Williams, David R; Eustache, Eddy; Louis, Ermaze; Jean-Paul, Thierry; Lambert, Wesler; Scanlan, Fiona C; Oswald, Catherine M; Fawzi, Mary Smith

    2010-07-01

    In many settings worldwide, HIV-positive individuals have experienced a significant level of stigma and discrimination. This discrimination may also impact other family members affected by the disease, including children. The aim of our study was to identify factors associated with stigma and/or discrimination among HIV-affected youth and their HIV-positive caregivers in central Haiti. Recruitment of HIV-positive patients with children aged 10-17 years was conducted in 2006-2007. Data on HIV-related stigma and/or discrimination were based on interviews with 451 youth and 292 caregivers. Thirty-two percent of caregivers reported that children were discriminated against because of HIV/AIDS. Commune of residence was associated with discrimination against children affected by HIV/AIDS and HIV-related stigma among HIV-positive caregivers, suggesting variability across communities. Multivariable regression models showed that lacking social support, being an orphan, and caregiver HIV-related stigma were associated with discrimination in HIV-affected children. Caregiver HIV-related stigma demonstrated a strong association with depressive symptoms. The results could inform strategies for potential interventions to reduce HIV-related stigma and discrimination. These may include increasing social and caregiver support of children affected by HIV, enhancing support of caregivers to reduce burden of depressive symptoms, and promoting reduction of HIV-related stigma and discrimination at the community-level.

  12. Determinants of Tuberculosis Infection among Adult HIV Positives Attending Clinical Care in Western Ethiopia: A Case-Control Study

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    Hatoluf Melkamu

    2013-01-01

    Full Text Available There has been a drastic rise of tuberculosis (TB infection across the world associated with the pandemic occurrence of HIV/AIDS. There are various determinants factors that increase the chance of TB infection among HIV positives (TB/HIV confection that varies contextually. This study aimed to assess the determinants of TB/HIV coinfection among adult HIV positives attending clinical care at two public health facilities in Nekemte, western Ethiopia. Unmatched case-control study was conducted from December 26, 2011, to February 29, 2012. Cases were 123 TB infected HIV positives, and controls were 246 non-TB infected HIV positives. Being divorced/widowed , 95% CI (1.70, 7.88, not attending formal education , 95% CI (2.20, 14.15, being underweight ( kg/m2 , 95% CI (2.18, 6.87, having history of diabetic mellitus , 95% CI (1.33, 9.94, and being in advanced WHO HIV/AIDS clinical staging , 95% CI (1.32, 3.98, were determinant factors associated with TB/HIV co-infection. Having a separate kitchen , 95% CI (0.28, 0.81 showed protective role. For most of these determinants interventions can be made at individual and institutional levels, whereas, factors like education and nutrition need societal level integrations.

  13. [Plasmablastic lymphoma: a case of rectal disease with bone marrow involvement in a HIV positive patient].

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    García Chihuan, Grisley; Fernández Butrón, Ana; Salazar Alejo, Ruth; Frisancho, Oscar; Beltrán, Brady

    2014-01-01

    Plasmablastic lymphoma is an aggressive form of lymphoma diffuse large B cell Lymphoma, initially described in HIV positive patients associated with lesions in the oral cavity. It is about 2% of NHL associated with HIV. This entity currently represents a challenge for the diagnosis and treatment, showing a poor long-term prognosis. This report describes a patient with VIH on HAART and CD4 count in 490 cells/ml associated with Plasmablastic lymphoma that involves rectum and bone marrow. The patient received 6 cycles of EPOCH regimen with complete response.

  14. Cryptococcemia Resulting in an Incomplete Abortion in an HIV-Positive Patient

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    Kurosh Rahimi

    2009-01-01

    Full Text Available Exotic infections and unusual presentations are the norm in immunocompromised patients. An unusual case of cryptococcemia resulting in a miscarriage is reported. This was the first presentation of the disease and the sentinel infection in the patient who was found to be HIV positive. Histological evaluation of the dilation and curettage specimen showed numerous typical organisms of cryptococcus present within the products of conception. There was a focal granulomatous response to the organisms. An accompanying cryptococcal endometritis was not noted. Other concomitant infections were not seen.

  15. Production of nanodrug for Bacillus cereus isolated from HIV positive patient using Mallotus philippensis

    OpenAIRE

    Bhuvaneswari, R.; R. John Xavier; Arumugam, M.

    2016-01-01

    The present investigation was aimed to synthesis of silver nanoparticles (AgNPs) using Mallotus philippensis leaf extract and their antibacterial potential against Bacillus cereus isolated from HIV positive patient. In this, UV- Visible spectroscopy showed the high peak of absorption band at 450 nm. Based on XRD analysis, face centered cubic structure and average size of the AgNPs was around 16 nm. FTIR spectroscopy study revealed the seventeen functional groups of the AgNPs was observed. The...

  16. Non-infective pulmonary disease in HIV-positive children

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    Theron, Salomine; Andronikou, Savvas; George, Reena; Plessis, Jaco du; Hayes, Murray; Mapukata, Ayanda [University of Stellenbosch, Department of Radiology, Tygerberg Academic Hospital, Faculty of Health Sciences, Cape Town (South Africa); Goussard, Pierre; Gie, Robert [University of Stellenbosch, Department of Child Health, Tygerberg Academic Hospital, Cape Town (South Africa)

    2009-06-15

    It is estimated that over 90% of children infected with human immunodeficiency virus (HIV) live in the developing world and particularly in sub-Saharan Africa. Pulmonary disease is the most common clinical feature of acquired immunodeficiency syndrome (AIDS) in infants and children causing the most morbidity and mortality, and is the primary cause of death in 50% of cases. Children with lung disease are surviving progressively longer because of earlier diagnosis and antiretroviral treatment and, therefore, thoracic manifestations have continued to change and unexpected complications are being encountered. It has been reported that 33% of HIV-positive children have chronic changes on chest radiographs by the age of 4 years. Lymphocytic interstitial pneumonitis is common in the paediatric HIV population and is responsible for 30-40% of pulmonary disease. HIV-positive children also have a higher incidence of pulmonary malignancies, including lymphoma and pulmonary Kaposi sarcoma. Immune reconstitution inflammatory syndrome is seen after highly active antiretroviral treatment. Complications of pulmonary infections, aspiration and rarely interstitial pneumonitis are also seen. This review focuses on the imaging findings of non-infective chronic pulmonary disease. (orig.)

  17. Are HIV positive patients resistant to statin therapy?

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    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.

  18. Willingness and acceptability of cervical cancer screening among HIV positive Nigerian women

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    Ezechi Oliver C

    2013-01-01

    Full Text Available Abstract Background The proven benefit of integrating cervical cancer screening programme into HIV care has led to its adoption as a standard of care. However this is not operational in most HIV clinics in Nigeria. Of the various reasons given for non-implementation, none is backed by scientific evidence. This study was conducted to assess the willingness and acceptability of cervical cancer screening among HIV positive Nigerian women. Methods A cross sectional study of HIV positive women attending a large HIV treatment centre in Lagos, Nigeria. Respondents were identified using stratified sampling method. A pretested questionnaire was used to obtain information by trained research assistants. Obtained information were coded and managed using SPSS for windows version 19. Multivariate logistic regression model was used to determine independent predictor for acceptance of cervical cancer screening. Results Of the 1517 respondents that returned completed questionnaires, 853 (56.2% were aware of cervical cancer. Though previous cervical cancer screening was low at 9.4%, 79.8% (1210 accepted to take the test. Cost of the test (35.2% and religious denial (14.0% were the most common reasons given for refusal to take the test. After controlling for confounding variables in a multivariate logistic regression model, having a tertiary education (OR = 1.4; 95% CI: 1.03-1.84, no living child (OR: 1.5; 95% CI: 1.1-2.0, recent HIV diagnosis (OR: 1.5; 95% CI: 1.1-2.0 and being aware of cervical cancer (OR: 1.5; 95% CI: 1.2-2.0 retained independent association with acceptance to screen for cervical cancer. Conclusions The study shows that HIV positive women in our environment are willing to screen for cervical cancer and that the integration of reproductive health service into existing HIV programmes will strengthen rather than disrupt the services.

  19. Detection of EBV, CMV and HSV-1 in subgingival samples of HIV positive and negative patients with chronic periodontitis.

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    Laura Escalona

    2016-06-01

    Full Text Available Objective: To detect the presence of infection by EBV (Epstein-Barr Virus, CMV (Cytomegalovirus and HSV-1 (Herpes Simplex Virus type 1 in subgingival samples from HIV- positive patients under HAART (High Activity Antiretroviral Therapy, HIV- positive patients without HAART, HIV-negative patients with chronic periodontitis and healthy controls. Methodology: Crevicular fluid samples of 11 HIV+ patients on therapy were evaluated, 6 without antiretroviral therapy, 7 HIV- negative subjects with chronic periodontitis and 7 periodontally-healthy controls. PI (Plaque index, GI (Gingival Index, PD (probing depth and CAL (Clinical Attachment Loss were registered at six sites per each tooth in all teeth and subgingival plaque samples of a tooth were collected per quadrant. Nested PCR was used to detect EBV and endpoint PCR to detect infection by CMV and HSV-1. Results: Clinical parameters showed statistically significant differences between HIV-positive patients and subjects with chronic periodontitis compared with the control group (p<0.05. DNA of EBV was detected mainly in HIV-positive patients under HAART, 91% (10/11. DNA of CMV was detected mainly in patients without HAART, 67% (4/6, while HSV-1 was observed in 27% (3/11 of patients under HAART. In the control group no virus was detected. Coinfection was observed in 50% of HIV patients without HAART, 36% of HIV patients with HAART and 14% of HIV-negative with chronic periodontitis. Conclusion: Viral infection was prevalent in HIV patients under HAART and EBV was the primary viral infection detected in HIV-positive patients with chronic periodontitis.

  20. Prevalence of human papillomavirus infection & cervical abnormalities in HIV-positive women in eastern India.

    Science.gov (United States)

    Chakravarty, Jaya; Chourasia, Ankita; Thakur, Minaxi; Singh, Abhishek Kumar; Sundar, Shyam; Agrawal, Nisha Rani

    2016-01-01

    India has the third highest burden of HIV and highest number of cervical cancer in the world. A cross-sectional study was performed to determine the prevalence and types of human papillomavirus (HPV) infection, and the factors associated with HPV infection and abnormal cervical cytology in HIV-positive women attending the Antiretroviral Therapy (ART) Centre in a tertiary care hospital in eastern India. We screened 216 HIV- positive women with Papanicolau smear cytology and HPV testing. HPV DNA was detected by using consensus primers followed by sequencing. Of the 216 HIV-positive women screened, 58 (26.85%) were HPV-positive; 56 (25.9%) were of high-risk (HR) HPV type. The most prevalent HPV type was HPV-16 (7.9%); non 16 and 18 HPV types were present in 17.6 per cent patients. Age ≤ 35 yr [(OR), 2.56 (1.26-5.19)], illiteracy [OR, 2.30 (1.19-4.46)], rural residence [OR, 3.99 (1.27-12.56)] and CD4 ≤ 350/µl [OR, 2.46 (1.26-4.83)] were associated with increased risk of acquisition of HPV. One hundred thirty nine (74.33%) patients had normal/ negative for intraepithelial lesions (NILM) cytology, three (1.60%) had atypical squamous cells of undetermined significance (ASCUS), 32 (17.11%) had low-grade squamous intraepithelial lesions (LSIL), 10 (5.35%) had high-grade squamous intraepithelial lesions (HSIL) and three (1.60%) had carcinoma cervix. WHO clinical Stage III and IV [OR, 2.83 (1.07-7.49)] and CD4 ≤ 350/µl [OR, 2.84 (1.30-6.20)] were risk factors for abnormal cytology. Our study showed 26.85 per cent HPV positivity in HIV infected women in this region, with HPV-16 as the commonest genotype. Abnormal cervical cytology was seen in about 25 per cent women. Regular Pap smear screening as recommended by the National AIDS Control Organization will help in early detection of cervical abnormalities in HIV- positive women.

  1. Prevalence of human papillomavirus infection & cervical abnormalities in HIV-positive women in eastern India

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    Jaya Chakravarty

    2016-01-01

    Full Text Available Background & objectives: India has the third highest burden of HIV and highest number of cervical cancer in the world. A cross-sectional study was performed to determine the prevalence and types of human papillomavirus (HPV infection, and the factors associated with HPV infection and abnormal cervical cytology in HIV-positive women attending the Antiretroviral Therapy (ART Centre in a tertiary care hospital in eastern India. Methods: We screened 216 HIV- positive women with Papanicolau smear cytology and HPV testing. HPV DNA was detected by using consensus primers followed by sequencing. Results: Of the 216 HIV-positive women screened, 58 (26.85% were HPV-positive; 56 (25.9% were of high-risk (HR HPV type. The most prevalent HPV type was HPV-16 (7.9%; non 16 and 18 HPV types were present in 17.6 per cent patients. Age ≤ 35 yr [(OR, 2.56 (1.26-5.19], illiteracy [OR, 2.30 (1.19-4.46], rural residence [OR, 3.99 (1.27-12.56] and CD4 ≤350/µl [OR, 2.46 (1.26-4.83] were associated with increased risk of acquisition of HPV. One hundred thirty nine (74.33% patients had normal/ negative for intraepithelial lesions (NILM cytology, three (1.60% had atypical squamous cells of undetermined significance (ASCUS, 32 (17.11% had low-grade squamous intraepithelial lesions (LSIL, 10 (5.35% had high-grade squamous intraepithelial lesions (HSIL and three (1.60% had carcinoma cervix. WHO clinical Stage III and IV [OR, 2.83 (1.07-7.49] and CD4 ≤350/µl [OR, 2.84 (1.30-6.20] were risk factors for abnormal cytology. Interpretation &conclusions: Our study showed 26.85 per cent HPV positivity in HIV infected women in this region, with HPV-16 as the commonest genotype. Abnormal cervical cytology was seen in about 25 per cent women. Regular Pap smear screening as recommended by the National AIDS Control Organization will help in early detection of cervical abnormalities in HIV- positive women.

  2. Prevalence of human papillomavirus infection & cervical abnormalities in HIV-positive women in eastern India

    Science.gov (United States)

    Chakravarty, Jaya; Chourasia, Ankita; Thakur, Minaxi; Singh, Abhishek Kumar; Sundar, Shyam; Agrawal, Nisha Rani

    2016-01-01

    Background & objectives: India has the third highest burden of HIV and highest number of cervical cancer in the world. A cross-sectional study was performed to determine the prevalence and types of human papillomavirus (HPV) infection, and the factors associated with HPV infection and abnormal cervical cytology in HIV-positive women attending the Antiretroviral Therapy (ART) Centre in a tertiary care hospital in eastern India. Methods: We screened 216 HIV- positive women with Papanicolau smear cytology and HPV testing. HPV DNA was detected by using consensus primers followed by sequencing. Results: Of the 216 HIV-positive women screened, 58 (26.85%) were HPV-positive; 56 (25.9%) were of high-risk (HR) HPV type. The most prevalent HPV type was HPV-16 (7.9%); non 16 and 18 HPV types were present in 17.6 per cent patients. Age ≤ 35 yr [(OR), 2.56 (1.26-5.19)], illiteracy [OR, 2.30 (1.19-4.46)], rural residence [OR, 3.99 (1.27-12.56)] and CD4 ≤350/μl [OR, 2.46 (1.26-4.83)] were associated with increased risk of acquisition of HPV. One hundred thirty nine (74.33%) patients had normal/ negative for intraepithelial lesions (NILM) cytology, three (1.60%) had atypical squamous cells of undetermined significance (ASCUS), 32 (17.11%) had low-grade squamous intraepithelial lesions (LSIL), 10 (5.35%) had high-grade squamous intraepithelial lesions (HSIL) and three (1.60%) had carcinoma cervix. WHO clinical Stage III and IV [OR, 2.83 (1.07-7.49)] and CD4 ≤350/μl [OR, 2.84 (1.30-6.20)] were risk factors for abnormal cytology. Interpretation &conclusions: Our study showed 26.85 per cent HPV positivity in HIV infected women in this region, with HPV-16 as the commonest genotype. Abnormal cervical cytology was seen in about 25 per cent women. Regular Pap smear screening as recommended by the National AIDS Control Organization will help in early detection of cervical abnormalities in HIV- positive women. PMID:26997018

  3. Progressive resistance training in elderly hiv-positive patients: does it work?

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    Paula Maria Loiola de Souza

    2008-01-01

    Full Text Available BACKGROUND: Elderly people present alterations in body composition and physical fitness, compromising their quality of life. Chronic diseases, including HIV/AIDS, worsen this situation. Resistance exercises are prescribed to improve fitness and promote healthier and independent aging. Recovery of strength and physical fitness is the goal of exercise in AIDS wasting syndrome. OBJECTIVE: This study describes a case series of HIV-positive elderly patients who participated in a progressive resistance training program and evaluates their body composition, muscular strength, physical fitness and the evolution of CD4+ and CD8+ cell counts. METHODS: Subjects were prospectively recruited for nine months. The training program consisted of three sets of 8-12 repetitions of leg press, seated row, lumbar extension and chest press, performed with free weight machines hts, twice/week for one year. Infectious disease physicians followed patients and reported all relevant clinical data. Body composition was assessed by anthropometric measures and dual-energy x-ray absorptiometry before and after the training program. RESULTS: Fourteen patients, aged 62-71 years old, of both genders, without regular physical activity who had an average of nine years of HIV/AIDS history were enrolled. The strengths of major muscle groups increased (74%-122%, p=0.003-0.021 with a corresponding improvement in sit-standing and walking 2.4 m tests (p=0.003. There were no changes in clinical conditions and body composition measures, but triceps and thigh skinfolds were significantly reduced (p=0.037. In addition, there were significant increases in the CD4+ counts (N=151 cells; p=0.008 and the CD4+/CD8+ ratio (0.63 to 0.81, p=0.009. CONCLUSION: Resistance training increased strength, improved physical fitness, reduced upper and lower limb skinfolds, and were associated with an improvement in the CD4+ and CD4+/CD8+ counts in HIV positive elderly patients without significant side effects.

  4. 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

  5. Management of dyslipidaemia in an HIV-positive cohort

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    A Loy

    2012-11-01

    Full Text Available Background: Dyslipidaemia, secondary to both HIV and the use of antiretroviral therapy (ART is well recognised, with HIV replication and immune status also thought to contribute to the risk. Traditionally the HIV physician has looked after HIV with primary care physicians (GP managing non-HIV-related medical issues. However with the ageing population and the effectiveness of ART the HIV physician is diversifying to focus management strategies on preventative measures also. Method: 127 subjects were recruited. All subjects were HIV-positive males without any traditional cardiovascular disease symptoms or history. Details of patients demographics, family history, statin therapy, and primary care physician contact were collected. Baseline parameters were recorded and fasting bloods taken. Results: 127 asymptomatic HIV-positive males were recruited. 74/127 (58.3% met the EACS criteria for statin prescription. 33/74 (44.6% were on a statin. There was no significant difference between the class of antiretroviral prescribed, (NNRTI v PI and lipid abnormalities (p=0.628. Hypertension and increased waist:hip ratio significantly increased the chances of the patient being hyperlipidaemic. Patients were more likely to be prescribed a statin if they were older, had hypertension, an increased waist circumference, increased Framingham risk, increased brain natriuretic peptide (BNP, or were diagnosed HIV-positive for longer (p<0.05. Pravastatin (21/33 [63.6%], was most commonly prescribed statin. 24.2% received their statin prescription from their HIV physician, with 75.8% receiving their prescription from their GP. 5/21 (23.8% on pravastatin met the target verses 7/7 (100% on atorvastatin verses 2/2 (100% on simvastatin versus 1/3 (33.3% on rosuvastatin (p=0.02. Meeting lipid targets was less successful in the protease inhibitor group (1/9 11.1% versus 11/21 (52.4% in the NNRTI group (p=0.16. Conclusion: The majority met criteria for lipid management but less

  6. Predictors of emphysema progression in HIV-positive patients

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    Giovanni Guaraldi

    2014-11-01

    Full Text Available Introduction: The aim of the study was to find factors associated with emphysema progression (EP, assessed on sequential thoracic CT scans, in a large cohort of HIV-positive patients. Materials and Methods: This was an observational, prospective study of 448 consecutive HIV-positive patients on antiretroviral therapy who underwent two sequential ECG-gated coronary artery calcium scoring CT scans. Images were reviewed by three radiologists by consensus to assess lung emphysema using a visual semi-quantitative score (0 to 4 for each of six lobes. EP was defined as an increase in emphysema score. Heavy smoking habit was defined as a self-reported number of cigarettes per day smoked greater than 10. Immune reconstitution was defined as the change in CD4 cell count between first CT scan and CD4 nadir and it was divided into tertiles. Progressors and non-progressors were compared using X2-test for categorical variables and T-test of Mann–Whitney U test for continuous variables where appropriate. Factors independently associated with EP were explored using multivariable logistic regression analyses. A p-value <.05 was considered statistically significant. Results: The mean age of the included patients was 47,9±7,7 years, 24,1% of them were females and 39,3% were smokers. The median interval between the two CT scans was 2,4 years (interquartile range 0,69–5,9 years. EP was significantly associated with HIV-infection duration (p=0,056, smoking (p=0,007 and in particular heavy smoking habit (p=0,015 and time interval between the two scans (p=0,021, while the highest tertile of immune reconstitution was borderline in significance (p=0,075. Age and sex were not significantly related to EP and were not included in further analyses. HIV infection duration (OR=1,01; p=0,013, time interval between the two scans (OR=1,51; p=0,032 and heavy smoking habit (OR=3,36; p=0,041 remained independently associated with EP in multivariate analysis. Conclusions: In

  7. Antifungal activity of natural compounds against Candida species isolated from HIV-positive patients

    Institute of Scientific and Technical Information of China (English)

    Dbora Oro; Andria Heissler; Eliandra Mirlei Rossi; Diane Scapin; Patrcia da Silva Malheiros; Everton Boff

    2015-01-01

    To evaluate the antifungal effect of Cinnamomum zeylanicum (C. zeylanicum) and Melaleuca alternifolia essential oils and honey against strains of Candida sp. from HIV-positive patients in order to subsidize new therapeutic strategies for candidiasis. Methods: The study evaluated the antifungal effect of natural antimicrobials against 30 strains of Candida sp. isolated from oral cavities in HIV-infected patients. Then, they were compared to the action of fluconazole and amphotericin B. Antifungal susceptibility was evaluated by the broth macrodilution technique and the minimum inhibitory concentration and the minimum fungicidal concentration were determined. Results: Among all antifungals evaluated in this study, amphotericin B was the one showing the best results; however, all compounds studied here showed inhibitory activities against isolates of Candida sp. Honey (0.031 3 to 64 μg/mL) demonstrated fungistatic activity inhibiting 70% of the isolates. C. zeylanicum essential oil (0.0313 to 64 μg/mL) inhibited 93.3% of the Candida strains and Melaleuca alternifolia essential oil (0.0313 to 64 μg/mL) was able to inhibit 73.3% of them. Conclusions: Therefore, all natural compounds evaluated in this study, especially C. zeylanicum essential oil, may become promising agents for oral candidiasis therapy including in HIV-positive patients.

  8. Evaluation of virulence factors of Candida albicans isolated from HIV-positive individuals using HAART.

    Science.gov (United States)

    de Paula Menezes, Ralciane; de Melo Riceto, Érika Bezerra; Borges, Aércio Sebastião; de Brito Röder, Denise Von Dolingër; dos Santos Pedroso, Reginaldo

    2016-06-01

    The colonization by Candida species is one of the most important factors related to the development of oral candidiasis in HIV-infected individuals. The aim of the study was to evaluate and discuss the phospholipase, proteinase, DNAse and haemolytic activities of Candida albicans isolated from the oral cavity of HIV individuals with high efficiency antiretroviral therapy. Seventy-five isolates of C. albicans obtained from saliva samples of patients with HIV and 41 isolates from HIV-negative individuals were studied. Haemolytic activity was determined in Sabouraud dextrose agar plates containing 3% glucose and 7% sheep red cells. Culture medium containing DNA base-agar, egg yolk, and bovine albumin were used to determine DNase, phospholipase and proteinase activities, respectively. All isolates from the HIV patients group had haemolytic activity, 98% showed phospholipase activity, 92% were positive for proteinase and 32% DNAse activity. Regarding the group of indivídios HIV negative, all 41 isolates presented hemolytic activity, 90.2% showed phospholipase and proteinase activity and 12.2% were positive for DNAse. The phospholipase activity was more intense for the group of HIV positive individuals. DNase production was more frequently observed in the group of HIV-positive individuals. The percentage of isolates having DNAse activity was also significantly different between the groups of patients not using any antiretroviral therapy, those using transcriptase inhibitors and those using transcriptase inhibitor and protease inhibitor in combination.

  9. Antifungal activity of natural compounds against Candida species isolated from HIV-positive patients

    Institute of Scientific and Technical Information of China (English)

    Débora; Oro; Andréia; Heissler; Eliandra; Mirlei; Rossi; Diane; Scapin; Patrícia; da; Silva; Malheiros; Everton; Boff

    2015-01-01

    Objective: To evaluate the antifungal effect of Cinnamomum zeylanicum(C. zeylanicum) and Melaleuca alternifolia essential oils and honey against strains of Candida sp. from HIV-positive patients in order to subsidize new therapeutic strategies for candidiasis.Methods: The study evaluated the antifungal effect of natural antimicrobials against 30 strains of Candida sp. isolated from oral cavities in HIV-infected patients. Then, they were compared to the action of fl uconazole and amphotericin B. Antifungal susceptibility was evaluated by the broth macrodilution technique and the minimum inhibitory concentration and the minimum fungicidal concentration were determined.Results: Among all antifungals evaluated in this study, amphotericin B was the one showing the best results; however, all compounds studied here showed inhibitory activities against isolates of Candida sp. Honey(0.031 3 to 64 μg/m L) demonstrated fungistatic activity inhibiting 70% of the isolates. C. zeylanicum essential oil(0.031 3 to 64 μg/m L) inhibited 93.3% of the Candida strains and Melaleuca alternifolia essential oil(0.031 3 to 64 μg/m L) was able to inhibit 73.3% of them.Conclusions: Therefore, all natural compounds evaluated in this study, especially C. zeylanicum essential oil, may become promising agents for oral candidiasis therapy including in HIV-positive patients.

  10. Clinical mimicry by herpetic ulceration in a HIV positive teenager.

    Science.gov (United States)

    Bhardwaj, Abhishek; Rathore, Bhagirath S; Sharma, Charu; Singh, Garima

    2015-01-01

    The human immunodeficiency virus (HIV) is known to cause altered disease presentations. We present here, the case of a 14-year-old boy who came to us with a chronic, painful, nonhealing ulcer of 4 months duration over the dorsum of right hand. Before our observation, he was variably diagnosed and treated as atypical mycobacterial infection, deep fungal infection, squamous cell carcinoma, and pyoderma gangrenosum. On administration of systemic corticosteroids his condition worsened, after which he was tested for, and found to be HIV positive. He was put onto valacyclovir, responded slowly, with healing after 2 months of antiviral therapy. The case report highlights unusual presentation in an under-considered age group and a slow response to otherwise effective therapy.

  11. Renal Impairment and Cardiovascular Disease in HIV-Positive Individuals

    DEFF Research Database (Denmark)

    Ryom, Lene; Lundgren, Jens D; Ross, Mike

    2016-01-01

    follow-up duration of 8.0 years (interquartile range, 5.4-8.9 years) 1357 of 35 357 individuals developed CVD (incidence rate, 5.2 cases/1000 person-years [95% confidence interval {CI}, 5.0-5.5]). Confirmed baseline eGFR and CVD were closely related with 1.8% of individuals (95% CI, 1.6%-2.0%) with an e...... relation between confirmed impaired eGFR and CVD was observed. This finding highlights the need for renal preventive measures and intensified monitoring for emerging CVD, particularly in older individuals with continuously low eGFRs.......BACKGROUND: While the association between renal impairment and cardiovascular disease (CVD) is well established in the general population, the association remains poorly understood in human immunodeficiency virus (HIV)-positive individuals. METHODS: Individuals with ≥2 estimated glomerular...

  12. Treatment of leishmaniasis in HIV-positive patients.

    Science.gov (United States)

    Laguna, F

    2003-10-01

    Although, in southern Europe, there has been considerable experience in the treatment of visceral leishmaniasis (VL) in HIV-positive patients, the optimal therapy has yet to be established. Pentavalent antimony salts, free amphotericin B deoxycholate (ABD) and lipidic formulations of amphotericin B are the drugs most commonly used. Treatment with pentavalent antimonials requires daily injections for 28 days, is not well tolerated and leads to initial clinical cure in only 66% of the co-infected cases. Free ABD has to be given, intravenously, for just as long, has significant toxicity and leads to initial clinical cure in even fewer cases (62%). In a prospective, comparative trial, treatment of co-infected cases with a pentavalent antimonial was found to have similar efficacy and toxicity to treatment with free ABD. The duration of treatment and the associated toxicity may both be reduced by the use of lipidic formulations of amphotericin B. Anecdotal evidence and the results of non-randomized trials indicate that treatment with liposomal amphotericin B is highly effective. In a comparative trial, amphotericin B lipid complex was found to be not only as effective as a pentavalent antimonial but also better tolerated. At the moment, however, such lipidic formulations have only been tested against VL/HIV cases in Europe, not elsewhere in the world, and they remain very expensive. However successful the treatment in terms of initial clinical cure, almost all VL/HIV cases develop VL relapses. Although the data available on secondary prophylaxis are limited and often inconclusive, it appears that regular treatment with a pentavalent antimonial drug, liposomal amphothericin B or amphotericin B lipid complex can reduce the incidence of leishmanial relapses in HIV-positive patients with VL. The development of new regimens, use of new oral drugs (such as miltefosine) and the development of new antileishmanial drugs could all improve the treatment of HIV-related VL in the

  13. Uptake and continuous use of copper intrauterine device in a cohort of HIV-positive women.

    Science.gov (United States)

    Landolt, Nadia Kancheva; Phanuphak, Nittaya; Teeratakulpisarn, Nipat; Kriengsinyot, Rosalin; Ahluwalia, Jennisa; Pinyakorn, Suteeraporn; Chaithongwongwatthana, Surasith; Ananworanich, Jintanat

    2013-01-01

    Copper intrauterine device (IUD) is not commonly used in many countries, though it provides effective reversible contraception with no or minimal primary systemic side effects. We assessed its uptake and continuation of use among HIV-positive Thai women. Sixty-six of 322 women of reproductive age, whom we approached for the study, met the eligibility criteria. Sterilization (62%) was the main reason for failure to enroll. Twenty-nine of them (44%) underwent IUD insertion. Considering condom use sufficient for pregnancy prevention (12%) was the main reason among eligible women for the refusal to participate in the study. At six months, 54% of enrolled participants reported one or more side effects such as increased menstrual flow (43%), spotting (21%) and dysmenorrhea (11%). The continuation rate of IUD use was high (93%), in spite of the persistent non-systemic side effects. The study showed that copper IUD could be an acceptable contraceptive choice for Thai HIV-positive women. Easy access to the method in a setting linked with the HIV service, and education on IUD risks and benefits is needed to promote the use of IUD in addition to condoms as an effective contraceptive option in HIV-infected women.

  14. Pneumocystis jirovecii colonisation in HIV-positive and HIV-negative subjects in Cameroon.

    Science.gov (United States)

    Riebold, D; Enoh, D O; Kinge, T N; Akam, W; Bumah, M K; Russow, K; Klammt, S; Loebermann, M; Fritzsche, C; Eyong, J E; Eppel, G; Kundt, G; Hemmer, C J; Reisinger, E C

    2014-06-01

    To determine the prevalence of Pneumocystis pneumonia (PCP), a major opportunistic infection in AIDS patients in Europe and the USA, in Cameroon. Induced sputum samples from 237 patients without pulmonary symptoms (126 HIV-positive and 111 HIV-negative outpatients) treated at a regional hospital in Cameroon were examined for the prevalence of Pneumocystis jirovecii by specific nested polymerase chain reaction (nPCR) and staining methods. CD4 counts and the history of antiretroviral therapy of the subjects were obtained through the ESOPE database system. Seventy-five of 237 study participants (31.6%) were colonised with Pneumocystis, but none showed active PCP. The Pneumocystis colonisation rate in HIV-positive subjects was more than double that of HIV-negative subjects (42.9% vs. 18.9%, P 500 cells/μl were colonised at a rate of 20.0%, subjects with CD4 counts between 200 and 500 cells/μl of 42.5%, and subjects with CD4 counts <200 cells/μl of 57.1%. Colonisation with Pneumocystis in Cameroon seems to be comparable to rates found in Western Europe. Prophylactic and therapeutic measures against Pneumocystis should be taken into account in HIV care in western Africa. © 2014 John Wiley & Sons Ltd.

  15. Chest physiotherapy for collecting sputum samples from HIV-positive patients suspected of having tuberculosis.

    Science.gov (United States)

    Souza Pinto, V; Bammann, R H

    2007-12-01

    A public referral hospital in Sao Paulo, Brazil. To evaluate chest physiotherapy as a means of obtaining sputum samples from human immunodeficiency virus (HIV) positive in-patients suspected of having pulmonary tuberculosis (TB). A prospective study. Five consecutive samples were collected from 132 patients using the 'spontaneous' technique (ST) on day 1, slow expiration with the glottis open in a lateral posture ('expiration lente totale glotte ouverte en infralatéral', ELTGOL) on day 2, ST on day 3, sputum induction with hypertonic saline (SIHS) on day 4 and ST on day 5. Samples were processed for acid-fast bacilli (AFB) smear and seeded onto Löwenstein-Jensen medium. Mycobacteria were recovered from 34 patients (25.8%). Nine (26.5%) of the strains were identified as mycobacteria other than Mycobacterium tuberculosis. AFB smear sensitivity was higher in ELTGOL samples than in ST or SIHS samples (52.9% vs. 32.4% and 29.4%), although the difference among the three was not significant (P = 0.098). In culture, the three ST samples proved significantly more sensitive (P = 0.05). Physiotherapy shows promise as a technique for obtaining sputum from HIV-positive patients, and AFB testing of a single sample presents high sensitivity. However, this does not preclude the routine collection of three samples, as TB cannot be ruled out before the culture results are known.

  16. 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.

  17. Oral opportunistic infections in HIV-positive individuals: review and role of mucosal immunity.

    Science.gov (United States)

    Leigh, Janet E; Shetty, Kishore; Fidel, Paul L

    2004-08-01

    Oral opportunistic infections in the HIV-positive individual have been documented since the first reports of the epidemic, with many lesions associated with reduced CD4(+) T lymphocyte cell count. The most common oral lesions seen in HIV disease prior to the advent of highly active antiretroviral therapy (HAART) were oropharyngeal candidiasis and oral hairy leukoplakia. However, since the advent of HAART while many oral lesions have decreased significantly the incidence of oral warts has surprisingly increased. Despite the correlation of diminished CD4(+) T lymphocyte count to the occurrence of these lesions, it is rare for the lesions to occur concurrently suggesting that each pathologic lesion type is associated with distinct host immune dysfunctions. To date, the oral opportunistic infection most frequently investigated is oropharyngeal candidiasis, where data suggests that both systemic and local immunity is important for protection against infection. In contrast, recent investigations into the host responses associated with oral hairy leukoplakia and oral warts show little to no evidence of systemic or mucosal immune responsiveness despite the presumed competence of several types of leukocytes other than CD4(+) T cells. Together these data are suggesting that susceptibility to oropharyngeal candidasis in HIV-positive persons is predominantly immune-based, whereas protection or susceptibility to oral hairy leukoplakia and oral warts may be more associated with factors other than mucosal immune function.

  18. Self-Efficacy for Sexual Risk Reduction and Partner HIV Status as Correlates of Sexual Risk Behavior Among HIV-Positive Adolescent Girls and Women.

    Science.gov (United States)

    Boone, Melissa R; Cherenack, Emily M; Wilson, Patrick A

    2015-06-01

    Little is known about the correlates of sexual risk behavior among HIV-positive adolescent girls and women in the United States. This study investigates two potential factors related to unprotected vaginal and anal intercourse (UVAI) that have yet to be thoroughly studied in this group: self-efficacy for sexual risk reduction and partner HIV status. Data was analyzed from 331 HIV-positive adolescent girls and women between 12 and 24 years old who reported vaginal and/or anal intercourse with a male partner in the past 3 months at fifteen sites across the United States. Results show that overall self-efficacy (B=-0.15, p=0.01), self-efficacy to discuss safe sex with one's partner (B=-0.14, p=0.01), and self-efficacy to refuse unsafe sex (B=-0.21, p=0.01) are related to UVAI episodes. Participants with only HIV-positive partners or with both HIV-positive and HIV-negative partners showed a trend towards higher percentages of UVAI episodes compared to participants with only HIV-negative partners (F(2, 319)=2.80, p=0.06). These findings point to the importance of including self-efficacy and partner HIV status in risk-reduction research and interventions developed for HIV-positive adolescent girls and young women.

  19. The cost and intensity of behavioral interventions to promote HIV treatment for prevention among HIV-positive MSM

    OpenAIRE

    Safren, Steven A.; Perry, Nicholas S.; Blashill, Aaron J.; O’CLEIRIGH, CONALL; Mayer, Kenneth H.

    2015-01-01

    Recently, behavioral prevention interventions for HIV have been criticized as being ineffective, costly, or inefficient. In this commentary, using HIV-positive men who have sex with men (MSM) as an illustrative high-risk population, we argue that the opposite is true – that behavioral interventions for HIV prevention, if implemented with the populations who need them, are affordable and critical for future prevention efforts. We base this argument on recent evidence showing that 1) adherence ...

  20. Antiretroviral adherence and virological outcomes in HIV-positive patients in Ugu district, KwaZulu-Natal province.

    Science.gov (United States)

    Kapiamba, Germain; Masango, Thembekile; Mphuthi, Ditaba

    2016-09-01

    Adherence to antiretroviral therapy is crucial to ensure viral suppression. In the scientific community it is widely accepted that an adherence level of at least 90% is necessary to achieve viral suppression. This study uses pharmacy refill records to describe antiretroviral adherence in HIV-positive patients in Ugu District, KwaZulu-Natal, South Africa and to describe pharmacy refill records as reliable monitoring method of antiretroviral therapy. In total, 61 patients' records were reviewed. Overall, 50 (82%) of the patients achieved an optimum adherence level of at least 90%, whereas 19 (38%) of these patients did not show any related viral suppression. A statistically significant relationship between adherence and viral suppression was not demonstrated. Therefore, pharmacy refill records cannot be recommended as an alternative method of monitoring response to antiretroviral therapy, but laboratory tests including CD4 cell count and or viral load must be combined with the pharmacy refill method for monitoring of antiretroviral therapy in HIV-positive patients.

  1. Experiences of HIV-related stigma among HIV-positive older ...

    African Journals Online (AJOL)

    Monica O. Kuteesa

    2014-07-23

    Jul 23, 2014 ... disclosure in a cohort of HIV-positive older people in Uganda. ... (rural site) and Wakiso district (peri-urban site) residents, we measured self-reported stigma levels for 183 ...... A Comparison of HIV Stigma and Disclosure Patterns .... Stigma among HIV-positive Mothers and Their Uninfected Adolescent Chil-.

  2. Estimated glomerular filtration rate, chronic kidney disease and antiretroviral drug use in HIV-positive patients

    NARCIS (Netherlands)

    A. Mocroft; O. Kirk; P. Reiss; S. de Wit; D. Sedlacek; M. Beniowski; J. Gatell; A.N. Phillips; B. Ledergerber; J.D. Lundgren

    2010-01-01

    Objectives: Chronic kidney disease (CKD) in HIV-positive persons might be caused by both HIV and traditional or non-HIV-related factors. Our objective was to investigate long-term exposure to specific antiretroviral drugs and CKD. Design: A cohort study including 6843 HIV-positive persons with at le

  3. Meningeal Hemangiopericytoma with Intracranial Metastases in an HIV-Positive Male: Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Zachary Beatty

    2012-03-01

    Full Text Available Background: Meningeal hemangiopericytoma is a rare, aggressive CNS tumor that tends to invade locally, metastasize, and has a high rate of recurrence. HIV classically increases the risk of 3 AIDS-defining malignancies: Kaposi’s sarcoma, non-Hodgkin’s lymphoma and invasive cervical cancer. More recently, considerable interest has been paid to the link between HIV and a wider range of non-AIDS-defining cancers. An HIV-positive patient with meningeal hemangiopericytoma is described. Case Description: A 36-year-old HIV-positive male presented with worsening headache and ataxia. The patient had experienced similar neurologic symptoms 4 months prior and MRI at that time had showed an extra-axial left cerebellar mass most consistent with benign meningioma. Repeat MRI showed the tumor had increased in size by a factor of greater than 20 in this 4-month period, with 4 small additional foci of similar enhancement. Subtotal resection was performed on the mass and final pathological diagnosis was meningeal hemangiopericytoma. Conclusions: This represents the first reported case of meningeal hemangiopericytoma in an HIV-positive patient. This is also the shortest time to intracranial metastasis ever reported for a meningeal hemangiopericytoma. Although the increased risk in the HIV-positive population of non-AIDS-defining cancers that has been observed in recent years can largely be attributed to cancers with a known viral pathogenesis, it is speculated that HIV infection in this patient may have contributed to the occurrence or unique behavior of this rare tumor.

  4. Reaction Time Variability in HIV-Positive Individuals

    Science.gov (United States)

    Ettenhofer, Mark L.; Foley, Jessica; Behdin, Nina; Levine, Andrew J.; Castellon, Steven A.; Hinkin, Charles H.

    2010-01-01

    Progression of HIV/AIDS is frequently associated with frontal/subcortical dysfunction and mean reaction time (RT) slowing. Beyond group means, within-subject variability of RT has been found to be particularly sensitive to frontal/subcortical dysfunction in other populations. However, the possible relevance of RT variability to HIV/AIDS patients remains unknown. This study evaluated the relationships between RT variability and indicators such as neurocognitive, behavioral, and immunological status. A total of 46 HIV-positive adults on antiretroviral medication regimens were included in this study. Overall performance of this sample was poorer than normative means on measures of RT latency, RT variability, and traditional neurocognitive domains. Results demonstrated that the measures of RT variability were associated with global cognition, medication adherence rates, and peak immunological dysfunction, above and beyond the effects of RT latency. These preliminary findings suggest that measures of RT variability may provide enhanced sensitivity to neurocognitive disease burden in HIV/AIDS relative to more traditional measures of mean RT or cognitive function. PMID:20798183

  5. 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.

  6. MHA-Tp testing on HIV positive and negative women in vigilance home at Madurai.

    Science.gov (United States)

    Ganapathysundaram, S; Mallika, M; Chandrasekaran, S; Mohan, G

    1992-01-01

    In the study group of 94 cases of female prostitutes and their children 55 cases showed positive for HIV infection by ELISA and Western Blot tests. They showed positive also for syphilis in 37 cases by VDRL and in 43 cases by MHA-Tp tests among HIV positive and negative women. The association of HIV infection and syphilis was observed in this study due to sexual transmission of these infections. But congenital spread from infected mother to their children was not observed in this study since both mothers and their children were negative for these infections. MHA-Tp testing confirmed VDRL test results in 27 cases and also increased specificity of MHA-Tp test result over VDRL result in 16 cases and exclusion of biological false positive by VDRL in 10 cases were noticed in this study.

  7. Illness Representations of HIV Positive Patients Are Associated with Virologic Success

    Science.gov (United States)

    Leone, Daniela; Borghi, Lidia; Lamiani, Giulia; Barlascini, Luca; Bini, Teresa; d’Arminio Monforte, Antonella; Vegni, Elena

    2016-01-01

    Introduction: It is important for HIV positive patients to be engaged in their care and be adherent to treatment in order to reduce disease progression and mortality. Studies found that illness representations influence adherence through the mediating role of coping behaviors. However, no study has ever tested if patient engagement to the visits mediate the relationship between illness perceptions and adherence. This study aimed to explore illness representations of HIV positive patients and test the hypothesis that illness representations predict adherence through the mediating role of a component of behavioral engagement. Methods: HIV-positive patients treated with highly active antiretroviral therapy (HAART) for at least one year and presenting to a check-up visit were eligible to participate in the study. Patients completed the Illness Perception Questionnaire-Revised. Behavioral engagement was measured based on the patients’ clinical attendance to the check-up visits; adherence to HAART was measured by viral load. Undetectable viral load or HIV-RNA < 40 copies/ml were considered indexes of virologic success. Results: A total of 161 patients participated in the study. Most of them coherently attributed the experienced symptoms to HIV/HAART; perceived their condition as chronic, stable, coherent, judged the therapy as effective, and attributed their disease to the HIV virus and to their behavior or bad luck. The majority of patients (80.1%) regularly attended check-up visits and 88.5% of them reached virologic success. The mediation model did not show good fit indexes. However, a significant direct effect of two independent variables on virologic success was found. Specifically, the perception that the disease does not have serious consequences on patient’s life and the prevalence of negative emotions toward HIV were associated with virologic success. On the contrary, the patient’s perception that the disease has serious consequences on his/her life and

  8. Depression in HIV-positive women is associated with changes in antiretroviral treatment regimens

    Directory of Open Access Journals (Sweden)

    Claus Philippe Küpper-Tetzel

    2014-11-01

    Full Text Available Introduction: Depression is a co-morbidity of clinical significance in HIV-positive patients with an estimated prevalence of more than 20%. Sex and gender-related differences in depression are well described in HIV-negative populations, demonstrating that more women are being affected. So far little is known about frequency and characteristics of depression in HIV-positive men and women. Materials and Methods: Primary objective of our prospective epidemiological study was the evaluation of the Beck score for depression in male and female patients of the Frankfurt HIV Cohort. The Beck Depression Inventory (BDI-II is a self-report symptom inventory made up of 21 questions, each with 4 possible answers, correlating with a certain point value. Interpretation: score 14–19: mild depression; score 20–28: moderate depression; score ≥29: severe depression. Secondary objectives of the analysis were factors that might possibly influence the disposition for depression in HIV-positive patients, e.g. age, antiretroviral treatment history, co-morbidities and socioeconomic status. Results: Between January and October 2013, 348 patients were enrolled in the study, 161 women and 187 men of the Frankfurt HIV Cohort, who had a routine appointment at the HIV-Center of the University Clinic Frankfurt. The mean age of all study participants was 45 years (range 22–80. The majority of patients were on antiretroviral therapy (91% at study entrance. The median BDI-II score in all patients was 8 (0–49; in female patients 10 (0–42, in male patients 6 (0–49, respectively (Table 1. Significant more women than men showed a score for moderate depression (p=0.006. Factors associated with a BDI-II score ≥20 in women were older age (>45 years, living alone, unemployment and the number of prior changes in antiretroviral therapy. Conclusions: Depression in people living with HIV shows sex and gender-related differences that might also influence antiretroviral

  9. Performance of visual inspection with acetic acid and human papillomavirus testing for detection of high-grade cervical lesions in HIV positive and HIV negative Tanzanian women

    DEFF Research Database (Denmark)

    Dartell, Myassa Arkam; Rasch, Vibeke; Iftner, Thomas;

    2014-01-01

    The aim of this cross sectional study was to assess type distribution of human papillomavirus (HPV) among HIV positive and HIV negative women who underwent cervical cancer screening, and to examine the ability of visual inspection with acetic acid (VIA), the standard detection method in Tanzania...... types among women with HSIL+ cytology with prevalences of 42.9, 35.7 and 28.6%, respectively, in HIV positive women which was higher than among HIV negative women (30.2, 21.9 and 16.7%). A total of 4.5% of the women were VIA positive, and VIA showed a low sensitivity compared to HPV......-testing for detection of HSIL+. The sensitivity of VIA varied with staff VIA experience, HIV status and age. Vaccines including HPV16, HPV52 and HPV18 will likely reduce the number of HSIL+ cases independently of HIV status. The frequency of HSIL+ was high among HIV positive women, emphasizing the importance...

  10. Pregnancy decision-making among HIV-positive women in Northern Vietnam

    DEFF Research Database (Denmark)

    Gammeltoft, Tine; Rasch, Vibeke; Bui Kim, Chi

    2011-01-01

    The global HIV epidemic confronts pregnant women with hard reproductive choices. This paper offers a theoretically innovative and ethnographically sensitive exploration of the social processes through which 20 HIV positive women living in Northern Vietnam decide whether to continue or terminate...... their pregnancies. Arguing that human agency must be seen as an outcome of intersubjective engagements in shared social worlds, this paper explores how these women came to the decisions that they had to make and shows that women's choices were configured through everyday social relations, shaped through intimate...... engagements with husbands, parents, siblings, and in-laws. Based on the findings, it is recommended that pregnancy counseling is offered not only to the woman herself, but also, if she desires, involves members of her extended family....

  11. Overall and cause-specific mortality in HIV-positive subjects compared to the general population

    Directory of Open Access Journals (Sweden)

    Belen Alejos

    2014-11-01

    Full Text Available Introduction: Emerging non-AIDS related causes of death have been observed in HIV-positive subjects in industrialized countries. We aimed to analyze overall and cause-specific excess of mortality of HIV-positive patients compared to the general population and to assess the effect of prognostic factors. Material and Methods: We used generalized linear models with Poisson error structure to estimate overall and cause-specific excess of mortality in HIV-positive patients from 2004 to 2012 in the cohort of the Spanish Network of HIV Research (CoRIS, compared to Spanish general population and to assess the impact of multiple risk factors. We investigated differences between short-term and long-term risk factors effects on excess of mortality. Multiple Imputation by Chained Equations was used to deal with missing data. Results: In 9162 patients there were 363 deaths, 16.0% were non-AIDS malignancies, 10.5% liver and 0.3% cardiovascular related. Excess mortality was 1.20 deaths per 100 person years (py for all-cause mortality, 0.16 for liver, 0.10 for non-AIDS malignancies and 0.03 for cardiovascular. Short-term (first-year follow-up excess Hazard Ratio (eHR for global mortality for baseline AIDS was 4.27 (95% CI 3.06–6.01 and 1.47 (95% CI 0.95–2.27 for HCV coinfection; long-term (subsequent follow-up eHR for baseline AIDS was 0.88 (95% CI 0.58–1.35 and 4.48 (95% CI 2.71–7.42 for HCV coinfection. Lower CD4 count and higher viral load at entry, lower education, being male and over 50 years were predictors for overall excess mortality. Excess of liver mortality was higher in patients with CD4 counts at entry below 200 cells compared to those above 350 (eHR: 6.49, 95% CI 1.21–34.84 and in HCV-coinfected patients (eHR: 3.85, 95% CI 0.85– 17.37, although it was borderline significant. Patients over 50 years old (eHR: 5.55, 95%CI 2.4–12.85 and HCV coinfected (eHR: 5.81, 95% CI 2.6–13 showed a higher risk of non-AIDS malignancies mortality

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

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    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

  13. Contraceptive use among HIV-positive women in Quang Ninh province, Vietnam.

    Science.gov (United States)

    Chi, Bui Kim; Gammeltoft, Tine; Hanh, Nguyen Thi Thuy; Rasch, Vibeke

    2012-10-01

    To investigate contraceptive use among HIV-positive women in Ha long city and Cam Pha town of Quang Ninh, a Northern province of Vietnam. Cross-sectional questionnaire study among HIV-positive women identified through the district HIV/AIDS register. Information on socioeconomic characteristics and contraceptive use before and after HIV diagnosis was obtained through structured questionnaires. Chi-square testing was used to assess whether the included women differed from the target population in terms of age. Crude Odds ratios (ORs) were calculated to show the association between contraceptive use and the women's socioeconomic characteristics. Logistic regression analyses were applied to adjust for possible confounding. The women's contraceptive use before HIV testing and after HIV testing was described and compared by Chi-square testing, and the association between post-test counselling and the women's use of condom was assessed by ORs. Of the 351 participants, 63% stated they had used contraception before HIV diagnosis and 89% stated they had used contraception after HIV diagnosis. Forty six per cent of the women had been using either the pill or an intrauterine device (IUD) before the diagnosis whereas the same applied for only 8% of the women after diagnosis. Thirty-nine per cent stated they had been using condom before HIV diagnosis whereas 87% stated condom use after HIV diagnosis. Condom use was more common among women who had received post-test counselling (OR 3.03, 95% CI 1.03-8.90). A change of contraceptive methods from IUD and oral contraception before HIV diagnosis to condom use after HIV diagnosis was observed. The women's use of condoms after HIV diagnosis was associated with having received post-test counselling. © 2012 Blackwell Publishing Ltd.

  14. Expression Analysis of Cellular Mir-29a and mir-29b in HIV Positive Patients

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    Hasan Kaleji (MSc

    2016-01-01

    Full Text Available Background and Objective: Various cellular factors affect the process of HIV activity. One of these cellular factors are structures known as microRN that are expected to be involved in controlling HIV replication and infectivity. The expression of one or a set of them may represent the patient's clinical conditions. In this study, the expression of miR-29a and miR-29b involved in regulating viral genes’ expression was evaluated in three HIV-positive groups and a healthy control group. Later, the expression level of these microRNAs was compared between the cases and controls. Methods: Total RNA extraction was performed on the collected samples using RNx-plus kit and then the microRNA expression levels were evaluated using Relative Real-time PCR. The obtained data was entered into SPSS 22 and Graphpad softwares and analyzed using Kruskal-Wallis and Man-Whitney tests. P-value of less than 0.05 was considered as statistical significance level. Results: The expression level of miR-29a was reduced in patients under treatment and drug-resistant patients ( P ≤ 0.05 . All three HIV-positive groups including people without drug treatment, patients under treatment and drug-resistant patients showed reduced miR-29b expression level compared to control group (P ≤ 0.05. Conclusion: the decreased expression of miR-29a and miR-29b in patients under treatment and drug-resistant patients indicates an increased viral replication and reduced CD4 cell count. It may be possible to predict the progression of the disease by miRNA measurement or control viral replication using these mir-RNAs that requires further studies.

  15. Immunopathology of the duodenal mucosa of HIV-positive patients during combined antiretroviral therapy

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    F.R. Machado

    2006-01-01

    Full Text Available The objective of the present study was to evaluate the duodenal mucosa of HIV-infected patients during antiretroviral therapy. This was an observational study conducted on HIV-positive patients and a control group. Group 1 comprised 22 HIV-negative individuals while 38 HIV-positive individuals were classified according to the CDC 1993 classification into group 2 (A1 or A2 or group 3 (B2, A3, B3, C2, C3. All subjects were submitted to upper gastrointestinal endoscopy with duodenal biopsies. Qualitative, semi-quantitative and quantitative histological analyses were performed. Results were considered significant when P < 0.05. A higher prevalence of inflammatory infiltrate and eosinophilia was observed in the HIV group, together with a reduction in mucosal CD4+ lymphocyte (L counts [median (lower-upper quartiles, 12.82 (8.30-20.33, 6.36 (1.75-11.66 and 1.75 (0.87-3.14 in groups 1, 2 and 3, respectively] which was not correlated with disease stage. The extent of CD4+L count reduction was similar in blood and duodenal mucosa. Normal CD8+L and CD45RO+L counts, and normal numbers of macrophages and antigen-presenting cells were also found in the HIV patients. The cytokine pattern did not differ among groups. Tissue HIV, assessed by p24 antigen, correlated with a higher CD45RO+L count (77.0 (61-79.8 and 43.6 (31.7-62.8 in p24+ and p24-, respectively, P = 0.003, and IL-4 positivity (100 and 48.2% in p24+ and p24-, respectively, P = 0.005. The duodenal mucosa of HIV+ patients showed a relatively preserved histological architecture. This finding may be characteristic of a population without opportunistic infections and treated with potent antiretroviral therapy, with a better preservation of the immune status.

  16. A Study of Parasitic and Bacterial Pathogens Associated with Diarrhea in HIV-Positive Patients

    Science.gov (United States)

    Kongre, Vaishali; Kumar, Varun; Bharadwaj, Renu

    2016-01-01

    Introduction Diarrhea is a common complication of acquired immune deficiency syndrome (AIDS), occurring in almost 90% of AIDS patients in developing countries like India. The present study was aimed to determine the prevalence and microbiological profile of pathogens associated with diarrhea in human immunodeficiency virus (HIV) positive patients and their relation to CD4 counts. Materials and methods Forty-five successive HIV-positive patients, 27 with diarrhea (study group) and 18 without diarrhea (control group), were included in the three-month study. The HIV infection was confirmed by three different antibody detection tests. The stool samples were collected on two consecutive days and were examined for parasites by microscopy using wet mount and modified Ziehl-Neelsen stain. They were examined for bacteria by Gram stain and conventional Ziehl-Neelsen stain and were inoculated on appropriate culture media. The isolates were identified by standard biochemical tests, followed by antibiotic susceptibility testing using the Kirby-Bauer disc diffusion method. Results  Twenty-four pathogens were detected in diarrheal HIV-positive patients, including 14 parasites (58.33%), seven bacteria (29.17%), and three fungi (12.50%). Isospora sp. was the most common parasite (25.9%) followed by Cryptosporidium sp. (14.8%). Other parasites included Cyclospora sp., Strongyloides stercoralis, and Entamoeba histolytica (3.7% each).​ Escherichia coli (18.5%) was the most common bacterial isolate, of which, 80% were Enterotoxigenic E. coli (ETEC) while 20% were Enteropathogenic E. coli (EPEC). Other isolates included Shigella flexneri and Mycobacterium tuberculosis (3.7% each). The isolates were sensitive to furazolidone (94.11%), chloramphenicol (76.47%), and gentamicin (52.94%). The isolates from diarrheal patients showed resistance to norfloxacin (5.88% vs. 50%, p<0.05) as compared to those from non-diarrheal patients. The diarrheal HIV-positive patients

  17. HIV positive patient with HSV-2 encephalitis: case report.

    Science.gov (United States)

    Pagliano, Pasquale; Ascione, Tiziana; Carleo, Maria Aurora; Boccia, Giovanni; De Caro, Francesco; Tortora, Fabio

    2016-09-01

    Incidence of brain infections in Human Immunodeficiency Virus (HIV) positive patients is reduced after the availability of current high active antiretroviral therapy (HAART). Herpes Simplex Virus type 2 (HSV-2) is an infrequent cause of encephalitis in HIV patients despite it is frequently involved in sexual transmitted infections. Here, we report a case of HSV-2 encephalitis occurring in a patient without full suppression of HIV replication within the brain. A 38 year-old HIV infected man was admitted to our department because of recurrent generalized seizure and fever during the previous 24 hours. Eight months before our observation the patient was switched from a protease inhibitor based regimen to a rilpivirine-based regimen without any evidence of HIV-RNA replication in the plasma. When the patient was admitted in our hospital, he was febrile and moderately confused, no deficit of cranial nerves was reported, motility was conserved, but he was unable to walk. Laboratory examinations performed at admission demonstrated an increase of cerebrospinal fluid (CSF) protein and cells with lymphocyte prevalence, and normal CSF glucose. HSV-2-DNA and HIV-RNA were present within CSF at admission. Nuclear Magnetic Resonance imaging of the brain revealed lesions of the medial part of both temporal lobes including hippocampus without any sign of bleeding. A 21-day course of acyclovir therapy was administered with consistent improvement of clinical findings and disappearance of HSV-2-DNA within CSF. After the episode, HAART was switched to a regimen with high CSF penetrability containing abacavir, lamivudine, darunavir and ritonavir. Twelve months after HSV-2 encephalitis neurologic evaluation was normal, but symptoms of depression were reported, HIV-RNA remained undetectable both in the plasma and CSF, and CD4+ lymphocytes were above 500/μL. No opportunistic infection was reported. Patients switched to regimen well tolerated such those containing rilpivirine, that have

  18. CLINICAL SPECTRUM OF OPPORTUNISTIC INFECTIONS IN HIV POSITIVE PATIENTS

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    Usmani

    2015-03-01

    Full Text Available The human immunodeficiency virus (HIV infection leading to Acquired Immunodeficiency Syndrome (AIDS causes progressive decline in immunological response in people living with HIV/AIDS, making them susceptible to a variety opportunistic infections (OIs which are responsible for morbidity and mortality. Therefore early diagnosis and management of opportunistic infections reduce the mortality and morbidity in HIV positive patients. CONTEXT : AIMS : To study the demographic variables; spectrum of opportunist ic infections and its correlation with CD4 count in HIV patients. SETTING AND DESIGN : The study was conducted on 200 HIV patients either admitted to Sanjay Gandhi Memorial Hospital or attending ART Center, Sh y am Shah Medical College, Rewa (M.P from Januar y 2013 to October 2014. METHODS AND MATERIAL : A detailed history was recorded with emphasis on personal history, high risk behavior, history of migration, mode of transmission of infection and complete thorough clinical examination was done. Data analysis was done by calculating P value using Chi Square test. RESULTS : Out of 200 HIV patients, most of them (88% belonged to the age group 20 - 49 years, 66% were males and 34% were females. 45% were illiterates, 62% were from low socioeconomic class. Majority of patients were married (79% and 72.2% had seropositive spouse. Unprotected sexual route was the most common (85% mode of transmission; among which heterosexual route was the only mode of transmission. 59.4% of males contracted infection through unprotect ed sex with either commercial sex workers (44.8% or multiple sex partners (14.6%. 61% of patients had history of emigration. Tuberculosis was the most common opportunistic infection (51%, followed by oral candidiasis 30% and chronic diarrhea (9%.Pulmon ary Tuberculosis was the most common form of Tuberculosis (64.7%, followed by tubercular lymphadenopathy (15.7%. CONCLUSION : HIV/AIDS has no vaccine or cure, so prevention is the only

  19. HIV POSITIVE MOTHERS; ISSUES AND CONCERNS: A QUALITATIVE STUDY

    Directory of Open Access Journals (Sweden)

    Manjunatha

    2014-04-01

    . They face discrimination in getting admission to schools for their children because of their positive status (especially when thrown out of the school.They find it difficult to get their daughters married as the bride groom may reject her after coming to know that her parents are HIV positives, even though she is negative. Positive network and mothers: The positive women find this network as a source of confidence, information and education regarding their rights, duties and the disease itself. By becoming members of this network they have rediscovered themselves and have developed a positive outlook towards life

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

    African Journals Online (AJOL)

    2013-04-11

    Apr 11, 2013 ... indicated that both HIV-positive respondents and their families face social and ..... 4. knowledge of anti-retroviral medication. ..... is an increased risk for HIV transmission during pregnancy, ... alternative medicine and herbs.

  1. 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

    Introduction: 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......-positive populations and to compare the existing models developed in the general population. Methods: All patients recruited to the Data Collection on Adverse events of Anti-HIV Drugs (D:A:D) study with follow-up data, without prior DM, myocardial infarction or other CVD events and with a complete DM risk factor...

  2. Pembrolizumab for HIV-Positive Patients with Recurrent or Refractory Cancer

    Science.gov (United States)

    In this phase I clinical trial, HIV-positive patients receiving combination antiretroviral therapy who have cancer that has recurred after or has not responded to previous treatment will receive the immune checkpoint inhibitor pembrolizumab.

  3. Antiretroviral therapy, immune suppression and renal impairment in HIV-positive persons

    DEFF Research Database (Denmark)

    Nielsen, Lene Ryom; Mocroft, Amanda; Lundgren, Jens D

    2014-01-01

    The purpose of this article is to review recent literature on antiretroviral treatment (ART) and immune suppression as risk factors for renal impairment in HIV-positive persons, and to discuss pending research questions within this field....

  4. Antifungal activity of natural compounds against Candida species isolated from HIV-positive patients

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    Débora Oro

    2015-09-01

    Conclusions: Therefore, all natural compounds evaluated in this study, especially C. zeylanicum essential oil, may become promising agents for oral candidiasis therapy including in HIV-positive patients.

  5. HIV/TB Co-infection Among HIV Positive Children Attending Clinics ...

    African Journals Online (AJOL)

    HIV/TB Co-infection Among HIV Positive Children Attending Clinics In Imo State ... of tuberculosis in children is partly attributed to the coexisting burden of human ... The factors found to affect TB development significantly were stage of HIV ...

  6. Bilateral vestibuloplasty utilizing palatal soft tissue grafts in an HIV-positive patient.

    Science.gov (United States)

    Kolhatkar, Shilpa; Mason, Suzanne; Winkler, James R; Bhola, Monish

    2009-07-01

    The dental treatment of HIV-positive individuals has undergone a change from the management of HIV-associated oral lesions to routine comprehensive dental care. To the authors' knowledge, this is the first report in which palatal soft tissue grafts were used for vestibuloplasty in an HIV-positive patient with a shallow mandibular vestibule. No adverse sequelae were seen during follow-up.

  7. Plasma lipidomic profiling of treated HIV-positive individuals and the implications for cardiovascular risk prediction.

    Science.gov (United States)

    Wong, Gerard; Trevillyan, Janine M; Fatou, Benoit; Cinel, Michelle; Weir, Jacquelyn M; Hoy, Jennifer F; Meikle, Peter J

    2014-01-01

    The increased risk of coronary artery disease in human immunodeficiency virus (HIV) positive patients is collectively contributed to by the human immunodeficiency virus and antiretroviral-associated dyslipidaemia. In this study, we investigate the characterisation of the plasma lipid profiles of treated HIV patients and the relationship of 316 plasma lipid species across multiple lipid classes with the risk of future cardiovascular events in HIV-positive patients. In a retrospective case-control study, we analysed plasma lipid profiles of 113 subjects. Cases (n = 23) were HIV-positive individuals with a stored blood sample available 12 months prior to their diagnosis of coronary artery disease (CAD). They were age and sex matched to HIV-positive individuals without a diagnosis of CAD (n = 45) and with healthy HIV-negative volunteers (n = 45). Association of plasma lipid species and classes with HIV infection and cardiovascular risk in HIV were determined. In multiple logistic regression, we identified 83 lipids species and 7 lipid classes significantly associated with HIV infection and a further identified 74 lipid species and 8 lipid classes significantly associated with future cardiovascular events in HIV-positive subjects. Risk prediction models incorporating lipid species attained an area under the receiver operator characteristic curve (AUC) of 0.78 (0.775, 0.785)) and outperformed all other tested markers and risk scores in the identification of HIV-positive subjects with increased risk of cardiovascular events. Our results demonstrate that HIV-positive patients have significant differences in their plasma lipid profiles compared with healthy HIV-negative controls and that numerous lipid species were significantly associated with elevated cardiovascular risk. This suggests a potential novel application for plasma lipids in cardiovascular risk screening of HIV-positive patients.

  8. Disclosure Decisions: HIV-Positive Persons Coping With Disease-Related Stressors

    DEFF Research Database (Denmark)

    Rodkjaer, Lotte; Sodemann, Morten; Østergaard, Lars Jørgen;

    2011-01-01

    The purpose of this grounded theory study was to investigate how Danish HIV-positive persons live with their disease, focusing on HIV-related stressors. Using the Glaserian method, we analyzed textual data from in-depth interviews with 16 HIV-positive persons. Decisions about disclosure appeared...... and plans, and offers a theoretical basis for interventions designed to assist persons living with HIV to make the best possible individual decisions regarding disclosure, and thereby reduce HIV-related stress....

  9. Chorioamnionitis in pregnancy: a comparative study of HIV-positive and HIV-negative parturients.

    Science.gov (United States)

    Ocheke, Amaka N; Agaba, Patricia A; Imade, Godwin E; Silas, Olugbenga A; Ajetunmobi, Olanrewaju I; Echejoh, Godwins; Ekere, Clement; Sendht, Ayuba; Bitrus, James; Agaba, Emmanuel I; Sagay, Atiene S

    2016-03-01

    Chorioamnionitis is an important risk factor for vertical transmission of HIV/AIDS. We compared the prevalence and correlates of histologic chorioamnionitis (HCA) in HIV-positive and HIV-negative pregnant women. HIV-positive and -negative parturients were interviewed, examined and had their placentas examined histologically for chorioamnionitis. Data regarding HIV were also retrieved from their hospital records. A total of 298 parturients (150 HIV positive and 148 HIV negative) were enrolled. The two groups were similar in socio-demographic and obstetric parameters except for age. The prevalence of HCA was 57.1% in HIV-positive women and 61.6% in HIV-negative women (p = 0.43). HCA staging was associated with the number of intrapartum vaginal examinations in HIV-positive subjects and nulliparity in HIV-negative subjects. The number of intrapartum vaginal examinations and coitus in the week prior to delivery significantly affected the grade of HCA in HIV-negative subjects. The prevalence of HCA in both HIV-positive and HIV-negative is high. Most variables did not affect the occurrence of HCA in both groups studied except number of intrapartum examinations, coitus in the preceding one week and nulliparity, which were related to severity of the disease. © The Author(s) 2016.

  10. Diffusion tensor MR imaging of white matter integrity in HIV-positive patients with planning deficit

    Energy Technology Data Exchange (ETDEWEB)

    Correa, Diogo Goulart; Doring, Thomas M.; Wilner, Nina Ventura; Cabral, Rafael Ferracini; Gasparetto, Emerson Leandro [Hospital Universitario Clementino Fraga Filho, Rio de Janeiro, RJ (Brazil); Clinica de Diagnostico por Imagem (CDPI), Rio de Janeiro, RJ (Brazil); Zimmermann, Nicolle; Fonseca, Rochele Paz [Hospital Universitario Clementino Fraga Filho, Rio de Janeiro, RJ (Brazil); Pontifical Catholic University of Rio Grande do Sul, Department of Psychology, Rio Grande do Sul (Brazil); Leite, Sarah C.B.; Bahia, Paulo R.V. [Hospital Universitario Clementino Fraga Filho, Rio de Janeiro, RJ (Brazil)

    2015-05-01

    The aim of this study was to evaluate whether normal controls and human immunodeficiency virus (HIV) patients with and without planning deficits differ on white matter integrity. A total of 34 HIV-positive patients with planning deficits were compared with 13 HIV-positive patients without planning deficits and 19 gender-, age-, and education-matched control subjects. Diffusion tensor imaging (DTI) was performed along 30 noncolinear directions in a 1.5-T scanner. For tract-based spatial statistics analysis, a white matter skeleton was created, and a permutation-based inference with 5000 permutations with a threshold of p < 0.05 was used to identify abnormalities in fractional anisotropy (FA). The median, radial, and axial diffusivities were also projected onto the mean FA skeleton. Compared with controls, HIV-positive patients with planning deficits had decreased FA in bilateral anterior thalamic radiations, bilateral inferior fronto-occiptal fasciculi, genu and splenium of the corpus callosum, bilateral superior longitudinal fascicule, and bilateral uncinate fasciculi. Compared to HIV-positive patients without planning deficits, patients with planning deficits had decreased FA in bilateral anterior thalamic radiations, bilateral inferior fronto-occiptal fasciculi, genu of the corpus callosum, bilateral superior longitudinal fascicule, and right uncinate fascicule. DTI can detect extensive white matter abnormalities in the normal-appearing white matter of HIV-positive patients with planning deficits compared with controls and HIV-positive patients without planning deficits. (orig.)

  11. Impact of ART on the fertility of HIV-positive women in sub-Saharan Africa.

    Science.gov (United States)

    Yeatman, Sara; Eaton, Jeffrey W; Beckles, Zosia; Benton, Lorna; Gregson, Simon; Zaba, Basia

    2016-09-01

    Understanding the fertility of HIV-positive women is critical to estimating HIV epidemic trends from surveillance data and to planning resource needs and coverage of prevention of mother-to-child transmission services in sub-Saharan Africa. In the light of the considerable scale-up in antiretroviral therapy (ART) coverage over the last decade, we conducted a systematic review of the impact of ART on the fertility outcomes of HIV-positive women. We searched Medline, Embase, Popline, PubMed and African Index Medicus. Studies were included if they were conducted in sub-Saharan Africa and provided estimates of fertility outcomes (live births or pregnancies) among women on ART relative to a comparison group. Of 2070 unique references, 18 published papers met all eligibility criteria. Comparisons fell into four categories: fertility of HIV-positive women relative to HIV-negative women; fertility of HIV-positive women on ART compared to those not yet on ART; fertility differences by duration on ART; and temporal trends in fertility among HIV-positive women. Evidence indicates that fertility increases after approximately the first year on ART and that while the fertility deficit of HIV-positive women is shrinking, their fertility remains below that of HIV-negative women. These findings, however, were based on limited data mostly during the period 2005-2010 when ART scaled up. Existing data are insufficient to characterise how ART has affected the fertility of HIV-positive women in sub-Saharan Africa. Improving evidence about fertility among women on ART is an urgent priority for planning HIV resource needs and understanding HIV epidemic trends. Alternative data sources such as antenatal clinic data, general population cohorts and population-based surveys can be harnessed to understand the issue. © 2016 John Wiley & Sons Ltd.

  12. Prevalence study of HPV mixed infections in Italian HIV positive women

    Directory of Open Access Journals (Sweden)

    Anna Rosa Garbuglia

    2010-06-01

    Full Text Available Introduction: HIV positive women, show a higher frequency of multiple HPV infections than HIV negative.The immune response seems to be genotype-specific, but evidence on different genotypes distribution and involvement of coinfections in the development of invasive cervix cancer (ICC remains limited. The aim of our study was to assess the prevalence of multiple infections in a group of Italian HIV positive women, the distribution of High risk (HR strains and Low Risk (LR strains in multiple and single infections, and their correlation with immune status and cervical lesions. Methods: 553 women were considered in the study. HPV search was performed with MY09-MY11 primers. HPV positive samples were typed with the Clinical Genomic array (HPV test (Genomica, Spain. Results: 244 samples were HPV positive (44.1%.129/244 (52.9% had a single infection and 103/244 (42.2% multiple infections.Among the 412 performed typing, 223 (54.1% were HR strains, while 189 (45.9% were LR strains.The HPV61 (40 times was more frequent among the LR strains.Among HR strains, the most frequently observed was the HPV16 (30 times. In 92% of multiple infections, at least one HR strain was found. 36% of LR strains was presented in single infections compared to 27% of HR strains (p = 0.06. The clades A3 (n = 124, 65.3% multiple infections and A10 (n = 37, 56.8% multiple infections were the most represented in LR;A9 (n = 95, 67.4% multiple infections and A6 (n = 57, 70.2% clades were the most representative among HR strains. Differences in age between women with single infection and those with multiple infection were not observed (p = 0.33 .Women with the best immune status (CD4 cell count of >500 cell/ mm3 showed a higher prevalence of single infection. HPV was positive in 75% of ASCUS/LSIL lesion and 77.3% of H-SIL. Conclusions: HPV-16 is the most frequent in both single and multiple infections as reported in a recent study about HIV negative women. Follow-up studies are

  13. Profile of clients tested HIV positive in a voluntary counseling and testing center of a district hospital, Udupi

    Directory of Open Access Journals (Sweden)

    Gupta Megha

    2009-01-01

    Full Text Available Background: The growing menace created by the HIV/AIDS (human immunodeficiency virus/acquired immunodeficiency syndrome has alarmed not only the public health officials but also the general community. The Voluntary Counseling and Testing Centre (VCTC services have begun as a cost-effective intervention in reversing this epidemic. Objectives: 1 To study the sociodemographic characteristics of HIV-positive clients and their risk behaviors. 2 To elucidate the reasons for their visit to the VCTC and know the problems anticipated by the clients after revealing their HIV-positive status. Study Design: A cross-sectional record-based study. Materials and Methods: The study was conducted in August 2007 among clients who tested positive for HIV in the VCTC of a district hospital in Karnataka from January to July 2007. Results: Study included 249 individuals of whom 161 were males and rest 88 females. A high percentage of nonresponse regarding the pattern of risk behavior was noted among the subjects (males: 42.8% and females: 90.9%. Of the individuals who responded, 91 males (98.9% and 6 females (75.0% had multiple heterosexual sex partners, while 1 male had homosexual partner. The figures in females show that two (25% of them had a history of blood transfusion. The reason for visiting the VCTC were cited as some form of illness (33.3%, confirmation of test results (32.9%, family members diagnosed as HIV positive (12.9% and 11.6% were referred from Directly Observed Treatment Scheme (DOTS center. More than one-thirds of the sample population anticipated discrimination at the time of medical treatment. Conclusion: People have begun using VCTC services, which reflects a change in their attitude toward HIV. The study provides us a clue to formulate an effective approach to educate people as well as the health personnel who are thought of as one of the important sources of discrimination.

  14. Racial and Ethnic Differences in Substance Use Diagnoses, Comorbid Psychiatric Disorders, and Treatment Initiation among HIV-Positive and HIV-Negative Women in an Integrated Health Plan

    Science.gov (United States)

    Storholm, Erik D.; Silverberg, Michael J.; Satre, Derek D.

    2017-01-01

    Access to substance use disorder (SUD) treatment is a critical issue for women with HIV. This study examined differences in SUD diagnoses, comorbid psychiatric diagnoses, and predictors of SUD treatment initiation among a racial/ethnically diverse sample of HIV-positive women (N=228) and a demographically similar cohort of HIV-negative women (N=693). Diagnoses and service utilization data were obtained from electronic health records of members of a large integrated healthcare system in Northern California. Overall, HIV-positive women were less likely to initiate SUD treatment. Among HIV-positive women, being diagnosed with an amphetamine use disorder, comorbid depressive disorder, and anxiety disorder was more common among white woman, while cocaine diagnosis was more common among black women. Among HIV-negative women, a diagnosis of alcohol SUD, comorbid depressive disorder, and comorbid anxiety disorder was more common among white women; diagnosis of cannabis SUD and cocaine SUD was more common among black women; and a diagnosis of amphetamine SUD and depressive disorder was more common among Latina women. Multivariable logistic regression models showed that alcohol, cannabis, and opiate diagnoses were predictive of SUD treatment initiation for both cohorts, while amphetamine SUD, comorbid depressive disorder, and being white or Latina were predictive of SUD treatment initiation for HIV-negative, but not HIV-positive women. Findings suggest that clinicians need to be aware of differences in substances of abuse, comorbid psychiatric disorders, and to consider the demographic and social factors that may contribute to differences in SUD treatment initiation among HIV-positive and HIV-negative women. PMID:27767406

  15. Sexual risk reduction among HIV-positive drug-using men who have sex with men.

    Science.gov (United States)

    Patterson, Thomas L; Semple, Shirley J

    2003-12-01

    According to the US Centers for Disease Control, the majority of new HIV infections are the direct result of unprotected sexual relations between serodiscordant individuals. Thus, the development of behavioral interventions to increase the safer sex practices of HIV-positive individuals has the potential to reduce the number of new infections. Currently, less than 1% of the total US population is infected with HIV. Targeting behavioral interventions to this smaller group of HIV-positive individuals has the potential for making cost-effective reductions in the number of new infections. Despite reports that some HIV-positive individuals continue to engage in high-risk behaviors, interventions designed to prevent secondary transmission of HIV are rare. In this era of highly active antiretroviral therapy (HAART), interventions for HIV-positive individuals are more critical than ever to address the unique challenges and issues they face regarding disclosure and partner notification, use of HAART and sexual risk behavior, and HIV-related stigma. Although a growing number of reports document the efficacy of sexual risk reduction interventions for HIV-positive individuals, to date none of these studies have focused on drug-using populations. This article focuses on sexual risk reduction interventions for HIV-positive men who have sex with men (MSM), the largest group of HIV-positive individuals in the United States. It reviews factors associated with high-risk behaviors and discusses some findings from research with HIV-positive methamphetamine users, including (1) data from a small qualitative study and its implications for the development of new interventions, and (2) baseline data from an ongoing large-scale study of the efficacy of a theory-based sexual risk reduction intervention for HIV-positive methamphetamine-using MSM. The article concludes with a discussion of future research issues, including, for example: Can sexual risks be reduced in the context of active

  16. Evaluating mental health difficulties and associated outcomes among HIV-positive adolescents in Tanzania.

    Science.gov (United States)

    Dow, Dorothy E; Turner, Elizabeth L; Shayo, Aisa M; Mmbaga, Blandina; Cunningham, Coleen K; O'Donnell, Karen

    2016-07-01

    AIDS-related mortality among HIV-positive adolescents has risen by 50% despite the scale up of antiretroviral therapy (ART). ART maladherence likely plays a role in the increase of AIDS-related deaths among adolescents and has shown to be associated with psychosocial and mental health difficulties. Addressing the specific mental health needs of HIV-positive adolescents is critical to ending the HIV epidemic. This cross-sectional study prospectively enrolled HIV-positive adolescents (12-24 years) in Moshi, Tanzania. A structured questionnaire was administered that included questions about home, school, adherence, and measures of stigma (Berger Stigma Scale) and mental health. Mental health measures included depression (Patient Health Questionnaire-9), emotional/behavioral difficulties (Strengths and Difficulties Questionnaire), and traumatic experiences/post-traumatic stress symptoms (The University of California Los Angeles-post-traumatic stress disorder-Reaction Index). Mental health difficulties were prevalent among HIV-positive adolescents and were associated with incomplete adherence and stigma. Resources are needed to reduce HIV stigma and address mental health among HIV-positive adolescents in low-resource settings. This will improve not only mental health, but may also improve ART adherence and virologic suppression, improving overall health of the individual and reducing the risk of HIV transmission to others.

  17. Social networks of HIV-positive women and their association with social support and depression symptoms.

    Science.gov (United States)

    Cederbaum, Julie A; Rice, Eric; Craddock, Jaih; Pimentel, Veronica; Beaver, Patty

    2017-02-01

    Social support is important to the mental health and well-being of HIV-positive women. Limited information exists about the specific structure and composition of HIV-positive women's support networks or associations of these network properties with mental health outcomes. In this pilot study, the authors examine whether support network characteristics were associated with depressive symptoms. Survey and network data were collected from HIV-positive women (N = 46) via a web-based survey and an iPad application in August 2012. Data were analyzed using multivariate linear regression models in SAS. Depressive symptoms were positively associated with a greater number of doctors in a woman's network; having more HIV-positive network members was associated with less symptom reporting. Women who reported more individuals who could care for them had more family support. Those who reported feeling loved were less likely to report disclosure stigma. This work highlighted that detailed social network data can increase our understanding of social support so as to identify interventions to support the mental health of HIV-positive women. Most significant is the ongoing need for support from peers.

  18. Cervical cancer screening adherence among HIV-positive female smokers from a comprehensive HIV clinic.

    Science.gov (United States)

    Fletcher, Faith E; Vidrine, Damon J; Tami-Maury, Irene; Danysh, Heather E; King, Rachel Marks; Buchberg, Meredith; Arduino, Roberto C; Gritz, Ellen R

    2014-03-01

    HIV-positive women are at elevated risk for developing cervical cancer. While emerging research suggests that gynecologic health care is underutilized by HIV-positive women, factors associated with adherence to Pap testing, especially among HIV-positive female smokers are not well known. We utilized baseline data from a smoking cessation trial and electronic medical records to assess Pap smear screening prevalence and the associated characteristics among the HIV-positive female participants (n = 138). 46 % of the women had at least 1 Pap test in the year following study enrollment. Multiple logistic regression analysis indicated that younger age, African American race, hazardous drinking, increased number of cigarettes smoked per day, and smoking risk perception were associated with non-adherence to Pap smear screening. Cervical cancer screening was severely underutilized by women in this study. Findings underscore the importance of identifying predictors of non-adherence and addressing multiple risk factors and behavioral patterns among HIV-positive women who smoke.

  19. Persistent Cryptococcal Brain Infection despite Prolonged Immunorecovery in an HIV-Positive Patient

    Directory of Open Access Journals (Sweden)

    Tom Wingfield

    2014-01-01

    Full Text Available Background. HIV-positive people starting combined antiretroviral therapy may develop immune reconstitution to latent or treated opportunistic infections. Immune reconstitution to cerebral Cryptococcus is poorly understood and can be fatal. Case Presentation. A 33-year-old Zimbabwean female presented with cryptococcal meningitis and newly diagnosed HIV with a CD4 count of 51 cells/μL (4%. She was treated with amphotericin and flucytosine. Combined antiretroviral therapy was started four weeks later and she showed early improvement. However, over the ensuing 18 months, her clinical course was marked by periodic worsening with symptoms resembling cryptococcal meningitis despite having achieved CD4 counts ≥400 cells/μL. Although initially treated for relapsing cryptococcal immune reconstitution syndrome, a brain biopsy taken 17 months after initial presentation showed budding Cryptococci. Conclusion. This unusually protracted case highlights the difficulties in differentiating relapsing cryptococcal meningitis from immune reconstitution and raises questions concerning the optimum timing of initiation of combined antiretroviral therapy in such patients.

  20. Burkitt's non-Hodgkins lymphoma presenting as facial nerve palsy in HIV-positive patients.

    Science.gov (United States)

    Woodcock, H; Nelson, M

    2011-02-01

    An isolated facial nerve palsy is rare as the presentation of a central nervous system lymphoma. In this case series, we present the clinical features of three HIV-positive patients presenting with facial nerve palsies due to HIV-associated Burkitt's lymphoma. These patients had a non-resolving facial paralysis, which occurred during a late stage of HIV. Magnetic resonance imaging (MRI) did not show leptomeningeal enhancement. Cerebrospinal fluid revealed a lymphocytosis with elevated protein and low glucose levels. The diagnosis of Burkitt's lymphoma was made on histology which showed the characteristic 'starry sky' appearance due to scattered tangible body-laden macrophages. The patients were commenced on the intensive chemotherapy regimen of CODOX-M/IVAC. Two patients died of disease progression and the third patient died of chemotherapy toxicity. This case series highlights the need for a high index of suspicion for underlying malignancy when a patient presents with a persistent facial paralysis in the later stages of HIV infection.

  1. Proteomic analysis of saliva in HIV-positive heroin addicts reveals proteins correlated with cognition.

    Science.gov (United States)

    Dominy, Stephen S; Brown, Joseph N; Ryder, Mark I; Gritsenko, Marina; Jacobs, Jon M; Smith, Richard D

    2014-01-01

    The prevalence of HIV-associated neurocognitive disorders (HAND) remains high despite effective antiretroviral therapies. Multiple etiologies have been proposed over the last several years to account for this phenomenon, including the neurotoxic effects of antiretrovirals and co-morbid substance abuse; however, no underlying molecular mechanism has been identified. Emerging evidence in several fields has linked the gut to brain diseases, but the effect of the gut on the brain during HIV infection has not been explored. Saliva is the most accessible gut biofluid, and is therefore of great scientific interest for diagnostic and prognostic purposes. This study presents a longitudinal, liquid chromatography-mass spectrometry-based quantitative proteomics study investigating saliva samples taken from 8 HIV-positive (HIV+), 11 -negative (HIV-) heroin addicts. In addition, saliva samples were investigated from 11 HIV-, non-heroin addicted healthy controls. In the HIV+ group, 58 proteins were identified that show significant correlations with cognitive scores, implicating disruption of protein quality control pathways by HIV. Notably, only one protein from the HIV- heroin addict cohort showed a significant correlation with cognitive scores, and no proteins correlated with cognitive scores in the healthy control group. In addition, the majority of correlated proteins have been shown to be associated with exosomes, allowing us to propose that the salivary glands and/or oral epithelium may modulate brain function during HIV infection through the release of discrete packets of proteins in the form of exosomes.

  2. Proteomic analysis of saliva in HIV-positive heroin addicts reveals proteins correlated with cognition.

    Directory of Open Access Journals (Sweden)

    Stephen S Dominy

    Full Text Available The prevalence of HIV-associated neurocognitive disorders (HAND remains high despite effective antiretroviral therapies. Multiple etiologies have been proposed over the last several years to account for this phenomenon, including the neurotoxic effects of antiretrovirals and co-morbid substance abuse; however, no underlying molecular mechanism has been identified. Emerging evidence in several fields has linked the gut to brain diseases, but the effect of the gut on the brain during HIV infection has not been explored. Saliva is the most accessible gut biofluid, and is therefore of great scientific interest for diagnostic and prognostic purposes. This study presents a longitudinal, liquid chromatography-mass spectrometry-based quantitative proteomics study investigating saliva samples taken from 8 HIV-positive (HIV+, 11 -negative (HIV- heroin addicts. In addition, saliva samples were investigated from 11 HIV-, non-heroin addicted healthy controls. In the HIV+ group, 58 proteins were identified that show significant correlations with cognitive scores, implicating disruption of protein quality control pathways by HIV. Notably, only one protein from the HIV- heroin addict cohort showed a significant correlation with cognitive scores, and no proteins correlated with cognitive scores in the healthy control group. In addition, the majority of correlated proteins have been shown to be associated with exosomes, allowing us to propose that the salivary glands and/or oral epithelium may modulate brain function during HIV infection through the release of discrete packets of proteins in the form of exosomes.

  3. Proteomic Analysis of Saliva in HIV-positive Heroin Addicts Reveals Proteins Correlated with Cognition

    Energy Technology Data Exchange (ETDEWEB)

    Dominy, Stephen; Brown, Joseph N.; Ryder, Mark I.; Gritsenko, Marina A.; Jacobs, Jon M.; Smith, Richard D.

    2014-04-01

    The prevalence of HIV-associated neurocognitive disorders (HAND) remains high despite effective antiretroviral therapies. Multiple etiologies have been proposed over the last few years to account for this phenomenon, including the neurotoxic effects of antiretrovirals and co-morbid substance abuse. However, no underlying molecular mechanism has been identified. Emerging evidence in several fields has linked the gut to brain diseases, but the effect of the gut on the brain during HIV infection has not been explored. Saliva is the most accessible gut biofluid, and is therefore of great scientific interest for diagnostic and prognostic purposes. This study presents a longitudinal, liquid chromatography-mass spectrometry-based quantitative proteomics study investigating saliva samples taken from 8 HIV-positive (HIV+) and 11 -negative (HIV-) heroin addicts. In the HIV+ group, 58 proteins were identified that show significant correlations with cognitive scores and that implicate disruption of protein quality control pathways by HIV. Notably, no proteins from the HIV- heroin addict cohort showed significant correlations with cognitive scores. In addition, the majority of correlated proteins have been shown to be associated with exosomes, allowing us to propose that the salivary glands and/or oral epithelium may modulate brain function during HIV infection through the release of discrete packets of proteins in the form of exosomes.

  4. Disease patterns and causes of death of hospitalized HIV-positive adults in West Africa

    DEFF Research Database (Denmark)

    Lewden, Charlotte; Drabo, Youssoufou J; Zannou, Djimon M

    2014-01-01

    definitions. Factors associated with in-hospital mortality were studied with a logistic regression model. RESULTS: Among 823 hospitalized HIV-positive adults (median age 40 years, 58% women), 24% discovered their HIV infection during the hospitalization, median CD4 count was 75/mm(3) (IQR: 25-177) and 48% had......OBJECTIVE: We aimed to describe the morbidity and mortality patterns in HIV-positive adults hospitalized in West Africa. METHOD: We conducted a six-month prospective multicentre survey within the IeDEA West Africa collaboration in six adult medical wards of teaching hospitals in Abidjan......, Ouagadougou, Cotonou, Dakar and Bamako. From April to October 2010, all newly hospitalized HIV-positive patients were eligible. Baseline and follow-up information until hospital discharge was recorded using standardized forms. Diagnoses were reviewed by a local event validation committee using reference...

  5. Serostatus Disclosure, Stigma Resistance, and Identity Management Among HIV-Positive Gay Men in Ireland.

    Science.gov (United States)

    Murphy, Patrick J; Hevey, David; O'Dea, Siobhán; Ní Rathaille, Neans; Mulcahy, Fiona

    2016-09-01

    In this study, we examined how non-infectiousness due to antiretroviral therapy has affected HIV-positive gay men's experience of serostatus disclosure to casual sex partners. Interviews were conducted with 15 seropositive gay men living in Ireland. Using grounded theory, three constructions of non-disclosure were proposed-as self-protection, as a morally permissible act, and as a rejection of the HIV-positive identity. Each construction entailed an aspect related to the sexual exclusion of those living with HIV, and an aspect related to their social exclusion. The extent to which the lives of those interviewed were affected by stigma was starkly revealed, as was the extent to which they stigmatized others living with HIV and rejected the HIV-positive identity. The research highlights the failure to socially normalize HIV and that interventions are needed to reduce the distress associated with seropositivity. © The Author(s) 2015.

  6. Recurrent focal epithelial hyperplasia due to HPV13 in an HIV-positive patient.

    Science.gov (United States)

    Moerman, M; Danielides, V G; Nousia, C S; Van Wanzeele, F; Forsyth, R; Vermeersch, H

    2001-01-01

    There are few reports on focal epithelial hyperplasia (FEH) in association with human immunodeficiency virus (HIV) infection; thus the relationship between them has not been completely clarified yet. We present a case of recurrent FEH in an HIV-positive man (the first described in Belgium), which, according to the PCR-DNA testing, was due to human papilloma virus type 13 (HPV13). To our knowledge, based on the accessible literature, this type of HPV has not been detected in any other documented study of FEH in HIV-positive patients before. Our patient experienced three recurrences of FEH in 1 year. It is therefore suggested that immunodeficiency due to HIV infection is responsible for the HPV-related FEH and the subsequent recurrences. In order to support the consideration of FEH as an oral manifestation of an HIV-related opportunistic infection, every new 'HPV-type' oral lesion in HIV-positive patients must be completely documented.

  7. Ethical dilemmas related to the HIV-positive person in the workplace.

    Science.gov (United States)

    Botes, Annatjie; Otto, Marianne

    2003-05-01

    This study's objectives were: (1) to describe and explore the ethical dilemmas surrounding the HIV-positive person in the workplace in South Africa; and (2) to describe the Rational Interaction for Moral Sensitivity (RIMS) approach as a possible mechanism for solving these ethical dilemmas. A qualitative, exploratory and descriptive research design was used. The target populations were HIV-positive employees and occupational health nurses working for a South African company. Data collected through individual HIV-positive employee interviews and occupational health nurse workgroups were analysed. The ethical dilemmas were conceptualized and described within the theoretical framework of the principles of ethics, namely, autonomy, beneficence, justice and confidentiality. To elicit a solution to the dilemmas, the data were recontextualized using the RIMS approach, a group decision-making strategy designed for the business environment.

  8. Does Family Matter to HIV-Positive Men Who Have Sex With Men?

    Science.gov (United States)

    Serovich, Julianne M.; Grafsky, Erika L.; Craft, Shonda M.

    2010-01-01

    Most studies have indicated that friends or families of choice provide more support to HIV-positive men who have sex with men (MSM) than members of the family of origin. The creation of families of choice by MSM has been viewed as a means of creating a support system in the absence of traditional family. The purpose of this study is to explore if HIV-positive MSM believe family of origin are important. Data was drawn from a qualitative study of HIV disclosure to family. Responses to the question “How important is family to you?” are explored. Results suggest that for many HIV-positive MSM relationships with family of origin are very important. While not definitive, data to be presented are provocative and challenge notions of the significance of family of origin to marginalized populations. PMID:21745231

  9. Using IGRA in the diagnosis of tuberculosis or latent tuberculosis infection in HIV-positive persons

    DEFF Research Database (Denmark)

    Ravn, P.

    2010-01-01

    Persons with HIV and LTBI are at very high risk of developing active TB. The CD4 count drops in persons during the natural course of HIV/AIDS and at the same time the risk of TB increases. It is clear that there is a TB protective effect when HIV patients are placed on highly active antiretroviral......-positive individuals, and our learning curve is going up with new knowledge and circumstantial evidence. There is clearly an effect on the performance of the IGRA test when persons with active TB are co-infected with HIV. Studies looking at the performance of QFT-GIT in HIV-positive/negative TB patients show...... a positive IGRA response. There are, however, important unresolved issues that require further studies. What is the added value of using IGRAs in a clinical setting to correctly diagnose patients and prevent new cases? Are the differences between QFT-GIT and T-SPOT clinically relevant? Will we ever have...

  10. [Prevalence of intestinal microsporidia and other intestinal parasites in hiv positive patients from Maracaibo, Venezuela].

    Science.gov (United States)

    Rivero-Rodríguez, Zulbey; Hernández, Amparo; Bracho, Ángela; Salazar, Solneumar; Villalobos, Rafael

    2013-01-01

    To detect the presence of microsporidia and other enteric parasites in patients with HIVAIDS of the Autonomous Services University Hospital of Maracaibo (SAHUM), where there are no previous studies in this field. Fecal samples were analyzed by means of direct exam, concetration method with formal-ether, Kinyoun coloration and fast Gram-Chromotrope coloration. Separate PCR were perfomed to differentiate Entamoeba histolytica and Entamoeba dispar , when the E. histolytica/E. dispar complex was observed in the microscope. Information on the patient was obtained trough clinical history. Of 56 individuals that participated, 38 (67.86%) presented some commensal parasite and/ or pathogenic species in their fecal sample. Carriers of pathogenic species were predominat (26/38). Protozoa such as Isospora belli protozoa (17.65%), Blastocystis spp. (17.65%), Cryptosporidium spp. (7.84%), E. histolytica/E. dispar (5.88%), Entamoeba coli (3.92%), Giardia lamblia (3.92%), Endolimax nana (3.92%), Cyclospora cayetanensis (3.92%), and Chilomastix mesnilli (1.96%) were diagnosed. Among the helminths, Ascaris lumbricoides, Trichuris trichiura and Strongyloides stercoralis , had a percentage of 27.27% each, and Hymenolepis nana , 18.18%. Entamoeba histolytica was only detected in one of three cases presenting complex microscopic examination. By Gram-chromotrope, 17 samples showed spores of the Microsporidia phylum, equivalent to 33.33% prevalence. Microsporidia may be first prevalente in HIV positive patients when specific diagnostic techniques are used.

  11. Successful Omalizumab treatment in HIV positive patient with chronic spontaneous urticaria: a case report.

    Science.gov (United States)

    Iemoli, E; Niero, F; Borgonovo, L; Cossu, M V; Piconi, S

    2017-03-01

    We described a case of a 56 year old homosexual HIV positive man who presented a history of CSU since one year (2012). All the allergologic, immunologic and microbiologic tests to evaluate the pathogenesis of wheals resulted negative. Therefore in June 2015 we decided to start therapy with Omalizumab while the patient kept on effective antiretroviral therapy with 310 cells/mm3 TCD4 counts and undetectable HIV viremia. After two monthly subcutaneuous injection of 150 mg of Omalizumab the patient had no more urticarial symptoms. UAS7 (Urticaria Activity Score over 7 days) and Cu-Q2oL (chronic urticarial quality of life questionnaire) dropped respectively to 14 from 42 and to 0 from 40 with increase of TCD4 counts while viral load remained undetectable. In November 2015, i.e. 4 months after the end of Omalizumab therapy, the patient was still asymptomatic with persistent effective immune-virological response to antiretroviral therapy. This case report confirms the excellent tolerability and efficacy of anti-IgE therapy in the treatment of spontaneous chronic urticarial even in an immunodepressed patient for HIV infection. Omalizumab therapy shows a remarkable clinical success and had no effect on peripheral TCD4 counts and HIV viral load.

  12. Magnetic resonance imaging evaluation of lipodystrophy in HIV-positive patients receiving highly active antiretroviral therapy.

    Science.gov (United States)

    Eichler, K; Bickel, T M; Klauke, S; Eisen, J; Vogl, T J; Zangos, S

    2015-07-01

    We evaluated retrospectively an automated method for the separate detection of subcutaneous and visceral fat in the abdominal region by magnetic resonance studies in HIV-positive patients on highly active antiretroviral therapy. The patients were divided into four different groups: lipoatrophy, lipohypertrophy, mixed and the control group. The use of software for the automated detection of abdominal compartment visceral adipose tissue (VAT), total adipose tissue (TAT) and subcutaneous adipose tissue (SAT) was compared to manual evaluation methods (fuzzy C-mean). The results of ROC analysis showed that the parameters, particularly the VAT, are better than the VAT/TAT and at identifying patients with the symptoms of abdominal fat accumulation. A sensitivity of 80.3% and a specificity of 79.5% resulted from a threshold VAT value of >87 cm(2). Moreover, the manual evaluation method was shown to provide greater values for VAT and the VAT/TAT ratio than those given by the automated method. In the present study, a rapid MRI protocol for the detection and assessment of the course of lipodystrophy was presented and tested on a group of patients with signs of HALS, as well as on an antiretroviral naïve control group.

  13. HIV-positive shopper who bit employee gets 10 years in jail.

    Science.gov (United States)

    1996-05-31

    Judge John Goshgarian sentenced John [name removed] to 10 years in prison for biting a store employee and then declaring he was HIV-positive. An unidentified employee at the Sam's Club store in Gurnee, IL tried to block [name removed] from exiting during questioning about a check he had just written. The bite [name removed] made on the employee's arm left teeth marks and drew blood. [Name removed] was charged with criminal transmission of HIV, a charge rarely used. He pled guilty to a lesser offense-aggravated battery in a public way, as well as related charges of forgery, possession of a fictitious driver's license, and obstruction of justice. The judge sentenced [name removed] to the maximum of 10 years in prison on the battery charge; criminal transmission punishment is 3 to 7 years in prison. [Name removed]'s test results remain sealed, although the store employee has been notified of the results and is undergoing monthly testing for HIV antibodies. Thus far, the results show he does not have the virus.

  14. 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.

  15. Prevalence, intensity and complications of Microsporidium spores amongst HIV-positive hospital patients in Ilorin, Nigeria

    Directory of Open Access Journals (Sweden)

    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.

  16. Expression of DC-SIGN and DC-SIGNRs in placentas of HIV-positive patients

    Directory of Open Access Journals (Sweden)

    Komala Pillay

    2014-09-01

    Full Text Available Background. Human dendritic cell-specific intracellular adhesion molecule-3 (ICAM3-grabbing non-integrin (DC-SIGN is a mannose-binding lectin that initiates interaction between dendritic cells and resting T-lymphocytes. DC-SIGN is highly expressed in placental tissue on dendritic cells and Hofbauer cells, and it is suggested that HIV may become adsorbed to DC-SIGN on Hofbauer cells as part of the mechanism of mother-to-child HIV transmission. A possible mechanism of transfer of the virus from the Hofbauer cells to the fetus is the subsequent adsorption to DC-SIGN-related molecules (DC-SIGNRs, present on immediately adjacent capillary vascular endothelium. However, data on DC-SIGN and DC-SIGNR expression in the placenta are few.Methods. Forty term placentas from HIV-positive mothers and 21 term placentas from HIV-negative mothers underwent immunohistochemistry staining for DC-SIGN and DC-SIGNR expression. Five random sets of 10 villi were assessed, and the average number of positive cells were counted in each case. In addition, where possible, maternal and cord blood viral loads and maternal CD4+ counts were performed in the HIV-positive group only.Results. The median maternal CD4+ count was 377 cells/µl and 27% of participants had undetectable viral loads; the median detectable viral load was 3.72 log. Most (97% of the cord bloods tested in infants from HIV-positive mothers had lower than detectable viral loads. HIV-positive cases had significantly greater expression of both DC-SIGNRs (median values in HIV-positive cases, 14.5 positive cells/10 villi (pc/10villi, compared with 11 pc/10villi in HIV-negative cases, p=0.020 and DC-SIGN (median value in HIV-positive cases, 26.5 pc/10villi, compared with 23 pc/10villi in HIV-negative cases, p=0.037. DC-SIGNR expression was also noted in Hofbauer cells and decidual macrophages in addition to endothelium (reported currently. There was no difference in expression of DC-SIGN and DC-SIGNRs in patients

  17. The Lived Experience of Pregnancy Among HIV-Positive Refugee Women: A Qualitative Study.

    Science.gov (United States)

    Chulach, Teresa; Gagnon, Marilou; Holmes, Dave

    2016-01-01

    Increasingly HIV-positive refugee women are becoming pregnant. The objective of this qualitative study was to describe and explore the meaning and experience of pregnancy from the perspective of HIV-positive refugee women. The phenomenological analysis revealed 4 core themes. "Making up stories" for privacy and protection emerged as the first theme. The second theme illuminates 2 types of isolation: a double isolation based on refugee and HIV statuses, and isolation endured throughout the pregnancy. Being-in-Between describes the third theme. Finally, the fourth theme sheds light on the experience of disconnection: from baby, culture, body/self, and health care providers.

  18. EPIDEMIOLOGICAL AND ORAL MANIFESTATIONS OF HIV-POSITIVE PATIENTS IN A SPECIALIZED SERVICE IN BRAZIL

    OpenAIRE

    Erick Nelo Pedreira; Camila Lopes Cardoso; Éder do Carmo Barroso; Jorge André de Souza Santos; Felipe Paiva Fonseca; Luís Antônio de Assis Taveira

    2008-01-01

    The purpose of this study was to evaluate the prevalence of oral lesions in HIV-positive patients attending the Specialized Service for Infectious-contagious Diseases and Parasitoses of the Health Secretariat of the State of Pará (URE-DIPE/SESPA), in the city of Belém, PA, Brazil. A total of 79 HIV-positive patients (53 males and 26 females) were examined. Clinical and epidemiological evaluations were done by correlating the lesions with gender, race, chronological age, risk behavior and prev...

  19. Adherence to WHO breastfeeding guidelines among HIV positive mothers in Southern Ethiopia: implication for intervention

    Directory of Open Access Journals (Sweden)

    Haile D

    2015-06-01

    Full Text Available Demewoz Haile,1 Tesfaye Setegn,2 Sibhatu Biadgilign31Department of Public Health, College of Medicine and Health Sciences, Madawalabu University, Bale Goba, Ethiopia; 2Department of Reproductive Health, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia; 3Independent Public Health Research Consultants, Addis Ababa, Ethiopia Background: Breastfeeding reduces major causes of infant mortality and morbidity. On the other hand, it is a major mode of vertical HIV transmission. In developing countries like Ethiopia, HIV positive mothers are advised to continue breastfeeding up to 12 months. But there is scarce literature regarding the mothers' adherence to continued breastfeeding recommendations. Therefore, the objective of this study is to assess HIV positive mothers' adherence to the infant feeding recommendations of the new World Health Organization (WHO guidelines for HIV-exposed infants aged ≥6 months. Methods: A cross-sectional study was conducted in health institutions with antiretroviral therapy and prevention of mother to child transmission facilities in Sidama Zone, Southern Ethiopia. Health institutions were considered as clusters and cluster sampling technique was employed. A total of 184 HIV positive mothers with their infants registered at respective health institutions were recruited and assessed for their infant breastfeeding practices. Descriptive statistics (frequency, mean, median, and standard deviation were computed to describe the breastfeeding practices of HIV positive mothers. Result: Almost all (181 [98.4%] of the HIV-exposed infants were “ever breastfed”. Among those mothers who had ever breastfed, 158 (87.3% initiated breastfeeding within an hour of delivery and 157 (85.8% had fed their babies colostrum while 31 (16.8% gave prelacteal food to their infants. The prevalence of continued breastfeeding at 1 year was (54.5% (46.9% for urban mothers and 75% for rural

  20. Papulonodular Secondary Syphilis Presenting as Multiple Distinct Cutaneous Lesions in an HIV-Positive Transgender Woman

    Directory of Open Access Journals (Sweden)

    Kristina Navrazhina

    2017-03-01

    Full Text Available We present the first reported case of papulonodular secondary syphilis in an HIV-positive transgender female. Syphilis is classified into primary, secondary, latent, and tertiary stages, with secondary syphilis having notably diverse cutaneous manifestations. Our patient presented with diverse lesions throughout her body, all pathologically consistent with papulonodular secondary syphilis. Proper identification of the multiple presentations of syphilis is crucial to early diagnosis and treatment. This report seeks to broaden the scope of dermatological manifestations that arise secondary to papulonodular syphilis in HIV-positive patients.

  1. Differences in housing, health, and well-being among HIV-positive women living in poverty.

    Science.gov (United States)

    Delavega, Elena; Lennon-Dearing, Robin

    2015-01-01

    The social context of living in poverty has a direct and indirect impact on a woman's health and well-being. This cross-sectional study investigates the relationship between housing and adherence to treatment, emotional wellness, environmental safety, physical health status, and risk behaviors among HIV-positive women receiving services from an AIDS service organization in the mid-South. Significant differences were found between stably housed and unstably housed women on the dependent outcome variables. Results suggest that housing services for HIV-positive women may be an effective way to increase their health and well-being as well as prevent transmission to others.

  2. Unsafe sexual behaviors among HIV-positive men in Kathmandu Valley, Nepal.

    Science.gov (United States)

    Poudel, Krishna C; Nakahara, Shinji; Poudel-Tandukar, Kalpana; Yasuoka, Junko; Jimba, Masamine

    2009-12-01

    We assessed unsafe sexual behaviors of the Nepalese HIV-positive men and their knowledge about the consequences of unsafe sex. We interviewed 167 participants recruited conveniently in the Kathmandu Valley, Nepal. Of total, 125 participants (75%) had sex in the past 6 months, 47% of whom with multiple partners. Fifty-seven (46%) of 123 participants who had sex did not always use condoms; unsafe sex was common in seroconcordant or serodiscordant relationships or in sero-unknown relationships. Only 41% (50/123) participants knew about the possibility of HIV superinfection. Our results suggest the urgent need of HIV prevention interventions for the Nepalese HIV-positive men.

  3. Project Exhale: preliminary evaluation of a tailored smoking cessation treatment for HIV-positive African American smokers.

    Science.gov (United States)

    Matthews, Alicia K; Conrad, Megan; Kuhns, Lisa; Vargas, Maria; King, Andrea C

    2013-01-01

    This study examined the feasibility, acceptability, and outcomes of a culturally tailored smoking cessation intervention for HIV-positive African American male smokers. Eligible smokers were enrolled in a seven-session group-based treatment combined with nicotine patch. The mean age of participants was M=46 years. The majority were daily smokers (71%), smoked a mentholated brand (80%), and averaged 8.6 (standard deviation [SD]=8.1) cigarettes per day. Baseline nicotine dependency scores (M=5.8) indicated a moderate to high degree of physical dependence. Of the 31 participants enrolled, the majority completed treatment (≥3 sessions; 68%), 1-month follow-up (74%), and 3-month follow-up (87%) interviews. Program acceptability scores were strong. However, adherence to the patch was low, with 39% reporting daily patch use. The majority of participants (80%, n=24) made a quit attempt. Furthermore, over the course of the intervention, smoking urge, cigarettes smoked, nicotine dependence, withdrawal symptoms, and depression scores all significantly decreased. Follow-up quit rates at 1 and 3 months ranged from 6% to 24%, with treatment completers having better outcomes. This first of its kind intervention for HIV-positive African American male smokers was feasible, acceptable, and showed benefit for reducing smoking behaviors and depression scores. Smoking cessation outcomes were on par with other similar programs. A larger trial is needed to address limitations and to confirm benefits.

  4. Bacillary angiomatosis in HIV-positive patient from Northeastern Brazil: a case report

    Directory of Open Access Journals (Sweden)

    Renata Félix da Justa

    2011-10-01

    Full Text Available It is a report of disseminated bacillary angiomatosis (BA in a 23-year-old female patient, who is HIV-positive and with fever, weight loss, hepatomegaly, ascites, and papular-nodular skin lesions. The clinical and diagnostic aspects involved in the case were discussed. Bacillary angiomatosis must always be considered in the diagnosis of febrile cutaneous manifestations in AIDS.

  5. Thoughts, Attitudes, and Feelings of HIV-Positive MSM Associated with High Transmission-Risk Sex

    Science.gov (United States)

    Skinta, Matthew D.; Murphy, Jessie L.; Paul, Jay P.; Schwarcz, Sandra K.; Dilley, James W.

    2012-01-01

    This study presents survey data collected from a sample of HIV-positive men (N = 182) who had high transmission-risk sex, defined as unprotected anal intercourse with a man whose HIV-status was negative or unknown, in the previous 6 months. Despite the tremendous changes in HIV treatment and their impact on people living with HIV, little recent…

  6. Symptomatic primary cytomegalovirus infection in a HIV-positive pregnant woman.

    LENUS (Irish Health Repository)

    Bergin, Sarah

    2014-12-01

    We describe a case of symptomatic primary Cytomegalovirus infection in a HIV-positive pregnant woman on antiretroviral treatment with a CD4 count >200 × 10(6)\\/l requiring intravenous ganciclovir. No adverse consequences from ganciclovir or evidence of congenital Cytomegalovirus infection were found.

  7. Development of a definition for Rapid Progression (RP) of renal function in HIV-positive persons

    DEFF Research Database (Denmark)

    Kamara, David A; Nielsen, Lene Ryom; Ross, Michael

    2014-01-01

    No consensus exists on how to define abnormally rapid deterioration in renal function (Rapid Progression, RP). We developed an operational definition of RP in HIV-positive persons with baseline estimated glomerular filtration rate (eGFR) >90ml/min/1.73m2 (using Cockcroft Gault) in the Data...

  8. cost of inpatient care for hiv- positive patients at red cross children's ...

    African Journals Online (AJOL)

    Enrique

    2004-11-01

    Nov 1, 2004 ... to determine the cost of inpatient care for paediatric HIV-positive patients; and (ii) to provide baseline data for health managers to .... to reduce the medical utilisation costs of HIV/AIDS cost by between ..... In reality this figure of.

  9. Non-typhoidal Salmonella and Campylobacter infections among HIV-positive patients in Denmark

    DEFF Research Database (Denmark)

    Jürgens, Gesche; Larsen, Inge Kristine; Gradel, Kim Oren;

    2011-01-01

    Registry for Enteric Pathogens and The Danish National Hospital Registry. We found that the incidences of NTS- and Campylobacter-related illness among HIV-positive patients in Denmark have declined since the introduction of HAART, although the incidences remained higher compared to the background...

  10. Diagnosis and Treatment of Acute Hepatitis C Among HIV Positive Men Having Sex with Men

    NARCIS (Netherlands)

    S.J. Hullegie (Sebastiaan)

    2016-01-01

    textabstractThe general aim of this thesis is to study different aspects of an acute HCV infection in HIV positive MSM. The primary aim is to study the effectivity and safety of boceprevir in addition to pegIFN and RBV for the treatment of acute HCV infections within the Dutch Acute HCV in HIV study

  11. Multi-drug-resistant tuberculosis in HIV positive patients in Eastern Europe

    DEFF Research Database (Denmark)

    Post, Frank A; Grint, Daniel; Efsen, Anne Marie Werlinrud

    2014-01-01

    Observational data from Eastern Europe on the management and outcome of multi-drug-resistant tuberculosis (MDR TB) in HIV positive populations remain sparse in the English-language literature.We compared clinical characteristics and outcomes of 55 patients who were diagnosed with HIV and MDR TB i...

  12. Active and latent tuberculosis among HIV-positive injecting drug users in Indonesia

    NARCIS (Netherlands)

    Meijerink, H.; Wisaksana, R.; Lestari, M.; Meilana, I.; Chaidir, L.; Ven, A.J. van der; Alisjahbana, B.; Crevel, R. van

    2015-01-01

    INTRODUCTION: Injecting drug use (IDU) is associated with tuberculosis but few data are available from low-income settings. We examined IDU in relation to active and latent tuberculosis (LTBI) among HIV-positive individuals in Indonesia, which has a high burden of tuberculosis and a rapidly growing

  13. Latent tuberculosis in HIV positive, diagnosed by the M. tuberculosis specific interferon-gamma test

    DEFF Research Database (Denmark)

    Brock, Inger; Ruhwald, Morten; Lundgren, Bettina

    2006-01-01

    BACKGROUND: Although tuberculosis (TB) is a minor problem in Denmark, severe and complicated cases occur in HIV positive. Since the new M. tuberculosis specific test for latent TB, the QuantiFERON-TB In-Tube test (QFT-IT) became available the patients in our clinic have been screened...

  14. Knowledge, practices and attitudes towards HIV positive and AIDS patients among dental auxiliaries.

    Science.gov (United States)

    Kaimenyi, J T; Ndung'u, F L

    1994-05-01

    The purpose of this study was to assess knowledge, practices and attitudes towards HIV positive and AIDS patients amongst 71 dental auxiliaries using on a self administered questionnaire. 65 (91.5%) returned the questionnaire. In general, respondents' knowledge was fair. 87.7% felt that dentistry as practised in Kenya today carries a high risk of transmission of HIV primarily because of improper sterilization of instruments. 72.3% had changed their sex habits since they became aware of the dangers posed by indiscriminate sex. Over 67% used gloves and masks routinely when assisting in the management of AIDS patients. Over 33% did not use protective eye wear and protective covers on operatories routinely because they were not provided by the employer. 27.7% felt that AIDS and HIV positive health workers should stop treating patients. 64.6% advocated that the cost of buying materials and equipment to prevent cross infection be met by the patient and the employer or dentist. 23.1% supported the idea that HIV positive and AIDS patients be isolated from uninfected individuals. In conclusion, a substantial number of dental auxiliaries were wanting in their knowledge, practices and attitudes towards HIV positive/AIDS patients.

  15. Multicenter European Prevalence Study of Neurocognitive Impairment and Associated Factors in HIV Positive Patients

    DEFF Research Database (Denmark)

    Haddow, Lewis J; Laverick, Rosanna; Daskalopoulou, Marina

    2017-01-01

    We conducted a cross-sectional study in 448 HIV positive patients attending five European outpatient clinics to determine prevalence of and factors associated with neurocognitive impairment (NCI) using computerized and pen-and-paper neuropsychological tests. NCI was defined as a normalized Z score...

  16. Disseminated Penicillium marneffei sepsis in a HIV-positive Thai woman in Denmark

    DEFF Research Database (Denmark)

    Mens, Helene; Højlyng, Niels; Arendrup, Maiken Cavling

    2004-01-01

    We report the first case of disseminated Penicillium marneffei infection, in a 32-y-old HIV positive Thai woman, in Denmark. Untreated it is a life-threatening infection. Therefore it is extremely important to consider P. marneffei in patients who are immunocompromized and who have been travellin...

  17. Aerobic endurance in HIV-positive young adults and HIV-negative ...

    African Journals Online (AJOL)

    2015-03-09

    Mar 9, 2015 ... Background. Aerobic endurance is an important aspect of physical fitness that ... Fifty five participants (17 males and 38 females) who have HIV and were not taking .... negative and HIV-positive females (20.9 ± 3.7 years versus. 28.1 ± 4.5 ... mean values for height, weight and body mass index between.

  18. Non-typhoidal Salmonella and Campylobacter infections among HIV-positive patients in Denmark

    DEFF Research Database (Denmark)

    Larsen, I.K.; Gradel, Kim Oren; Helms, M.;

    2011-01-01

    Non-typhoidal Salmonella (NTS) and Campylobacter are common causes of diarrhoea in human immunodeficiency virus (HIV)-positive patients. To investigate if incidence has changed since the introduction of highly active antiretroviral therapy (HAART), we combined data from The Danish Surveillance...

  19. Risky Behaviors among HIV-Positive Female Sex Workers in Northern Karnataka, India

    Directory of Open Access Journals (Sweden)

    Apoorva Jadhav

    2013-01-01

    Full Text Available Purpose. Little is known about the risky sexual behaviors of HIV-positive female sex workers (FSWs in the developing world, which is critical for programmatic purposes. This study aims to shed light on their condom use with regular clients as well as husband/cohabiting partner, a first in India. Methods. Multivariate logistic regression analyses for consistent condom use with regular clients and husband/cohabiting partner are conducted for the sample of 606 HIV-positive FSWs. Results. Older FSWs are 90% less likely and nonmobile FSWs are 70% less likely to consistently use condoms. FSWs on ART are 3.84 times more likely to use condoms. Additionally, FSWs who changed their occupation after HIV diagnosis are 70% less likely to use condoms. FSWs who are currently cohabiting are more likely to consistently use condoms with repeat clients and are 3.22 times more likely to do so if they have felt stigma associated with being HIV-positive. FSWs who have multiple repeat clients, and who do not know the sexual behavior of these clients, are more likely to use condoms consistently. Conclusion. This study would help inform programs to target the following particularly vulnerable HIV-positive FSWs: those who are older, those who changed their occupation post-HIV diagnosis, and those who are nonmobile.

  20. HIV-Positive Mothers' Communication about Safer Sex and Std Prevention with Their Children

    Science.gov (United States)

    Murphy, Debra A.; Roberts, Kathleen Johnston; Herbeck, Diane M.

    2012-01-01

    Mothers play an important role in promoting the sexual health of their adolescent children. Fifty-seven HIV-positive mothers with adolescent children participated in an in-depth, qualitative interview regarding whether they have talked to their children about safer sex and sexually transmitted disease (STD) prevention, including at what age they…

  1. Total laparoscopic intestinal vaginoplasty as neovaginal reconstruction in an HIV-positive transgender woman

    NARCIS (Netherlands)

    Sluis, W.B. van der; Verweij, S.P.; Ozer, M.; Meijerink, W.J.H.J.; Bouman, M.B.

    2016-01-01

    A 46-year-old, HIV-positive transgender woman of South American ethnicity consulted our outpatient clinic to discuss the possibilities of a surgical, secondary neovaginal reconstruction because of complete stenosis of her inverted penile skin-lined neovagina. She was taking abacavir/lamivudine and n

  2. Disseminated Penicillium marneffei sepsis in a HIV-positive Thai woman in Denmark

    DEFF Research Database (Denmark)

    Mens, Helene; Højlyng, Niels; Arendrup, Maiken Cavling

    2004-01-01

    We report the first case of disseminated Penicillium marneffei infection, in a 32-y-old HIV positive Thai woman, in Denmark. Untreated it is a life-threatening infection. Therefore it is extremely important to consider P. marneffei in patients who are immunocompromized and who have been travelling...

  3. Predicting the short-term risk of diabetes in HIV-positive patients

    DEFF Research Database (Denmark)

    Petoumenos, Kathy; Worm, Signe W; 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...

  4. What HIV-positive young women want from behavioral interventions: a qualitative approach.

    Science.gov (United States)

    Hosek, Sybil; Brothers, Jennifer; Lemos, Diana

    2012-05-01

    Young women living with HIV in the United States face many social and psychological challenges, including involvement in health care and secondary prevention efforts. The factors that put these young women at risk for HIV acquisition initially, such as poverty, gender roles, cultural norms, and limited perceived control over sexual relationships, continue to place them at risk for both adverse mental and physical health outcomes that impact their daily lives and secondary prevention efforts. This study utilized focus groups with young HIV-positive women in order to better understand their perceived problems and pressures and to inform a developmentally appropriate secondary prevention intervention for young HIV-positive women that could be implemented in clinical care settings. Focus groups with young HIV-positive women were convened in three U.S. cities: Baltimore, Chicago, and Tampa. A total of 17 young, HIV-positive women, age range 17–24 (mean age=21), participated in the focus groups. This article describes the psychological and social challenges these young women face as well as their suggestions regarding secondary HIV prevention intervention components.

  5. Fibroblast growth factor 23 in hypophosphataemic HIV-positive adults on tenofovir

    NARCIS (Netherlands)

    Bech, A.; Bentum, P. van; Nabbe, K.; Gisolf, J.; Richter, C.; Boer, H. de

    2012-01-01

    OBJECTIVES: Hypophosphataemia is common in HIV-positive patients, in particular in those using tenofovir disoproxil fumarate (TDF). Its pathogenesis is not well understood. The importance of fibroblast growth factor 23 (FGF-23), the most potent phosphaturic hormone known today, has not been studied

  6. 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 gluc...

  7. Future Life Goals of HIV-Positive Gay and Bisexual Male Emerging Adults

    Science.gov (United States)

    Bruce, Douglas; Harper, Gary W.

    2012-01-01

    This qualitative study explores the future life goals reported by a sample of HIV-positive gay/bisexual male emerging adults. Semi-structured interviews were conducted with 54 participants ages 17-24 at four geographically and demographically diverse adolescent HIV medicine programs to explore the content of participants' goals, perceived…

  8. HIV-Positive Mothers' Communication about Safer Sex and Std Prevention with Their Children

    Science.gov (United States)

    Murphy, Debra A.; Roberts, Kathleen Johnston; Herbeck, Diane M.

    2012-01-01

    Mothers play an important role in promoting the sexual health of their adolescent children. Fifty-seven HIV-positive mothers with adolescent children participated in an in-depth, qualitative interview regarding whether they have talked to their children about safer sex and sexually transmitted disease (STD) prevention, including at what age they…

  9. Double-blind trial of bestatin in HIV-positive patients

    DEFF Research Database (Denmark)

    Hørding, M; Gøtzsche, P C; Dalh Christensen, L

    1990-01-01

    Twenty-two HIV-positive homosexual men with a moderately impaired immune system were randomized to bestatin capsules 60 mg a day or placebo for 4 weeks. None suffered from opportunistic infections. The immunomodulating effect of bestatin was investigated by lymphocyte proliferation assay with pok...

  10. Latent tuberculosis in HIV positive, diagnosed by the M. tuberculosis specific interferon-gamma test

    DEFF Research Database (Denmark)

    Brock, Inger; Ruhwald, Morten; Lundgren, Bettina

    2006-01-01

    BACKGROUND: Although tuberculosis (TB) is a minor problem in Denmark, severe and complicated cases occur in HIV positive. Since the new M. tuberculosis specific test for latent TB, the QuantiFERON-TB In-Tube test (QFT-IT) became available the patients in our clinic have been screened...

  11. Latent tuberculosis in HIV positive, diagnosed by the M. tuberculosis specific interferon-gamma test

    DEFF Research Database (Denmark)

    Brock, Inger; Ruhwald, Morten; Lundgren, Bettina

    2006-01-01

    Although tuberculosis (TB) is a minor problem in Denmark, severe and complicated cases occur in HIV positive. Since the new M. tuberculosis specific test for latent TB, the QuantiFERON-TB In-Tube test (QFT-IT) became available the patients in our clinic have been screened for the presence of latent...

  12. Candida infection in HIV positive patients 1985-2007.

    Science.gov (United States)

    Traeder, Christian; Kowoll, Susann; Arastéh, Keikawus

    2008-09-01

    Infection with Candida species remains a major problem in HIV infected patients. The analysis of over 15,000 hospitalisations (1985-2007) in the AVK cohort shows an increasing incidence of non-albicans species in candida esophagitis. Although our analysis shows a decreasing incidence of opportunistic infections like PCP, cerebral toxoplasmosis and others since the introduction of highly active antiretroviral therapy the incidence of candida esophagitis remains as high as in the years before the HAART era. This observation might reflect the development of resistance against fluconazole and the selection of non-albicans species as a consequence of a long-term prophylactic treatment of HIV+ patients over years.

  13. Case report of lymph nodal, hepatic and splenic tuberculosis in an HIV-positive patient

    Directory of Open Access Journals (Sweden)

    Bianca Barone

    2006-04-01

    Full Text Available We describe a case of a male patient, 38 years old, HIV-positive (most recent CD4 count about 259/mm³, with abdominal pain, nausea, vomiting, anorexia, weight loss, and vespertine high fever with chills. His hemogram showed normocytic and normochromic anemia, with a high erythrocyte sedimentation rate (ESR and gross granulations in the neutrophils. Transaminases were normal. Bone marrow biopsy evidenced a chronic disease anemia pattern and a lack of infectious agents. Abdominal ultrasound examination showed a normal-size spleen, which exhibited heterogeneous parenchyma and multiple small hypoechoic images, together with small ascites, peripancreatic and para-aortic lymphadenopathy. These findings were confirmed by abdominal CT. The liver was normal in size, but had a hyperechoic image, which was not visualized on CT. Histopathological analysis of one of the multiple abdominal lymph nodes obtained by laparoscopic biopsy exhibited a chronic granulomatous inflammatory process, with caseous necrosis. Tissue sections were positive for BAAR (acid-alcohol-resistant bacillus, and the cultures were positive for Mycobacterium tuberculosis. Anti-tuberculosis treatment was begun, and the patient evolved with improvement of his general state, fever remission and weight gain. Splenic tuberculosis is a rare disease, occurring predominantly in patients in late stages of AIDS and/or disseminated tuberculosis. It is a difficult diagnosis, since there are no specific findings. Hence, complementary examinations, such as abdominal ultrasound/ CT, or fine needle aspiration, are usually necessary for investigation and differential diagnosis. Often, lesion regression after anti-tuberculosis regimens can be seen, and splenectomy is restricted to complicated or refractory disease.

  14. Pattern of Utilisation of Dental Health Care Among HIV-positive Adult Nigerians.

    Science.gov (United States)

    Adedigba, Michael A; Adekanmbi, Victor T; Asa, Sola; Fakande, Ibiyemi

    2016-01-01

    To determine the pattern of dental care utilisation of people living with HIV (PLHIV). A cross-sectional questionnaire survey of 239 PLHIV patients in three care centres was done. Information on sociodemographics, dental visit, risk groups, living arrangement, medical insurance and need of dental care was recorded. The EC Clearinghouse and WHO clinical staging was used to determine the stage of HIV/AIDS infection following routine oral examinations under natural daylight. Multivariate logistic regression models were created after adjusting for all the covariates that were statistically significant at univariate/bivariate levels. The majority of subjects were younger than 50 years, about 93% had not seen a dentist before being diagnosed HIV positive and 92% reported no dental visit after contracting HIV. Among nonusers of dental care, 14.3% reported that they wanted care but were afraid to seek it. Other reasons included poor awareness, lack of money and stigmatisation. Multivariate analysis showed that lack of dental care was associated with employment status, living arrangements, educational status, income per annum and presenting with oral symptoms. The area under the receiver operating curve was 84% for multivariate logistic regression model 1, 70% for model 2, 67% for model 3 and 71% for model 4, which means that the predictive power of the models were good. Contrary to our expectations, dental utilisation among PLHIV was generally poor among this group of patients. There is serious and immediate need to improve the awareness of PLHIVs in African settings and barriers to dental care utilisation should also be removed or reduced.

  15. Syphilitic periostitis in a newly diagnosed HIV-positive man.

    Science.gov (United States)

    Coyne, K; Browne, R; Anagnostopoulos, C; Nwokolo, N

    2006-06-01

    A 36-year-old man presented for an HIV test, which answered positive. He gave a six-week history of headache and fever. His syphilis serology was also positive with a Venereal Disease Research Laboratory (VDRL) titre of 1:32, and positive Treponema pallidum particle agglutination (TPPA) assay and fluorescent treponemal antibody (FTA). When he attended for treatment of the syphilis, he had developed severe pain in both lower limbs. Plain radiographs were normal. An isotope bone scan showed multiple areas of increased uptake, consistent with syphilitic periostitis. Some of these lesions were asymptomatic. He was treated with benzathine penicillin and his pain resolved. The bone scan had normalized after six months. We review the previous literature regarding syphilitic bone pain and periostitis. We discuss the importance of considering syphilis in the differential diagnosis of any sexually active adult presenting with bone pain, and highlight the usefulness of isotope bone scans in clarifying the clinical picture.

  16. Parasite Genotypically Related to a Monoxenous Trypanosomatid of Dog's Flea Causing Opportunistic Infection in an HIV Positive Patient

    Directory of Open Access Journals (Sweden)

    Raquel S Pacheco

    1998-07-01

    Full Text Available An HIV positive patient presenting a clinical picture of visceral leishmaniasis co-infection was submitted to a bone marrow aspiration after admission to hospital. Amastigotes forms were seen in the bone marrow aspirate and the parasite grew in culture as promastigotes. Molecular analyses showed that the flagellates isolated did not belong to the genera Leishmania, Trypanosoma or Sauroleishmania. It was not possible to establish infection in laboratory animals. In vitro culture of mouse peritoneal macrophages revealed the invasion of the host cells by the flagellates and their killing 48 hr after infection. Opportunistic infection with an insect trypanosomatid was suspected. Further hybridization analyses against a pannel of different monoxenous and heteroxenous trypanosomatids showed kDNA cross-homology with Leptomonas pulexsimulantis a trypanosomatid found in the dog's flea

  17. Sociodemographic profile and predictors of outpatient clinic attendance among HIV-positive patients initiating antiretroviral therapy in Selangor, Malaysia

    Science.gov (United States)

    Abdulrahman, Surajudeen Abiola; Rampal, Lekhraj; Othman, Norlijah; Ibrahim, Faisal; Hayati, Kadir Shahar; Radhakrishnan, Anuradha P

    2017-01-01

    Background Inconsistent literature evidence suggests that sociodemographic, economic, and system- and patient-related factors are associated with clinic attendance among the HIV-positive population receiving antiretroviral therapy (ART) around the world. We examined the factors that predict outpatient clinic attendance among a cohort of HIV-positive patients initiating ART in Selangor, Malaysia. Patients and methods This cross-sectional study analyzed secondary data on outpatient clinic attendance and sociodemographic, economic, psychosocial, and patient-related factors among 242 adult Malaysian patients initiating ART in Selangor, Malaysia. Study cohort was enrolled in a parent randomized controlled trial (RCT) in Hospital Sungai Buloh Malaysia between January and December 2014, during which peer counseling, medication, and clinic appointment reminders were provided to the intervention group through short message service (SMS) and telephone calls for 24 consecutive weeks. Data on outpatient clinic attendance were extracted from the hospital electronic medical records system, while other patient-level data were extracted from pre-validated Adult AIDS Clinical Trial Group (AACTG) adherence questionnaires in which primary data were collected. Outpatient clinic attendance was categorized into binary outcome – regular attendee and defaulter categories – based on the number of missed scheduled outpatient clinic appointments within a 6-month period. Multivariate regression models were fitted to examine predictors of outpatient clinic attendance using SPSS version 22 and R software. Results A total of 224 (93%) patients who completed 6-month assessment were included in the model. Out of those, 42 (18.7%) defaulted scheduled clinic attendance at least once. Missed appointments were significantly more prevalent among females (n=10, 37.0%), rural residents (n=10, 38.5%), and bisexual respondents (n=8, 47.1%). Multivariate binary logistic regression analysis showed that

  18. Profile of clients tested HIV positive in a voluntary counseling and testing center of a district hospital, Udupi, South Kannada

    Directory of Open Access Journals (Sweden)

    Kumar A

    2008-01-01

    Full Text Available Background: The growing menace created by the HIV/AIDS (human immunodeficiency virus/acquired immunodeficiency syndrome has alarmed not only the public health officials but also the general community. The Voluntary Counseling and Testing Centre (VCTC services have begun as a cost-effective intervention in reversing this epidemic. Objectives: 1. To study the sociodemographic characteristics of HIV-positive clients and their risk behaviors. 2. To elucidate the reasons for their visit to the VCTC and know the problems anticipated by the clients after revealing their HIV-positive status. Study Design: A cross-sectional record-based study. Materials and Methods: The study was conducted in August 2007 among clients who tested positive for HIV in the VCTC of a district hospital in Karnataka from January to July 2007. Results: Study included 249 individuals, of whom 64.7% were males, 88.7% (age, 15-49 years, married (72.7% males and 84.0% females and literate (females 71.5% and males 85.7%. A high percentage of nonresponse regarding the pattern of risk behavior was noted among the subjects (males: 42.8% and females: 90.9%. Of the individuals who responded, 91 males (98.9% and 6 females (75.0% had multiple heterosexual sex partners, while 1 male had homosexual partner. The figures in females show that two (25% of them had a history of blood transfusion. The reason for visiting the VCTC were cited as some form of illness (33.3%, confirmation of test results (32.9%, family members diagnosed as HIV positive (12.9% and 11.6% were referred from Directly Observed Treatment Scheme (DOTS center. More than three quarter of the sample population anticipated discrimination at the time of medical treatment. Conclusion: People have begun using VCTC services, which reflects a change in their attitude toward HIV. The study provides us a clue to formulate an effective approach to educate people as well as the health personnel who are thought of as one of the important

  19. Comparison of T-lymphocyte Subsets and Phenotypes between HIV-positive Subjects and HIV-negative Subjects

    Institute of Scientific and Technical Information of China (English)

    陈小平; 陈观今; 肖斌权; 施文钧; 徐惠芳; 高凯

    2001-01-01

    @@ With the advance of research on HIV/AIDS, CD8 T-lymphocyte is believed to be independently an important immune factor of controlling HIV infection not only in its number but also in its function. Multiple studies on phenotypic markers or surface antigens of lymphocytes show that level of expression of CD25 decrease while that of HIA-DR increased on lymphocytes in HIV-infected individuals compared with that in HIV-negative subjects and that levels of expression of these molecules represent a part of function of lymphocytes. But function testing of CD4 cell and CD8 cell is complicated in technique and time spending. In addition, some studies indicate that apoptosis of CD4 cells play an important role in HIV/AIDS pathogenesis. So it is clinically important to compare the lymphocyte subsets and phenotypes in HIV-positive subjects with those in HIV-negative individuals.

  20. Comparison of T-lymphocyte Subsets and Phenotypes between HIV-positive Subjects and HIV-negative Subjects

    Institute of Scientific and Technical Information of China (English)

    陈小平; 陈观今; 肖斌权; 施文钧; 徐惠芳; 高凯

    2001-01-01

    With the advance of research on HIV/AIDS, CD8 T-lymphocyte is believed to be independently an important immune factor of controlling HIV infection not only in its number but also in its func-tion. Multiple studies on phenotypic markers or surface antigens of lymphocytes show that level of expression of CD25 decrease while that of HLA-DR increased on lymphocytes in HIV-infected individuals compared with that in HIV-negative subjects and that levels of expression of these molecules represent a part of function of lymphocytes. But function testing of CD4 cell and CD8 cell is complicated in technique and time spending. In addition, some studies indicate that apoptosis of CD4 cells play an important role in HIV/AIDS pathogenesis. So it is clinically important to compare the lymphocyte subsets and phenotypes in HIV-positive subjects with those in HIV-negative individuals.

  1. Changes in depression in a cohort of Danish HIV-positive individuals: time for routine screening

    DEFF Research Database (Denmark)

    Rodkjaer, Lotte; Laursen, Tinne; Christensen, Nils B

    2011-01-01

    Background: The aim of this study was to follow a cohort of HIV-positive individuals for 3 years in order to assess changes in depression, adherence, unsafe sex and emotional strains from living with HIV. Methods: Participants were assessed for depression, adherence, emotional strain and unsafe sex...... via a questionnaire. The Beck Depression Inventory II (BDI) was used to assess the prevalence and severity of depressive symptoms. Patients with a BDI score of 20 or above (moderate to major depression) were offered a clinical evaluation by a consultant psychiatrist. Results: In 2005, 205 HIV......-positive individuals participated in the study. Symptoms of depression (BDI >14) were observed in 77 (38%) and major depression (BDI ≥20) in 53 (26%) individuals. In 2008, 148 participants were retested (72% of original sample). Depression (BDI >14) was observed in 38 (26%) and symptoms of major depression (BDI ≥20...

  2. Doppler echocardiographic evaluation of HIV-positive patients in different stages of the disease

    Directory of Open Access Journals (Sweden)

    Werneck Guilherme Lobosco

    1999-01-01

    Full Text Available OBJETIVE: To evaluate by Doppler echocardiography (DE early abnormalities of ventricular function in HIV-positive patients, as well as other cardiac abnormalities that can be detected by this method, with special emphasis on mitral valve flow. METHODS: 84 HIV- positive patients, 59 with CD4 cell count >500/mm³ (Group A and 25 with CD4 cell count 500/mm³ had no abnormalities by DE. Patients with a more advanced infection (those with a CD4 cell count <500/mm³, had a significantly abnormal LV systolic function and a higher incidence of pericardial effusion and mitral regurgitation. Mitral valve inflow by Doppler did not indicate diastolic dysfunction.

  3. Adequacy of Mental Health Services for HIV-Positive Patients with Depression

    DEFF Research Database (Denmark)

    Choi, Stephanie K Y; Boyle, Eleanor; Cairney, John;

    2016-01-01

    BACKGROUND: 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. METHODS: We conducted a prospective cohort study linking data from the Ontario HIV Treatment Network Cohort Study...... 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...

  4. Relationship satisfaction of HIV-positive Ugandan individuals with HIV-negative partners.

    Science.gov (United States)

    Pasipanodya, Elizabeth C; Heatherington, Laurie

    2015-01-01

    Challenges of relational coping are well documented in the literature on couples and chronic illnesses, but there is significantly less research on the psychological aspects of couple relationships and HIV, particularly in international contexts. Coping with the uncertainty of illness progression, family planning, disclosure to friends and family, social isolation and stigma, fear of transmission, sexual intimacy, changes to social and physical functioning, and receiving and providing care pose special challenges for couples with discordant HIV statuses. This study examined the correlates of relationship satisfaction in Ugandan HIV-positive individuals seeking treatment at a community clinic. Relationship satisfaction of HIV-positive individuals was uniquely predicted by their couple identity and depression, underscoring the importance of mental and relational health in HIV/AIDS.

  5. Gender differences in HIV-positive persons in use of cardiovascular disease-related interventions

    DEFF Research Database (Denmark)

    Hatleberg, Camilla Ingrid; Ryom, Lene; El-Sadr, Wafaa;

    2014-01-01

    INTRODUCTION: There is a lack of data on potential gender differences in the use of interventions to prevent and treat cardiovascular disease (CVD) in HIV-positive individuals. We investigated whether such differences exist in the D:A:D study. MATERIALS AND METHODS: Follow-up was from 01/02/99 un......INTRODUCTION: There is a lack of data on potential gender differences in the use of interventions to prevent and treat cardiovascular disease (CVD) in HIV-positive individuals. We investigated whether such differences exist in the D:A:D study. MATERIALS AND METHODS: Follow-up was from 01......). CONCLUSION: Use of most CVD interventions was lower among women than men in the D:A:D study. Our findings suggest that actions should be taken to ensure that both men and women are monitored for CVD and, if eligible, receive appropriate CVD interventions....

  6. Sexual Behavior and Risk Practices of HIV Positive and HIV Negative Rwandan Women.

    Science.gov (United States)

    Adedimeji, Adebola A; Hoover, Donald R; Shi, Qiuhu; Gard, Tracy; Mutimura, Eugene; Sinayobye, Jean d'Amour; Cohen, Mardge H; Anastos, Kathryn

    2015-07-01

    It is not well understood how infection with HIV and prior experience of sexual violence affects sexual behavior in African women. We describe factors influencing current sexual practices of Rwandan women living with or without HIV/AIDS. By design, 75 % of participants were HIV positive and ~50 % reported having experienced genocidal rape. Univariate and multivariate logistic regression models were fit to describe demographic and clinical characteristics that influenced sexual behavior in the previous 6 months, condom use, history of transactional sex, and prior infection with a non-HIV sexually transmitted disease. Respondents' age, where they lived, whether or not they lived with a husband or partner, experience of sexual trauma, CD4 count, CES-D and PTSD scores were strongly associated with risky sexual behavior and infection with non-HIV STI. HIV positive women with a history of sexual violence in the contexts of war and conflict may be susceptible to some high-risk sexual behaviors.

  7. Post Caesarean section infective morbidity in HIV-positive women at a tertiary training hospital in Zimbabwe.

    Science.gov (United States)

    Zvandasara, P; Saungweme, G; Mlambo, J T; Moyo, J

    2007-01-01

    To investigate the infective morbidity in HIV-positive and HIV-negative women whose babies were delivered by Caesarean section. A hospital based, prospective study: part of a larger operational research project. Harare Maternity Hospital, a tertiary referral teaching hospital in Harare, Zimbabwe. 164 HIV-positive and 382 HIV-negative women who were delivered of their babies by Caesarean sections. Minor and major infective complications. The results compare HIV-positive and HIV-negative women, 18/164 (10.9%) HIV-positive women developed anaemia requiring blood transfusion compared with 15/382 (3.9%) HIV-negative women. The difference was statistically significant (RR 3.05). HIV-positive women had a statistically significant increase in the incidence of post operative fever (RR 1.3) and wound sepsis/sinus (p = 0.002). Our study indicates that HIV-positive women who were given prophylactic pre-operative antibiotics were at an increased risk of minor infective complications and blood transfusion post Caesarean section. The risk of blood transfusion was higher in women who had a pre-operative haemoglobin of 10.5 grams/dl. Post operative fever, wound sepsis and wound sinus was commoner in HIV-positive when compared to HIV-negative women.

  8. Comparing Papanicolau smear, visual inspection with acetic acid and human papillomavirus cervical cancer screening methods among HIV-positive women by immune status and antiretroviral therapy

    National Research Council Canada - National Science Library

    Chung, Michael H; McKenzie, Kevin P; De Vuyst, Hugo; Richardson, Barbra A; Rana, Farzana; Pamnani, Ritesh; Njoroge, Julia W; Nyongesa-Malava, Evans; Sakr, Samah R; John-Stewart, Grace C; Mugo, Nelly R

    2013-01-01

    ...) and colposcopy-directed biopsy has not been performed among HIV-positive women. Between June and November 2009, 500 HIV-positive women were enrolled at an HIV treatment clinic in Nairobi, Kenya, and underwent Papanicolau (Pap...

  9. New ILO standard on HIV rejects discrimination against HIV-positive workers.

    Science.gov (United States)

    Brands, Ronald

    2010-10-01

    2010 saw a significant development in advocating for enhanced rights protection of HIV-positive workers: the adoption of an International Labour Organisation (ILO) recommendation on HIV/AIDS in the employment sphere. In this article, based on a presentation made at AIDS 2010, Ronald Brands outlines the key components of the document and how it seeks to protect employees and job-seekers from discrimination on the grounds of real or perceived HIV status.

  10. "Life in Brackets": Biographical Uncertainties of HIV-Positive Women in South Africa

    OpenAIRE

    Burchardt, Marian

    2010-01-01

    As South Africa is witnessing a maturing AIDS epidemic, the experience and impact of the disease are written ever more firmly into the biographical self-constructions of the infected. In this article, I explore typical strategies of dealing with uncertainties arising from new challenges, after the shock of ontological insecurity ensuing from the diagnosis, has been overcome. The analysis is based on contrasting interpretations of problem-centered biographical interviews with HIV-positive Sout...

  11. After the fall from grace: Negotiation of new identities among HIV-positive women in Peru

    OpenAIRE

    Valencia-Garcia, Dellanira; Starks, Helene; Strick, Lara; Simoni, Jane M.

    2008-01-01

    Despite increasing rates of HIV infection among heterosexual women in Peru, married women remain virtually invisible as a group at risk of HIV or requiring treatment. This study analyzed the intersections of HIV with machismo and marianismo, the dominant discourses in Latin America that prescribe gender roles for men and women. Data sources include recent literature on machismo and marianismo and interviews conducted with 14 HIV-positive women in Lima, Peru. Findings indicate how the stigma a...

  12. Pregnancy outcomes in HIV-positive women: a retrospective cohort study.

    Science.gov (United States)

    Arab, Kholoud; Spence, Andrea R; Czuzoj-Shulman, Nicholas; Abenhaim, Haim A

    2017-03-01

    In the United States, an estimated 8500 HIV (human immunodeficiency virus) positive women gave birth in 2014. This rate appears to be increasing annually. Our objective is to examine obstetrical outcomes of pregnancy among HIV-positive women. A population-based cohort study was conducted using the Nationwide Inpatient Sample database (2003-2011) from the United States. Pregnant HIV-positive women were identified and compared to pregnant women without HIV. Multivariate logistic regression was used to estimate the adjusted effect of HIV status on obstetrical and neonatal outcomes. Among 7,772,999 births over the study period, 1997 were in HIV-positive women (an incidence of 25.7/100,000 births). HIV-infected patients had greater frequency of pre-existing diabetes and chronic hypertension, and use of cigarettes, drugs, and alcohol during pregnancy (p < 0.001). Upon adjustment for baseline characteristics, HIV-infected women had greater likelihood of antenatal complications: preterm premature rupture of membranes (OR 1.35, 95% CI 1.14-1.60) and urinary tract infections (OR 3.02, 95% CI 2.40-3.81). Delivery and postpartum complications were also increased among HIV-infected women: cesarean delivery (OR 3.06, 95% CI 2.79-3.36), postpartum sepsis (OR 8.05, 95% CI 5.44-11.90), venous thromboembolism (OR 2.21, 95% CI 1.46-3.33), blood transfusions (OR 3.67, 95% CI 3.01-4.49), postpartum infection (OR 3.00, 95% CI 2.37-3.80), and maternal mortality (OR 21.52, 95% CI 12.96-35.72). Neonates born to these mothers were at higher risk of prematurity and intrauterine growth restriction. Pregnancy in HIV-infected women is associated with adverse maternal and newborn complications. Pregnant HIV-positive women should be followed in high-risk healthcare centers.

  13. Infant feeding and HIV positive mothers in the Capricorn District of Limpopo Province

    Directory of Open Access Journals (Sweden)

    N.S. Ramara

    2010-09-01

    Full Text Available HIV-positive mothers who practise infant feeding of their choice at Mankweng clinic in the Limpopo province are experiencing specific problems with various feeding methods. This study was undertaken with the aim to explore and describe the socioeconomic and cultural experiences of HIV-positive mothers who practise infant feeding of their choice. The research design was exploratory, descriptive, qualitative and contextual in nature. A phenomenological approach was adopted to focus on the lived experiences of HIV-positive mothers. The study sample was purposely selected. Ten HIV-positive mothers volunteered to participate in the study. Data were collected through in-depth unstructured interviews. All participants responded to an open-ended question: “Could you please tell me, in detail, your experience on infant feeding of your choice?” Interviews were conducted until saturation, as was reflected in repeating themes, was reached. The model of trustworthiness, as outlined in Guba and Lincoln (1985:301 -318, to ensure credibility and dependability, was used in this study. The study adhered to the ethical standards as set by DENOSA (1998:2.3.2-2.3.4. Data were analysed according to Tesch’s method, as outlined in Creswell (2003:192 and De Vos (1998:343. Literature control was performed to verify the results. Two main categories that emerged were guided by options for infant feeding; namely those that chose formula feeding for their babies and those participants who opted to breast-feed their babies The study proposed to recommend guidelines for the development of relevent content for inclusion in health education programmes of registered midwives who, in turn, can use such information to educate mothers

  14. Infant feeding and HIV positive mothers in the Capricorn District of Limpopo province.

    Science.gov (United States)

    Ramara, N S; Maputle, M S; Lekhuleni, M E

    2010-03-01

    HIV-positive mothers who practise infant feeding of their choice at Mankweng clinic in the Limpopo province are experiencing specific problems with various feeding methods. This study was undertaken with the aim to explore and describe the socioeconomic and cultural experiences of HIV-positive mothers who practise infant feeding of their choice. The research design was exploratory, descriptive, qualitative and contextual in nature. A phenomenological approach was adopted to focus on the lived experiences of HIV-positive mothers. The study sample was purposely selected. Ten HIV-positive mothers volunteered to participate in the study. Data were collected through in-depth unstructured interviews. All participants responded to an open-ended question: "Could you please tell me, in detail, your experience on infant feeding of your choice?" Interviews were conducted until saturation, as was reflected in repeating themes, was reached. The model of trustworthiness, as outlined in Guba and Lincoln (1985:301-318), to ensure credibility and dependability, was used in this study. The study adhered to the ethical standards as set by DENOSA (1998:2.3.2-2.3.4). Data were analysed according to Tesch's method, as outlined in Creswell (2003:192) and De Vos (1998:343). Literature control was performed to verify the results. Two main categories that emerged were guided by options for infant feeding; namely those that chose formula feeding for their babies and those participants who opted to breast-feed their babies. The study proposed to recommend guidelines for the development of relevent content for inclusion in health education programmes of registered midwives who, in turn, can use such information to educate mothers.

  15. Postnatal Depression Symptoms are Associated with Increased Diarrhea among Infants of HIV-Positive Ghanaian Mothers

    OpenAIRE

    Okronipa, Harriet E.T.; Marquis, Grace S.; Lartey, Anna; Brakohiapa, Lucy; Perez-Escamilla, Rafael; Mazur, Robert E

    2012-01-01

    HIV infection is linked to increased prevalence of depression which may affect maternal caregiving practices and place young infants at increased risk of illness. We examined the incidence and days ill with diarrhea among infants of HIV positive (HIV-P), HIV negative (HIV-N), and unknown HIV status (HIV-U) women, and determined if symptoms of maternal postnatal depression (PND) modulated the risk of diarrhea. Pregnant women (n=492) were recruited from 3 antenatal clinics; mothers and infants ...

  16. Cigarette smoking among Chinese PLWHA: An exploration of changes in smoking after being tested HIV positive.

    Science.gov (United States)

    Wang, Yuanhui; Chen, Xinguang; Li, Xiaoming; Wang, Yan; Shan, Qiao; Zhou, Yuejiao; Shen, Zhiyong

    2016-01-01

    Prevention and cessation of Tobacco use among persons living with HIV/AIDS (PLWHA) represents a significant challenge for HIV/AIDS patient care in China and across the globe. Awareness of HIV-positive status may alter the likelihood for PLWHA smokers to change their smoking habit. In this study, we tested the risk enhancement and risk reduction hypotheses by assessing changes in cigarette smoking behavior among PLWHA after they received the positive results of their HIV tests. Cross-sectional survey data collected from a random sample of 2973 PLWHA in care in Guangxi, China were analyzed. Changes in cigarette smoking after receiving the HIV-positive test results, as well as the current levels of cigarette smoking were measured. Among the total participants, 1529 (51.7%) were self-identified as cigarette smokers, of whom 436 (28.9%) reduced smoking and 286 (19.0%) quit after receiving their HIV-positive test results. Among the quitters, 210 (73.9%) remained abstinent for a median duration of two years. There were also 124 (8.2%) who increased cigarette smoking. Older age, female gender, more education, and receiving antiretroviral therapy were associated with quitting. In conclusion, our study findings support the risk reduction and risk enhancement hypotheses. A large proportion of smoking PLWHA reduced or quit smoking, while a small proportion increased smoking. Findings of this study suggest that the timing when a person receives his or her HIV-positive test result may be an ideal opportunity for care providers to deliver tobacco cessation interventions. Longitudinal studies are indicated to verify the findings of this study and to support smoking cessation intervention among PLWHA in the future.

  17. HIV-positive man from DRC deemed a "person in need of protection".

    Science.gov (United States)

    2008-12-01

    In an in camera hearing on 9 July 2008, the Refugee Protection Division of the Immigration and Refugee Board of Canada, accepted that the manner in which the government of the Democratic Republic of the Congo (DRC) dealt with the HIV epidemic in its country posed a "risk to life" to an HIV-positive man from that country who was applying for asylum in Canada.

  18. Tuberculosis among HIV-positive patients at Butajira Hospital, South-Central Ethiopia

    Directory of Open Access Journals (Sweden)

    Seada Mohammed

    2015-12-01

    Full Text Available Background: Tuberculosis (TB is the leading cause of morbidity and mortality among people living with Human Immunodeficiency Virus (HIV. This study was carried out to determine the prevalence of tuberculosis and its associated factors among HIV-positive patients at Butajira Hospital, South-Central Ethiopia. Methods: A retrospective review of standardized 222 HIV-positive patient records between July 2011 and June 2012 was conducted. A data sheet was used to collect relevant variables. Data were entered, organized and analysed using SPSS Version 16.0 Software. A p-value 15 years (18.95%. Among 45 TB/HIV cases, 26.7% had smear-positive pulmonary TB; 62.2% had smear-negative pulmonary TB; and 11.1% had extra-pulmonary TB. Malnutrition (OR= 45.7, CD4+ T-cell count <200/μl (OR= 5.4 and WHO clinical stage III or IV (OR= 4.12 were associated with tuberculosis in HIV-positive patients. Conclusion: In conclusion, the prevalence of TB/HIV co-infection at Butajira Zonal Hospital, South-Central Ethiopia was high. The co-infection was associated with malnutrition, low CD4 + T-cell count and WHO clinical stage III or IV. Therefore, compulsory TB screening among HIV-positive patients is mandatory. Besides, public awareness, community mobilization should be encouraged. Moreover, large scale studies on the trends in TB/HIV co-infection and associated factors should also be implemented across the country.

  19. Isolated penile Kaposi's sarcoma in a HIV-positive patient stable on treatment for three years.

    Science.gov (United States)

    Lebari, Dornubari; Gohil, Jesal; Patnaik, Lipsita; Wasef, Wafaa

    2014-07-01

    Kaposi's sarcoma (KS) is an AIDS-defining condition. Typically, KS affects the skin with or without visceral involvement. The extensive use of antiretroviral therapy (ART) has decreased the incidence of KS amongst the HIV-positive population. We report a case of a 40-year-old man with HIV-1 infection with CD4 count of 551 cells/mm(3)and an undetectable viral load who presented with two skin-coloured KS lesions on the prepuce of the penis. Diagnosis was confirmed by histopathology. He had been commenced on ART three years earlier with a nadir CD4 count of 255 cells/mm(3) He had achieved and maintained viral suppression since commencing ART. The patient was initially treated with cryotherapy and 5% imiquimod as the lesions were presumed to be warts. The lack of response to treatment prompted further investigation. We carried out a literature search of published cases of penile KS over the past 10 years. The majority of articles regarding penile KS were published in the pre-ART era and involved patients with AIDS. Over the past 10 years, published cases of penile KS have almost exclusively been in HIV-negative men. We found 10 published cases of penile KS in HIV-negative men and only one other published case of penile KS in a HIV-positive man, who had severe immune suppression with CD4 count below 200 cells/mm(3) This is the first case report to describe a HIV-positive patient stable on ART with a CD4 count above 200 cells/mm(3)and suppressed HIV-1 viral load, to develop two KS lesions on the penis. Clinicians have to remain suspicious of penile lesions and appreciate the crucial role a biopsy with histopathological analysis plays in confirming a diagnosis. In addition, this case illustrates that unusual presentations of KS can still occur in treated HIV-positive patients with sustained immune recovery.

  20. Determining protein biomarkers for DLBCL using FFPE tissues from HIV negative and HIV positive patients.

    Science.gov (United States)

    Magangane, Pumza; Sookhayi, Raveendra; Govender, Dhirendra; Naidoo, Richard

    2016-12-01

    DLBCL is the most common lymphoma subtype occurring in older populations as well as in younger HIV infected patients. The current treatment options for DLBCL are effective for most patients yet the relapse rate is high. While many biomarkers for DLBCL exist, they are not in clinical use due to low sensitivity and specificity. In addition, these biomarkers have not been studied in the HIV context. Therefore, the identification of new biomarkers for HIV negative and HIV positive DLBCL, may lead to a better understanding of the disease pathology and better therapeutic design. Protein biomarkers for DLBCL were determined using MALDI imaging mass spectrometry (IMS) and characterised using LC-MS. The expression of one of the biomarkers, heat shock protein (Hsp) 70, was confirmed on a separate cohort of samples using immunohistochemistry. The biomarkers identified in the study consisted of four protein clusters including glycolytic enzymes, ribosomal proteins, histones and collagen. These proteins could differentiate between control and tumour tissue, and the DLBCL immunohistochemical subtypes in both cohorts. The majority (41/52) of samples in the confirmation cohort were negative for Hsp70 expression. The HIV positive DLBCL cases had a higher percentage of cases expressing Hsp70 than their HIV negative counterparts. The non-GC subtype also frequently overexpressed Hsp70, confirming MALDI IMS data. The expression of Hsp70 did not correlate with survival in both the HIV negative and HIV positive cohort. This study identified potential biomarkers for HIV negative and HIV positive DLBCL from FFPE tissue sections. These may be used as diagnostic and prognostic markers complementary to current clinical management programmes for DLBCL.

  1. Unusual formation of keloids after each episode of recurrent herpes zoster in an HIV positive patient

    Directory of Open Access Journals (Sweden)

    Koley Sankha

    2009-01-01

    Full Text Available Herpes Zoster (HZ lesions are well known to heal with keloids. As immunity plays an important role in the development of abnormal scars and keloids, the latter is unusual in HIV where immunity is low. We report a rare case of recurrent HZ in an HIV-positive male where the lesions have healed with formation of keloids in both episodes. Within 50 days of last episode, he had an attack of herpes progenitalis.

  2. Recreational drug use and related social factors among HIV-positive men in Japan.

    Science.gov (United States)

    Togari, Taisuke; Inoue, Yoji; Takaku, Yosuke; Abe, Sakurako; Hosokawa, Rikuya; Itagaki, Takashi; Yoshizawa, Shigeyuki; Oki, Sachiko; Katakura, Naoko; Yamauchi, Asae; Wakabayashi, Chihiro; Yajima, Takashi

    2016-07-01

    This study aims to determine the relationship between recreational drug use in HIV-positive males in the past year and socio-economic factors and/or social support networks in Japan. A national online survey in a cross-sectional study was conducted by HIV Futures Japan project from July 2013 to February 2014. Of the 1095 HIV-positive individuals who responded, 913 responses were determined to be valid; responses from the 875 males were analysed. A total of 282 participants used addictive drugs (32.2%) in past year. New psychoactive substances were used by 121 participants (13.8%), methamphetamine or amphetamine by 47 (5.4%), air dusters/sprays/gas by 31 (3.5%), 5-methoxy-N,N-diisopropyltryptamine (5MeO-DIPT) by 16 (1.8%) and cannabis (1.0%) by 9. Multiple logistic regression analysis was performed with the use of alkyl nitrites, addictive drugs, air dusters and thinners, which are low illegality, as dependent variables. We found that the odds ratio (95% confidence interval) for use among participants with full-time and temp/contracted/part-time employees compared to management/administration professions were 2.59 (0.99-6.77) and 2.61 (0.91-7.51). Also, a correlation was observed between alkyl nitrites and new psychoactive substances and usage rates in people engaged in few HIV-positive networks. It is necessary to develop targeted policies for drug use prevention and user support among HIV-positive men and to support and provide care for drug users who are isolated or have a narrow HIV/AIDS support network.

  3. An unusual cause of abdominal pain in an HIV-positive man

    Science.gov (United States)

    Saing, Chit; Yoganathan, Kathir G

    2015-01-01

    We report a case of an HIV-positive man on antiretroviral therapy (ART) who developed abdominal pain due to acute-on-chronic intestinal ischaemia secondary to superior mesenteric vein thrombosis (SMVT) requiring emergency surgery. He was found to have persistently low levels of protein C on thrombophilia screening. To the best of our knowledge, the association linking SMVT to protein C deficiency in an HIV-infected patient has never been reported in the literature. PMID:25819818

  4. Study of factors affecting maternal and fetal outcome in HIV positive women

    Directory of Open Access Journals (Sweden)

    Sumitra Yadav

    2016-12-01

    Full Text Available Background: HIV virus infection was detected first time in India in Tamil Nadu in April 1986; India has the third largest HIV epidemic in the world. In 2013, HIV prevalence in India was an estimated 0.3 percent. The pregnant women and her unborn child who are HIV reactive are mostly innocent bearers of the brunt of the infection. Mother-to-child transmission of HIV is a major route of new infections in children. Without any intervention, the risk of transmission of HIV from infected pregnant women to her child is estimated to be around 20- 45%.Early diagnosis of children born to HIV positive mother using HIV DNA PCR and treating children who are diagnosed HIV-positive with antiretroviral drugs within their first 12 weeks of life reduces mortality by 75%. Methods: This retrospective data analytic study of HIV positive pregnant women who attended antenatal clinic and delivered at M.Y. Hospital, Indore from January 2011 to December 2013 .For screening of ANC patients ELISA method was used. For the children, HIV DNA was done by sending the dried blood smear on blot paper and was sent to the reference laboratory Kasturba Hospital, Mumbai and used for diagnosis at 6 week and 6 month. Results: Only 50% of HIV positive children were started on ART, 20% died, 20% loss to follow up and 10% were not willing for follow up. Also 30% mothers practiced mixed feeding. Neonatal mortality rate was 54.87 per thousand live births which is more than the seronegative mothers. Conclusions: First HIV DNA testing can be done at 72 hours to detect antenatal HIV transmission. Early testing can pick up these cases early and ensure treatment. Mixed feeding should be strongly discouraged by counseling and modern methods of communication.

  5. Sexual Dysfunctions of HIV-Positive Men: Associated Factors, Pathophysiology Issues, and Clinical Management

    Directory of Open Access Journals (Sweden)

    Marco de Tubino Scanavino

    2011-01-01

    Full Text Available Sexual dysfunctions in HIV-positive men are associated with an increase in risky sexual behavior and decreased adherence to antiretroviral drug regimens. Because of these important public health issues, we reviewed the literature on the pathophysiology, associated factors and clinical management of sexual dysfunction in HIV-positive men. The goal was to investigate the current research on these issues. Literature searches were performed in June 2011 on PubMed, Web of Science, and PsycInfo databases with the keywords “AIDS” and “sexual dysfunction” and “HIV” and “sexual dysfunction”, resulting in 54 papers. Several researchers have investigated the factors associated with sexual dysfunction in HIV-positive men. The association between sexual dysfunction and antiretroviral drugs, particularly protease inhibitors, has been reported in many studies. The lack of standardized measures in many studies and the varying study designs are the main reasons that explain the controversial results. Despite some important findings, the pathophysiology of sexual dysfunction in the HAART era still not completely understood. Clinical trials of testosterone replacement therapy have shown the treatment to be beneficial to the improvement of sexual dysfunctions related to hypogonadism. However, there are not enough psychological intervention studies to make conclusions regarding the therapeutic effects of psychotherapy.

  6. Low prevalence of H. pylori Infection in HIV-Positive Patients in the Northeast of Brazil

    Directory of Open Access Journals (Sweden)

    Silva Cícero IS

    2011-02-01

    Full Text Available Abstract Background This study conducted in Northeastern Brazil, evaluated the prevalence of H. pylori infection and the presence of gastritis in HIV-infected patients. Methods There were included 113 HIV-positive and 141 age-matched HIV-negative patients, who underwent upper gastrointestinal endoscopy for dyspeptic symptoms. H. pylori status was evaluated by urease test and histology. Results The prevalence of H. pylori infection was significantly lower (p H. pylori status and gender, age, HIV viral load, antiretroviral therapy and the use of antibiotics. A lower prevalence of H. pylori was observed among patients with T CD4 cell count below 200/mm3; however, it was not significant. Chronic active antral gastritis was observed in 87.6% of the HIV-infected patients and in 780.4% of the control group (p = 0.11. H. pylori infection was significantly associated with chronic active gastritis in the antrum in both groups, but it was not associated with corpus chronic active gastritis in the HIV-infected patients. Conclusion We demonstrated that the prevalence of H. pylori was significantly lower in HIV-positive patients compared with HIV-negative ones. However, corpus gastritis was frequently observed in the HIV-positive patients, pointing to different mechanisms than H. pylori infection in the genesis of the lesion.

  7. After the fall from grace: negotiation of new identities among HIV-positive women in Peru.

    Science.gov (United States)

    Valencia-Garcia, Dellanira; Starks, Helene; Strick, Lara; Simoni, Jane M

    2008-10-01

    Despite increasing rates of HIV infection among heterosexual women in Peru, married women remain virtually invisible as a group at risk of HIV or requiring treatment. This study analyzed the intersections of HIV with machismo and marianismo, the dominant discourses in Latin America that prescribe gender roles for men and women. Data sources include recent literature on machismo and marianismo and interviews conducted with 14 HIV-positive women in Lima, Peru. Findings indicate how the stigma associated with HIV constructs a discourse that restricts the identities of HIV-positive women to those of 'fallen women' whether or not they adhere to social codes that shape and inform their identities as faithful wives and devoted mothers. Lack of public discourse concerning HIV-positive marianas silences women as wives and disenfranchises them as mothers, leaving them little room to negotiate identities that allow them to maintain their respected social positions. Efforts must be aimed at expanding the discourse of acceptable gender roles and behaviour for both men and women within the context of machismo and marianismo so that there can be better recognition of all persons at risk of, and living with, HIV infection.

  8. Religion, sexuality and family: the case in which one partner is HIV positive

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    Carolina Teles Lemos

    2014-06-01

    Full Text Available This article examines the relationship between religion, sexuality and family of HIV seropositive individuals. It aims to verify the repercussion of finding that one of ( or both spouses is HIV positive , within the representations and configuration of their families , based on a possible religious ideas underlying to gender identities male and female , as well as to the exercise of sexuality that such gender identity entails. For this purpose, a qualitative survey was conducted. Participants were men and women who live or have lived in a marital status, and this relationship has occurred or took place between members of the opposite sex or same sex, selected in an institution to support HIV positive and their families. All seropositive participants of the mentioned institution were asked to answer a questionnaire composed of nine open questions related to the subject in focus. Data analysis allowed the perception that although there is a strong   incidence of religious ideas about family and sexuality for that population, the main focus of this notion is not within the representations of family structures, but within the triggering element of prejudice towards HIV-positive both in the family space and beyond.

  9. Examining HIV Viral Load in a Matched Cohort of HIV Positive Individuals With and Without Psoriasis.

    Science.gov (United States)

    Wu, Jashin J; Gilbert, Kathleen E; Batech, Michael; Manalo, Iviensan F; Towner, William J; Raposo, Rui André Saraiva; Nixon, Douglas F; Liao, Wilson

    2017-04-01

    BACKGROUND: HIV-associated psoriasis is well-documented. Genetic, cellular, and cytokine profiles have been used as evidence to suggest psoriasis activates antiviral pathways. There has been a lack of epidemiologic evidence investigating whether psoriasis patients have lower HIV viral counts compared to non-psoriasis patients. OBJECTIVE: Compare the viral load set point of HIV positive patients with and without psoriasis. METHODS: A retrospective matched cohort study of HIV positive patients with and without psoriasis using the Kaiser Permanente Southern California Health Plan database. RESULTS: We identified 101 HIV-positive psoriasis cases; 19 met inclusion criteria and were matched with 3-5 control patients; 94 total patients were analyzed. The mean age was 41.4 (12.07) years and 83% were male. Overall, the median log of the viral load of cases was slightly higher than controls (4.3 vs 4.2; P less than 0.01). CONCLUSIONS: The serum viral load set point of patients with HIV and psoriasis was slightly higher than the viral load set point of HIV patients without psoriasis. J Drugs Dermatol. 2017;16(4):372-377..

  10. Determinants of Intimate Partner Violence Among HIV-Positive and HIV-Negative Women in India.

    Science.gov (United States)

    Chakraborty, Hrishikesh; Patted, Shobhana; Gan, Anita; Islam, Farahnaz; Revankar, Amit

    2016-02-01

    To reduce the many adverse health outcomes associated with intimate partner violence (IPV), high-risk groups need to be specifically targeted in the fight against domestic violence in India. This study aims to examine the prevalence and correlates of IPV in HIV-positive and HIV-negative women from India. A convenience sample of HIV-positive and HIV-negative women responded to questionnaires to assess their experience and perception of violence. Multivariate logistic regression analysis was used to model the association between IPV and age, education, employment status, contraception use, age at first marriage, and HIV status. Although adjusting for age, education, employment status, contraception use, age at first marriage, and HIV status, women who are employed were 3.5 times more likely to suffer IPV (confidence interval [CI] = [1.5, 8.5]), women aged 18 or above at first marriage are 0.3 times less likely to face IPV (CI = [0.1, 0.6]), and women who use contraception are 7 times more likely to suffer IPV (CI = [1.4, 30.2]). Also, HIV-positive women are 3 times more likely to face sexual violence compared with HIV-negative women (CI = [1.1, 7.6]). © The Author(s) 2014.

  11. Prevalence survey of infection with Treponema pallidum among HIV-positive patients in Tehran

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    Banafsheh; Moradmand; Badie; Zeinab; Yavari; Shooka; Esmaeeli; Koosha; Paydary; Sahra; Emamzadeh-Fard; SeyedAhmad; SeyedAlinaghi; Mehrnaz; Rasoulinejad

    2013-01-01

    Objective:To identify the frequency of syphilis among Iranian HIV-positive patients.Methods:A cross-sectional study on the prevalence of syphilis and HIV co-infection among 450 patients diagnosed with HIV infection was conducted between 2004 and 2008 at Imam Khomeini hospital,Tehran,Iran.The lab tests including CD4 cell count,cerebrospinal fluid,veneral disease research laboratory(VDRL),fluorescent treponema antibody-absorption(FTA-Abs)and viral load were performed for all the patients.Data regarding medical history and their demographics were also collected.Results:Of all 450 HIV-positive patients,24(5.3%)had a positive VDRL test and only two men had a FTA-Abs positive test which means 0.45%of them had a definite co-infection of syphilis.65.3%of the HIV-positive patients were injection drug users that the co-infection prevalence of them was 0.7%.We did not find any patient with neurosyphilis.Conclusions:Considering the increasing prevalence of HIV and also extensive use of highly active antiretroviral therapy in developing nations,the diagnosis of syphilis should be timely established using screening tests among such patients.

  12. Acid fast cysts in diarrheal stool samples of HIV positive patients

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    Anuradha Mokkapati

    2015-02-01

    Full Text Available Background: Gastrointestinal infections are very common in patients with HIV infection or AIDS, and diarrhea is a common clinical presentation of these infections. Acid fast protozoans are very commonly responsible for diarrhea in HIV positive patients leading to death in many cases. Methods: The study group included 50 HIV seropositive patients suffering from diarrhea and the control group included 50 HIV seronegative patients suffering from diarrhea. The stool samples collected were concentrated using formol-ether concentration technique and stained using modified Ziehl-Neelsen's staining procedure. Results: Among the diarrheal stool samples of HIV positive patients (n=50, 17 (34% were positive for acid fast cysts, and among the HIV negative stool samples (n=50, 2 (4% were positive for acid fast cysts. Cryptosporidium oocysts were detected in 15 (30% and Isospora oocysts in 2 (4% of the samples in the study group. Cryptosporidium oocysts were detected in 2 (4% of the samples in the control group. There existed a significant difference between the positivity of HIV-positive and HIV-negative diarrheal stool samples. Conclusion: Timely and effective diagnosis could help in delivering appropriate treatment in an already immunocompromised patient. [Int J Res Med Sci 2015; 3(2.000: 425-428

  13. Perinatal Outcomes in HIV Positive Pregnant Women with Concomitant Sexually Transmitted Infections

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    Erin Burnett

    2015-01-01

    Full Text Available Objective. To evaluate whether HIV infected pregnant women with concomitant sexually transmitted infection (STIs are at increased risk of adverse perinatal and neonatal outcomes. Methods. We conducted a cohort study of HIV positive women who delivered at an inner-city hospital in Atlanta, Georgia, from 2003 to 2013. Demographics, presence of concomitant STIs, prenatal care information, and maternal and neonatal outcomes were collected. The outcomes examined were the association of the presence of concomitant STIs on the risk of preterm birth (PTB, postpartum hemorrhage, chorioamnionitis, preeclampsia, intrauterine growth restriction, small for gestational age, low Apgar scores, and neonatal intensive care admission. Multiple logistic regression was performed to adjust for potential confounders. Results. HIV positive pregnant women with concomitant STIs had an increased risk of spontaneous PTB (odds ratio (OR 2.11, 95% confidence interval [CI] 1.12–3.97. After adjusting for a history of preterm birth, maternal age, and low CD4+ count at prenatal care entry the association between concomitant STIs and spontaneous PTB persisted (adjusted OR 1.96, 95% CI 1.01–3.78. Conclusions. HIV infected pregnant women with concomitant STIs relative to HIV positive pregnant women without a concomitant STI are at increased risk of spontaneous PTB.

  14. Spatial Analysis of HIV Positive Injection Drug Users in San Francisco, 1987 to 2005

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    Alexis N. Martinez

    2014-04-01

    Full Text Available Spatial analyses of HIV/AIDS related outcomes are growing in popularity as a tool to understand geographic changes in the epidemic and inform the effectiveness of community-based prevention and treatment programs. The Urban Health Study was a serial, cross-sectional epidemiological study of injection drug users (IDUs in San Francisco between 1987 and 2005 (N = 29,914. HIV testing was conducted for every participant. Participant residence was geocoded to the level of the United States Census tract for every observation in dataset. Local indicator of spatial autocorrelation (LISA tests were used to identify univariate and bivariate Census tract clusters of HIV positive IDUs in two time periods. We further compared three tract level characteristics (% poverty, % African Americans, and % unemployment across areas of clustered and non-clustered tracts. We identified significant spatial clustering of high numbers of HIV positive IDUs in the early period (1987–1995 and late period (1996–2005. We found significant bivariate clusters of Census tracts where HIV positive IDUs and tract level poverty were above average compared to the surrounding areas. Our data suggest that poverty, rather than race, was an important neighborhood characteristic associated with the spatial distribution of HIV in SF and its spatial diffusion over time.

  15. Experiences of work among people with disabilities who are HIV-positive in Zambia.

    Science.gov (United States)

    Njelesani, Janet; Nixon, Stephanie; Cameron, Deb; Parsons, Janet; Menon, Anitha

    2015-01-01

    This paper focuses on accounts of how having a disability and being HIV-positive influences experiences of work among 21 people (12 women, 9 men) in Lusaka, Zambia. In-depth semi-structured interviews were conducted in English, Bemba, Nyanja, or Zambian sign language. Descriptive and thematic analyses were conducted. Three major themes were generated. The first, a triple burden, describes the burden of having a disability, being HIV-positive, and being unemployed. The second theme, disability and HIV is not inability, describes participants' desire for work and their resistance to being regarded as objects of charity. Finally, how work influences HIV management, describes the practicalities of working and living with HIV. Together these themes highlight the limited options available to persons with disabilities with HIV in Lusaka, not only secondary to the effects of HIV influencing their physical capacity to work, but also because of the attendant social stigma of being a person with a disability and HIV-positive.

  16. Epidemiological and oral manifestations of HIV-positive patients in a specialized service in Brazil

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    Erick Nelo Pedreira

    2008-12-01

    Full Text Available The purpose of this study was to evaluate the prevalence of oral lesions in HIV-positive patients attending the Specialized Service for Infectious-contagious Diseases and Parasitoses of the Health Secretariat of the State of Pará (URE-DIPE/SESPA, in the city of Belém, PA, Brazil. A total of 79 HIV-positive patients (53 males and 26 females were examined. Clinical and epidemiological evaluations were done by correlating the lesions with gender, race, chronological age, risk behavior and prevailing immune status (CD4+ cells count. Lesion location and the presence of associated factors, such as alcohol use, smoking and denture wearing, were quantified individually for each type of lesion using a diagnostic pattern based on the clinical aspects. Approximately 47% of the patients (n=37 presented some type of oral lesion. Candidiasis (28% and periodontal disease (28% were the most common, followed by cervical-facial lymphadenopathy (17.5%. Other lesions observed were hairy leukoplakia, melanin hyperpigmentation, ulcerative stomatitis (aphthous, herpes simplex, frictional keratosis and pyogenic granuloma. This analysis presented some relevance as to the statistical data. Concerning CD4+ cells, most lesions manifested with the reduction of the CD count. There were a larger number of HIV-positive female heterosexual patients. Alcohol and/or smoking were strongly associated with the occurrence of hairy leukoplakia in these patients. Candidiasis and periodontal disease were the most common oro-regional clinical manifestations in the patients.

  17. Optimism, community attachment and serostatus disclosure among HIV-positive men who have sex with men.

    Science.gov (United States)

    Murphy, Patrick J; Hevey, David; O'Dea, Siobhán; Ní Rathaille, Neans; Mulcahy, Fiona

    2015-01-01

    This study investigated the relationship between HIV health optimism (HHO) (the belief that health will remain good after HIV infection due to treatment efficacy), HIV-positive community attachment (HCA), gay community attachment (GCA) and serostatus disclosure to casual sex partners by HIV-positive men who have sex with men (MSM). Cross-sectional questionnaire data were gathered from 97 HIV-positive MSM attending an HIV treatment clinic in Dublin, Ireland. Based on self-reported disclosure to casual partners, participants were classified according to their pattern of disclosure (consistent, inconsistent or non-disclosers). Multinomial logistic regression was used to assess HHO, HCA and GCA as predictors of participants' pattern of disclosure. Classification as a non-discloser (compared to a consistent discloser) was associated with higher HHO, less HCA and greater GCA. Classification as an inconsistent discloser (compared to a consistent discloser) was associated with higher GCA. The study provided novel quantitative evidence for associations between the constructs of interest. The results suggest that (1) HHO is associated with reduced disclosure, suggesting optimism may preclude individuals reaping the benefits of serostatus disclosure and (2) HCA and GCA represent competing attachments with conflicting effects on disclosure behaviour. Limitations and areas for future research are discussed.

  18. Prevalence survey of infection with Treponema pallidum among HIV-positive patients in Tehran

    Institute of Scientific and Technical Information of China (English)

    Banafsheh Moradmand Badie; Zeinab Yavari; Shooka Esmaeeli; Koosha Paydary; Sahra Emamzadeh-Fard; SeyedAhmad SeyedAlinaghi; Mehrnaz Rasoulinejad

    2013-01-01

    Objective: To identify the frequency of syphilis among Iranian HIV-positive patients. Methods:A cross-sectional study on the prevalence of syphilis and HIV co-infection among 450 patients diagnosed with HIV infection was conducted between 2004 and 2008 at Imam Khomeini hospital, Tehran, Iran. The lab tests including CD4 cell count, cerebrospinal fluid, veneral disease research laboratory (VDRL), fluorescent treponema antibody-absorption (FTA-Abs) and viral load were performed for all the patients. Data regarding medical history and their demographics were also collected. Results: Of all 450 HIV-positive patients, 24 (5.3%) had a positive VDRL test and only two men had a FTA-Abs positive test which means 0.45% of them had a definite co-infection of syphilis. 65.3% of the HIV-positive patients were injection drug users that the co-infection prevalence of them was 0.7%. We did not find any patient with neurosyphilis. Conclusions: Considering the increasing prevalence of HIV and also extensive use of highly active antiretroviral therapy in developing nations, the diagnosis of syphilis should be timely established using screening tests among such patients.

  19. Oral ranula in an HIV-positive patient: case report and literature review.

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    Kinshuck, Andrew Jon; Schober, Marianne; Kokai, George; Clarke, Ray

    2012-07-10

    We describe the presentation and treatment of an HIV-positive patient with an oral ranula, and review the literature. Ranulas are mucoceles or retention cysts formed by the extravasation of mucus from the sublingual gland, presumably due to continued production of saliva in the presence of ductal obstruction. Oral ranulas in children are rare and the overall prevalence of mucoceles has been reported as 0.08% in children aged 0-12 years. However, there has been a documented increased occurrence in HIV-positive patients. This has been attributed to a blockage of the salivary gland by inflammation and peri-ductal fibrosis following HIV-associated salivary gland disease. Oral lesions may indicate infection with HIV and can also predict progression of HIV to AIDS. The most common oral manifestation is oral candidiasis occurring in 67% of children with HIV. Following this salivary gland disease, periodontal and gingival disease and herpes simplex are the next most common. The exact prevalence of ranulas in an HIV population is not known but the occurrence of a paediatric patient with HIV having at least one oral lesion has been documented as high as 63% and salivary gland disease at 50%. The true extent of the relationship between HIV and ranula is as yet unknown. This represents the only reported case of oral ranula in an HIV-positive patient in the UK.

  20. Chlamydia and gonorrhea infections in HIV-positive women in urban Lusaka, Zambia

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    Maria L Alcaide

    2012-01-01

    Full Text Available Background: Sexually transmitted infections (STIs remain an important public health issue in sub-Saharan Africa. STIs in HIV-positive women are associated not only with gynecological complications but with increased risk of HIV transmission to HIV-negative partners and newborns. Aims: The aims of this study are to determine the prevalence of chlamydia (CT and gonorrhea (GC and examine the demographic characteristics and risk behaviors associated with these STIs in a group of HIV-positive women in Lusaka, Zambia. Settings and Design: Cross-sectional study of a sample of HIV-infected women enrolled in two large studies conducted in urban Lusaka, Zambia. Materials and Methods: HIV-seropositive women (n = 292 were assessed for demographic and behavioral risk factors and tested for CT and GC. Univariate analysis was used to determine the demographic characteristics and risk behaviors associated with having CT or GC. Results: The identified prevalence of CT was 1% and of GC was 1.4%. There was an association of CT/GC with the use of alcohol before sex (OR = 9.I, CI = 0.59-0.15, P = 0.03. Conclusions: Rates of CT and GC are described in this sample of HIV-positive women. While being in HIV care may serve to increase medical care and condom use, alcohol use should be addressed in this population.

  1. Quality of life and emotional distress among HIV-positive women during transition to motherhood.

    Science.gov (United States)

    Pereira, Marco; Canavarro, Maria Cristina

    2012-11-01

    The purpose of this preliminary study was to describe the quality of life (QOL) and emotional distress during pregnancy and early postpartum, and to examine the ability of psychopathological symptoms to predict QOL at early postpartum. A sample of 75 pregnant women (31 HIV-positive and 44 HIV-negative) was assessed during the second trimester of pregnancy and two to four days postpartum. QOL was assessed with the WHOQOL-Bref. The emotional distress was assessed with the Brief Symptom Inventory, and with the Emotional Assessment Scale. Seropositive women reported increased negative emotional reactivity and lower scores in social relationships and overall QOL during pregnancy than HIV-negative women. Both HIV-positive and HIV-negative women reported better QOL after the birth of their child, when compared with the pregnancy period. Among HIV-positive women, lower anxiety and depressive symptoms during pregnancy were, respectively, significant predictors of better psychological QOL and overall QOL at early postpartum. Less intense somatic symptoms predicted better physical QOL. Longitudinal assessment of QOL and emotional status may provide potentially useful information for tailoring psychological interventions in the maternity care of HIV-infected women, during their transition to motherhood.

  2. Validating a shortened depression scale (10 item CES-D among HIV-positive people in British Columbia, Canada.

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    Wendy Zhang

    Full Text Available OBJECTIVE: To establish the reliability and validity of a shortened (10-item depression scale used among HIV-positive patients enrolled in the Drug Treatment Program in British Columbia, Canada. METHODS: The 10-item CES-D (Center for Epidemiologic Studies Depression Scale was examined among 563 participants who initiated antiretroviral therapy (ART between August 1, 1996 and June 30, 2002. Internal consistency of the scale was measured by Cronbach's alpha. Using the original CES-D 20 as primary criteria, comparisons were made using the Kappa statistic. Predictive accuracy of CES-D 10 was assessed by calculating sensitivity, specificity, positive predictive values and negative predictive values. Factor analysis was also performed to determine if the CES-D 10 contained the same factors of positive and negative affect found in the original development of the CES-D. RESULTS: The correlation between the original and the shortened scale is very high (Spearman correlation coefficient  =0.97 (P<0.001. Internal consistency reliability coefficients of the CES-D 10 were satisfactory (Cronbach α=0.88. The CES-D 10 showed comparable accuracy to the original CES-D 20 in classifying participants with depressive symptoms (Kappa=0.82, P<0.001. Sensitivity of CES-D 10 was 91%; specificity was 92%; and positive predictive value was 92%. Factor analysis demonstrates that CES-D 10 contains the same underlying factors of positive and negative affect found in the original development of the CES-D 20. CONCLUSION: The 10-item CES-D is a comparable tool to measure depressive symptoms among HIV-positive research participants.

  3. Cervical Screening within HIV Care: Findings from an HIV-Positive Cohort in Ukraine

    Science.gov (United States)

    Bailey, Heather; Thorne, Claire; Semenenko, Igor; Malyuta, Ruslan; Tereschenko, Rostislav; Adeyanova, Irina; Kulakovskaya, Elena; Ostrovskaya, Lyudmila; Kvasha, Liliana; Cortina-Borja, Mario; Townsend, Claire L.

    2012-01-01

    Introduction HIV-positive women have an increased risk of invasive cervical cancer but cytologic screening is effective in reducing incidence. Little is known about cervical screening coverage or the prevalence of abnormal cytology among HIV-positive women in Ukraine, which has the most severe HIV epidemic in Europe. Methods Poisson regression models were fitted to data from 1120 women enrolled at three sites of the Ukraine Cohort Study of HIV-infected Childbearing Women to investigate factors associated with receiving cervical screening as part of HIV care. All women had been diagnosed as HIV-positive before or during their most recent pregnancy. Prevalence of cervical abnormalities (high/low grade squamous intraepithelial lesions) among women who had been screened was estimated, and associated factors explored. Results Overall, 30% (337/1120) of women had received a cervical screening test as part of HIV care at study enrolment (median 10 months postpartum), a third (115/334) of whom had been tested >12 months previously. In adjusted analyses, women diagnosed as HIV-positive during (vs before) their most recent pregnancy were significantly less likely to have a screening test reported, on adjusting for other potential risk factors (adjusted prevalence ratio (APR) 0.62, 95% CI 0.51–0.75 p<0.01 for 1st/2nd trimester diagnosis and APR 0.42, 95% CI 0.28–0.63 p<0.01 for 3rd trimester/intrapartum diagnosis). Among those with a cervical screening result reported at any time (including follow-up), 21% (68/325) had a finding of cervical abnormality. In adjusted analyses, Herpes simplex virus 2 seropositivity and a recent diagnosis of bacterial vaginosis were associated with an increased risk of abnormal cervical cytology (APR 1.83 95% CI 1.07–3.11 and APR 3.49 95% CI 2.11–5.76 respectively). Conclusions In this high risk population, cervical screening coverage as part of HIV care was low and could be improved by an organised cervical screening programme for HIV-positive

  4. Cervical screening within HIV care: findings from an HIV-positive cohort in Ukraine.

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    Heather Bailey

    Full Text Available INTRODUCTION: HIV-positive women have an increased risk of invasive cervical cancer but cytologic screening is effective in reducing incidence. Little is known about cervical screening coverage or the prevalence of abnormal cytology among HIV-positive women in Ukraine, which has the most severe HIV epidemic in Europe. METHODS: Poisson regression models were fitted to data from 1120 women enrolled at three sites of the Ukraine Cohort Study of HIV-infected Childbearing Women to investigate factors associated with receiving cervical screening as part of HIV care. All women had been diagnosed as HIV-positive before or during their most recent pregnancy. Prevalence of cervical abnormalities (high/low grade squamous intraepithelial lesions among women who had been screened was estimated, and associated factors explored. RESULTS: Overall, 30% (337/1120 of women had received a cervical screening test as part of HIV care at study enrolment (median 10 months postpartum, a third (115/334 of whom had been tested >12 months previously. In adjusted analyses, women diagnosed as HIV-positive during (vs before their most recent pregnancy were significantly less likely to have a screening test reported, on adjusting for other potential risk factors (adjusted prevalence ratio (APR 0.62, 95% CI 0.51-0.75 p<0.01 for 1(st/2(nd trimester diagnosis and APR 0.42, 95% CI 0.28-0.63 p<0.01 for 3(rd trimester/intrapartum diagnosis. Among those with a cervical screening result reported at any time (including follow-up, 21% (68/325 had a finding of cervical abnormality. In adjusted analyses, Herpes simplex virus 2 seropositivity and a recent diagnosis of bacterial vaginosis were associated with an increased risk of abnormal cervical cytology (APR 1.83 95% CI 1.07-3.11 and APR 3.49 95% CI 2.11-5.76 respectively. CONCLUSIONS: In this high risk population, cervical screening coverage as part of HIV care was low and could be improved by an organised cervical screening programme

  5. Late gadolinium enhancement and subclinical cardiac dysfunction on cardiac MRI in asymptomatic HIV-positive men

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    A Loy

    2012-11-01

    Full Text Available Background: HIV is associated with an increased risk of cardiovascular disease (CVD and related clinical events. While traditional risk factors play an important role in the pathology of cardiovascular disease, HIV infection and its sequelae of immune activation and inflammation may have significant effects on the myocardium before becoming clinically evident. Cardiac MRI (CMR can be used to detect the pattern of these subclinical changes. This will lead to a better understanding of risk factors contributing to cardiovascular disease prior to it becoming clinically significant in HIV-positive patients. Methods: Prospective cohort study of 127 asymptomatic HIV-positive men on ART compared to 35 matched controls. Baseline demographics, HIV parameters, 12-lead ECG, routine biochemistry, and traditional cardiovascular risk factors were recorded. Images were acquired on a 3T Achieva Philips MRI scanner with 5 channel phase array cardiac coil and weight-based IV gadolinium was given at 0.15 mmol/kg dose with post-contrast inversion recovery imaging after 10 minutes. Results: 6/127 (4.7% of asymptomatic HIV-positive men had late gadolinium enhancement (LGE on MRI verses 1/35 (2.9% in the control group. In 3/6 (50% of cases this was in a classical infarction pattern with subendocardial involvement. 3/6 (50% were consistent with prior myocarditis. There was no significant difference in mean LVEF (66.93% vs 65.18%, LVMI (60.05g/m2 vs 55.94g/m2 or posterolateral wall thickness (8.28 mm and 8.16 mm between cases and controls respectively. There was significantly more diastolic dysfunction, E:A ratio < 1, found in the HIV-positive group, 18% vs 7% of controls (p = 0.037. Framingham risk did not predict either of these outcomes. Conclusions: There is an increased incidence of LGE detected on CMR in this asymptomatic HIV-positive cohort. Two distinct pathological processes were identifed as causing these changes, myocardial infarction and myocarditis

  6. Kidney transplantation in HIV-positive patients: a report of 14 cases

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    S Casari

    2012-11-01

    Full Text Available The HAART reduces the risk of HIV-related renal disease but the incidence of end-stage renal disease (ESRD. Therefore, efficacy and safety of renal transplantation (Tx is an important resource in the HIV-infected population. We reported the results of kidney Tx in HIV+patients from deceased donors from June 2007 to March 2012 at our institution. The patients had to have CD4+T-cell counts≥200/mm3 and undetectable plasma HIV-RNA if on HAART. The induction immunosuppressive therapy consisted of metilprednisolone and basilixmab; tacrolimus and/or mycofenolic acid were used for maintenance therapy. The therapeutic drug monitoring (TDM has been performed for the adjusting of both their doses [1]. A total of 14 patients underwent kidney Tx. They were on dialysis (haemodialysis=13, 92.9%; peritoneal=1, 7.1% for 5±3.1 years and they were included on the Tx waiting list for 10±8 months. The baseline characteristics are showed in Table 1. At the last available point of follow-up (median=42.8 months, IQR=8.5–55.2, 8 out of the 13 patients (61.6% without steroid had at least one acute rejection episode, but only 1 patient lost the graft, after 43 months (7.1% due to chronic rejection associated with infectious and vascular complications. After Tx the median CD4+T-cell count increased from 382.5 (IQR range=233–415 to 434 (IQR range=282–605 cells/mm3 (p=0.055. In Figure 1 are reported the CD4+trends of 9 patients with a follow-up of at least 6 months. HIV infection was well controlled, with only 2 (14.3% cases of virological failure which were promptly resolved after HAART regimen modification. Table 1 shows the observed infectious complications. The skin Kaposi sarcoma has been resolved by switching to immunosuppressive therapy with sirolimus [2]. Kidney Tx appears to be safe in HIV-positive patients undergoing HAART. The viro-immunological parameters remained well controlled with no increases in infectious complications or neoplasm and a

  7. Impact of antiretroviral therapy on tuberculosis incidence among HIV-positive patients in high-income countries.

    NARCIS (Netherlands)

    Brouwer, A.E.; Koopmans, P.P.; Hofstede, H.J. ter; Keuter, M.; Ven, A.J. van der; Groot, R. de

    2012-01-01

    BACKGROUND: The lower tuberculosis incidence reported in human immunodeficiency virus (HIV)-positive individuals receiving combined antiretroviral therapy (cART) is difficult to interpret causally. Furthermore, the role of unmasking immune reconstitution inflammatory syndrome (IRIS) is unclear. We a

  8. Impact of antiretroviral therapy on tuberculosis incidence among HIV-positive patients in high-income countries

    NARCIS (Netherlands)

    del Amo, Julia; Moreno, Santiago; Bucher, Heiner C; Furrer, Hansjakob; Logan, Roger; Sterne, Jonathan; Pérez-Hoyos, Santiago; Jarrín, Inma; Phillips, Andrew; Lodi, Sara; van Sighem, Ard; de Wolf, Wolf; Sabin, Caroline; Bansi, Loveleen; Justice, Amy; Goulet, Joseph; Miró, José M; Ferrer, Elena; Meyer, Laurence; Seng, Rémonie; Toulomi, Giota; Gargalianos, Panagiotis; Costagliola, Dominique; Abgrall, Sophie; Hernán, Miguel A; Schölvinck, Elisabeth H.

    2012-01-01

    BACKGROUND: The lower tuberculosis incidence reported in human immunodeficiency virus (HIV)-positive individuals receiving combined antiretroviral therapy (cART) is difficult to interpret causally. Furthermore, the role of unmasking immune reconstitution inflammatory syndrome (IRIS) is unclear. We a

  9. Improvement in screening for sexually transmitted infections in HIV-positive patients following implementation of a nurse-led clinic.

    Science.gov (United States)

    Hamlyn, E; Barrett, S; Kelsey, J; Lockyer, S; Welz, T; Poulton, M

    2007-06-01

    The objective of this study was to assess changes in the uptake of sexually transmitted infection (STI) screening resulting from implementation of a specific STI clinic for HIV-positive patients. An audit of STI screening in HIV-positive patients was undertaken before and after the establishment of the clinic. Significant increases in the number of patients having a sexual health discussion and annual health screen were seen. High rates of positive results were found in all patient groups. National guidelines recommend regular STI screening for all HIV-positive patients. A specific clinic for HIV-positive patients is feasible and acceptable and may result in an increase in uptake of STI screening.

  10. Breast or bottle? HIV-positive women's responses to global health policy on infant feeding in India.

    Science.gov (United States)

    Van Hollen, Cecilia

    2011-12-01

    This article describes how local responses to global health initiatives on infant feeding for HIV-positive mothers reflect and transform sociocultural values in Tamil Nadu, India. Drawing from ethnographic research conducted from 2002 to 2008, the article compares guidelines for counseling HIV-positive mothers established by UNICEF and WHO with decision-making processes and perceptions of HIV-positive mothers. In addition to the financial considerations, three factors are identified as impinging on this decision: (1) a strong sociocultural value in favor of breastfeeding linked to historical traditions and contemporary state and international development discourses, (2) constructions of class identity, (3) the influence of a rights-based discourse in HIV/AIDS advocacy. This wide range of factors points to the difficulty of implementing the international protocols. This is the first study of its kind to closely examine the complex determinants in HIV-positive women's decisions and evaluations of infant feeding methods in India.

  11. Advanced chronic kidney disease, end-stage renal disease and renal death among HIV-positive individuals in Europe

    DEFF Research Database (Denmark)

    Nielsen, Lene Ryom; Kirk, O; Lundgren, J D

    2013-01-01

    Knowledge about advanced chronic kidney disease (CKD) and end-stage renal disease (ESRD) in HIV-positive persons is limited. The aim of this study was to investigate incidence, predictors and outcomes for advanced CKD/ESRD and renal death.......Knowledge about advanced chronic kidney disease (CKD) and end-stage renal disease (ESRD) in HIV-positive persons is limited. The aim of this study was to investigate incidence, predictors and outcomes for advanced CKD/ESRD and renal death....

  12. Factors associated with specific causes of death amongst HIV-positive individuals in the D:A:D Study

    DEFF Research Database (Denmark)

    Smith, Colette; Sabin, Caroline A; Lundgren, Jens D;

    2010-01-01

    To investigate any emerging trends in causes of death amongst HIV-positive individuals in the current cART era, and to investigate the factors associated with each specific cause of death.......To investigate any emerging trends in causes of death amongst HIV-positive individuals in the current cART era, and to investigate the factors associated with each specific cause of death....

  13. Substance-related coping, HIV-related factors, and mental health among an HIV-positive sexual minority community sample.

    Science.gov (United States)

    Cramer, Robert J; Colbourn, Scholar L; Gemberling, Tess M; Graham, James; Stroud, Caroline H

    2015-01-01

    HIV-positive status poses a unique set of social stressors, especially among lesbian, gay, and bisexual (LGB) persons. Among these difficulties are the internalization of HIV-related stigma and poor mental health. Unfortunately, substance use as a coping mechanism is also common, dependent on other demographic factors, among HIV-positive and LGB samples. The present study integrates these bodies of literature by examining main and interactive effects of HIV-related experiences (i.e., disclosure of HIV-positive status, fear of disclosure, HIV-related victimization, and internalized HIV-related stigma) and substance-related coping with discrimination as they impact mental health (i.e., stress, anxiety, depressive symptoms, and suicide and self-injury proneness). Participants were 216 HIV-positive LGB community members from an urban community medical clinic. Prominent results included: (1) robust negative effects of internalized HIV-related stigma on all mental health indicators when controlling for other HIV-related experiences and (2) a significant interaction in which substance-related coping significantly increases suicide proneness, only for those who have disclosed HIV-positive status to family or friends. Results are discussed with respect to theoretical perspectives of internalized stigma, implications for clinical work with LGB persons of HIV-positive status, and future research.

  14. Undernutrition among HIV-positive children in Dar es Salaam, Tanzania: antiretroviral therapy alone is not enough

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    Sunguya Bruno F

    2011-11-01

    Full Text Available Abstract Background The prevalence of HIV/AIDS has exacerbated the impact of childhood undernutrition in many developing countries, including Tanzania. Even with the provision of antiretroviral therapy, undernutrition among HIV-positive children remains a serious problem. Most studies to examine risk factors for undernutrition have been limited to the general population and ART-naive HIV-positive children, making it difficult to generalize findings to ART-treated HIV-positive children. The objectives of this study were thus to compare the proportions of undernutrition among ART-treated HIV-positive and HIV-negative children and to examine factors associated with undernutrition among ART-treated HIV-positive children in Dar es Salaam, Tanzania. Methods From September to October 2010, we conducted a cross-sectional survey among 213 ART-treated HIV-positive and 202 HIV-negative children in Dar es Salaam, Tanzania. We measured the children's anthropometrics, socio-demographic factors, food security, dietary habits, diarrhea episodes, economic status, and HIV clinical stage. Data were analyzed using both univariate and multivariate methods. Results ART-treated HIV-positive children had higher rates of undernutrition than their HIV-negative counterparts. Among the ART-treated HIV-positive children, 78 (36.6% were stunted, 47 (22.1% were underweight, and 29 (13.6% were wasted. Households of ART-treated HIV-positive children exhibited lower economic status, lower levels of education, and higher percentages of unmarried caregivers with higher unemployment rates. Food insecurity was prevalent in over half of ART-treated HIV-positive children's households. Furthermore, ART-treated HIV-positive children were more likely to be orphaned, to be fed less frequently, and to have lower body weight at birth compared to HIV-negative children. In the multivariate analysis, child's HIV-positive status was associated with being underweight (AOR = 4.61, 95% CI 1

  15. Treatment of Periodontal Disease with an Octenidine-based Antiseptic in HIV-positive Patients.

    Science.gov (United States)

    Gušić, I; Medić, D; Radovanović Kanjuh, M; Ðurić, M; Brkić, S; Turkulov, V; Predin, T; Mirnić, J

    2016-05-01

    To evaluate the effects of a periodontal therapy with subsequent application of an octenidine (OCT)-based antiseptic in HIV-positive patients receiving highly active antiretroviral therapy. HIV-positive patients with a clinically diagnosed periodontal disease were randomly divided into two groups (n = 30/group). Both groups initially received a periodontal therapy. Patients in the OCT group additionally used an OCT-based mouthwash. Subgingival plaque samples and periodontal indices were analysed prior to treatment onset as well as one and 3 months post-treatment. Periodontal therapy has resulted in a significant decrease in the values of all periodontal indices one and 3 months following the therapy completion (P = 0.000). The effects of the two applied therapeutic protocols differed significantly in terms of the variation in the PBI (F = 4.617; P = 0.017) and the PD (F = 3.203; P = 0.044) value. In the patients in the OCT group, a more pronounced decrease in the PBI and PD was noted at 1-month follow-up as well as a greater increase in the PD value 3 months upon treatment completion. In the OCT group, no more atypical microorganisms were detectable 1 month post-treatment, while in the control group they were found in 34.5% of patients. The periodontal therapy bears good results in HIV-positive patients. Additional administration of OCT contributes to the significant decline in the PBI and DS values and eliminates atypical microorganisms within 1 month post-treatment. However, more favourable results were not noted in the OCT group at the 3-month assessment. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. Efficacy and safety of anti-tuberculosis drugs in HIV-positive patients: A prospective study

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    Jigar D Kapadia

    2013-01-01

    Full Text Available Objectives: To assess the efficacy and safety of anti-tuberculosis drugs in HIV-positive patients at a tertiary care teaching hospital. Materials and Methods: As a part of an ongoing study of opportunistic infections (OIs in HIV-positive patients, drug treatment in patients suffering from tuberculosis was assessed to determine its efficacy and safety. Based on prevalence data for last three years, a purposive sampling of study population was carried out in this observational, prospective, single centre study. Tuberculosis (TB was the most common OI observed. The selected patients were followed up for a period of one year to evaluate the clinical course and outcome of OIs, and the efficacy and safety of drugs used was checked. Results: Tuberculosis was observed in 89 out of 134 enrolled patients. These included 79 adults and 10 children. Males (66.2% were commonly affected. Extra pulmonary TB (73% was the most common manifestation with abdominal TB observed in 55 (61.7% patients. All patients were treated in accordance with the Revised National Tuberculosis Control Programme (RNTCP guidelines as recommended by National AIDS Control Organization (NACO, India. Outcome of TB was assessable in 70 patients. Majority (82.8% of the patients were cured, while 12 patients (17.1% died during the course of treatment. A total of 149 ADRs were observed in 67 (75.2% patients. Majority of ADRs (n = 147 were non-serious and did not warrant a change in therapy. Discoloration of urine was the most common ADR observed. Conclusion: TB is the most common opportunistic infection in HIV-positive patients with abdominal TB being the most common manifestation. RNTCP and NACO guidelines are adhered to in these patients. Anti-tuberculosis drugs are well tolerated and effective in majority of the patients.

  17. Prevalence of and risk factors for MRSA colonization in HIV-positive outpatients in Singapore

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    Kyaw Win

    2012-11-01

    Full Text Available Abstract Background Whilst there have been studies on the risks and outcomes of MRSA colonization and infections in HIV-positive patients, local data is limited on the risk factors for MRSA colonization among these patients. We undertook this study in a tertiary HIV care centre to document the risk factors for colonization and to determine the prevalence of MRSA colonization among HIV-positive outpatients in Singapore. Methods This was a cross-sectional study in which factors associated with MRSA positivity among patients with HIV infection were evaluated. A set of standardized questionnaire and data collection forms were available to interview all recruited patients. Following the interview, trained nurses collected swabs from the anterior nares/axilla/groin (NAG, throat and peri-anal regions. Information on demographics, clinical history, laboratory results and hospitalization history were retrieved from medical records. Results MRSA was detected in swab cultures from at least 1 site in 15 patients (5.1%. Inclusion of throat and/or peri-anal swabs increased the sensitivity of NAG screening by 20%. Predictors for MRSA colonization among HIV-positive patients were age, history of pneumonia, lymphoma, presence of a percutaneous device within the past 12 months, history of household members hospitalized more than two times within the past 12 months, and a most recent CD4 count less than 200. Conclusions This study highlights that a proportion of MRSA carriers would have been undetected without multiple-site screening cultures. This study could shed insight into identifying patients at risk of MRSA colonization upon hospital visit and this may suggest that a risk factor-based approach for MRSA surveillance focusing on high risk populations could be considered.

  18. Altered monoamine and acylcarnitine metabolites in HIV-positive and HIV-negative subjects with depression

    Science.gov (United States)

    Cassol, Edana; Misra, Vikas; Morgello, Susan; Kirk, Gregory D.; Mehta, Shruti H.; Gabuzda, Dana

    2015-01-01

    Background Depression is a frequent comorbidity in HIV infection that has been associated with worse treatment outcomes and increased mortality. Recent studies suggest that increased innate immune activation and tryptophan catabolism are associated with higher risk of depression in HIV infection and other chronic inflammatory diseases, but the mechanisms leading to depression remain poorly understood. Methods The severity of depressive symptoms was assessed by Beck Depression Inventory or Center for Epidemiological Studies Depression Scale. Untargeted metabolomic profiling of plasma from 104 subjects (68 HIV-positive and 36 HIV-negative) across three independent cohorts was performed using liquid or gas chromatography followed by mass spectrometry. Cytokine profiling was by Bioplex array. Bioinformatic analysis was performed in Metaboanalyst and R. Results Decreased monoamine metabolites (phenylacetate, 4-hydroxyphenylacetate) and acylcarnitines (propionylcarnitine, isobutyrylcarnitine, isovalerylcarnitine, 2-methylbutyrylcarnitine) in plasma distinguished depressed subjects from controls in HIV-positive and HIV-negative cohorts, and these alterations correlated with the severity of depressive symptoms. In HIV-positive subjects, acylcarnitines and other markers of mitochondrial function correlated inversely with tryptophan catabolism, a marker of IFN responses, suggesting inter-relationships between inflammatory pathways, tryptophan catabolism, and metabolic alterations associated with depression. Altered metabolites mapped to pathways involved in monoamine metabolism, mitochondrial function, and inflammation, suggesting a model in which complex relationships between monoamine metabolism and mitochondrial bioenergetics contribute to biological mechanisms involved in depression that may be augmented by inflammation during HIV infection. Conclusions Integrated approaches targeting inflammation, monoamine metabolism, and mitochondrial pathways may be important for

  19. Comparison of colorectal cancer screening and diagnoses in HIV-positive and HIV-negative veterans.

    Science.gov (United States)

    Guest, J L; Rentsch, C T; Rimland, D

    2014-01-01

    Non-AIDS defining malignancies, including colorectal cancer (CRC), are emerging as significant problems in HIV-infected people. Some data suggest that HIV-positive patients have higher incidence of CRC at younger ages than those who are HIV-negative. This investigation examined CRC rates and screening types and trends between 943 HIV-infected cases and their age, race, and gender matched HIV-negative controls (n = 943) from 1 January 2005 to 31 December 2008 at the Atlanta VA Medical Center. The most common screening type among these patients was fecal occult blood testing (FOBT), but colonoscopies were more common in the controls (16.4% for cases, 27.5% for controls; p screening for CRC during the four years of follow-up even though average age was 55 years. Fifty-one percent of cases had at least one screening test during follow-up compared to 48% of the controls; 7.6% of the cases had a screening each of the four years compared to only 2.4% of the controls (p HIV-positive patients were diagnosed with CRC during the study period compared to no CRC diagnoses among controls (p = 0.0015), though there was no difference in the diagnosis of colon polyps (4.6% vs. 5.1%, p = 0.5911). These data also suggest a discrepancy in CRC incidence between race and age groups: 80% of HIV-positive cases diagnosed with CRC during the study were black and two were less than 50 years of age. Future studies will need to address whether different recommendations are needed for screening based on HIV status, younger age, or race.

  20. Relationships matter: contraceptive choices among HIV-positive women in Tanzania.

    Science.gov (United States)

    Nyanja, Tabitha Alexandria Njeri; Tulinius, Charlotte

    2017-07-01

    Efforts to eliminate mother-to-child transmission of HIV in Tanzania are guided by a four-prong strategy advocated by the World Health Organization (WHO). Prong 2, prevention of unintended pregnancies among women living with HIV, has, however, received the least attention and contraceptive use to prevent unintended pregnancies remains low. This study explored the perceived barriers to the use of modern methods of contraception, and factors influencing contraceptive choice among HIV-positive women in urban Dar-es-Salaam, Tanzania. A qualitative multi-site study was conducted, utilising in-depth interviews and focus group discussions with 37 sexually active HIV-positive women aged between 20 and 44 years, attending three health facilities within Dar-es-Salaam. The theoretical framework was a patient centred model. Four barriers were identified: the influence of the women's spousal relationships; personal beliefs and the relationship of these in understanding her disease; the influence of the social demands on the woman and her relationships; and the importance of a woman's relationship with her healthcare provider/healthcare system. Being the bearers of bad news (HIV-positive status) the pregnant women experienced conflicts, violence, abandonment and rejection. The loss in negotiating power for the women was in relation to their intimate partners, but also in the patient-healthcare provider relationship. The role of the male partner as a barrier to contraceptive use cannot be understated. Therefore, the results suggest that healthcare providers should ensure patient-focused education and provide support that encompasses the importance of their relationships. Additional research is required to elucidate the functional association between contraceptive choices and personal and social relationships.

  1. [Discourses on sexual responsibility in a group of HIV-positive MSM in Spain].

    Science.gov (United States)

    Fernández-Dávila, Percy; Morales Carmona, Adriana

    2013-01-01

    High rates of sexual risk behaviours are being reported among HIV-positive MSM which raises the question about the ideas of sexual responsibility that exist in this population to prevent the transmission and/or re-infection of HIV and other STIs. This study sought to understand the discourses on sexual care and responsibility in men living with HIV who have sex with men. A qualitative study was carried out with 78 men (aged 27-65): 35 individual interviews and 43 in five discussion groups, in the cities of Barcelona, Madrid and Palma de Mallorca, between 2007 and 2008. The selection criterion was that eighteen months had passed after a HIV diagnosis was established. The grounded theory approach was used to analyze the data. Three distinct discourses about sexual responsibility were observed: (1) sole responsibility: it is the HIV-positive man who should protect himself in order to protect others. This discourse is based on an ethical position (altruistic), in which the duty and obligation to protect others is a priority; (2) shared responsibility: both parties agree and/or consent to high risk sexual practices although those who tend to use this discourse, in practice, ultimately assume full responsibility, and (3) individual responsibility: each person is responsible for himself, although the type of emotional bond with others may affect the decision to protect only oneself (there is some commitment to protect a sexual partner when something is felt for that person). The sexual care behaviour among HIV-positive MSM was determined by three discourses. Those discourses were influenced by various factors: moral conscience, sexual context, type of sexual partner and disclosure of HIV status.

  2. Total protein, albumin and low-molecular-weight protein excretion in HIV-positive patients

    Directory of Open Access Journals (Sweden)

    Campbell Lucy J

    2012-08-01

    Full Text Available Abstract Background Chronic kidney disease is common in HIV positive patients and renal tubular dysfunction has been reported in those receiving combination antiretroviral therapy (cART. Tenofovir (TFV in particular has been linked to severe renal tubular disease as well as proximal tubular dysfunction. Markedly elevated urinary concentrations of retinal-binding protein (RBP have been reported in patients with severe renal tubular disease, and low-molecular-weight proteins (LMWP such as RBP may be useful in clinical practice to assess renal tubular function in patients receiving TFV. We analysed 3 LMWP as well as protein and albumin in the urine of a sample of HIV positive patients. Methods In a cross-sectional fashion, total protein, albumin, RBP, cystatin C, and neutrophil gelatinase-associated lipocalin (NGAL were quantified in random urine samples of 317 HIV positive outpatients and expressed as the ratio-to-creatinine (RBPCR, CCR and NGALCR. Exposure to cART was categorised as none, cART without TFV, and cART containing TFV and a non-nucleoside reverse-transcriptase-inhibitor (TFV/NNRTI or TFV and a protease-inhibitor (TFV/PI. Results Proteinuria was present in 10.4 % and microalbuminuria in 16.7 % of patients. Albumin accounted for approximately 10 % of total urinary protein. RBPCR was within the reference range in 95 % of patients while NGALCR was elevated in 67 % of patients. No overall differences in urine protein, albumin, and LMWP levels were observed among patients stratified by cART exposure, although a greater proportion of patients exposed to TFV/PI had RBPCR >38.8 μg/mmol (343 μg/g (p = 0.003. In multivariate analyses, black ethnicity (OR 0.43, 95 % CI 0.24, 0.77 and eGFR 2 (OR 3.54, 95 % CI 1.61, 7.80 were independently associated with upper quartile (UQ RBPCR. RBPCR correlated well to CCR (r2 = 0.71, but not to NGALCR, PCR or ACR. Conclusions In HIV positive patients, proteinuria was predominantly of

  3. A Cultural Perspective on Sexual Health: HIV Positive and Negative Monolingual Hispanic Women in South Florida.

    Science.gov (United States)

    Villar-Loubet, Olga M; Vamos, Szonja; Jones, Deborah L; Lopez, Eliot; Weiss, Stephen M

    2011-06-01

    This study explored feelings and attitudes with regard to HIV and sexual health among 82 monolingual Spanish-speaking, HIV-positive (n = 30) and at-risk women (n = 52), participating in the NOW en Español Project-a cognitive behavioral sexual risk-reduction intervention in Miami, Florida. Hispanic cultural values and beliefs, such as machismo, marianismo, and sexual silence, emerged throughout the intervention as important determinants of sexual behavior. Recommendations for integrating these culture-specific issues in sexual health interventions for Hispanic women are provided.

  4. Religious influences on the reproductive health decisions of HIV-positive Latinas on the border.

    Science.gov (United States)

    Instone, Susan; Mueller, Mary-Rose

    2011-12-01

    The number of HIV-positive Latinas of child-bearing age living on the US-Mexico border is a growing concern. Little is known about how religious beliefs influence the reproductive health decisions of these women in light of disease demands and cultural and religious norms that support high fertility rates and childbearing. Such decisions may be further complicated by the stigma of HIV/AIDS and structural issues related to immigration status and trans-border lives. This paper analyzes extant literature and supports the need for further research so that policy makers and heath and social service providers can develop meaningful and comprehensive reproductive-health related interventions.

  5. Osteoarticular tuberculosis in an HIV-positive patient: a case report

    Directory of Open Access Journals (Sweden)

    Gabriela de Moraes Rêgo Guedes

    2014-06-01

    Full Text Available The authors report a case of a 38-year-old HIV-positive woman, with subcutaneous nodules on the thoracic region with 3 months of evolution. Clinical, laboratory, and epidemiological features were evaluated and associated with apparent damage to the T11-T12 vertebrae, identification by imaging tests, positivity in a polymerase chain reaction-based test, and reactivity to the Mantoux tuberculin skin test (PPD-RT 23. The patient was diagnosed with osteoarticular tuberculosis and received treatment for a year, and clinical cure was achieved.

  6. Baseline prevalence and predictors of liver fibrosis among HIV-positive individuals

    DEFF Research Database (Denmark)

    Matthews, G V; Neuhaus, J; Bhagani, S

    2015-01-01

    OBJECTIVES: Liver disease is increasingly recognized in HIV-positive individuals, even among those without viral hepatitis, partly as a result of the recent availability of noninvasive methods of liver fibrosis assessment. The objective of this substudy is to compare the effects of early versus...... in multivariate analysis were higher alanine aminotransferase (ALT) per 10 U/L (P = 0.045), higher log10 HIV RNA (P ...% of participants, with higher ALT and HIV RNA the only clinical factors associated with increasing TE score. TE will be used annually to monitor fibrosis and evaluate the role of ART in further fibrosis progression....

  7. Sudden cardiac death in a young HIV-positive man on effective antiretroviral therapy.

    Science.gov (United States)

    Tincati, Camilla; Bauer, Dario; Bellistrì, Giusi M; Casana, Maddalena; Ranieri, Roberto; Bini, Teresa; Marchetti, Giulia; d'Arminio Monforte, Antonella

    2008-11-01

    We describe the case of a young HIV-positive man on effective HAART with excellent viro-immunological control who presented a massive cardiac infarction. Despite the presence of clinical risk factors for cardiovascular disease, the patient had normal arterial carotid IMT values, known to be strong predictors of atherosclerosis and stroke. Interestingly, parameters of T-cell activation (CD8+CD38+) were shown to increase just before the onset of myocardial infarction. As T-cell activation is known to mediate atherosclerosis, the authors suggest that surrogate immunologic markers should be identified to better assess cardiovascular risk in the setting of HIV infection.

  8. Plasma viraemia in HIV-positive pregnant women entering antenatal care in South Africa

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    Landon Myer

    2015-07-01

    Full Text Available Introduction: Plasma HIV viral load (VL is the principle determinant of mother-to-child HIV transmission (MTCT, yet there are few data on VL in populations of pregnant women in sub-Saharan Africa. We examined the distribution and determinants of VL in HIV-positive women seeking antenatal care (ANC in Cape Town, South Africa. Methods: Consecutive HIV-positive pregnant women making their first antenatal clinic visit were recruited into a cross-sectional study of viraemia in pregnancy, including a brief questionnaire and specimens for VL testing and CD4 cell enumeration. Results & discussion: Overall 5551 pregnant women sought ANC during the study period, of whom 1839 (33% were HIV positive and 1521 (85% were included. Approximately two-thirds of HIV-positive women in the sample (n=947 were not on antiretrovirals at the time of the first ANC visit, and the remainder (38%, n=574 had initiated antiretroviral therapy (ART prior to conception. For women not on ART, the median VL was 3.98 log10 copies/mL; in this group, the sensitivity of CD4 cell counts ≤350 cells/µL in detecting VL>10,000 copies/mL was 64% and this increased to 78% with a CD4 threshold of ≤500 cells/µL. Among women on ART, 78% had VL1000 copies/mL at the time of their ANC visit. Conclusions: VL >10,000 copies/mL was commonly observed in women not on ART with CD4 cell counts >350 cells/µL, suggesting that CD4 cell counts may not be adequately sensitive in identifying women at greatest risk of MTCT. A large proportion of women entering ANC initiated ART before conception, and in this group more than 10% had VL>1000 copies/mL despite ART use. VL monitoring during pregnancy may help to identify pregnancies that require additional clinical attention to minimize MTCT risk and improve maternal and child health outcomes.

  9. Oral ranula in an HIV-positive patient: case report and literature review

    OpenAIRE

    Kinshuck, Andrew Jon; Schober, Marianne; Kokai, George; Clarke, Ray

    2012-01-01

    We describe the presentation and treatment of an HIV-positive patient with an oral ranula, and review the literature. Ranulas are mucoceles or retention cysts formed by the extravasation of mucus from the sublingual gland, presumably due to continued production of saliva in the presence of ductal obstruction. Oral ranulas in children are rare and the overall prevalence of mucoceles has been reported as 0.08% in children aged 0–12 years. However, there has been a documented increased occurrenc...

  10. The politics of invisibility: homophobia and low-income HIV-positive women who have sex with women.

    Science.gov (United States)

    Arend, Elizabeth D

    2005-01-01

    HIV-positive women who have sex with women (WSW) have been overlooked by government researchers, health care providers and the AIDS service community. In addition to stigmas against homosexuality and HIV in larger society, low-income, African-American and Latina HIV-positive WSWs face culturally-based stigmas and are disproportionately affected by poverty, drug addiction, homelessness, sex work and abuse. Through an analysis of sixteen intensive interviews with low-income HIV-positive WSWs of color, I critically examine the physical, emotional and psychological needs of this population and their methods of coping with HIV. I also examine the participants' percepHIV-positive women who have sex with women (WSW) have been overlooked by government researchers, health care providers and the AIDS service community. In addition to stigmas against homosexuality and HIV in larger society, low-income, African-American and Latina HIV-positive WSWs face culturally-based stigmas and are disproportionately affected by poverty, drug addiction, homelessness, sex work and abuse. Through an analysis of sixteen intensive interviews with low-income HIV-positive WSWs of color, I critically examine the physical, emotional and psychological needs of this population and their methods of coping with HIV. I also examine the participants' percepHIV-positive women who have sex with women (WSW) have been overlooked by government researchers, health care providers and the AIDS service community. In addition to stigmas against homosexuality and HIV in larger society, low-income, African-American and Latina HIV-positive WSWs face culturally-based stigmas and are disproportionately affected by poverty, drug addiction, homelessness, sex work and abuse. Through an analysis of sixteen intensive interviews with low-income HIV-positive WSWs of color, I critically examine the physical, emotional and psychological needs of this population and their methods of coping with HIV. I also examine the

  11. HPV infection-associated anogenital cyto-colpo-histological findings and molecular typing in HIV-positive women.

    Science.gov (United States)

    Tso, F K; Rodrigues, C L L; Levi, J E; Mattosinho de Castro Ferraz, M G; Speck, N M G; Ribalta, J C L

    2015-12-21

    HIV and human papillomavirus (HPV) coinfection is increasing, especially in the anal canal (AC) and cervico-vaginal regions. We identified anal epithelium abnormalities related to high-risk HPV (HR-HPV) lesions in the lower genital tracts (LGTs) of HIV-positive women, described the HPV genotypes identified, and assessed the expression of E6/E7 oncogenes in coinfected patients. Ninety-eight women were enrolled in groups combining HIV status and presence or absence of HPV in the LGT. Anal and cervical smears were collected for cytology and HR-HPV assays using Cobas(®) and/or PapilloCheck(®). Samples with highly oncogenic HPV genotypes were confirmed by NucliSENS EasyQ(®). Forty-two HIV-positive (25-52; mean age 39.5) and 56 HIV-negative (18-58; mean age 35.7) patients were included. E2 and C1 groups presented AC alterations (P = 0.002); altered images for high-resolution anoscopy were higher in E1 and C2 (P HIV-negative and 58.62% were HIV-positive (P HIV-positive patients accounted for 29% of the anal high-grade squamous intraepithelial lesions (P = 0.015). The Cobas(®) positive result frequency was higher in three AC groups than in the other groups. There was variation in the number of HPV types in the cervico-vaginal samples among the study groups (P HIV-positive patients with HPV in the LGT. HR-HPV anal infections by various genotypes are common and are associated with cervical infections in HIV-positive patients. E6/E7 expression is apparently more common in the AC of HIV-positive women.

  12. Estimated glomerular filtration rate, chronic kidney disease and antiretroviral drug use in HIV-positive patients

    DEFF Research Database (Denmark)

    Mocroft, Amanda; Kirk, Ole; Reiss, Peter

    2010-01-01

    OBJECTIVES:: Chronic kidney disease (CKD) in HIV-positive persons might be caused by both HIV and traditional or non-HIV-related factors. Our objective was to investigate long-term exposure to specific antiretroviral drugs and CKD. DESIGN:: A cohort study including 6843 HIV-positive persons...... with at least three serum creatinine measurements and corresponding body weight measurements from 2004 onwards. METHODS:: CKD was defined as either confirmed (two measurements >/=3 months apart) estimated glomerular filtration rate (eGFR) of 60 ml/min per 1.73 m or below for persons with baseline eGFR of above...... 60 ml/min per 1.73 m or confirmed 25% decline in eGFR for persons with baseline eGFR of 60 ml/min per 1.73 m or less, using the Cockcroft-Gault formula. Poisson regression was used to determine factors associated with CKD. RESULTS:: Two hundred and twenty-five (3.3%) persons progressed to CKD during...

  13. HIV-positive patients treated for multidrug-resistant tuberculosis: clinical outcomes in the HAART era.

    Science.gov (United States)

    Palacios, E; Franke, M; Muñoz, M; Hurtado, R; Dallman, R; Chalco, K; Guerra, D; Mestanza, L; Llaro, K; Bonilla, C; Sebastian, J; Bayona, J; Lygizos, M; Lyzigos, M; Anger, H; Shin, S

    2012-01-01

    Multidrug-resistant tuberculosis (MDR-TB) and the human immunodeficiency virus (HIV) pose two of the greatest threats to global tuberculosis (TB) control. Given expanding global access to antiretroviral therapy (ART) and second-line TB drugs, more data are needed on experiences treating MDR-TB and HIV co-infection in resource-poor settings. To describe the clinical characteristics, management, outcomes, and factors associated with survival among HIV-positive individuals receiving treatment for MDR-TB. This was a retrospective case series of 52 HIV-positive individuals receiving treatment for MDR-TB in Lima, Peru. We used Cox proportional hazards regression models to identify risk factors for mortality. A total of 31 (57%) of the cohort died on treatment, with the majority of deaths due to MDR-TB. Low baseline weight predicted a three-fold increased rate of death (aHR 3.1, 95%CI 1.5-6.7), while individuals receiving highly active ART experienced a significantly lower rate of death compared to those who were not (aHR 0.4, 95%CI 0.2-0.9). Early ART is likely a key component of effective MDR-TB management in co-infected individuals.

  14. Oral colonization by yeasts in HIV-positive patients in Brazil

    Directory of Open Access Journals (Sweden)

    Juliana C. Junqueira

    2012-02-01

    Full Text Available INTRODUCTION: In HIV-infected patients, colonization of the oral cavity by potential pathogenic yeast may lead to development of systemic fungemia. We evaluated the prevalence of yeast in the oral cavity of Brazilian HIV-positive patients and verified whether or not the species characterized were enzymatically active. Furthermore, the species identified were tested for their susceptibility to antifungal treatment. METHODS: Patient saliva and oropharyngeal candidiasis samples were collected from 60 seropositive HIV patients and identified by the API20C system. Enzymatic activity was evaluated by the production of proteinase and phospholipase. Susceptibility to antifungal treatments were determined using the broth microdilution method. RESULTS: the most commonly isolated species were C. albicans (51.56% followed by non-albicans Candida species (43.73%, Trichosporon mucoides (3.12% and Kodamaea ohmeri (1.56%. Oral colonization by association of different species was observed in 42% of the patients. Enzymatic activity was verified in most of species isolated, except for C. glabrata, C. lusitaniae and C. guilliermondii. Resistance to Fluconazole and Amphotericin B was observed in isolates of C. albicans, C. glabrata, C. parapsilosis, C. krusei, and K. ohmeri. CONCLUSION: HIV-positive patients are orally colonized by single or multiple species of yeast that are occasionally resistant to Fluconazole or Amphotericin B.

  15. Neurological findings in early syphilis: a comparison between HIV positive and negative patients

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    Alejandra González-Duarte

    2013-11-01

    Full Text Available After a decade of steady decline, syphilis has reemerged within the past few years and it is seeping back into the HIV negative population. We describe herein 16 consecutive cases of neurosyphilis and compare its clinical characteristics. Of the 16 patients, 14 (87% were men. Mean age at onset was 43 years old (range: 23-82. Twelve patients (75% were HIV positive; stage was B2 in 2 patients, B3 and C2 in one patient each, and C3 in 8 patients. The clinical presentation was meningitis in 6 (40%, stroke in 3 (18%, ocular manifestations in 4 (27%, and psychiatric manifestations in 2 (13% cases. Five additional patients had ocular involvement after a formal ophthalmologic examination. High venereal disease research laboratory test (VDRL titers in serum and cerebrospinal fluid (CSF were found. Patients in C3 stage of HIV had less CSF pleocytosis (<5 cells/mm3 than patients in earlier stages (P=0.018. Disease onset was earlier in patients older than 50 years old with HIV (P=0.049. We found that meningitis, ocular manifestations and stroke were the most common clinical findings in early syphilis. Moreover, stroke included the carotid and cerebrobasilar vascular territories. CSF VDRL continues to be a crucial test in all idiopathic cases of meningitis, stroke and uveitis, regardless of the HIV status or CSF pleocytosis. Except for less pleocytosis, there were no important differences between HIV positive and HIV negative patients.

  16. Squamous cell carcinoma of the anus-an opportunistic cancer in HIV-positive male homosexuals

    Institute of Scientific and Technical Information of China (English)

    Pascal Gervaz; Alexandra Calmy; Ymer Durmishi; Abdelkarim S Allal; Philippe Morel

    2011-01-01

    Squamous cell carcinoma of the anus (SCCA) is a common cancer in the human immunodeficiency virus (HIV)- infected population, and its incidence continues to increase in male homosexuals. Combined chemoradiation with mitomycin C and 5-fluorouracil was poorly tolerated by severely immunocompromised patients in the early 1990s. In the era of highly active antiretroviral therapy (HAART), however, recent data indicate that: (1) most HIV patients with anal cancer can tolerate standard chemotherapy regimens; and (2) this approach is associated with survival rates similar to those of HIV-negative patients. However, HIV-positive patients with SCCA are much younger, more likely to develop local tumor recurrence, and ultimately die from anal cancer than immune competent patients. Taken together, these findings suggest that anal cancer is an often fatal neoplasia in middle- aged HIV-positive male homosexuals. In this population, SCCA is an opportunistic disease resulting in patients with suboptimal immune function from persistent papillomaviruses (HPVs). Large-scale cancer-prevention strategies (routine anuscopy and anal papanicolaou testing) should be implemented in this population. In addition, definitive eradication of oncogenic HPVs within the anogenital mucosa of high-risk individuals might require a proactive approach with repeated vaccination.

  17. Perspectives of Never-in-Care HIV-Positive Patients and Providers in Rakai, Uganda

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    Gertrude Nakigozi

    2013-01-01

    Full Text Available Background. Early entry into HIV care is low in Sub-Saharan Africa. In Rakai, about a third (31.5% of HIV-positive clients who knew their serostatus did not enroll into free care services. This qualitative study explored barriers to entry into care from HIV-positive clients who had never enrolled in care and HIV care providers. Methods. We conducted 48 in-depth interviews among HIV-infected individuals aged 15–49 years, who had not entered care within six months of result receipt and referral for free care. Key-informant interviews were conducted with 12 providers. Interviews were audio-recorded and transcripts subjected to thematic content analysis based on the health belief model. Results. Barriers to using HIV care included fear of stigma and HIV disclosure, women’s lack of support from male partners, demanding work schedules, and high transport costs. Programmatic barriers included fear of antiretroviral drug side effects, long waiting and travel times, and inadequate staff respect for patients. Denial of HIV status, belief in spiritual healing, and absence of AIDS symptoms were also barriers. Conclusion. Targeted interventions to combat stigma, strengthen couple counseling and health education programs, address gender inequalities, and implement patient-friendly and flexible clinic service hours are needed to address barriers to HIV care.

  18. Oral colonization by yeasts in HIV-positive patients in Brazil.

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    Junqueira, Juliana C; Vilela, Simone F G; Rossoni, Rodnei D; Barbosa, Júnia O; Costa, Anna Carolina B P; Rasteiro, Vanessa M C; Suleiman, Jamal M A H; Jorge, Antonio Olavo C

    2012-01-01

    In HIV-infected patients, colonization of the oral cavity by potential pathogenic yeast may lead to development of systemic fungemia. We evaluated the prevalence of yeast in the oral cavity of Brazilian HIV-positive patients and verified whether or not the species characterized were enzymatically active. Furthermore, the species identified were tested for their susceptibility to antifungal treatment. Patient saliva and oropharyngeal candidiasis samples were collected from 60 seropositive HIV patients and identified by the API20C system. Enzymatic activity was evaluated by the production of proteinase and phospholipase. Susceptibility to antifungal treatments were determined using the broth microdilution method. the most commonly isolated species were C. albicans (51.56%) followed by non-albicans Candida species (43.73%), Trichosporon mucoides (3.12%) and Kodamaea ohmeri (1.56%). Oral colonization by association of different species was observed in 42% of the patients. Enzymatic activity was verified in most of species isolated, except for C. glabrata, C. lusitaniae and C. guilliermondii. Resistance to Fluconazole and Amphotericin B was observed in isolates of C. albicans, C. glabrata, C. parapsilosis, C. krusei, and K. ohmeri. HIV-positive patients are orally colonized by single or multiple species of yeast that are occasionally resistant to Fluconazole or Amphotericin B.

  19. Nutritional status of HIV-positive patients in Niterói, Rio de Janeiro, Brazil.

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    De Senna, Andrea F Kroll; De Oliveira, Solange A; Velarde, Luis G C; Setúbal, Sérgio

    2014-12-01

    The objective of this cross-sectional study was to assess the nutritional status of HIV-positive patients in a hospital in the city of Niteroi, Rio de Janeiro, Brazil. We studied 235 patients (130 men and 105 women) from May 2009 to June 2010. The frequency of undernourishment among women was 7.6%; 26.7% of the women were overweight, and 16.2% were obese. Among men, the frequency of undernourishment was 3.8%; 25.4% of the men were overweight, and 6.9% were obese. A logistic regression was done to investigate the relationship between nutritional status and potential predisposing factors. Women were more frequently affected by obesity and undernourishment than men. However, only the difference in obesity was significant, and women had almost three times higher odds of being obese (OR 2.6; 95% CI 1.03-6.65). According to a nationwide survey done in Brazil during 2008-2009, 50.1% of the Brazilian healthy males were overweight, and 12.5% were obese; 48% of healthy females were overweight, and 16.9% were obese. Although the prevalence of undernourishment in HIV-positive patients is now lower than that observed in the beginning of the AIDS epidemic and excess weight is increasingly common among people living with HIV/AIDS, the proportion of excess weight was found lower and of undernourishment was higher in the present study than that found in the Brazilian population.

  20. Quality of life as a mode of governance: NGO talk of HIV 'positive' health in India.

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    Finn, Mark; Sarangi, Srikant

    2008-04-01

    Quality of life (QOL) is being increasingly emphasized in healthcare research and practice around the world as a desirable and measurable outcome of health policy, health-seeking behaviour and overall life satisfaction. Drawing on F notions of governmentality and biopower, we take the position that the promotion of a universal and apolitical concept of QOL, as it pertains to individual health and well-being, can be seen as being tied to a neoliberal rationality of global socio-economic and health governance. In understanding non-government organizations (NGOs) as a prime catalyst for socio-economic change under neoliberalism, we highlight ways in which HIV-related NGOs in India can be seen to deploy aspects of the prescriptive and regulatory QOL discourse in their promotions of an empowered HIV 'positive' health and subjectivity. Implications are discussed in terms of the inevitable tensions involved for many under-resourced HIV-positive people in India who, in the name of QOL, are called upon to identify and act as entrepreneurial and (self)empowered individuals in particular normalizing terms.

  1. "Survivors" and "victims": long-term HIV positive individuals and the ethos of self-empowerment.

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    Crossley, M L

    1997-12-01

    Recent research on contemporary processes of self-construction has suggested that the concepts of "self", "health", "morality" and "responsibility" have become inextricably interconnected, to the extent that the "pursuit of health has become the pursuit of moral personhood" [R. Crawford (1994) The boundaries of the self and the unhealthy other: reflections on health, culture and AIDS, Social Science & Medicine 38(10), 1347-1365]. What happens then when a person becomes "diseased"? Are they doomed to the stagnant mire of "illness" and "immorality", to the role of undesirable "other"? What if the disease is HIV infection? Is it the case of HIV = AIDS = DEATH = "OTHER" par excellence? This paper addresses these issues by examining the constructions of "self" and "other" used by HIV positive individuals themselves. By reference to a specific group of people living with long-term HIV positive diagnoses, it demonstrates how unhealthy HIV infected "others", as perceived by "healthy" members of society, create their own conceptions of "self" and "other" which microcosmically mirror typical processes of identity construction. The content, function and potential advantages and disadvantages of these processes are highlighted.

  2. Food insecurity and antiretroviral adherence among HIV positive adults who drink alcohol.

    Science.gov (United States)

    Kalichman, Seth C; Grebler, Tamar; Amaral, Christina M; McKerney, Megan; White, Denise; Kalichman, Moira O; Cherry, Chauncey; Eaton, Lisa

    2014-10-01

    Food insecurity is associated with HIV treatment non-adherence and poor health outcomes for people living with HIV/AIDS. Given the poor nutritional status common to people who drink alcohol, food insecurity may be particularly problematic for HIV positive individuals who drink alcohol. To examine food insecurity among HIV positive men and women who drink alcohol and its association with antiretroviral therapy (ART) adherence, health outcomes and health service utilization. Adults living with HIV (N = 183) in Atlanta, Georgia who reported alcohol use in the previous week and were receiving ART participated in a 12-month cohort. Participants were recruited from infectious disease clinics and social services to complete computerized interviews, monthly-unannounced pill counts to monitor ART adherence, and daily cell-phone delivered interactive-text assessments for alcohol use. Forty-three percent of participants experienced food insecurity during at least one month of the study period. Food insecurity was independently associated with suboptimal ART adherence and less suppressed HIV viral load over. Individuals who experienced food insecurity also had histories of more medical and psychiatric hospitalizations, and greater mental health problems. Food insecurity is prevalent among alcohol using people receiving ART and food insecurity is associated with treatment non-adherence, poor health outcomes, and increased medical and psychiatric hospitalizations.

  3. HIV-positive parents, HIV-positive children, and HIV-negative children’s perspectives on disclosure of a parent’s and child’s illness in Kenya

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    Grace Gachanja

    2014-07-01

    Full Text Available HIV disclosure from parent to child is complex and challenging to HIV-positive parents and healthcare professionals. The purpose of the study was to understand the lived experiences of HIV-positive parents and their children during the disclosure process in Kenya. Sixteen HIV-positive parents, seven HIV-positive children, and five HIV-negative children completed semistructured, in-depth interviews. Data were analyzed using the Van Kaam method; NVivo 8 software was used to assist data analysis. We present data on the process of disclosure based on how participants recommended full disclosure be approached to HIV-positive and negative children. Participants recommended disclosure as a process starting at five years with full disclosure delivered at 10 years when the child was capable of understanding the illness, or by 14 years when the child was mature enough to receive the news if full disclosure had not been conducted earlier. Important considerations at the time of full disclosure included the parent’s and/or child’s health statuses, number of infected family members’ illnesses to be disclosed to the child, child’s maturity and understanding level, and the person best suited to deliver full disclosure to the child. The results also revealed it was important to address important life events such as taking a national school examination during disclosure planning and delivery. Recommendations are made for inclusion into HIV disclosure guidelines, manuals, and programs in resource-poor nations with high HIV prevalence.

  4. Injecting drug use is associated with a more rapid CD4 cell decline among treatment naïve HIV-positive patients in Indonesia

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    Hinta Meijerink

    2014-01-01

    Full Text Available Background: It remains unclear whether the natural course of human immunodeficiency virus (HIV differs in subjects infected through injecting drug use (IDU and no data have been published from low- or middle-income countries. We addressed this question in an urban cohort in Indonesia, which is experiencing a rapidly growing HIV epidemic strongly driven by IDU. Methods: All antiretroviral treatment (ART naïve HIV-positive patients who had at least two subsequent CD4 cell counts available before starting ART were included in this study. We examined the association between IDU and CD4 cell decline using a linear mixed model, with adjustment for possible confounders such as HIV viral load and hepatitis C antibodies. Results: Among 284 HIV-positive ART naïve patients, the majority were male (56% with a history of IDU (79% among men. People with a history of IDU had a statistically significant faster decline in CD4 cells (p<0.001. Based on our data, patients with a history of IDU would have an average 33% decline in CD4 cells after one year without ART, compared with a 22% decline among non-users. At two years, the decline would average 66 and 40%, respectively. No other factor was significantly associated with CD4 cell decline. Conclusions: We show that a history of IDU is associated with a more rapid CD4 cell natural decline among HIV-positive individuals in Indonesia. These findings have implications for monitoring ART naïve patients with a history of IDU and for starting ART in this group.

  5. A chromosome 5q31.1 locus associates with tuberculin skin test reactivity in HIV-positive individuals from tuberculosis hyper-endemic regions in east Africa.

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    Sobota, Rafal S; Stein, Catherine M; Kodaman, Nuri; Maro, Isaac; Wieland-Alter, Wendy; Igo, Robert P; Magohe, Albert; Malone, LaShaunda L; Chervenak, Keith; Hall, Noemi B; Matee, Mecky; Mayanja-Kizza, Harriet; Joloba, Moses; Moore, Jason H; Scott, William K; Lahey, Timothy; Boom, W Henry; von Reyn, C Fordham; Williams, Scott M; Sirugo, Giorgio

    2017-06-01

    One in three people has been infected with Mycobacterium tuberculosis (MTB), and the risk for MTB infection in HIV-infected individuals is even higher. We hypothesized that HIV-positive individuals living in tuberculosis-endemic regions who do not get infected by Mycobacterium tuberculosis are genetically resistant. Using an "experiment of nature" design that proved successful in our previous work, we performed a genome-wide association study of tuberculin skin test positivity using 469 HIV-positive patients from prospective study cohorts of tuberculosis from Tanzania and Uganda to identify genetic loci associated with MTB infection in the context of HIV-infection. Among these individuals, 244 tested were tuberculin skin test (TST) positive either at enrollment or during the >8 year follow up, while 225 were not. We identified a genome-wide significant association between a dominant model of rs877356 and binary TST status in the combined cohort (Odds ratio = 0.2671, p = 1.22x10-8). Association was replicated with similar significance when examining TST induration as a continuous trait. The variant lies in the 5q31.1 region, 57kb downstream from IL9. Two-locus analyses of association of variants near rs877356 showed a haplotype comprised of rs877356 and an IL9 missense variant, rs2069885, had the most significant association (p = 1.59x10-12). We also replicated previously linked loci on chromosomes 2, 5, and 11. IL9 is a cytokine produced by mast cells and TH2 cells during inflammatory responses, providing a possible link between airway inflammation and protection from MTB infection. Our results indicate that studying uninfected, HIV-positive participants with extensive exposure increases the power to detect associations in complex infectious disease.

  6. Sociodemographic profile and predictors of outpatient clinic attendance among HIV-positive patients initiating antiretroviral therapy in Selangor, Malaysia

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    Abdulrahman SA

    2017-07-01

    period. Multivariate regression models were fitted to examine predictors of outpatient clinic attendance using SPSS version 22 and R software.Results: A total of 224 (93% patients who completed 6-month assessment were included in the model. Out of those, 42 (18.7% defaulted scheduled clinic attendance at least once. Missed appointments were significantly more prevalent among females (n=10, 37.0%, rural residents (n=10, 38.5%, and bisexual respondents (n=8, 47.1%. Multivariate binary logistic regression analysis showed that Indian ethnicity (adjusted odds ratio [AOR] =0.235; 95% CI [0.063–0.869]; P=0.030 and heterosexual orientation (AOR =4.199; 95% CI [1.040–16.957]; P=0.044 were significant predictors of outpatient clinic attendance among HIV-positive patients receiving ART in Malaysia.Conclusion: Ethnicity and sexual orientation of Malaysian patients may play a significant role in their level of adherence to scheduled clinic appointments. These factors should be considered during collaborative adherence strategy planning at ART initiation.Keywords: sociodemographic, predictors, HIV/AIDS, clinic attendance, behavior, antiretroviral therapy, ART

  7. Efficacy of topical imiquimod in HIV-positive patients with recurrent anal condylomata acuminata

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    Sidney Roberto Nadal

    2012-03-01

    Full Text Available INTRODUCTION: Imiquimod is a topical chemotherapic and immunostimulant agent with antitumoral and antiviral activities, used for anal condylomata acuminata treatment, mainly in recurrences. OBJECTIVE: Evaluate the imiquimod efficiency in chronic and recurrent anal condylomata acuminata in HIV-infected persons. METHOD: A prospective study that analyzed 61 patients with recurrent anal condylomata treated with topic 5% imiquimod, for at least 8 weeks. These patients had already been submitted to other topical and surgical treatments for anal warts. We evaluated the efficiency of this agent, through wart remission, with clinical examination and high-resolution anoscopy, CD4+ T lymphocyte count and side effects. The patients were 55 males and 6 females, from 22 to 63 years old. RESULTS: Remission was seen in 90%, being 46% complete remission and 44% partial remission. Other 10% did not respond to the treatment with imiquimod within the 16th week. Recurrences were observed in 11% of patients in 24-week follow-up. Statistics showed no differences in CD4+ T cell scores when groups with and without complete remission were compared. Adverse effects were reported by 45% of patients. They were mild to moderate burning (25%, intense burning (7%, ulcerative dermatitis (8% and systemic symptoms (5%. CONCLUSION: Imiquimod was effective in controlling recurrent anal condylomata acuminata in HIV-positive patients, regardless of CD4+ T cell count.INTRODUÇÃO: O imiquimode é agente tópico quimioterápico e imunoestimulante, com atividades antitumoral e antiviral, usado para tratamento dos condilomas acuminados perianais, principalmente os recidivantes. OBJETIVO: Avaliar a eficácia do imiquimode nos condilomas acuminados perianais crônicos e multirrecidivantes dos doentes soropositivos para o vírus da imunodeficiência adquirida (HIV. CASUÍSTICA E MÉTODO: Estudo clínico prospectivo por 12 meses em que observamos o uso tópico de imiquimode creme 5%, por no

  8. Antiretroviral Therapy Helps HIV-Positive Women Navigate Social Expectations for and Clinical Recommendations against Childbearing in Uganda

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    Jasmine Kastner

    2014-01-01

    Full Text Available Understanding factors that influence pregnancy decision-making and experiences among HIV-positive women is important for developing integrated reproductive health and HIV services. Few studies have examined HIV-positive women’s navigation through the social and clinical factors that shape experiences of pregnancy in the context of access to antiretroviral therapy (ART. We conducted 25 semistructured interviews with HIV-positive, pregnant women receiving ART in Mbarara, Uganda in 2011 to explore how access to ART shapes pregnancy experiences. Main themes included: (1 clinical counselling about pregnancy is often dissuasive but focuses on the importance of ART adherence once pregnant; (2 accordingly, women demonstrate knowledge about the role of ART adherence in maintaining maternal health and reducing risks of perinatal HIV transmission; (3 this knowledge contributes to personal optimism about pregnancy and childbearing in the context of HIV; and (4 knowledge about and adherence to ART creates opportunities for HIV-positive women to manage normative community and social expectations of childbearing. Access to ART and knowledge of the accompanying lowered risks of mortality, morbidity, and HIV transmission improved experiences of pregnancy and empowered HIV-positive women to discretely manage conflicting social expectations and clinical recommendations regarding childbearing.

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

    Science.gov (United States)

    Toth, Steven; A York, Jill; DePinto, Nicholas

    2016-01-01

    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 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.

  10. Population-Based Assessment of Hypertension Epidemiology and Risk Factors among HIV-Positive and General Populations in Rural Uganda.

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    Dalsone Kwarisiima

    Full Text Available Antiretroviral therapy scale-up in Sub-Saharan Africa has created a growing, aging HIV-positive population at risk for non-communicable diseases such as hypertension. However, the prevalence and risk factors for hypertension in this population remain incompletely understood.We measured blood pressure and collected demographic data on over 65,000 adults attending multi-disease community health campaigns in 20 rural Ugandan communities (SEARCH Study: NCT01864603. Our objectives were to determine (i whether HIV is an independent risk factor for hypertension, and (ii awareness and control of hypertension in HIV-positive adults and the overall population.Hypertension prevalence was 14% overall, and 11% among HIV-positive individuals. 79% of patients were previously undiagnosed, 85% were not taking medication, and 50% of patients on medication had uncontrolled blood pressure. Multivariate predictors of hypertension included older age, male gender, higher BMI, lack of education, alcohol use, and residence in Eastern Uganda. HIV-negative status was independently associated with higher odds of hypertension (OR 1.2, 95% CI: 1.1-1.4. Viral suppression of HIV did not significantly predict hypertension among HIV-positives.The burden of hypertension is substantial and inadequately controlled, both in HIV-positive persons and overall. Universal HIV screening programs could provide counseling, testing, and treatment for hypertension in Sub-Saharan Africa.

  11. Pneumocystis pneumonia in HIV-positive patients in Spain: epidemiology and environmental risk factors

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    Alejandro Alvaro-Meca

    2015-05-01

    Full Text Available Introduction: Specific environmental factors may play a role in the development of Pneumocystis pneumonia (PCP in HIV-positive patients. The aim of this study was to estimate the PCP incidence and mortality in hospitalized HIV-positive patients in Spain during the combination antiretroviral therapy (cART era (1997 to 2011, as well as to analyze the climatological factors and air pollution levels in relation to hospital admissions and deaths. Methods: We carried out a retrospective study. Data were collected from the National Hospital Discharge Database and the State Meteorological Agency of Spain. A case-crossover analysis was applied to identify environmental risk factors related to hospitalizations and deaths. For each patient, climatic factors and pollution levels were assigned based on readings from the nearest meteorological station to his or her postal code. Results: There were 13,139 new PCP diagnoses and 1754 deaths in hospitalized HIV-positive patients from 1997 to 2011. The PCP incidence (events per 1000 person-years dropped from 11.6 in 1997 to 2000, to 5.4 in 2004 to 2011 (p<0.001. The mortality (events per 10,000 person-years also decreased from 14.3 in 1997 to 2000, to 7.5 in 2004 to 2011 (p<0.001. Most hospital admissions and deaths occurred in the winter season and the fewest occurred in the summer, overlapping respectively with the lowest and highest temperatures of the year in Spain. Moreover, lower temperatures prior to PCP admission, as well as higher concentrations of NO2 and particulate matter up to 10 m in size (PM10 at the time of admission were associated with higher likelihoods of hospital admission due to PCP when two weeks, one month, 1.5 months or two months were used as controls (p<0.01. Furthermore, higher concentrations of ozone at one month (p=0.007, 1.5 months (p<0.001 and two months (p=0.006 prior to admission were associated with higher likelihoods of hospital admission with PCP. For PCP-related deaths, lower

  12. Neurocognitive impairment among HIV-positive individuals in Botswana: a pilot study

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    Lawler Kathy

    2010-04-01

    Full Text Available Abstract Background The primary objective of this study was to determine the prevalence of neurocognitive impairment among HIV-positive individuals in Botswana, using the International HIV Dementia Scale (IHDS. We also compared performance on the IHDS with performance on tests of verbal learning/memory and processing speed, and investigated the association between performance on the IHDS and such variables as depression, age, level of education and CD4 count. Methods We conducted a cross-sectional study of 120 HIV-positive individuals randomly selected from an outpatient HIV clinic in Gaborone, Botswana. Patients provided a detailed clinical history and underwent neuropsychological testing; measures of depression, daily activities and subjective cognitive complaints were recorded. Results Despite the fact that 97.5% of subjects were receiving highly active antiretroviral therapy (HAART, 38% met criteria for dementia on the IHDS, and 24% were diagnosed with major depressive disorder. There was a significant association between neurocognitive impairment as measured by the IHDS and performance on the other two cognitive measures of verbal learning/memory and processing speed. Level of education significantly affected performance on all three cognitive measures, and age affected processing speed and performance on the IHDS. Depression and current CD4 count did not affect performance on any of the cognitive measures. Conclusions The prevalence of neurocognitive impairment in HIV-positive individuals in Botswana is higher than expected, especially since almost all of the subjects in this study were prescribed HAART. This suggests the need to reconsider the timing of introduction of antiretroviral therapy in developing countries where HAART is generally not administered until the CD4 cell count has dropped to 200/mm3 or below. The contribution of other factors should also be considered, such as poor central nervous system penetration of some

  13. The politics of invisibility: HIV-positive women who have sex with women and their struggle for support.

    Science.gov (United States)

    Arend, Elizabeth D

    2003-01-01

    HIV-positive women who have sex with women (WSW) have been routinely overlooked by government researchers, health care providers, and the AIDS service community. In addition to stigmas against homosexuality and HIV in larger society, low-income African American and Latina HIV-positive WSW in particular face culturally based stigmas and are disproportionately affected by poverty, drug addiction, homelessness, sex work, and abuse. By analyzing 16 intensive interviews with low-income HIV-positive WSW of color, the author examined the physical, emotional, and psychological needs of this population and their methods of coping with HIV. Also examined were the participants' perceptions of available support networks, which were examined in order to raise awareness of the complex battle fought by these women against HIV and homophobia in the face of greater social, cultural, and economic strife.

  14. The interplay between socio-demographic variables, nutritional and immune status of HIV-positive/AIDS patients.

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    Oguntibeju, O O; van den Heever, W M J; Van Schalkwyk, F E

    2007-10-15

    This study examined the association between socio-demographic factors (educational level and employment status) and the nutritional and immune status of 35 HIV-positive/AIDS patients at baseline. Assessment of selected macro-and micronutrient dietary intake was done using a validated food frequency questionnaire. Evaluation of anthropometric profiles (body mass index, waist-hip ratio and percentage of body fat) was also evaluated. A questionnaire was applied to obtain information on the educational level and employment status of the patients. The CD4+ T-cell counts and viral loads of the same patients were determined using the flow cytometry and Polymerase Chain Reaction (PCR) method respectively. An association between educational level and dietary intake was significant (p 0.05) association between the two socio-demographic variables (education and employment) and anthropometric profiles. The association between education, employment and CD4+ T-cell count was not significant (p > 0.05). The viral load showed a significant (p nutritional and immune status. It is suggested that the results of this study should be interpreted with caution. Further studies with larger sample sizes are recommended.

  15. Isoniazid-resistant Mycobacterium kansasii in an HIV-positive patient, and possible development of immune reconstitution inflammatory syndrome after initiation of highly active antiretroviral therapy: case report

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    A. Despotovic

    2016-01-01

    Full Text Available Non-tuberculous mycobacteria are rare but important causes of infection in HIV-positive individuals. A 28-year-old HIV-positive male presented with a high fever, non-productive cough, right subcostal pain, splenomegaly, a very low CD4 count, elevated C-reactive protein and erythrocyte sedimentation rate, and a normal white blood cell count. The suspicion of tuberculosis (TB was very high, and sputum samples were positive for acid-fast bacilli. Standard quadruple anti-TB therapy was initiated, but once culture of the sample revealed Mycobacterium kansasii, pyrazinamide was withdrawn. Highly active antiretroviral therapy (HAART was initiated soon after, consisting of abacavir/lamivudine and efavirenz. The patient's general condition deteriorated 2 weeks after HAART initiation, which could have been due to the development of immune reconstitution inflammatory syndrome (IRIS. The patient recovered and was discharged in good condition. However, the results of resistance testing of the isolated organism arrived after discharge, and showed isoniazid and streptomycin resistance. This is the first case report of M. kansasii infection from Serbia and shows the difficulties encountered during the course of treatment.

  16. The cost and intensity of behavioral interventions to promote HIV treatment for prevention among HIV-positive men who have sex with men.

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    Safren, Steven A; Perry, Nicholas S; Blashill, Aaron J; O'Cleirigh, Conall; Mayer, Kenneth H

    2015-10-01

    Recently, behavioral prevention interventions for HIV have been criticized as being ineffective, costly, or inefficient. In this commentary, using HIV-positive men who have sex with men (MSM) as an illustrative high-risk population, we argue that the opposite is true-that behavioral interventions for HIV prevention, if implemented with the populations who need them, are affordable and critical for future prevention efforts. We base this argument on recent evidence showing that (1) adherence to antiretroviral treatment (ART) for prevention purposes is necessary to suppress HIV replication and reduce transmissibility, (2) individuals living with HIV have multiple psychosocial concerns that impact self-care and moderate the potential effectiveness of health behavior interventions, and (3) intensive interventions targeting both concerns together (psychosocial and HIV care) can show clinically significant improvement. We follow by comparing the cost of these types of interventions to the cost of standard clinical treatment for HIV with ART and demonstrate a cost-savings of potential intensive behavioral interventions for, in this case, HIV-positive MSM who have uncontrolled virus. Keeping this evidence in mind, we conclude that individual intervention must remain a mainstay of HIV prevention for certain critical populations.

  17. Risk factors for high-risk human papillomavirus detection among HIV-negative and HIV-positive women from Tanzania.

    Science.gov (United States)

    Dartell, Myassa; Rasch, Vibeke; Munk, Christian; Kahesa, Crispin; Mwaiselage, Julius; Iftner, Thomas; Kjaer, Susanne Krüger

    2013-09-01

    Human papillomavirus (HPV) is one of the most common sexually transmitted infections worldwide. The prevalence is dependent on several known factors notably sexual behavior and age, and factors still under scrutiny. This study aimed to examine risk factors for high-risk (HR) HPV infection among HIV-positive and HIV-negative women from the general population of Tanzania and to assess whether specific risk factors could contribute to the high prevalence of HR HPV infection in older age found in some populations including Tanzanian women. A cross-sectional study of 3699 women from Tanzania was conducted. We obtained information on sociodemographic and lifestyle factors through personal interview. Cervical swabs were collected for detection of HR HPV (Hybrid Capture 2; Qiagen, Hildesheim, Germany) and genotyping (LiPaExtra; Innogenetics, Gent, Belgium). Finally, we obtained a blood sample for HIV testing. HIV positivity was the strongest risk factor for HR HPV (odds ratio, 4.1; 95% confidence interval, 3.3-5.3). Young age, shorter duration of present relationship, and increasing number of sex partners were also associated with higher risk for HR HPV. Among women 20 to 29 years old, especially number of partners (P = 0.005) and HIV positivity (P HIV positivity (P = 0.0009) increased the risk, whereas increasing number of partners was not related to the risk of HR HPV (P = 0.46). Human papillomavirus risk factors among HIV-positive and HIV-negative women were similar, but the strength of association was greater among HIV-positive women, notably for lifetime number of sex partners, time in present relationship, genital warts, and body mass index. We were not able to identify a clear explanation for the high HPV prevalence among older women. However, in the age-stratified analysis, potential indicators of decreased immunity increased the risk for HPV infection among older women, whereas in younger women, risk was particularly associated with sexual activity.

  18. The prevalence of xerostomia and salivary gland hypofunction in a cohort of HIV-positive and at-risk women.

    Science.gov (United States)

    Navazesh, M; Mulligan, R; Komaroff, E; Redford, M; Greenspan, D; Phelan, J

    2000-07-01

    The association of xerostomia and salivary gland hypofunction with HIV infection has been established for men but not for women. We investigated the prevalence of these conditions in a national cohort (n = 733) of HIV-positive and at-risk HIV-negative women. Participants in this prospective cross-sectional study were recruited from the Women's Interagency HIV Study (WIHS) at five outpatient USA clinics. Xerostomia was assessed based on "yes" responses to a dry-mouth questionnaire. Samples of unstimulated whole and chewing-stimulated whole saliva were collected under standardized conditions. The major salivary glands were also evaluated clinically. The prevalence of dry-mouth complaint, the absence of saliva upon palpation, and zero unstimulated whole saliva (flow rate = 0 mL/min) were significantly (p = 0.001) higher in HIV-positive women. Adjusted odds of zero unstimulated whole saliva were significantly (p = 0.02) higher in HIV-positive women vs. HIV-negative women (OR = 2.86; 95% CI, 1.23 to 6.63). Significant (p = 0.03) univariate association was found between zero unstimulated whole saliva and CD4 counts. Adjusted odds of zero unstimulated whole saliva were significantly (p = 0.02) higher for HIV-positive women with CD4 500 (OR = 2.61; 95% CI, 1.17 to 5.85). Chewing-stimulated flow rates were not significantly different between seropositive and seronegative women. The prevalence of xerostomia and salivary gland hypofunction appears to be significantly higher in HIV-positive women relative to a comparable group of at-risk seronegative women. Immunosuppression levels measured by CD4 cell counts are significantly associated with xerostomia and salivary gland hypofunction in a population of HIV-positive women.

  19. Oral non-Hodgkin′s lymphoma as an initial diagnosis in a HIV positive patient

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    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.

  20. Strongyloides stercoralis infection in an HIV positive patient--a case report from RIMS, Imphal, Manipur.

    Science.gov (United States)

    Pukhrambam, Pratita Devi; Rebachandra, H; Singh, Ng Brajachand; Singh, Th Nabakumar

    2010-09-01

    Strongyloides stercoralis, a nematode parasite in human with free living and autoinfective cycles, is often an asymptomatic infection of the upper small intestine. If the host becomes immunocompromised, autoinfection may increase the intestinal worm burden and lead to disseminated strongyloidiasis. We report a case of a 33 year old male HIV positive patient admitted on 2/6/08 in male medical ward, Regional Institute of Medical Sciences, Imphal, Manipur with complaints of loose stools, pain abdomen, nausea, vomiting, generalized weakness, loss of appetite and loss of weight for past one month with fever off and on. Stool examination reveals larvae of Strongyloides stercoralis. The patient was successfully treated with Ivermectin 200 microgm/kg daily for 2 days.

  1. Is nelfinavir exposure associated with cancer incidence in HIV-positive individuals?

    DEFF Research Database (Denmark)

    Boettiger, David C; Sabin, Caroline A; Grulich, Andrew

    2016-01-01

    OBJECTIVE: Nelfinavir exhibits potent anticancer properties against a range of tumours. However, in 2006/2007, nelfinavir supplies were accidently contaminated with a carcinogen. This analysis investigated the association between nelfinavir use and cancer risk in HIV-positive persons. DESIGN......: Observational cohort study. METHODS: D:A:D study data was analysed using Poisson regression models to examine associations between cancer incidence and cumulative nelfinavir exposure, current nelfinavir exposure, and exposure to nelfinavir between 1 July 2006-30 June 2007. RESULTS: A total of 42 006 individuals......-up, nelfinavir was used by 2476 individuals for a median of 1.7 (IQR 0.7-3.8) years; 1063 were exposed to nelfinavir between 1 July 2006 and 30 June 2007. Overall, 2279 cancers were diagnosed at a rate of 0.75 [95% confidence interval (95% CI) 0.72-0.78] per 100 person-years. Neither greater cumulative exposure...

  2. Chronic Kidney Disease and Antiretroviral Therapy in HIV-Positive Individuals

    DEFF Research Database (Denmark)

    Achhra, Amit C; Nugent, Melinda; Mocroft, Amanda

    2016-01-01

    Chronic kidney disease (CKD) has emerged as an important health concern in HIV-positive individuals. Preventing long-term kidney toxicity from an antiretroviral therapy is therefore critical. Selected antiretroviral agents, especially tenofovir disoproxil fumarate (TDF) and some ritonavir...... awaited. Promising results have also emerged from recent trials on alternative dual-therapy antiretroviral regimens which exclude the nucleoside(tide) reverse transcriptase class as well as possibly the PI/rs, thereby reducing the drug burden, and possibly the toxicity. However, long-term safety...... or benefits of these dual-therapy regimens are still unclear and will need to be studied in future prospective studies. Finally, addressing risk factors such as hypertension and diabetes will continue to be important in this population....

  3. Change in sexual activity 12 months after ART initiation among HIV-positive Mozambicans.

    Science.gov (United States)

    Pearson, Cynthia R; Cassels, Susan; Kurth, Ann E; Montoya, Pablo; Micek, Mark A; Gloyd, Stephen S

    2011-05-01

    We assessed sexual behaviors before and 12-months after ART initiation among 277 Mozambicans attending an HIV clinic. Measured behaviors included the number of sexual partners, condom use, concurrent relationships, disclosure of HIV status, alcohol use, and partners' serostatus. Compared to before ART initiation, increases were seen 12 months after ART in the proportion of participants who were sexually active (48% vs. 64% respondents, P initiation. Although reported correct and consist condom use increased, the number of unprotected sexual relationships remained the same (n = 45). Non-disclosure of HIV-serostatus to sexual partners was the only significant predictor of practicing unprotected sex with partners of HIV-negative or unknown serostatus. Sexual activity among HIV-positive persons on ART increased 12 months after ART initiation. Ongoing secondary transmission prevention programs addressing sexual activity with multiple partners, disclosure to partners and consistent condom use with serodisconcordant partners must be incorporated throughout HIV care programs.

  4. Recurrent visceral leishmaniasis in a HIV positive patient—a case report

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    Anjo Sunny

    2014-01-01

    Full Text Available Current treatment options for visceral leishmaniasis (kala-azar are pentavalent antimony, amphotericin B, liposomal amphotericin B and miltefosine, which achieve long term clinical relief in the majority of HIV patient. Disease relapse is usually provoked by T-cell number or function impairment (corticosteroid or cytotoxic therapy, transplant recipient, advanced human immunodeficiency virus disease. We report a case of visceral leishmaniasis with multiply relapses in a 45 year old Indian HIV positive man. The disease was diagnosed with rK-39 test and confirmed by spleen aspiration test (presence of Leishmania donovani bodies. These findings demonstrate that human immune deficiency virus-positive with visceral leishmaniasis was caused by dissemination of viscerotropic Leishmania donovani parasites as a consequence of immunosuppression.

  5. Disfiguring molluscum contagiosum in a HIV-positive patient responding to antiretroviral therapy

    Directory of Open Access Journals (Sweden)

    Sen Sumit

    2009-01-01

    Full Text Available Molluscum contagiosum (MC is caused by a double stranded DNA virus belonging to the pox virus family. MC lesions are usually pearly, dome shaped, small, discrete lesions with central umbilication. In HIV-positive patients atypical varieties are found. They may be large or nonumbilicated. Individual papules may join to form the agminate variety. This form is rare. Lesions of MC in healthy immunocompetent patients may occur at any part of the body including face, trunk, and limbs. Sexually active adults have lesions usually on the genitalia, pubis, and inner thigh, rarely on the face and scalp. We present a case of agminate MC occurring in a patient with acquired immunodeficiency disease responding to highly active antiretroviral therapy.

  6. Elevated triglycerides and risk of myocardial infarction in HIV-positive persons

    DEFF Research Database (Denmark)

    Worm, Signe W; Kamara, David Alim; Reiss, Peter;

    2011-01-01

    Objectives: To explore the relationship between elevated triglyceride levels and the risk of myocardial infarction (MI) in HIV-positive persons after adjustment for total cholesterol (TC), high-density lipoprotein–cholesterol (HDL-C) and nonlipid risk factors. Background: Although elevated...... the independent association between the latest triglyceride level and MI risk after adjusting for TC and HDL-C, nonlipids cardiovascular disease (CVD) risk factors, HIV and treatment-related factors. Results: The 33 308 persons included in the study from 1999 to 2008 experienced 580 MIs over 178 835 person......-years. Unadjusted, the risk of MI increased by 67% [relative risk (RR) 1.67, 95% confidence interval 1.54–1.80] per doubling in triglyceride level. After adjustment for the latest TC and HDL-C level, the RR dropped to 1.33 (95% confidence interval 1.21–1.45); this effect was further attenuated by other CVD risk...

  7. TUBERCULIN RESPONSIVENESS AS A PROGNOSTIC INDICATOR IN HIV POSITIVE PULMONARY TUBERCULOSIS, KIMS, AMALAPURUM

    Directory of Open Access Journals (Sweden)

    Nagaraja

    2014-11-01

    Full Text Available With the emergence of HIV pandemic there is an alarming increase in both HIV and Tuberculosis cases cause’s major health problems due to poor socio-economic status in developing and resource poor countries. HIV and Tuberculosis infection hand in hand kills more population than all other infections combined. Both HIV and Tuberculosis is a major health problem. So the present study is under taken to know present scenario of HIV and TB in the rural set up, Amalapuram, East Godavari District, Andhra Pradesh. Out of 100 suspected cases with HIV and Tuberculosis with malnutrition, 10 samples were found to be HIV positive by rapid and ELISA. Among 10 positive HIV cases 6 cases were found to be positive for AFB by ZN stain indicating both HIV and Tuberculosis go hand in hand.

  8. HIV-positive and HIV-negative consumers accept an instant soy maize porridge

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    Susanna C Bouwer

    2008-03-01

    Full Text Available The objective of this study was to assess consumer acceptability, preference and consumption intent of an instant soy maize porridge, compared to an instant plain maize porridge, in order to determine the successful inclusion of the soy maize porridge as a food supplement for HIV subjects in a subsequent nutrition intervention trial, to improve their nutritional status. A 5-point hedonic and food action rating scale was used for this purpose. HIV-positive (n=57 and HIV-negative (n=47 subjects were recruited on a basis of availability and willingness to participate. Long-term acceptability and compliance of HIV-positive consumers (n=9 was assessed after three and five months. Analysis of variance (ANOVA, Tukey’s multiple comparison test and T-tests (p≤0.05 were performed. Overall, consumers found the soy maize porridge significantly more acceptable, preferred it to, and also intended to consume it more often than the plain maize porridge. There were no significant differences between the HIV-positive and HIV-negative group regarding acceptability, preference and consumption intent. After three and five months, the HIV-positive consumers (n=9 did not find acceptability of the soy maize porridge significantly different from the first evaluation. It therefore had the potential to be included successfully in the nutrition intervention trial. The current study emphasises the need for sensory evaluation of food products prior to including them in intervention studies, to assess consumers’ acceptance of them. Opsomming Die doel van hierdie studie was om verbruikers se aanvaarding, voorkeur en voorneme van verbruik van ‘n kitssojamieliepap, in vergelyking met ‘n gewone kitsmieliepap te bepaal, ten einde die suksesvolle insluiting van die kitssojamieliepap as voedselaanvulling vir HIV-proefpersone om hul voedingstatus te verbeter, in ‘n daaropvolgende voedingsintervensiestudie te ondersoek. ‘n Vyf-punt hedoniese en voedselaksie

  9. Focal epithelial hyperplasia in an HIV positive man. An illustrated case and review of the literature.

    Science.gov (United States)

    Marvan, E; Firth, N

    1998-10-01

    Focal epithelial hyperplasia (FEH) is a rare but distinctive entity of viral aetiology with characteristic clinical and histopathological features. It is usually seen in children and adolescents of American Indian and Eskimo background; however, it has recently been described in adults who are HIV positive. Suppression of the immune system leaves the individual vulnerable to opportunistic infections. With improved management of immunocompromised patients it is increasingly possible that the general dental practitioner will encounter secondary oral infections such as FEH and must therefore be able to recognize, diagnose and treat these lesions. The following report presents a case of FEH in an HIV-infected man, and is followed by a review of the literature.

  10. Self-disclosure of serostatus by youth who are HIV-positive: a review.

    Science.gov (United States)

    Thoth, Candace A; Tucker, Christy; Leahy, Matthew; Stewart, Sunita M

    2014-04-01

    Self-disclosure of serostatus by youth who are HIV-positive has been considered an important objective for preventing transmission and can have positive outcomes including enhancement of social support. This paper reviews the literature on self-disclosure. Several findings are consistent with the literature in adults, including the influence of gender, lower likelihood of disclosure in casual sexual relationships, and the identified barriers of rejection and stigma. Important areas of difference include youth's expressed needs for communication skills and the significant role of the family in influencing the decision to disclose. The findings raise questions about the relationship between disclosure and safe sexual practices in adolescents and moderate the concept of universal psychological gain from disclosure. The implications from the findings are reviewed, including the individual balance of risk versus benefit, practitioner strategies that might influence this balance and enhance the likelihood of positive outcomes following disclosure, and future research directions are discussed.

  11. Multifocal Buruli Ulcer Associated with Secondary Infection in HIV Positive Patient

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    Kassi Komenan

    2013-01-01

    Full Text Available Buruli ulcer is a chronic and infectious skin disease, caused by Mycobacterium ulcerans. It leads to large skin ulceration and sometimes bone infection which is responsible for deformities. Here, we report a case of multifocal form of Buruli ulcer associated with secondary infection in a 46-year-old human immunodeficiency virus (HIV positive woman. The antimycobacterial drugs combined to surgery allowed curing this multifocal case and rose up two relevant issues: the susceptibility of immune reconstitution inflammatory syndrome (IRIS occurrence and Mycobacterium dissemination. The deep immune depression, the underline biological, and clinical disorders of the patient might contribute to IRIS occurrence and Buruli ulcer dissemination. Future investigations have to be conducted on the mechanism of IRIS on set and on Mycobacterium ulcerans dissemination after ARV drugs initiation and the patient related underline clinical or biological disorders.

  12. Tenofovir treatment in an unselected cohort of highly antiretroviral experienced HIV positive patients

    DEFF Research Database (Denmark)

    Lerbaek, A; Kristiansen, Thomas Birk; Katzenstein, TL;

    2004-01-01

    Tenofovir treatment in an unselected cohort of highly antiretroviral experienced HIV positive patients.Lerbaek A, Kristiansen TB, Katzenstein TL, Mathiesen L, Gerstoft J, Nielsen C, Larsen K, Nielsen JO, Obel N, Laursen AL, Nielsen SD. Department of Infectious Diseases, Hvidovre Hospital......, Copenhagen, Denmark. The aim of the present study was to explore the treatment effect of tenofovir as implemented in clinical practice. Data are presented on 34 patients. 11 patients had tenofovir added to a stable anti-retroviral treatment (ART) and 23 patients had drugs other than tenofovir. CD4 counts......, HIV-RNA levels and genotypic resistance were determined at baseline and after 3 and 6 months. After initiation of tenofovir treatment, a mean decrease in HIV-RNA for all 34 patients was observed (-0.43 log1o copies/ml (+/- 1.22) and -0.49 log10 copies/ml (+/- 1.36) after 3 and 6 months, respectively...

  13. Rural epidemiology of HIV positive tribal patients from Chhattisgarh in India

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    Singh Harminder

    2010-01-01

    Full Text Available Objective: The primary objective was to study the epidemiology of Human Immunodeficiency Virus (HIV positive tribal patients, and the secondary objective was to study the associated comorbidities in a tertiary care hospital in the tribal (Bastar region of Chhattisgarh, India, between December 2006 and November 2008, and their relation to CD4 counts. Materials and Methods : In this study 90 tribal HIV positive subjects were enrolled. Information on demographics, that is, weight, height, age, educational status, sex, clinical finding, and laboratory parameters (CD4 counts were noted. Results: Among 90 HIV patients, 54 (60% were males and 36 (40% were females. Among these, most patients, 37 (41.1%, were in the age group of 30 to 39 years. Among these patients, 79.56% belonged to the lower socioeconomic status, whereas, only 1.45% were from a high socioeconomic status. The largest group was made up of drivers (32.2%, with the second largest group being housewives (27.7% and laborers (17.7%, respectively. A majority of the patients had a low education, 35.5% were educated only up to the fifth standard and 31.8% up to high school, while 18.8% were illiterate. The predominant mode of transmission was heterosexual contact (78.8%, only one patient (1.1% was infected through transfusion of infected blood, five (5.5% patients acquired infection via vertical (mother to child transmission, and in 13 patients the transmission history was not clear. Conclusion: There was a high frequency of behavioral risk factors, together with unawareness, and very little health infrastructure, thus creating an impending risk for the rapid spread of HIV/AIDS (acquired immunodeficiency syndrome.

  14. The impact of childhood bullying among HIV-positive men: psychosocial correlates and risk factors.

    Science.gov (United States)

    Kamen, Charles; Bergstrom, Jessica; Vorasarun, Chaniga; Mardini, Mona; Patrick, Rudy; Lee, Susanne; Lazar, Rachael; Koopman, Cheryl; Gore-Felton, Cheryl

    2013-04-01

    While some studies have examined the deleterious effects of childhood bullying on adults, no studies to date have focused on the effects of bullying on Persons Living with HIV (PLH), a particularly at-risk population. PLH experience higher rates of childhood and adulthood physical and sexual abuse than the population at large, and experience of childhood abuse appears to be predictive of sexual and other risk behaviors in this population. Thus it remains critical to examine rates of childhood bullying and correlates of bullying in adult PLH. A sample of 171 HIV-positive men over 18 years of age were recruited from the San Francisco Bay Area. All participants reported experiencing symptoms of traumatic stress. The participants were recruited as part of a larger study assessing a group intervention for individuals with HIV and symptoms of trauma. Self-report questionnaires were administered to assess participants' exposure to bullying in childhood and trauma symptoms in adulthood. Bullying was commonly reported by men in the current sample, with 91% of the sample endorsing having experienced some level of bullying before age 18. Having been bullied in childhood was significantly (pbullying in childhood predicted additional, unique variance in trauma symptoms in adulthood above and beyond the effect of exposure to other forms of trauma, resulting in a better-fitting model. The current study highlights the association between rate of childhood bullying and symptoms of trauma in adulthood, accounting for the effect of exposure to other forms of trauma. Given the impact of trauma symptoms on disease progression in PLH, exposure to bullying must be considered in any intervention aiming to reduce trauma symptoms or improve mental or physical health among HIV-positive populations. Copyright © 2012 Elsevier Ltd. All rights reserved.

  15. Oral manifestations and related factors of HIV positive patients in south-east of Iran

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    Shirin Saravani

    2017-03-01

    Full Text Available Introduction: Oral manifestations can be the first signs of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS and a useful marker for the progression of this disease. The present study aimed to determine the prevalence of oral manifestations and examine their relationship with socio-demographic factors in HIV-positive patients in the health centers affiliated to Zahedan University of Medical Sciences (Southeast Iran. Methods: In this cross-sectional study in addition to determining oral manifestations based on the classification of EC-clearing house (European Commission clearing house, information such as age, gender, marital status, residence, education, occupation, habits, oral hygiene, loss of weight in the last six months. Body Mass Index (BMI, mode of HIV transmission, stage of disease, anti-retroviral therapy (ART, and duration of HIV were gathered through direct question from the patients or the information contained in their records. Then the relationship between various factors and oral manifestations was analyzed using Chi-square, Fisher’s Exact Test, Student T Test, Mann- Whitney tests and logistic regression. Results: Oral examination was performed on 119 HIV-positive patients who were 69.7% male and 30.3% female and had a mean age of 35.4±12.7 years. Oral manifestations were found in 57.1% of the patients. Pseudomembranous candidiasis (34.1% and linear gingival erythema (33% were the most common lesions in these patients. The probability of oral manifestations occurrence increased with age and duration of smoking in smokers with HIV (P=0.036 and P=0.012, respectively. Conclusion: Most oral manifestations were those strongly associated with HIV infection (91%. Timely diagnosis and treatment of oral manifestations in HIV patients should be considered in conjunction with other treatments.

  16. Renal Function in Chinese HIV-Positive Individuals following Initiation of Antiretroviral Therapy.

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    Yan Zhao

    Full Text Available To identify the prevalence and predictors of abnormal renal function among HIV-positive Chinese patients prior to antiretroviral therapy (ART initiation and to evaluate subsequent changes in renal function after ART exposure.We conducted a nationwide cohort study of subjects who enrolled in the national Chinese ART program from January 1, 2012 to December 31, 2012. We estimated the glomerular filtration rate (eGFR of subjects prior to and after initiating ART. Risk factors for abnormal renal function, as defined by eGFR 6.1 mmol/L (AOR = 1.46, 95% CI: 1.25-1.72, and hepatitis C co-infection (AOR = 1.36, 95% CI: 1.06-1.73. Among subjects with baseline eGFR >90 ml/min/1.73m2, the incidence of the eGFR falling to <60 ml/min/1.73m2 was 0.92/100 person-years after a median of 15.0 months of ART. Being on a tenofovir with lopinavir/ritonavir regimen (Adjusted hazard ratio [AHR] = 3.02, 95% CI: 1.96-4.66 and having an unsuppressed viral load (AHR = 2.70, 95% CI: 1.80-4.03 were independent predictors for eGFR <60 ml/min/1.73m2 after ART initiation as well as older age, female, and hemoglobin <120 g/L.A high proportion of HIV-positive subjects in China presented with abnormal renal function prior to ART initiation. But the incidence of the eGFR decrease after ART was low. Patient renal function should be regularly monitored by eGFR before initiating and during ART.

  17. Confidentiality of the medical records of HIV-positive patients in the United Kingdom – a medicolegal and ethical perspective

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    Mike Williams

    2011-01-01

    Full Text Available Mike WilliamsHead of Service, Cambridge University Dental Service, Cambridge, UKAbstract: This article examines the legal and ethical issues that surround the confidentiality of medical records, particularly in relation to patients who are HIV positive. It records some historical background of the HIV epidemic, and considers the relative risks of transmission of HIV from individual to individual. It explains the law as it pertains to confidentiality, and reports the professional guidance in these matters. It then considers how these relate to HIV-positive individuals in particular.Keywords: HIV/AIDS, confidentiality, medical records

  18. Ethical standards for the occupational health-nursing practitioner regarding the HIV positive person in the workplace

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    A C Botes

    2001-01-01

    Full Text Available The occupational health-nursing practitioner often becomes involved in ethical dilemmas with regard to the handling of HIV-positive people in the workplace in that the interests of the HIV-positive people conflict with the interests of the employer.

    Opsomming
    Die beroepsgesondheidsverpleegkundige raak dikwels in etiese dilemmas betrokke ten opsigte van die hantering van die MIV-positiewe persoon by die werkplek deurdat die belange van die MIV-positiewe persoon botsend is met die belange van die werkgewer. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.

  19. Risk Factors for Kaposi’s sarcoma among HIV-Positive Individuals in a Case Control Study in Cameroon

    Science.gov (United States)

    Stolka, Kristen; Ndom, Paul; Hemingway-Foday, Jennifer; Iriondo-Perez, Jeniffer; Miley, Wendell; Labo, Nazzarena; Jennifer, Stella;; Abassora, Mahamat; Woelk, Godfrey; Ryder, Robin; Whitby, Denise; Smith, Jennifer S

    2014-01-01

    Background Individuals co-infected with Kaposi’s sarcoma herpesvirus (KSHV) and Human Immunodeficiency Virus (HIV) are at greatly increased risk of developing Kaposi’s sarcoma (KS). The objective of the current analysis is to identify risk cofactors, for KS among HIV-positive individuals. Methods We conducted a case-control study of KS in Cameroon on 161 HIV-positive and 14 HIV-negative cases and 680 HIV-positive and 322 HIV-negative controls. Participants answered a physician-administered questionnaire and provided blood and saliva specimens. Antibodies against KSHV lytic, K8.1, and latent, ORF73, antigens were measured by ELISA to determine KSHV serostatus. Conditional logistic regression was performed to determine multivariate odds ratios (OR) and 95% confidence intervals (CI) for risk factors associated with KS among HIV-positive cases and controls. Results Overall, 98% (158) of HIV-positive cases, 100% (14) of HIV-negative cases, 81% (550) of HIV-positive controls, and 80% (257) of HIV-negative controls were KSHV seropositive. Risk factors for KS among HIV-positive individuals included KSHV seropositivity (OR=9.6; 95% CI 2.9, 31.5), non-use of a mosquito bed net (OR 1.9; 95% CI 1.2, 2.9), minority ethnicity (OR=3.1; 95% CI 1.1, 9.3), treatment from a traditional healer (OR=2.3; 95% CI 1.5, 3.7), history of transfusion (OR=2.4; 95% CI 1.5, 3.9), and family history of cancer (OR=1.9; 95% CI 1.1, 3.1). Conclusion KSHV seroprevalence of ≥80% indicates a high prevalence in the general population in Cameroon. Among HIV-positive individuals, the strong association of KS with non-use of mosquito nets and treatment from traditional healers are compelling findings, consistent with recently reported data from East Africa. PMID:24631417

  20. Care of the HIV-positive patient in the emergency department in the era of highly active antiretroviral therapy.

    Science.gov (United States)

    Venkat, Arvind; Piontkowsky, David M; Cooney, Robert R; Srivastava, Adarsh K; Suares, Gregory A; Heidelberger, Cory P

    2008-09-01

    More than 1 million individuals in the United States are HIV positive, with greater than 40,000 new patients being diagnosed per year. With the advent of highly active antiretroviral therapy (HAART), HIV-infected patients in the United States are living longer. HIV-infected patients receiving HAART now more commonly have noninfectious and nonopportunistic complications of their disease. This review article will discuss the assessment and treatment of HIV-positive patients in the era of HAART, with an emphasis on the noninfectious and changing infectious complications that require emergency care.

  1. Brief Report: Sexual Violence Against HIV-Positive Women in the Nyanza Region of Kenya: Is Condom Negotiation an Instigator?

    Science.gov (United States)

    Onu, Chinwe C.; Dworkin, Shari L.; Ongeri, Linnet G.; Oyaro, Patrick; Neylan, Thomas C.; Cohen, Craig R.; Bukusi, Elizabeth A.; Rota, Grace

    2017-01-01

    Abstract: For people living with HIV, exposure to sexual violence (SV) is associated with decreased adherence to antiretroviral medication, a primary predictor of their survival. Identification of risk factors for SV is a pressing issue in sub-Saharan Africa, where the global majority of HIV-positive women live and the prevalence of SV against women is high. We used qualitative data to examine SV against HIV-positive women enrolled in HIV care in Kenya. Respondents identified husbands as perpetrators of SV in the context of women's efforts to use condoms as directed by HIV care providers. PMID:27509254

  2. Brief Report: Sexual Violence Against HIV-Positive Women in the Nyanza Region of Kenya: Is Condom Negotiation an Instigator?

    Science.gov (United States)

    Onu, Chinwe C; Dworkin, Shari L; Ongeri, Linnet G; Oyaro, Patrick; Neylan, Thomas C; Cohen, Craig R; Bukusi, Elizabeth A; Rota, Grace; Meffert, Susan M

    2017-01-01

    For people living with HIV, exposure to sexual violence (SV) is associated with decreased adherence to antiretroviral medication, a primary predictor of their survival. Identification of risk factors for SV is a pressing issue in sub-Saharan Africa, where the global majority of HIV-positive women live and the prevalence of SV against women is high. We used qualitative data to examine SV against HIV-positive women enrolled in HIV care in Kenya. Respondents identified husbands as perpetrators of SV in the context of women's efforts to use condoms as directed by HIV care providers.

  3. Concealment, communication and stigma: The perspectives of HIV-positive immigrant Black African men and their partners living in the United Kingdom.

    Science.gov (United States)

    Owuor, John Oa; Locke, Abigail; Heyman, Bob; Clifton, Andrew

    2016-12-01

    This study explored the perspectives of Black men, originally from East Africa, living in the United Kingdom and their partners on what it means to live with diagnosed HIV. This article reports on concealment of HIV-positive status as a strategy adopted by the affected participants to manage the flow of information about their HIV-positive status. Analysis of the data, collected using in-depth interviews involving 23 participants, found widespread selective concealment of HIV-positive status. However, a few respondents had 'come out' publicly about their condition. HIV prevention initiatives should recognise concealment as a vital strategy in managing communication about one's HIV-positive status.

  4. The effectiveness of cognitive behavioral stress management training on mental health, social interaction and family function in adolescents of families with one Human Immunodeficiency Virus (HIV) positive member*

    Science.gov (United States)

    Keypour, Maryam; Arman, Soroor; Maracy, Mohammad Reza

    2011-01-01

    BACKGROUND: This study evaluated stress management training to improve mental health, social interaction and family function among adolescents of families with one Human Immunodeficiency Virus (HIV) positive member. METHODS: There were 34 adolescents (13-18 years old) with at least one family member living with HIV from whom finally 15 attended the study and participated in 8 weekly sessions of stress management training. The tests used in this study were: Strengths and Difficulties Questionnaire (self and parent report), General Health Questionnare-28 (GHQ-28) and Family Assessment Device (FAD), conducted before, after and three months after the intervention. The collected data were analyzed by repeated measure test using SPSS software (Version 18.0). RESULTS: Adolescents with one HIV positive family member showed high level of emotional problem (40%) and conduct problem (33.3%). There was a significant difference between before, after and 3months after intervention based on GHQ-28 mean scores and FAD mean sores (p < 0.001). There was a significant difference between mean scores of peers’ relationship based on SDQ (self report and parents report forms) before and after intervention, but there was no significant difference between mean scores of pro social behavior based on SDQ (self report and parents report forms) in all three stages (before, after and three months after intervention). CONCLUSIONS: Stress management training is effective in improving mental health, family function and social interaction among adolescents living with parents infected with HIV/AIDS. PMID:22091302

  5. The effectiveness of cognitive behavioral stress management training on mental health, social interaction and family function in adolescents of families with one Human Immunodeficiency Virus (HIV positive member

    Directory of Open Access Journals (Sweden)

    Maryam Keypour

    2011-01-01

    Full Text Available Background: This study evaluated stress management training to improve mental health, social interaction and family function among adolescents of families with one Human Immunodeficiency Virus (HIV positive member. Methods: There were 34 adolescents (13-18 years old with at least one family member living with HIV from whom finally 15 attended the study and participated in 8 weekly sessions of stress management training. The tests used in this study were: Strengths and Difficulties Questionnaire (self and parent report, General Health Questionnare-28 (GHQ-28 and Family Assessment Device (FAD, conducted before, after and three months after the intervention. The collected data were analyzed by repeated measure test using SPSS software (Version 18.0. Results: Adolescents with one HIV positive family member showed high level of emotional problem (40% and conduct problem (33.3%. There was a significant difference between before, after and 3months after intervention based on GHQ-28 mean scores and FAD mean sores (p < 0.001. There was a significant difference between mean scores of peers′ relationship based on SDQ (self report and parents report forms before and after intervention, but there was no significant difference between mean scores of pro social behavior based on SDQ (self report and parents report forms in all three stages (before, after and three months after intervention. Conclusions: Stress management training is effective in improving mental health, family function and social interaction among adolescents living with parents infected with HIV/AIDS.

  6. An Approach to Developing a Prediction Model of Fertility Intent Among HIV-Positive Women and Men in Cape Town, South Africa: A Case Study.

    Science.gov (United States)

    Bai, Dan; Leu, Cheng-Shiun; Mantell, Joanne E; Exner, Theresa M; Cooper, Diane; Hoffman, Susie; Kelvin, Elizabeth A; Myer, Landon; Constant, Debbie; Moodley, Jennifer

    2017-02-01

    As a 'case-study' to demonstrate an approach to establishing a fertility-intent prediction model, we used data collected from recently diagnosed HIV-positive women (N = 69) and men (N = 55) who reported inconsistent condom use and were enrolled in a sexual and reproductive health intervention in public sector HIV care clinics in Cape Town, South Africa. Three theoretically-driven prediction models showed reasonable sensitivity (0.70-1.00), specificity (0.66-0.94), and area under the receiver operating characteristic curve (0.79-0.89) for predicting fertility intent at the 6-month visit. A k-fold cross-validation approach was employed to reduce bias due to over-fitting of data in estimating sensitivity, specificity, and area under the curve. We discuss how the methods presented might be used in future studies to develop a clinical screening tool to identify HIV-positive individuals likely to have future fertility intent and who could therefore benefit from sexual and reproductive health counseling around fertility options.

  7. Attitudes of practicing nurses as predictors of intended care behavior with persons who are HIV positive: testing the Ajzen-Fishbein Theory of Reasoned Action.

    Science.gov (United States)

    Laschinger, H K; Goldenberg, D

    1993-12-01

    The purpose of this descriptive correlational study was to examine practicing nurses' attitudes, subjective norms, and intentions to care for HIV positive patients, using the Theory of Reasoned Action. One hundred and forty-one subjects completed a questionnaire developed according to guidelines described by Ajzen and Fishbein (1980). Consistent with the theory, nurses' attitudes and subjective norms were found to be significant predictors of intentions to care for persons who are HIV positive (R2 = 0.27). Personal beliefs found to discriminate between intenders and nonintenders were those related to possible consequences for self, family, and friends, but not job-related consequences. Normative beliefs which discriminated between groups were also related to nonprofessional referents' expectations. In addition, qualitative data showed persistent concerns about occupational risk for contracting AIDS. Based on the results of this research, it is recommended that nurse educators in both clinical and academic settings, target specific educational/training interventions to include transmission, prevention, as well as exploration of feelings, attitudes, beliefs, and behavioral intentions about HIV-related topics. Further theory-based research and testing of interventions to change practicing nurses' attitudes and beliefs about HIV disease are advocated.

  8. Prevalence of Strongyloides stercoralis infection among HIV-positive immigrants attending two Italian hospitals, from 2000 to 2009.

    Science.gov (United States)

    Mascarello, M; Gobbi, F; Angheben, A; Gobbo, M; Gaiera, G; Pegoraro, M; Lanzafame, M; Buonfrate, D; Concia, E; Bisoffi, Z

    2011-12-01

    In patients with Strongyloides stercoralis infection, a dysregulation of host immunity can lead to hyperinfection syndrome (HS) and disseminated strongyloidiasis (DS), characterized by high fatality rate. HS has been reported in HIV-positive patients following use of corticosteroids or during immune reconstitution inflammatory syndrome (IRIS). A retrospective study was conducted to estimate the prevalence of S. stercoralis infection among HIV-positive immigrants, attending two Italian hospitals. From January 2000 to August 2009, 138 HIV-positive immigrants were systematically screened for strongyloidiasis, as a part of their routine care, with an indirect immunofluorescent antibody test (IFAT) developed at the Centre for Tropical Diseases, Sacro Cuore Hospital of Negrar, Verona. The majority were also submitted to stool examination. Fifteen (11%) resulted infected by S. stercoralis, of whom four (27%) had a negative serology (diagnosis made with stool examination). A higher eosinophil count (0·94 versus 0·24×10(9)/l, Ptest sensitivity. Considering the high prevalence detected and the apparent, lower sensitivity of serology, we propose a systematic screening for Strongyloides infection, with both serology and stool culture, for all HIV-positive immigrants coming from endemic areas.

  9. Change in serum 25-hydroxyvitamin D with antiretroviral treatment initiation and nutritional intervention in HIV-positive adults

    DEFF Research Database (Denmark)

    Yilma, Daniel; Kæstel, Pernille; Olsen, Mette F;

    2016-01-01

    Low vitamin D level in HIV-positive persons has been associated with disease progression. We compared the levels of serum 25-hydroxyvitamin D (25(OH)D) in HIV-positive and HIV-negative persons, and investigated the role of nutritional supplementation and antiretroviral treatment (ART) on serum 25...... daily allowance of vitamin D (10 μg/200 g). The level of serum 25(OH)D before nutritional intervention and ART initiation was compared with serum 25(OH)D of HIV-negative individuals. A total of 348 HIV-positive and 100 HIV-negative persons were recruited. The median baseline serum 25(OH)D level......-supplemented group had a 10·8 (95 % CI 7·8, 13·9) nmol/l decrease in serum 25(OH)D level after 3 months of ART. Nutritional supplementation that contained vitamin D prevented a reduction in serum 25(OH)D levels in HIV-positive persons initiating ART. Vitamin D replenishment may be needed to prevent reduction...

  10. HIV transmission risk behaviors among HIV-positive individuals: stress and coping in the aftermath of 9/11.

    Science.gov (United States)

    Rose, Carol S Dawson; Ress, Barry

    2002-01-01

    Using case studies, this article discusses a nursing approach for working with HIV-positive clients who have experienced stress as the result of the 9/11 attack on the United States. The stress and coping framework developed by Lazarus and Folkman is used to guide nursing care.

  11. Treatment of calcium and vitamin D deficiency in HIV-positive men on tenofovir-containing antiretroviral therapy

    NARCIS (Netherlands)

    Bech, A.; Bentum, P. van; Telting, D.; Gisolf, J.; Richter, C.; Boer, H. de

    2012-01-01

    BACKGROUND: Hypophosphatemia and bone disease are common in HIV-positive (HIV+) patients on tenofovir disoproxil fumarate-containing antiretroviral therapy (TDF-containing ART). The underlying etiology is not completely understood. OBJECTIVE: To examine the effects of treatment of calcium and vitami

  12. Regional differences in AIDS and non-AIDS related mortality in HIV-positive individuals across Europe and Argentina

    DEFF Research Database (Denmark)

    Reekie, Joanne; Kowalska, Justyna Dominika; Karpov, Igor

    2012-01-01

    Differences in access to care and treatment have been reported in Eastern Europe, a region with one of the fastest growing HIV epidemics, compared to the rest of Europe. This analysis aimed to establish whether there are regional differences in the mortality rate of HIV-positive individuals acros...

  13. Family-of-Origin Factors and Partner Violence in the Intimate Relationships of Gay Men Who Are HIV Positive

    Science.gov (United States)

    Craft, Shonda M.; Serovich, Julianne M.

    2005-01-01

    This exploratory study examined the prevalence of intimate partner violence in a sample of gay men who are HIV positive. The concept of intergenerational transmission of violence, from family systems theory, provided the basis of this examination. It was hypothesized that men who had witnessed or experienced violence in their families of origin…

  14. Advanced renal disease, end-stage renal disease and renal death among HIV-positive individuals in Europe

    DEFF Research Database (Denmark)

    Ryom, L; Kirk, O; Lundgren, Jens

    2012-01-01

    Many studies have focused on chronic kidney disease in HIV-positive individuals, but few have studied the less frequent events, advanced renal disease (ARD) and end-stage renal disease (ESRD). The aim of this study was to investigate incidence, predictors and outcomes for ARD/ESRD and renal death...

  15. Awareness and Interest in Intrauterine Contraceptive Device Use among HIV-Positive Women in Cape Town, South Africa

    Directory of Open Access Journals (Sweden)

    Catherine S. Todd

    2012-01-01

    Full Text Available Objective. To assess awareness of and interest in intrauterine contraceptive device (IUCD use among HIV-positive women in Cape Town, South Africa. Design. Cross-sectional survey. Methods. HIV-positive women aged 18 through 45 years presenting for care at a primary health care clinic in Cape Town, South Africa participated in this study. Consented participants completed a staff-administered questionnaire in a private setting. Descriptive statistics were generated. Comparisons between demographic and reproductive health-related variables and IUCD awareness and interest were performed with multiple logistic regression. Analyses for IUCD interest excluded women with prior surgical sterilization. Results. Of 277 HIV-positive women, 37% were aware of the IUCD; awareness was independently associated with greater age (adjusted odds ratio (AOR = 1.15, 95%; confidence interval (CI: 1.10–1.20 and not switching contraceptive methods in the last year (AOR = 2.45, 95% CI: 1.03–5.83. Following an IUCD information session, 86% of women (=206/240 were interested in IUCD use. IUCD interest was inversely associated with age (AOR = 0.91, 95% CI: 0.86–0.97 and marginally positively associated with current menstrual bleeding pattern complaints (AOR = 2.14, 95% CI: 0.98–4.68. Conclusions. Despite low levels of method awareness, HIV-positive women in this setting are frequently interested in IUCD use, indicating need for programming to expand method access.

  16. Variation in genes of beta-glucan recognition pathway and susceptibility to opportunistic infections in HIV-positive patients

    NARCIS (Netherlands)

    Rosentul, D.C.; Plantinga, T.S.; Papadopoulos, A.; Joosten, L.A.B.; Antoniadou, A.; Venselaar, H.; Kullberg, B.J.; Meer, J.W.M. van der; Giamarellos-Bourboulis, E.J.; Netea, M.G.

    2011-01-01

    Opportunistic infections are the main cause of morbidity and death among HIV-positive patients. Most of these infections are linked to the immunodeficiency due to low CD4+ counts. However, not all patients with low CD4+ counts are equally susceptible to infections, and we hypothesize that variabilit

  17. Project Roadmap: Reeducating Older Adults in Maintaining AIDS Prevention--A Secondary Intervention for Older HIV-Positive Adults

    Science.gov (United States)

    Illa, Lourdes; Echenique, Marisa; Saint Jean, Gilbert; Bustamante-Avellaneda, Victoria; Metsch, Lisa; Mendez-Mulet, Luis; Eisdorfer, Carl; Sanchez-Martinez, Mario

    2010-01-01

    The number of older adults living with HIV/AIDS is larger than ever. Little is known about their sexual behaviors, although contrary to stereotypes, older adults desire and engage in sexual activity. Despite increased recognition of the need for prevention interventions targeting HIV-positive individuals, no secondary HIV prevention interventions…

  18. Weighing the Consequences: Self-Disclosure of HIV-Positive Status among African American Injection Drug Users

    Science.gov (United States)

    Valle, Maribel; Levy, Judith

    2009-01-01

    Theorists posit that personal decisions to disclose being HIV positive are made based on the perceived consequences of that disclosure. This study examines the perceived costs and benefits of self-disclosure among African American injection drug users (IDUs). A total of 80 African American IDUs were interviewed in-depth subsequent to testing HIV…

  19. Spoligotype profile of Mycobacterium tuberculosis complex strains from HIV-positive and -negative patients in Nigeria: a comparative analysis.

    NARCIS (Netherlands)

    Cadmus, S.; Hill, V.; Soolingen, D. van; Rastogi, N.

    2011-01-01

    We ran a comparative analysis of all patients for whom a positive culture of Mycobacterium tuberculosis complex was available between April 2004 and October 2005 and whose HIV serology results were known, with spoligotyping results (n = 163) split into 49 HIV-positive patients and 114 HIV-negative p

  20. Quebec: employer who disclosed employee's HIV-positive status violated rights to dignity and freedom from discrimination.

    Science.gov (United States)

    Kazatchkine, Cécile

    2011-04-01

    The Quebec human rights tribunal held that an employer who disclosed the HIV-positive status of an employee to his staff violated the employee's right to the safeguard of his dignity, without distinction or exclusion based on disability, contrary to Sections 4 and 10 of the Charter of Human Rights and Freedoms (the Quebec Charter).

  1. Essentials from the 2015 European AIDS Clinical Society (EACS) guidelines for the treatment of adult HIV-positive persons

    DEFF Research Database (Denmark)

    Nielsen, Lene Ryom; Boesecke, C; Gisler, V

    2016-01-01

    BACKGROUND: The European AIDS Clinical Society (EACS) guidelines are intended for all clinicians involved in the care of HIV-positive persons, and are available in print, online, and as a free App for download for iPhone and Android. GUIDELINE HIGHLIGHTS: The 2015 version of the EACS guidelines...

  2. Regional differences in AIDS and non-AIDS related mortality in HIV-positive individuals across Europe and Argentina

    DEFF Research Database (Denmark)

    Reekie, Joanne; Kowalska, Justyna Dominika; Karpov, Igor;

    2012-01-01

    Differences in access to care and treatment have been reported in Eastern Europe, a region with one of the fastest growing HIV epidemics, compared to the rest of Europe. This analysis aimed to establish whether there are regional differences in the mortality rate of HIV-positive individuals acros...

  3. Family-of-Origin Factors and Partner Violence in the Intimate Relationships of Gay Men Who Are HIV Positive

    Science.gov (United States)

    Craft, Shonda M.; Serovich, Julianne M.

    2005-01-01

    This exploratory study examined the prevalence of intimate partner violence in a sample of gay men who are HIV positive. The concept of intergenerational transmission of violence, from family systems theory, provided the basis of this examination. It was hypothesized that men who had witnessed or experienced violence in their families of origin…

  4. Financial Incentives for Linkage to Care and Viral Suppression Among HIV-Positive Patients: A Randomized Clinical Trial (HPTN 065).

    Science.gov (United States)

    El-Sadr, Wafaa M; Donnell, Deborah; Beauchamp, Geetha; Hall, H Irene; Torian, Lucia V; Zingman, Barry; Lum, Garret; Kharfen, Michael; Elion, Richard; Leider, Jason; Gordin, Fred M; Elharrar, Vanessa; Burns, David; Zerbe, Allison; Gamble, Theresa; Branson, Bernard

    2017-08-01

    Achieving linkage to care and viral suppression in human immunodeficiency virus (HIV)-positive patients improves their well-being and prevents new infections. Current gaps in the HIV care continuum substantially limit such benefits. To evaluate the effectiveness of financial incentives on linkage to care and viral suppression in HIV-positive patients. A large community-based clinical trial that randomized 37 HIV test and 39 HIV care sites in the Bronx, New York, and Washington, DC, to financial incentives or standard of care. Participants at financial incentive test sites who had positive test results for HIV received coupons redeemable for $125 cash-equivalent gift cards upon linkage to care. HIV-positive patients receiving antiretroviral therapy at financial incentive care sites received $70 gift cards quarterly, if virally suppressed. Linkage to care: proportion of HIV-positive persons at the test site who linked to care within 3 months, as indicated by CD4+ and/or viral load test results done at a care site. Viral suppression: proportion of established patients at HIV care sites with suppressed viral load (financial incentive test sites and 39 359 gift cards were dispensed to 9641 HIV-positive patients eligible for gift cards at 17 financial incentive care sites. Financial incentives did not increase linkage to care (adjusted odds ratio, 1.10; 95% CI, 0.73-1.67; P = .65). However, financial incentives significantly increased viral suppression. The overall proportion of patients with viral suppression was 3.8% higher (95% CI, 0.7%-6.8%; P = .01) at financial incentive sites compared with standard of care sites. Among patients not previously consistently virally suppressed, the proportion virally suppressed was 4.9% higher (95% CI, 1.4%-8.5%; P = .007) at financial incentive sites. In addition, continuity in care was 8.7% higher (95% CI, 4.2%-13.2%; P financial incentive sites. Financial incentives, as used in this study (HPTN 065), significantly

  5. Cholelithiasis and Nephrolithiasis in HIV-Positive Patients in the Era of Combination Antiretroviral Therapy.

    Directory of Open Access Journals (Sweden)

    Kuan-Yin Lin

    Full Text Available This study aimed to describe the epidemiology and risk factors of cholelithiasis and nephrolithiasis among HIV-positive patients in the era of combination antiretroviral therapy.We retrospectively reviewed the medical records of HIV-positive patients who underwent routine abdominal sonography for chronic viral hepatitis, fatty liver, or elevated aminotransferases between January 2004 and January 2015. Therapeutic drug monitoring of plasma concentrations of atazanavir was performed and genetic polymorphisms, including UDP-glucuronosyltransferase (UGT 1A1*28 and multidrug resistance gene 1 (MDR1 G2677T/A, were determined in a subgroup of patients who received ritonavir-boosted or unboosted atazanavir-containing combination antiretroviral therapy. Information on demographics, clinical characteristics, and laboratory testing were collected and analyzed.During the 11-year study period, 910 patients who underwent routine abdominal sonography were included for analysis. The patients were mostly male (96.9% with a mean age of 42.2 years and mean body-mass index of 22.9 kg/m2 and 85.8% being on antiretroviral therapy. The anchor antiretroviral agents included non-nucleoside reverse-transcriptase inhibitors (49.3%, unboosted atazanavir (34.4%, ritonavir-boosted lopinavir (20.4%, and ritonavir-boosted atazanavir (5.5%. The overall prevalence of cholelithiasis and nephrolithiasis was 12.5% and 8.2%, respectively. Among 680 antiretroviral-experienced patients with both baseline and follow-up sonography, the crude incidence of cholelithiasis and nephrolithiasis was 4.3% and 3.7%, respectively. In multivariate analysis, the independent factors associated with incident cholelithiasis were exposure to ritonavir-boosted atazanavir for >2 years (adjusted odds ratio [AOR], 6.29; 95% confidence interval [CI], 1.12-35.16 and older age (AOR, 1.04; 95% CI, 1.00-1.09. The positive association between duration of exposure to ritonavir-boosted atazanavir and incident

  6. Cholelithiasis and Nephrolithiasis in HIV-Positive Patients in the Era of Combination Antiretroviral Therapy.

    Science.gov (United States)

    Lin, Kuan-Yin; Liao, Sih-Han; Liu, Wen-Chun; Cheng, Aristine; Lin, Shu-Wen; Chang, Sui-Yuan; Tsai, Mao-Song; Kuo, Ching-Hua; Wu, Mon-Ro; Wang, Hsiu-Po; Hung, Chien-Ching; Chang, Shan-Chwen

    2015-01-01

    This study aimed to describe the epidemiology and risk factors of cholelithiasis and nephrolithiasis among HIV-positive patients in the era of combination antiretroviral therapy. We retrospectively reviewed the medical records of HIV-positive patients who underwent routine abdominal sonography for chronic viral hepatitis, fatty liver, or elevated aminotransferases between January 2004 and January 2015. Therapeutic drug monitoring of plasma concentrations of atazanavir was performed and genetic polymorphisms, including UDP-glucuronosyltransferase (UGT) 1A1*28 and multidrug resistance gene 1 (MDR1) G2677T/A, were determined in a subgroup of patients who received ritonavir-boosted or unboosted atazanavir-containing combination antiretroviral therapy. Information on demographics, clinical characteristics, and laboratory testing were collected and analyzed. During the 11-year study period, 910 patients who underwent routine abdominal sonography were included for analysis. The patients were mostly male (96.9%) with a mean age of 42.2 years and mean body-mass index of 22.9 kg/m2 and 85.8% being on antiretroviral therapy. The anchor antiretroviral agents included non-nucleoside reverse-transcriptase inhibitors (49.3%), unboosted atazanavir (34.4%), ritonavir-boosted lopinavir (20.4%), and ritonavir-boosted atazanavir (5.5%). The overall prevalence of cholelithiasis and nephrolithiasis was 12.5% and 8.2%, respectively. Among 680 antiretroviral-experienced patients with both baseline and follow-up sonography, the crude incidence of cholelithiasis and nephrolithiasis was 4.3% and 3.7%, respectively. In multivariate analysis, the independent factors associated with incident cholelithiasis were exposure to ritonavir-boosted atazanavir for >2 years (adjusted odds ratio [AOR], 6.29; 95% confidence interval [CI], 1.12-35.16) and older age (AOR, 1.04; 95% CI, 1.00-1.09). The positive association between duration of exposure to ritonavir-boosted atazanavir and incident

  7. The High Cost of HIV-Positive Inpatient Care at an Urban Hospital in Johannesburg, South Africa.

    Directory of Open Access Journals (Sweden)

    Lawrence C Long

    Full Text Available While most HIV care is provided on an outpatient basis, hospitals continue to treat serious HIV-related admissions, which is relatively resource-intensive and expensive. This study reports the primary reasons for HIV-related admission at a regional, urban hospital in Johannesburg, South Africa and estimates the associated lengths of stay and costs.A retrospective cohort study of adult, medical admissions was conducted. Each admission was assigned a reason for admission and an outcome. The length of stay was calculated for all patients (N = 1,041 and for HIV-positive patients (n = 469, actual utilization and associated costs were also estimated. Just under half were known to be HIV-positive admissions. Deaths and transfers were proportionately higher amongst HIV-positive admissions compared to HIV-negative and unknown. The three most common reasons for admission were tuberculosis and other mycobacterial infections (18%, n = 187, cardiovascular disorders (12%, n = 127 and bacterial infections (12%, n = 121. The study sample utilized a total of 7,733 bed days of those, 55% (4,259/7,733 were for HIV-positive patients. The average cost per admission amongst confirmed HIV-positive patients, which was an average of 9.3 days in length, was $1,783 (United States Dollars.Even in the era of large-scale antiretroviral treatment, inpatient facilities in South Africa shoulder a significant HIV burden. The majority of this burden is related to patients not on ART (298/469, 64%, and accounts for more than half of all inpatient resources. Reducing the costs of inpatient care is thus another important benefit of expanding access to ART, promoting earlier ART initiation, and achieving rates of ART retention and adherence.

  8. Disengagement of HIV-positive pregnant and postpartum women from antiretroviral therapy services: a cohort study

    Directory of Open Access Journals (Sweden)

    Tamsin Phillips

    2014-10-01

    Full Text Available Introduction: Recent international guidelines call for expanded access to triple-drug antiretroviral therapy (ART in HIV-positive women during pregnancy and postpartum. However, high levels of non-adherence and/or disengagement from care may attenuate the benefits of ART for HIV transmission and maternal health. We examined the frequency and predictors of disengagement from care among women initiating ART during pregnancy in Cape Town, South Africa. Methods: We used routine medical records to follow-up pregnant women initiating ART within prevention of mother-to-child transmission of HIV services in Cape Town, South Africa. Outcomes assessed through six months postpartum were (1 disengagement (no attendance within 56 days of a scheduled visit and (2 missed visits (returning to care 14–56 days late for a scheduled visit. Results: A total of 358 women (median age, 28 years; median gestational age, 26 weeks initiated ART during pregnancy. By six months postpartum, 24% of women (n=86 had missed at least one visit and an additional 32% (n=115 had disengaged from care; together, 49% of women had either missed a visit or had disengaged by six months postpartum. Disengagement was more than twice as frequent postpartum compared to in the antenatal period (6.2 vs. 2.4 per 100 woman-months, respectively; p<0.0001. In a proportional hazards model, later gestational age at initiation (HR: 1.04; 95% CI: 1.00–1.07; p=0.030 and being newly diagnosed with HIV (HR: 1.57; 95% CI: 1.07–2.33; p=0.022 were significant predictors of disengagement after adjusting for patient age, starting CD4 cell count and site of ART initiation. Conclusions: These results demonstrate that missed visits and disengagement from care occur frequently, particularly post-delivery, among HIV-positive women initiating ART during pregnancy. Women who are newly diagnosed with HIV may be particularly vulnerable and there is an urgent need for interventions both to promote retention

  9. Feelings of hopelessness in stable HIV-positive patients on antiretrovirals

    Directory of Open Access Journals (Sweden)

    M Y H Moosa

    2010-04-01

    Full Text Available Aim. The coping skills and styles individuals utilise to deal with the stress of HIV infection greatly influence the psychological impact of this illness and potential consequent feelings of hopelessness. The aim of this study was to describe levels of hopelessness in a group of stable, non-depressed HIV-positive patients receiving antiretroviral therapy, and factors associated with hopelessness. Method. Thirty randomly selected non-depressed patients (according to Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV criteria were included in this study. Demographic and other data were obtained from all subjects, who also completed the Beck’s Hopelessness Scale (BHS. The 20 true-false items of the BHS (29 measured three major aspects of hopelessness, which was interpreted on the total scale score as follows: ≤3 minimal, and >3 significant. Results. The study population comprised 30 patients with a mean age of 37.9 years (standard error (SE 1.18 ( range 28 - 51 years. The mean BHS score was 4.03 (SE 0.55, with a range from 0 to 12. There were no statistically significant correlations between BHS scores of the study population and gender, marital status, employment status, level of education, years since the diagnosis of HIV, or number of children (p>0.05. Eighteen subjects (60% scored 3 or less on the BHS, considered minimal levels of hopelessness. However, 12 (40% scored more than 3, which is considered significant; of these 23% had scores of 7 or more. There was no statistically significant association between BHS scores and gender, employment status, level of education, number of children or number of years since diagnosis (p>0.05. However, patients who were married or living with partners were statistically more likely to score higher on the hopelessness scale compared with those who were single (p<0.05. Conclusion. Hopelessness is a psychological distress reaction that is common but largely undetected in stable HIV-positive

  10. HIV positive asylum seekers receiving the order to leave the Belgian territory.

    Science.gov (United States)

    Demeester, Remy; Legrand, Jean-Claude

    2014-01-01

    In a human rights based approach, the Parliamentary Assembly of the Council of Europe has recently released a resolution about migrants and refugees and the fight against HIV (1). It states that "an HIV positive migrant should never be expelled when it is clear that he will not receive adequate health care and assistance in the country to which he is being sent back. To do otherwise would amount to a death sentence for that person." Nevertheless, in Belgium, for the last 2 years, none of the HIV-infected migrants in care in the AIDS Reference Centers (ARC) received the right to stay in Belgium for medical reasons. We identified all HIV-infected asylum seekers in care between 1 July 2012 and 1 July 2014 in the ARC of Charleroi, Belgium, and we analyzed their medical and social files. Among the 302 patients in active follow up in our ARC, 45 HIV positive asylum seekers were in care during the last 2 years. Male/female ratio was 0/96. Mean age was 35 years. Countries of origin and reasons for migration are detailed in the Table 1. 18% (8/45) knew their seropositivity before arriving in Europe. All the patients introduced an asylum request, 29 (64%) have received a negative answer and an order to leave the territory, 4 (9%) were regularized for non-medical reasons (see Table 1), 4 (9%) are waiting for an answer and for 8 (18%) outcome is unknown due to lost follow up (LFU). 31 (69%) patients have also introduced a request to stay for medical reasons: 18 (58%) have received a refusal, 7 (23%) are still waiting for an answer, and 6 (19%) are LFU. Only 23 (51%) patients are still in care in our ARC on 1 July 2014 (see Table 1). The immigration office bases its decisions on availability of the treatment in the country even if accessible only to a limited number of patients. Decisions taken by the Belgian authorities for the last two years concerning HIV-infected asylum seekers do not guarantee the continuity of care of those patients and push them towards illegality. Such

  11. Stigma and self-esteem: A case of HIV-positive sex-workers.

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    Kalemi, G; Gkioka, S; Tsapatsari, P; Tzeferakos, G; Kandri, T; Psarra, M L; Konstantopoulou, F; Douzenis, A

    2017-01-01

    Stigma associated with sex work and HIV can be easily recognized in public reactions towards the members of discriminated groups. Nevertheless, there are only a few studies examining the impact of discrimination to the self-esteem of individuals who suffer the coexistence of multiple stigmatizing conditions. In our case, the unprecedented stigmatization of sex workers through the media as a menace of public health as well as criminals due to their seropositivity should be examined with respect and scientificity. The sample consisted of the 27 women found to be HIV positive. The small number of subject and the uniqueness of the situation made necessary the use of qualitative research method. Data were collected of through a semi-structured interview during which personal and medical history was taken and Rosenberg self-esteem scale was completed. Information for each domain of interest was systematically collected from multiple interview guide items. Interpretive Phenomenological Analysis was used to analyze data derived from qualitative interview (IPA). Four main categories emerged from the horizontal analysis of the interviews referring to the mechanism used by those women in order to cope with stigma and protect their self-esteem, a description of their felt stigma and feelings about seropositivity, as well as the existence of self-destructive behaviors. The existence of a normal self-esteem on the majority of those women is well explained by the use of certain coping strategies in order to confront the enacted stigma, such as the avoidance of self-blame for their condition (HIV-positive), the disregard of public's discriminating comments and behaviors, the acknowledge of their competence in specific issues they have to deal with in their everyday life, in common with the existence of a strongly supportive network. Despite those women's felt stigma, structured by community's discriminating approach of their families and their feelings of helplessness and

  12. Survival of infants born to HIV-positive mothers, by feeding modality, in Rakai, Uganda.

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    Joseph Kagaayi

    Full Text Available BACKGROUND: Data comparing survival of formula-fed to breast-fed infants in programmatic settings are limited. We compared mortality and HIV-free of breast and formula-fed infants born to HIV-positive mothers in a program in rural, Rakai District Uganda. METHODOLOGY/PRINCIPAL FINDINGS: One hundred eighty two infants born to HIV-positive mothers were followed at one, six and twelve months postpartum. Mothers were given infant-feeding counseling and allowed to make informed choices as to whether to formula-feed or breast-feed. Eligible mothers and infants received antiretroviral therapy (ART if indicated. Mothers and their newborns received prophylaxis for prevention of mother-to-child HIV transmission (pMTCT if they were not receiving ART. Infant HIV infection was detected by PCR (Roche Amplicor 1.5 during the follow-up visits. Kaplan Meier time-to-event methods were used to compare mortality and HIV-free survival. The adjusted hazard ratio (Adjusted HR of infant HIV-free survival was estimated by Cox regression. Seventy-five infants (41% were formula-fed while 107 (59% were breast-fed. Exclusive breast-feeding was practiced by only 25% of breast-feeding women at one month postpartum. The cumulative 12-month probability of infant mortality was 18% (95% CI = 11%-29% among the formula-fed compared to 3% (95% CI = 1%-9% among the breast-fed infants (unadjusted hazard ratio (HR = 6.1(95% CI = 1.7-21.4, P-value < 0.01. There were no statistically significant differentials in HIV-free survival by feeding choice (86% in the formula-fed compared to 96% in breast-fed group (Adjusted RH = 2.8[95%CI = 0.67-11.7, P-value = 0.16] CONCLUSIONS/SIGNIFICANCE: Formula-feeding was associated with a higher risk of infant mortality than breastfeeding in this rural population. Our findings suggest that formula-feeding should be discouraged in similar African settings.

  13. Despondency among HIV-positive older men and women in Uganda.

    Science.gov (United States)

    Wright, Stuart; Zalwango, Flavia; Seeley, Janet; Mugisha, Joseph; Scholten, Francien

    2012-12-01

    Forty people over 60 years of age took part in longitudinal research over the course of a year on the impact of the HIV epidemic in southern Uganda. In this paper we focus mainly on the data from 26 of the 40 who were HIV-positive. While we observed that feelings of depression were frequently experienced by many of the people in our study, the state of 'being depressed' was not constant. Participants regularly expressed economic frustration (because of a lack of money to buy food and other commodities including sugar and soap); medical problems (including those related to HIV) as well as old age, the burden of dependents (including concerns about school fees for grandchildren), feelings of sadness and isolation, and a lack of support from others, as well as stigma, whether real or perceived. However, while worries, sorrow and despondent thoughts were reported in many of the interviews across the study, moods fluctuated moving from happiness and hope, to sadness and despair, from month to month. Concerns regarding the psychological wellbeing amongst older people, including those living with HIV and older carers in Uganda deserve greater attention.

  14. Occult Hepatitis B Virus Infection among HIV Positive Patients in Nigeria

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    Oluyinka Oladele Opaleye

    2014-01-01

    Full Text Available HIV has been known to interfere with the natural history of hepatitis B virus (HBV infection. In this study we investigate the prevalence of occult hepatitis B virus infection (OBI among HIV-infected individuals in Nigeria. Overall, 1200 archived HIV positive samples were screened for detectable HBsAg using rapid technique, in Ikole Ekiti Specialist Hospital. The HBsAg negative samples were tested for HBsAg, anti-HBc, and anti-HCV by ELISA. Polymerase chain reaction was used for HBV DNA amplification and CD4 counts were analyzed by cytometry. Nine hundred and eighty of the HIV samples were HBsAg negative. HBV DNA was detected in 21/188 (11.2% of patients without detectable HBsAg. CD4 count for the patients ranged from 2 to 2,140 cells/μL of blood (mean = 490 cells/μL of blood. HCV coinfection was detected only in 3/188 (1.6% of the HIV-infected patients (P>0.05. Twenty-eight (29.2% of the 96 HIV samples screened were positive for anti-HBc. Averagely the HBV viral load was <50 copies/mL in the OBI samples examined by quantitative PCR. The prevalence of OBI was significantly high among HIV-infected patients. These findings highlight the significance of nucleic acid testing in HBV diagnosis in HIV patients.

  15. Assessment of quality of life of HIV-positive people receiving art: An Indian perspective

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    Deepika Anand

    2012-01-01

    Full Text Available Context: HIV/AIDS is known to affect an individual not only physically but also mentally, socially, and financially. It is a syndrome that builds a vacuum in a person affecting his/her life as a whole. Aims: The purpose of the present study is to evaluate the quality of life (QOL of people living with HIV/AIDS (PLHIV receiving ART and its association with Body mass index (BMI and CD4 count. Study Design: An observational study was performed on PLHIV receiving ART in Orissa, India. Materials and Methods: Data on sociodemographic profile, BMI, and CD4 were gathered from 153 HIV-positive subjects. QOL was assessed using WHOQOL-HIV BREF scale. Results: The overall QOL score of the subjects was moderate; PLHIV with lower BMI also had poorer QOL (P<0.05. Employment affected only the social health domain of the subjects. Men reported poorer level of independence and physical health while women reported poorer social relationships and environment. All the six domains correlated significantly with the overall QOL indicated by the G-facet. Conclusion: Attention toward improving the nutritional status of PLHIV should be accorded high priority to ensure improvement in the overall QOL of PLHIV.

  16. Extramedullary Plasmacytoma Diagnosed in an HIV-Positive Patient by an Unusual Clinical Presentation

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    de Camargo Moraes, Paulo; Thomaz, Luiz Alexandre; Montalli, Victor Angelo Martins; Junqueira, José Luiz Cintra; Ribeiro, Camila Maria Beder

    2016-01-01

    The aim of this paper is to describe a case report of EMP in an HIV-positive patient. A 44-year-old, dark-skinned HIV-infected woman was referred to the Oral Diseases Treatment Center with a swelling at palate and left gingival fornix in the maxilla. Biopsy was taken and the oral lesion was diagnosed as EMP with well-differentiated plasma cells and restriction of the lambda light-chain. Skeletal survey was performed and no radiograph alterations were observed, thus supporting the diagnosis of EMP. Patient was referred to treatment and after two months of chemo and radiotherapy, an expanding lesion was observed in L5/S1 patient's vertebrae. Biopsy of the spinal lesion was consistent with lymphoma with plasmocitary differentiation, supporting the diagnosis of multiple myeloma (MM). Regarding the medical history, the final diagnostic was an oral extramedullary plasmacytoma with rapid progression into multiple myeloma. It is crucial to emphasize the relevance of HIV infection as a risk factor for both aggressive clinical behavior and unusual clinical presentation of extramedullary plasmacytoma cases. PMID:27980867

  17. Clinical analysis of neurological system complications in AIDS and HIV positive patients

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective:To report the clinical manifestations of AIDS with nervous system complications. Methods:We collected the clinical material of AIDS and HIV positive patients who were admitted to our hospital from January 1998 to July 2006, and retrospectively analyzed the 39 cases having nervous system complications, among 146 cases in total. Results:Among 39 cases, there were 3 cases of HIV dementia, 1 case of vacuolar myelopathy, 3 cases of Gullain-barre syndrome, 3 cases of myopathy and 26 cases of secondary opportunistic infection of CNS,including 9 cases of tuberculosis, 6 cases of cryptococcus, 5 cases of toxoplasma, 3 cases of herpes zoster virus, 2 cases of herpes simples virus, 1 case of cytomegalovirus, 1 case of progressive multifocal leukoencencephalitis. 2 cases with central nervous system lymphoma.Among them 12 patients gave up treatment, other patients received anti-HIV treatment and antimicroorganism treatment. 5 patients died of respiratory failure, 2 patients died of multiple organs failure. Conclusion:Up to now, AIDS still has not very good management. So prevention is very important.

  18. A systematic review of complication risks for HIV-positive patients undergoing invasive dental procedures.

    Science.gov (United States)

    Patton, Lauren L; Shugars, Daniel A; Bonito, Arthur J

    2002-02-01

    This systematic literature review determined the strength of evidence regarding whether patients with human immunodeficiency virus, or HIV, are at higher risk of developing complications from invasive oral procedures than similar patients without HIV. MEDLINE and EMBASE searches of the English literature from the early 1980s through April 2000 yielded five articles meeting the inclusion and exclusion criteria: original research, concurrent treatment of HIV-positive and HIV-negative subjects, presence of complications (for example, local or systemic infection, bleeding, alveolitis, delayed healing) resulting from extractions, orthognathic surgery, periodontal therapy, endodontic therapy, placement of dental implants, prophylaxis, or scaling and root planing. The authors found no studies involving orthognathic surgery, periodontal therapy, dental implants, prophylaxis, or scaling and root planing, and only one study reporting few immediate endodontic therapeutic complications. Thus, the evidence is insufficient with respect to any additional risk associated with these procedures among people with HIV/AIDS. Because of the few studies, low overall complication rates and variability in results from different analytic approaches, the authors consider the evidence to be too poor to rule in or out a meaningful relationship between HIV status and complications from tooth extractions. Limited published scientific evidence is available to guide clinicians in regard to possible increased risks of invasive oral procedures associated with the HIV status of the patient.

  19. Postmortem findings and opportunistic infections in HIV-positive patients from a public hospital in Peru

    Science.gov (United States)

    Eza, Dominique; Cerrillo, Gustavo; Moore, David A.J.; Castro, Cecilia; Ticona, Eduardo; Morales, Domingo; Cabanillas, Jose; Barrantes, Fernando; Alfaro, Alejandro; Benavides, Alejandro; Rafael, Arturo; Valladares, Gilberto; Arevalo, Fernando; Evans, Carlton A.; Gilman, Robert H.

    2010-01-01

    There is a paucity of HIV autopsy data from South America and none that document the postmortem findings in patients with HIV/AIDS in Peru. The purpose of this autopsy study was to determine the spectrum of opportunistic infections and the causes of mortality in HIV-positive patients at a public hospital in Lima. Clinico-epidemiological information regarding HIV infection in Peru is also reviewed. Sixteen HIV-related hospital postmortems, performed between 1999 and 2004, were included in this retrospective analysis. The primary cause of death was established in 12 patients: one died of neoplasia and 11 of infectious diseases, including 3 from pulmonary infection, 7 from disseminated infection, and 2 from central nervous system infection (one case had dual pathology). Opportunistic infections were identified in 14 cases, comprising cytomegalovirus, histoplasmosis, cryptococcosis, toxoplasmosis, Pneumocystis pneumonia, aspergillosis, tuberculosis, varicella zoster virus, and cryptosporidiosis. Fourteen patients had at least one AIDS-related disease that had been neither clinically suspected nor diagnosed premortem. Moreover, 82% of the diagnoses considered to be of important clinical significance had not been suspected antemortem. The spectrum and frequency of certain opportunistic infections differed from other South American autopsy studies, highlighting the importance of performing HIV/AIDS postmortems in resource-limited countries where locally specific disease patterns may be observed. PMID:16979302

  20. Assessing sexual motives for drinking alcohol among HIV-positive men who have sex with men.

    Science.gov (United States)

    Kahler, Christopher W; Wray, Tyler B; Pantalone, David W; Mastroleo, Nadine R; Kruis, Ryan D; Mayer, Kenneth H; Monti, Peter M

    2015-03-01

    Individuals who drink alcohol for the explicit motive of facilitating or enhancing sex may be more likely to engage in risky sexual behavior, including having sex under the influence of alcohol. However, efforts to assess sexual motives for drinking (SMDs) have been very limited to date. We examined the psychometric properties of a 5-item measure of SMDs in a sample of HIV-positive heavy drinking men who have sex with men. Findings provided excellent support for the scale's internal consistency and concurrent validity with a well-established measure of sexual alcohol expectancies (SAEs). Good discriminant validity was also established, as SMDs were correlated with other drinking motives but uniquely predicted the proportion of sex acts occurring under the influence of alcohol and other drugs, over and above other drinking motives and SAEs. SMDs were not significantly associated with unprotected anal intercourse. Adjusting for alcohol problem severity, higher SMDs were associated with lower willingness to consider changing drinking. Results suggest this measure of SMDs exhibits sound psychometric properties and may be useful in studies examining the association between alcohol use and sexual behavior. (PsycINFO Database Record

  1. Pneumonia caused by Bordetella bronchiseptica in two HIV-positive patients

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    Roberta Filipini Rampelotto

    Full Text Available ABSTRACT: CONTEXT AND OBJECTIVE: Bordetella bronchiseptica (BB is a Gram-negative coccobacillus responsible for respiratory diseases in dogs, cats and rabbits. Reports on its development in humans are rare. However, in immunosuppressed patients, especially in those with the immunodeficiency virus (HIV, BB can cause severe pulmonary infections. We report on two cases of pneumonia caused by BB in HIV-positive male patients in a university hospital. CASE REPORT: The first case comprised a 43-year-old patient who was admitted presenting chronic leg pain and coughing, with suspected pneumonia. BB was isolated from sputum culture and was successfully treated with trimethoprim/sulfamethoxazole in association with levofloxacin. The second case comprised a 49-year-old patient who was admitted presenting fever, nausea, sweating and a dry cough, also with suspected pneumonia. BB was isolated from sputum culture, tracheal secretions and bronchoalveolar lavage. The disease was treated with ciprofloxacin but the patient died. CONCLUSION: BB should be included in the etiology of pneumonia in immunodeficient HIV patients. As far as we know, these two were the first cases of pneumonia due to BB to occur in this university hospital.

  2. Psychosexual development among HIV-positive adolescents in Abidjan, Côte d'Ivoire.

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    Aka Dago-Akribi, Hortense; Cacou Adjoua, Marie-Chantal

    2004-05-01

    Some 84,000 children with HIV/AIDS live in Côte d'Ivoire, where very little therapeutic or psychological help is available to them. The Yopougon Child Programme of the "Agence Nationale de Recherche sur le Sida" was launched in Abidjan in October 2000. It provides services for HIV-infected children and psychological consultations for children and their parents. This paper is about the psychosexual development of the HIV-positive adolescents in the Programme, 11 girls and 8 boys aged 13-17, their problems with HIV-related physiological and psychosexual changes, and relationships with their parents. The information was gathered in individual therapy sessions, group discussions and family support sessions. Bodily development was of major importance to these adolescents, particularly among those who had not yet developed secondary sexual characteristics and were shorter and weighed less than their peers. Those who had not achieved puberty were unable to participate in traditional rituals and worried whether they could ever marry or have children. In most cases, adolescents with HIV have been infected by a sexually transmitted virus without having had sexual relations themselves. They need support dealing with their sexual development and sexual feelings, along with medical care, in a context in which HIV infection is a secret, impossible to talk about with their peers.

  3. Relationship Power and Sexual Violence Among HIV-Positive Women in Rural Uganda.

    Science.gov (United States)

    Conroy, Amy A; Tsai, Alexander C; Clark, Gina M; Boum, Yap; Hatcher, Abigail M; Kawuma, Annet; Hunt, Peter W; Martin, Jeffrey N; Bangsberg, David R; Weiser, Sheri D

    2016-09-01

    Gender-based power imbalances place women at significant risk for sexual violence, however, little research has examined this association among women living with HIV/AIDS. We performed a cross-sectional analysis of relationship power and sexual violence among HIV-positive women on anti-retroviral therapy in rural Uganda. Relationship power was measured using the Sexual Relationship Power Scale (SRPS), a validated measure consisting of two subscales: relationship control (RC) and decision-making dominance. We used multivariable logistic regression to test for associations between the SRPS and two dependent variables: recent forced sex and transactional sex. Higher relationship power (full SRPS) was associated with reduced odds of forced sex (AOR = 0.24; 95 % CI 0.07-0.80; p = 0.020). The association between higher relationship power and transactional sex was strong and in the expected direction, but not statistically significant (AOR = 0.47; 95 % CI 0.18-1.22; p = 0.119). Higher RC was associated with reduced odds of both forced sex (AOR = 0.18; 95 % CI 0.06-0.59; p women should consider approaches that increase women's power in their relationships.

  4. Association of vitamin D levels, lipid profile and intima media thickness in HIV positive patients

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    Sarita Bajaj

    2012-01-01

    Full Text Available Background: People with HIV are living decades longer than before due to combination ART; however, complications including CVD< osteoporosis and non AIDS defining malignancies are higher than in the general population. Many of the emerging complications related to chronic HIV infection represent disease processes where vitamin D is known to play an important role. Objectives: A single point cross sectional case control study was conducted in a tertiary care hospital to determine the prevalence of vitamin D deficiency and its association with carotid intima media thickness (CIMT in HIV patients and to study the association of lipid profile with HIV infection. Out of the 45 HIV positive cases, vitamin D deficiency was found in 42 cases (93.33% whereas only 33 out of 45 (73.33% healthy controls. Fifty one point eleven percent of cases had dyslipidemia compared to 15.55% of controls. A positive association was seen between CD4 levels and 25 hydroxy vitamin D. An inverse co-relation between CD4 count and triglycerides and VLDL levels while a positive co-relation with total cholesterol, LDL cholesterol and HDL cholesterol levels was seen. No significant difference was seen in CIMT in cases and controls.

  5. DETECTION OF MYCOBACTERIUM TUBERCULOSIS IN BLOOD FOR DIAGNOSIS OF GENERALISED TUBERCULOSIS IN HIV-POSITIVE PATIENTS

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    V. N. Zimina

    2017-01-01

    Full Text Available Objective: To study the informative value of the detection of mycobacteria in blood with the cultural method in patients with suspected tuberculous sepsis and to determine the most significant clinical and laboratory criteria for testing. Materials and methods: The investigation to detect M.tuberculosis was fulfilled in 159 HIV-positive patients with suspected tuberculosis sepsis. Blood culture was completed with culture medium Myco/F Lytic Culture Vials and analyzer BACTEC 9050. Results: Mycobacteria were detected in blood of 19 patients (11,9% of all patients: in 18 patients the growth of М. tuberculosis complex was detected (25,3% of all patients with diagnosed tuberculosis and in 1 patient it was Mycobacterium avium complex (0,6% of all patients. It was shown, that the probability of M.tuberculosis detection was especially associated with the severity of the disease, immunosupression (less than 100 cells/mkl, hemoglobin quantity less than 90 g/l (levels were determined through the seeking for the most significant cutoffs. It was not proofed, that meningoencephalitis develops more often in patients with proven bacteremia. There were no evident differences in detection frequency of mycobacteria in sputum between patients with tuberculous sepsis and without it.

  6. Hepatitis C virus increases the risk of kidney disease among HIV-positive patients: Systematic review and meta-analysis.

    Science.gov (United States)

    Fabrizi, Fabrizio; Dixit, Vivek; Martin, Paul; Messa, Piergiorgio

    2016-03-01

    Kidney disease has become an important co-morbidity among human immunodeficiency virus-infected patients as they live longer in the era of highly effective antiretroviral therapy. It remains unclear how co-infection with hepatitis C virus impacts on the trajectory of kidney disease among HIV-infected patients. To evaluate the effect of co-infection with HCV on the risk of kidney disease in HIV-infected populations. We conducted a systematic review of the published medical literature to determine if hepatitis C co-infection is associated with increased likelihood of chronic kidney disease in HIV-positive adults. We used the random effects model of DerSimonian and Laird to generate a summary estimate of the relative risk for chronic kidney disease (defined by reduced glomerular filtration rate and/or detectable proteinuria) with hepatitis C virus across the published studies. Meta-regression and stratified analysis were also conducted. We identified 19 studies (146,151 unique patients with HIV) and separate meta-analyses were performed according to the outcome. Aggregation of longitudinal studies (n = 8, 105,462 unique patients) showed a relationship between HCV infection and increased risk of reduced glomerular filtration rate among HIV-infected individuals, the summary estimate for adjusted hazard ratio was 1.64 (95%CI, 1.28; 2.0, P Hepatitis C co-infection is associated with a significant increase in the risk of reduced glomerular filtration rate and/or detectable proteinuria among HIV-infected individuals.

  7. Employment-based abstinence reinforcement following inpatient detoxification in HIV-positive opioid and/or cocaine-dependent patients.

    Science.gov (United States)

    Dunn, Kelly E; Fingerhood, Michael; Wong, Conrad J; Svikis, Dace S; Nuzzo, Paul; Silverman, Kenneth

    2014-02-01

    Employment-based reinforcement interventions have been used to promote abstinence from drugs among chronically unemployed injection drug users. The current study used an employment-based reinforcement intervention to promote opioid and cocaine abstinence among opioid and/or cocaine-dependent, HIV-positive participants who had recently completed a brief inpatient detoxification. Participants (n = 46) were randomly assigned to an abstinence and work group that was required to provide negative urine samples in order to enter the workplace and to earn incentives for work (n = 16), a work-only group that was permitted to enter the workplace and to earn incentives independent of drug use (n = 15), and a no-voucher control group that did not receive any incentives for working (n = 15) over a 26-week period. The primary outcome was urinalysis-confirmed opioid, cocaine, and combined opioid/cocaine abstinence. Participants were 78% male and 89% African American. Results showed no significant between-groups differences in urinalysis-verified drug abstinence or HIV risk behaviors during the 6-month intervention. The work-only group had significantly greater workplace attendance, and worked more minutes per day when compared to the no-voucher group. Several features of the study design, including the lack of an induction period, setting the threshold for entering the workplace too high by requiring immediate abstinence from several drugs, and increasing the risk of relapse by providing a brief detoxification that was not supported by any continued pharmacological intervention, likely prevented the workplace from becoming established as a reinforcer that could be used to promote drug abstinence. However, increases in workplace attendance have important implications for adult training programs.

  8. The value of high-resolution anoscopy in the diagnosis of anal cancer precursor lesions in hiv-positive patients

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    Felicidad Gimenez

    2011-06-01

    Full Text Available CONTEXT: Anal cancer, although a still rare disease, is being observed in ascending rates among some population segments known to be at risk for the development of the disease. Human papillomavirus (HPV infection, immunodepression and anal intercourse are some factors associated with the development of the malignancy. Its similarities to cervical cancer have led to many studies aiming to establish guidelines for detecting and treating precursor lesions of anal cancer, with the goal of prevention. High-resolution anoscopy is routinely used for the diagnosis of anal cancer precursor lesions in many centers but the medical literature is still deficient concerning the role of this diagnostic modality. OBJECTIVES: To evaluate diagnostic validation and precision measures of high-resolution anoscopy in comparison to histopathological results of anal biopsies performed in HIV-positive patients treated at the Tropical Medicine Foundation of Amazonas, AM, Brazil. To observe any possible association between some risk factors for the development of anal cancer and the presence of anal squamous intraepithelial lesions. METHODS: A hundred and twenty-eight HIV-positive patients were submitted to anal canal cytological sampling for the detection of HPV infection by a PCR based method. High-resolution anoscopy was then performed after topical application of acetic acid 3% in the anal canal for 2 minutes. Eventual acetowhite lesions that were detected were recorded in respect to location, and classified by their tinctorial pattern, distribution aspect, relief, surface and vascular pattern. Biopsies of acetowhite lesions were performed under local anesthesia and the specimens sent to histopathological analysis. The patients were interviewed for the presence of anal cancer risk factors. RESULTS: The prevalences of anal HPV infection and of anal squamous intraepithelial lesions in the studied population were, respectively, 79% and 39.1%. High-resolution anoscopy

  9. Evaluation of the 2007 WHO guideline to improve the diagnosis of tuberculosis in ambulatory HIV-positive adults.

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    Olivier Koole

    Full Text Available BACKGROUND: In 2007 WHO issued a guideline to improve the diagnosis of smear-negative and extrapulmonary tuberculosis (EPTB in HIV-positive patients. This guideline relies heavily on the acceptance of HIV-testing and availability of chest X-rays. METHODS AND FINDINGS: Cohort study of TB suspects in four tuberculosis (TB clinics in Phnom Penh, Cambodia. We assessed the operational performance of the guideline, the incremental yield of investigations, and the diagnostic accuracy for smear-negative tuberculosis in HIV-positive patients using culture positivity as reference standard. 1,147 (68.9% of 1,665 TB suspects presented with unknown HIV status, 1,124 (98.0% agreed to be tested, 79 (7.0% were HIV-positive. Compliance with the guideline for chest X-rays and sputum culture requests was 97.1% and 98.3% respectively. Only 35 of 79 HIV-positive patients (44.3% with a chest X-ray suggestive of TB started TB treatment within 10 days. 105 of 442 HIV-positive TB suspects started TB treatment (56.2% smear-negative pulmonary TB (PTB, 28.6% smear-positive PTB, 15.2% EPTB. The median time to TB treatment initiation was 5 days (IQR: 2-13 days, ranging from 2 days (IQR: 1-11.5 days for EPTB, over 2.5 days (IQR: 1-4 days for smear-positive PTB to 9 days (IQR: 3-17 days for smear-negative PTB. Among the 34 smear-negative TB patients with a confirmed diagnosis, the incremental yield of chest X-ray, clinical suspicion or abdominal ultrasound, and culture was 41.2%, 17.6% and 41.2% respectively. The sensitivity and specificity of the algorithm to diagnose smear-negative TB in HIV-positive TB suspects was 58.8% (95%CI: 42.2%-73.6% and 79.4% (95%CI: 74.8%-82.4% respectively. CONCLUSIONS: Pending point-of-care rapid diagnostic tests for TB disease, diagnostic algorithms are needed. The diagnostic accuracy of the 2007 WHO guideline to diagnose smear-negative TB is acceptable. There is, however, reluctance to comply with the guideline in terms of immediate treatment

  10. Trends and predictors of mortality among HIV positive patients in the era of highly active antiretroviral therapy in Uganda

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    John Rubaihayo

    2015-09-01

    Full Text Available Knowledge of mortality trends and predictors among HIV-positive patients in the era of highly active antiretroviral therapy (HAART in resource poor settings is still limited. The aim of this study was to describe trends and predictors of mortality among HIV-positive patients in the era of HAART in Uganda. Data from 2004 to 2013 for adult HIV-positive patients (≥15 years obtaining care and treatment from the AIDS Support Organization in Uganda were reviewed for mortality. Descriptive statistics were analyzed by frequencies and cross tabulations. Calendar period was used as a proxy measure for HAART exposure and a time plot of the proportion of HIV-positive patients reporting dead per year was used to describe the trends. Logistic regression was used to determine the predictors of mortality at bivariate and multivariate levels, respectively. We included in the analysis 95,857 HIV positive patients; 64% were female with median age of 33 years (interquartile range 27-40. Of these 36,133 (38% were initiated on ART and a total of 4279 (4.5% died; 19.5% (835/4279 of those who died had an opportunistic infection. Overall, mortality first increased between 2004 and 2006 and thereafter substantially declined (X2trend=211.9, P<0.001. Mortality was relatively higher in Eastern Uganda compared to other geographical areas. Male gender, older age (>45 years, being from Eastern or Northern Uganda, having none or primary education, being unemployed, advanced immunodeficiency (CD4 count <100 cell/μL or WHO stage III or IV and underweight (<45 kg weight at HAART initiation and calendar period 2004-2008 were significant predictors of mortality (P<0.001. Overall, the expanding coverage of HAART is associated with a declining trend in mortality among HIV positive patients in Uganda. However, mortality trends differed significantly by geographical area and men remain potentially at higher risk of death probably because of delayed initiation on ART. There is urgent

  11. Immune Recovery Syndrome in the HIV-positive patient: Radiological Findings of Paradoxical Reactions; Sindrome de recuperacion inmune en el enfermo positivo al VIH: hallazgos radiologicos de reacciones paradojicas

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    Martinez, E.; Sanchez, M. A.; Torres, M.; Benito, J.; Avila, A. [Hospital Universitario 12 de Octubre. Madrid (Spain)

    2004-07-01

    To describe immune recovery syndrome (IRS) and related radiological findings in HIV-positive patients. To alert radiologists to the ever-increasingly frequent appearance of paradoxical reactions (PR) in granulomatous diseases under antiretroviral treatment. We present a retrospective study of 9 adult HIV-positive patients who showed IRS, 6 cases of tuberculosis (TBC), 2 cases of atypical mycobacterium and a case of sarcoidosis. At the time of IRS/PR diagnosis, any suspicion of infectious activity was excluded through the use of appropriate microbiological tests. clinical and radiological characteristics of the above mentioned cases are analyze here. All patients experienced a clinical and/or radiological worsening of condition following variable periods of antiretroviral and/or anti-tuberculosis treatment, and coinciding with viral load decrease and CD4-T-lymphocyte recovery. Diagnosis of IRS/PR was clinical in five cases and radiological in four. In all but one case, antiretroviral treatment had at some time been previously administered. IRS/PR is a diagnosis of exclusion which must be included in the differential diagnosis of newly appearing lesions or worsening of already existing ones in HIV-positive patients that have recently begun antiretroviral and/or anti-tuberculosis treatment. Such should be done after excluding drug resistance, treatment non-adherence and intercurrent disease. (Author) 8 refs.

  12. Necrotizing Cervical Lymphadenitis Caused by Mycobacterium simiae in an HIV Positive Patient: Imaging with {sup 18F} FDG PET/CT

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    Makis, William [Brandon Regional Health Centre, Brandon (Canada); Rush, Christopher [Jewish General Hospital, McGill Univ., Montreal (Canada)

    2011-09-15

    Mycobacterium simiae is an opportunistic pathogen rarely associated with human disease, although in recent years M. simiae has been detected with increasing frequency in human immunodeficiency virus (HIV) infected patients, usually causing disseminated infection with fever, diarrhea and weight loss. We report the case of an HIV positive man, who was referred for an 1{sup 8F} FDG PET/CT to evaluate a solitary pulmonary nodule. The PET/CT showed incidental large necrotic cervical lymph nodes, compatible with necrotizing cervical lymph adenitis. Biopsy and culture of one of the affected lymph nodes were positive for M. simiae. We present the first report of {sup 18F} FDG PET/CT imaging of an infectious process caused by M. simiae in humans.

  13. Morbidade febril puerperal em pacientes infectadas pelo HIV Puerperal morbidity in HIV-positive women

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    Andrea De Marcos

    2003-04-01

    Full Text Available OBJETIVO: avaliar as taxas de morbidade febril puerperal em pacientes infectadas pelo HIV e sua correlação com a via de parto, duração do trabalho de parto, tempo de rotura de membranas, número de células CD4+ e carga viral do HIV periparto. MÉTODOS: foram incluídas 207 gestantes infectadas pelo HIV, com seguimento pré-natal e parto entre maio de 1997 e dezembro de 2001, sendo 32 submetidas a parto vaginal e 175 a cesárea. Do total de pacientes, 62,8% foram submetidas a cesárea eletiva. A idade média no grupo analisado foi de 27,4 anos, 25,6% eram nulíparas e 26% primíparas, com idade gestacional média de 37,8 semanas no momento do parto. A contagem média de células CD4+ foi de 481 células /mm³ e da carga viral do HIV de 49.100 cópias/mL, ambas no final da gestação. RESULTADOS: a morbidade febril puerperal ocorreu em 34 pacientes, sendo 33 pós-cesárea e 1 pós-parto vaginal. O tipo mais comum de intercorrência infecciosa pós-cesárea foi infecção de cicatriz cirúrgica (13% dos casos de infecção. Os fatores analisados, como duração do trabalho de parto, tempo de rotura de membranas, contagem de células CD4+ ou carga viral do HIV periparto, não interferiram na taxa de morbidade febril puerperal. CONCLUSÕES: A incidência de morbidade febril puerperal foi de 16,8%, sendo mais freqüente pós-cesárea (18,9% que pós-parto vaginal (3,1%. Os demais fatores não mostraram relação significativa com a taxa de morbidade febril puerperal.PURPOSE: the morbidity in HIV-positive patients due to puerperal fever was studied and correlated to the method and duration of labor, the duration of premature rupture of the membranes, CD4+ cell count and the viral load (VL at peridelivery. METHODS: a total of 207 HIV-positive women with prenatal examinations and deliveries between May 1997 and December 2001 were enrolled. Of these, 32 had natural childbirth and 175 had a cesarean section. Of the total of enrolled patients, 62

  14. Routine cranial computed tomography before lumbar puncture in HIV-positive adults presenting with seizures at Mitchells Plain Hospital, Cape Town

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    Salma Moolla

    2015-04-01

    Full Text Available Background: Current international guidelines recommend that a cranial computed tomography (CT be performed on all HIV-positive patients presenting with new onset seizures, before a lumbar puncture (LP is performed. In the South African setting, however,this delay could be life threatening. The present study sought to measure the number of cranial CTs that contraindicate an LP and to predict which clinical signs and symptoms are likely to pose an increased risk from LP.Methods: The study was performed at a district level hospital in Western Cape Province. Data were collected retrospectively from October 2013 to October 2014. Associations between categorical variables were analysed using Pearson’s chi-squared test. Generalised linear regression was used to estimate prevalence ratios.Results: One hundred out of 132 patients were studied. Brain shift contraindicated an LP in 5% of patients. Patients with brain shift presented with decreased level of consciousness, focal signs, headache and neck stiffness. Twenty-five per cent of patients had a space-occupying lesion (SOL (defined as a discrete lesion that has a measurable volume or cerebral oedema. Multivariate analysis showed a CD4 count <50 (p = 0.033 to be a statistically significant predictor of patients with SOL and cerebral oedema. Univariate analysis showed focal signs (p = 0.0001, neck stiffness (p = 0.05, vomiting (p = 0.018 and a Glascow Coma Scale (GCS < 15 (p = 0.002 to be predictors of SOL and cerebral oedema.Conclusion: HIV-positive patients with seizures have a high prevalence of SOL and cerebral oedema but the majority of them are safe for LP. Doctors can use clinical parameters to determine which patients can undergo immediate LP.

  15. Overall and cause-specific excess mortality in HIV-positive persons compared with the general population: Role of HCV coinfection.

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    Alejos, Belén; Hernando, Victoria; Iribarren, Jose; Gonzalez-García, Juan; Hernando, Asuncion; Santos, Jesus; Asensi, Victor; Gomez-Berrocal, Ana; Del Amo, Julia; Jarrin, Inma

    2016-09-01

    We aimed to estimate overall and cause-specific excess mortality of HIV-positive patients compared with the general population, and to assess the effect of risk factors.We included patients aged >19 years, recruited from January 1, 2004 to May 31, 2014 in Cohort of the Spanish Network on HIV/AIDS Research. We used generalized linear models with Poisson error structure to model excess mortality rates.In 10,340 patients, 368 deaths occurred. Excess mortality was 0.82 deaths per 100 person-years for all-cause mortality, 0.11 for liver, 0.08 for non-AIDS-defining malignancies (NADMs), 0.08 for non-AIDS infections, and 0.02 for cardiovascular-related causes. Lower CD4 count and higher HIV viral load, lower education, being male, and over 50 years were predictors of overall excess mortality. Short-term (first year follow-up) overall excess hazard ratio (eHR) for subjects with AIDS at entry was 3.71 (95% confidence interval [CI] 2.66, 5.19) and 1.37 (95% CI 0.87, 2.15) for hepatitis C virus (HCV)-coinfected; medium/long-term eHR for AIDS at entry was 0.90 (95% CI 0.58, 1.39) and 3.83 (95% CI 2.37, 6.19) for HCV coinfection. Liver excess mortality was associated with low CD4 counts and HCV coinfection. Patients aged ≥50 years and HCV-coinfected showed higher NADM excess mortality, and HCV-coinfected patients showed increased non-AIDS infections excess mortality.Overall, liver, NADM, non-AIDS infections, and cardiovascular excesses of mortality associated with being HIV-positive were found, and HCV coinfection and immunodeficiency played significant roles. Differential short and medium/long-term effects of AIDS at entry and HCV coinfection were found for overall excess mortality.

  16. The transplantation of solid organs from HIV-positive donors to HIV-negative recipients: ethical implications.

    Science.gov (United States)

    Wispelwey, Bram P; Zivotofsky, Ari Z; Jotkowitz, Alan B

    2015-05-01

    HIV-positive individuals have traditionally been barred from donating organs due to transmission concerns, but this barrier may soon be lifted in the USA in limited settings when recipients are also infected with HIV. Recipients of livers and kidneys with well-controlled HIV infection have been shown to have similar outcomes to those without HIV, erasing ethical concerns about poorly chosen beneficiaries of precious organs. But the question of whether HIV-negative patients should be disallowed from receiving an organ from an HIV-positive donor has not been adequately explored. In this essay, we will discuss the background to this scenario and the ethical implications of its adoption from the perspectives of autonomy, beneficence/non-maleficence and justice.

  17. Epidemiology of HPV in HIV-positive and HIV-negative fertile women in Cameroon, West Africa.

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    Desruisseau, Andrew J; Schmidt-Grimminger, Delf; Welty, Edith

    2009-01-01

    HPV types vary by country and HIV status. There are no data on the prevalent HPV genotypes from Cameroon. We conducted a cross-sectional, observational study on 65 Cameroonian women. Samples were sent for HPV genotyping and Thin Prep analyses. 41 out of 61 samples tested (67.2%) had HPV subtypes detected. The most common high risk types encountered were: 45 (24.6%) and 58 (21.5%). HIV-positive women were more likely to test positive for any HPV (P = .014), have more than one HPV subtype (P = .003), and to test positive for the high risk subtypes (P = .007). Of those with high risk HPV, HIV-positive women were more likely to have Thin Prep abnormalities than HIV-negative women (P = .013). Oncogenic HPV subtypes 45 and 58 were more prevalent than those subtypes carried in the quadrivalent vaccine. Further studies are needed to assess whether the current vaccine will be effective in this region.

  18. Stress and coping in HIV-positive former plasma/blood donors in China: a test of cognitive appraisal theory.

    Science.gov (United States)

    Meade, Christina S; Wang, Jianping; Lin, Xiuyun; Wu, Hao; Poppen, Paul J

    2010-04-01

    Throughout the 1990s, many villagers in rural China were infected with HIV through commercial plasma/blood donation. These former plasma/blood donors (FPDs) experienced many HIV-related stressors. This study tested a cognitive appraisal model of stress and coping in a sample of HIV-positive adult FPDs. Participants (N = 207) from multiple villages completed a battery of questionnaires assessing HIV-related stress, HIV symptoms, cognitive appraisal, coping behaviors, and psychological distress. Participants reported high levels of HIV-related stress, depression, and anxiety. In a structural equation model, greater HIV-related stress, HIV symptoms, and threat appraisal were directly associated with psychological distress. HIV-related stress was also indirectly associated with psychological distress through threat appraisal. In a second model, coping was found to mediate the relationship between challenge appraisal and psychological distress. Results support the utility of cognitive appraisal theory. Stress management interventions targeting HIV-positive FPDs in China are indicated.

  19. Management of chronic hepatitis B in an HIV-positive patient with 3TC-resistant hepatitis B virus.

    Science.gov (United States)

    Ristig, Maria; Drechsler, Henning; Crippin, Jeffrey; Lisker-Melman, Mauricio; Tebas, Pablo

    2003-09-01

    Chronic viral hepatitis has emerged as one of the leading causes of morbidity and mortality among HIV-positive patients. These individuals are at risk for aggressive chronic active hepatitis, cirrhosis, and hepatocellular carcinoma, and eventually, death. Currently available therapies for hepatitis B are limited and include interferon-alpha, lamivudine (3TC), and adefovir. Tenofovir (TDF), a recently approved drug for the treatment of HIV, is also active against hepatitis B. We report the case of a HIV-positive patient with liver cirrhosis secondary to chronic hepatitis B virus (HBV) with evidence of resistance to 3TC. The patient was initially accepted as a liver transplant candidate. However, when TDF was added to his treatment, a remarkable virologic and histopathologic improvement was achieved. The patient was subsequently removed from the liver transplant program and has not suffered from any further hepatic complications.

  20. Use of North America's first medically supervised safer injecting facility among HIV-positive injection drug users.

    Science.gov (United States)

    Reddon, Hudson; Wood, Evan; Tyndall, Mark; Lai, Calvin; Hogg, Robert; Montaner, Julio; Kerr, Thomas

    2011-10-01

    The objective of this study was to examine supervised injecting facility (SIF) use among a cohort of 395 HIV-positive injection drug users (IDUs) in Vancouver, Canada. The correlates of SIF use were identified using generalized estimating equation analyses. In multivariate analyses, frequent SIF use was associated with homelessness (adjusted odds ratio [AOR] = 1.90), daily heroin injection (AOR = 1.56), and daily cocaine injection (AOR = 1.59). The reasons given for not using the SIF included a preference for injecting at home and already having a safe place to inject. The SIF services most commonly used were needle exchange and nursing services. The SIF appears to have attracted a high-risk subpopulation of HIV-positive IDUs; this coverage perhaps could be extended with the addition of HIV-specific services such as disease monitoring and the provision of antiretroviral therapy.

  1. HIV treatment optimism and sexual risk behaviors among HIV positive African American men who have sex with men.

    Science.gov (United States)

    Peterson, John L; Miner, Michael H; Brennan, David J; Rosser, B R Simon

    2012-04-01

    The association between HIV treatment optimism--beliefs about susceptibility to transmit HIV, motivation to use condoms, and severity of HIV--and sexual risk behavior was examined among HIV-positive African American men who have sex with men (MSM). Participants were 174 men recruited in four major metropolitan areas of the United States to participate in a weekend HIV risk reduction intervention. Baseline results revealed that beliefs in less susceptibility to transmit HIV and less motivation to use condoms were significantly associated with more unprotected anal intercourse among serodiscordant casual partners. Less motivation to use condoms also predicted more unprotected insertive and receptive anal sex and was more important than susceptibility beliefs in predicting these behaviors. Suggestions are offered of ways to better inform HIV-positive African American MSM about their misperceptions about HIV treatment and how their level of optimism about HIV treatment may diminish or encourage condom use.

  2. Forms of Stigma and Discrimination in the Daily Lives of HIV-Positive Individuals in Mauritania.

    Science.gov (United States)

    Mohamed Boushab, Boushab; Fatim-Zahra, Malick Fall; Cheikh Melaïnine Mohamed Limame, Ould; Leonardo Kishi, Basco

    2017-01-01

    People living with HIV/AIDS (PLWHA) are often discriminated against in their daily lives. The objective of this descriptive and transversal study was to describe the experiences of PLWHA followed at a specialized outpatient center in Nouakchott to assess the forms of stigma from the perspective of those who suffer from discrimination. All HIV-positive patients over the age of 18 years who were aware of their HIV status and provided consent to participate in the study were included from June 1 to 29, 2015. Data collection was conducted using a pre-tested questionnaire. A total of 210 PLWHA were interviewed. Men accounted for 54% of the sample population with a sex ratio of 1.2. About half of respondents were married (51%) and resided in Nouakchott (55%). Subjects who had never attended school represented 42% of the cases. Among our respondents, 64% knew their HIV status for over a year and admitted that they refused to reveal this information to any person. The distribution of forms of stigma experienced by PLWHA by demographic category was, in descending order, stigma in interpersonal relationships (78%), self-stigma (20%), and stigma in health services (2%). There was a significant association between the form of stigma and marital status (p = 0.007) and between the form of stigma and knowledge of HIV status for a period greater than one year (p = 0.02). The forms of stigma can be sources of discrimination and are a major obstacle to reintegration and support of PLWHA. This creates a vicious circle that, on the one hand, leads to the suffering, marginalization, and isolation of PLWHA, and on the other hand, has deleterious effects on their family and social relationships, self-esteem and self-confidence.

  3. Testing HIV positive in pregnancy: A phenomenological study of women's experiences.

    Science.gov (United States)

    Lingen-Stallard, Andrew; Furber, Christine; Lavender, Tina

    2016-04-01

    globally women receive HIV testing in pregnancy; however, limited information is available on their experiences of this potentially life-changing event. This study aims to explore women's experiences of receiving a positive HIV test result following antenatal screening. a qualitative, phenomenological approach. two public National Health Service (NHS) hospitals and HIV support organisations. a purposive sampling strategy was used. Thirteen black African women with a positive HIV result, in England, participated. data were collected using in-depth semi-structured interviews. An interpretive phenomenological approach to data analysis was used. the emergent phenomenon was transition and transformation of 'being,' as women accepted HIV as part of their lives. Paired themes support the phenomenon: shock and disbelief; anger and turmoil; stigma and confidentiality issues; acceptance and resilience. Women had extreme reactions to their positive HIV diagnosis, compounded by the cultural belief that they would die. Initial disbelief of the unexpected result developed into sadness at the loss of their old self. Turmoil was evident, as women considered termination of pregnancy, self-harm and suicide. Women felt isolated from others and relationship breakdowns often occurred. Most reported the pervasiveness of stigma, and how this was managed alongside living with HIV. Coping strategies included keeping HIV 'secret' and making their child(ren) the prime focus of life. Growing resilience was apparent with time. this study gives midwives unique understanding of the complexities and major implications for women who tested positive for HIV. Women's experiences resonated with processes of bereavement, providing useful insight into a transitional and transformational period, during which appropriate support can be targeted. midwives are crucial in improving the experience of women when they test HIV positive and to do this they need to be appropriately trained. Midwives need to

  4. The Effect of Cryotherapy on Human Papillomavirus Clearance among HIV-positive Women in Lusaka, Zambia

    Science.gov (United States)

    Katundu, Katundu; Bateman, Allen C.; Pfaendler, Krista S.; Mwanahamuntu, Mulindi H.; Kapambwe, Sharon; Vermund, Sten H.; Sahasrabuddhe, Vikrant V.; Msadabwe, Susan C.; Stringer, Jeffrey S.A.; Parham, Groesbeck P.; Chibwesha, Carla J.

    2015-01-01

    Objective We sought to investigate the progression of human papillomaviruses (HPV) infection in HIV-positive women after cryotherapy. Methods We examined changes in detection of high-risk HPV (hrHPV) cervical infections among HIV-infected women over a 12-week period following cryotherapy using stored specimens from a cohort study conducted between June 2009 and March 2011 in Lusaka, Zambia. Samples from visits at baseline and weeks 4, 8, and 12 were tested using the Roche Linear Array assay. Results A total of 89 women were included in the analysis. The median age was 32 years (interquartile range [IQR]: 28–36 years). The median CD4+ cell count was 350 cells/μL (IQR: 214–470 cells/μL) and 66% of women were receiving antiretroviral therapy. At baseline, the prevalence of hrHPV was 91% (95% confidence interval [CI]: 83–95%). HPV45 was the most common HPV type, present in (30%) women, followed by HPV16 (27%), HPV18 (27%), HPV51 (20%), and HPV58 (22%). Among women with valid results both at baseline and 12 weeks, 17/67 (25%) cleared their initial hrHPV infection within 12 weeks of treatment, though 65% (11/17) had new hrHPV types detected. Conclusions Cryotherapy led to clearance of 25% of hrHPV infections within 12 weeks of treatment. However, hrHPV infection remained persistent in most women and new hrHPV types were detected often, explaining the high rate of persistence and recurrence of cervical disease in this population. Continued efforts to scale-up HPV vaccination and cervical screening should remain a priority in high HIV burden settings such as Zambia. PMID:26125097

  5. Developing a Nicotine Patch Adherence Intervention for HIV-positive Latino Smokers

    Science.gov (United States)

    Shadel, William G.; Galvan, Frank H.; Tucker, Joan S.

    2016-01-01

    This paper describes two phases of formative research that were undertaken to develop a smoking cessation treatment module that has the goal of improving adherence with the nicotine patch in HIV-positive Latino smokers. Each research phase (Phase I and II) was conducted independent of the other and used different methods to inform the development of the intervention. Phase I interviewed n=14 smokers who had previous experience using the nicotine patch to gain detailed understanding of how, when, and why they used it; their perceived barriers to using it; and their perspective on ways to improve adherence to it. Phase II provided n=35 smokers with brief smoking cessation treatment and nicotine patches, then interviewed them in “near real time” over a two month period about their use of the patch during a quit attempt (e.g., perceived barriers and facilitators). Authors of the paper conducted a qualitative analysis of the themes emerging from the interview transcripts across these two phases. Results indicated that consistent use of the nicotine patch was associated with maintaining high motivation for use (i.e., not necessarily motivation to quit, but motivation to continue patch use); linking its use with established daily routines (e.g., with taking other medications, with brushing teeth); and maintaining realistic expectations for patch efficacy (e.g., that users may still experience some level of craving and/or withdrawal). This information will used to develop and pilot test a brief treatment module that focuses on improving nicotine patch adherence. PMID:27070097

  6. Anal HPV infection in HIV-positive men who have sex with men from China.

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    Lei Gao

    Full Text Available BACKGROUND: Anal HPV infection, which contributes to the development of anal warts and anal cancer, is well known to be common among men who have sex with men (MSM, especially among those HIV positives. However, HIV and anal HPV co-infection among MSM has not been addressed in China. METHODS: A cross-sectional study was conducted in Beijing and Tianjin, China. Study participants were recruited using multiple methods with the collaboration of local volunteer organizations. Blood and anal swabs were collected for HIV-1 serological test and HPV genotyping. RESULTS: A total of 602 MSM were recruited and laboratory data were available for 578 of them (96.0%. HIV and anal HPV prevalence were 8.5% and 62.1%, respectively. And 48 MSM (8.3% were found to be co-infected. The HPV genotypes identified most frequently were HPV06 (19.6%, HPV16 (13.0%, HPV52 (8.5% and HPV11 (7.6%. Different modes of HPV genotypes distribution were observed with respect to HIV status. A strong dose-response relationship was found between HIV seropositivity and multiplicity of HPV genotypes (p<0.001, which is consistent with the observation that anal HPV infection was an independent predictor for HIV infection. CONCLUSIONS: A high prevalence of HIV and anal HPV co-infection was observed in the MSM community in Beijing and Tianjin, China. Anal HPV infection was found to be independently associated with increased HIV seropositivity, which suggests the application of HPV vaccine might be a potential strategy to reduce the acquisition of HIV infection though controlling the prevalence of HPV.

  7. Colagenoma eruptivo em paciente HIV+ Eruptive collagenoma in an HIV-positive patient

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    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.

  8. Identification of psychobiological stressors among HIV-positive women. HIV Neurobehavioral Research Center (HNRC) Group.

    Science.gov (United States)

    Semple, S J; Patterson, T L; Temoshok, L R; McCutchan, J A; Straits-Tröster, K A; Chandler, J L; Grant, I

    1993-01-01

    This research describes major stressors in the lives of women who have been infected with the human immunodeficiency virus (HIV). Thirty-one HIV antibody positive (HIV+) women infected primarily through heterosexual contact participated in a two hour semi-structured interview detailing the circumstances, context, and consequences of all stressful life events and difficulties experienced within the preceding six months. Qualitative methods of data analyses were utilized (Miles & Huberman, 1984). HIV-related life events and difficulties were classified into primary and secondary stressors based on the stress process model (Pearlin et al., 1981). Problems arising directly from one's seropositivity were defined as primary stressors. Stressful life events and difficulties occurring in other role areas were defined as secondary stressors. Six categories of HIV-related stressors were identified and quantified. Primary stressors were health-related, and included both gynecological problems (e.g., amenorrhea) and general symptoms of HIV infection (e.g., fatigue). Secondary stressors related to child and family (e.g., future guardianship of children), marital/partner relations (e.g., disclosure of HIV+ status), occupation (e.g., arranging time-off for medical appointments), economic problems (e.g., insurance "hassles"), and social network events (e.g., death of friends from AIDS). This research indicates that HIV-positive women are exposed to multiple stressors; some may be viewed as unique to women, whereas others may be considered common to both sexes. Identification of stressors has implications for the design of medical and psychiatric interventions for women.

  9. Evaluation of adverse drug reactions in HIV positive patients in a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Anshu Kumar Jha

    2015-01-01

    Full Text Available Context: The advancement and development of new drugs and treatment strategies increase the risk of unusual Adverse Events (AEs in HIV patients. Aims: The objective of our study was to assess the incidence, types and nature of AEs in HIV positive subjects. Settings and Design: Patients with WHO stage IV disease irrespective of the CD4 cell count, or WHO stage III disease with a CD4 cell count <350 cell/cu. Mm, or, WHO stage I or II disease with a CD4 cell count of <200 cells/cu. mm, and on prior anti-retroviral therapy for not more than six months preceding the observation date, were included in the study. After initiation of therapy, the patients were examined for the occurrence any adverse events including the type and severity, or any other abnormal laboratory findings. Causality assessment of the adverse events was done using the Naranjo′s scale. Results: Out of 327 patients studied prospectively, 43 patients developed AEs. Out of these, 23 (53.5% were males and 20 (46.5% were females. A total of 53 (16.21% AEs were reported. Antitubercular drugs caused the maximum AEs (28.3% followed by zidovudine (20.7%, nevirapine (15.0% and efavirenz (5.6%. Stavudine, ethambutol, sulfamethoxazole and trimethoprim, and atazanavir were also responsible for 3.7% of AEs individually. Causality assessment done according to the Naranjo′s scale revealed that 66.04% AEs were ′probable′ and 33.96% were ′possible′. Conclusions: Anemia, hepatitis and dermatological adverse effects are the most common AEs. Antitubercular drugs contributed significantly for the incidence of AEs in these patients. Frequency of AEs was slightly more in males compared to females.

  10. Orofacial manifestations in HIV positive children attending Mildmay Clinic in Uganda.

    Science.gov (United States)

    Nabbanja, Juliet; Gitta, Sheba; Peterson, Stefan; Rwenyonyi, Charles Mugisha

    2013-01-01

    The aim of this study was to assess the orofacial manifestations and their influence on oral function in human immunodeficiency virus (HIV) positive children attending Mildmay Clinic in Uganda. This was a cross-sectional study based on clinical examination, medical records and a structured questionnaire of 368 children aged between 1.5 and 17 years. The clinical examination for dental caries was based on decayed, extracted and filled teeth (deft) and decayed, missing and filled teeth (DMFT) indices as defined by World Health Organisation. The soft tissue orofacial lesions were assessed using the classification and diagnostic criteria as described by the Collaborative Workgroup on the Oral Manifestations of Pediatric HIV Infections. Approximately 67.4% of the children were on highly active antiretroviral therapy (HAART). The majority (77.4%) of the children had at least one orofacial lesion associated with HIV, pseudomembranous candidiasis being the most prevalent. Overall, 61.7% of the children with orofacial lesions reported at least one form of discomfort in the mouth. Discomfort was particularly associated with swallowing. The prevalence of orofacial lesions was significantly higher in children with poor oral hygiene and lower in those on HAART than in their respective counterparts. The CD4+ cell count, age and gender of the children did not significantly influence the distribution of orofacial lesions. The mean deft and DMFT scores were 11.8 and 2.7, respectively. The d- and D-components contributed 54.7 and 42.1%, respectively. Consumption of sugary snacks was directly associated with dental caries. Despite these children attending an HIV care centre of excellence, they have a high prevalence of orofacial manifestations associated with HIV. The majority of the children experienced discomfort in the oral cavity, particularly during swallowing.

  11. Mutations associated with occult hepatitis B in HIV-positive South Africans.

    Science.gov (United States)

    Powell, Eleanor A; Gededzha, Maemu P; Rentz, Michael; Rakgole, Nare J; Selabe, Selokela G; Seleise, Tebogo A; Mphahlele, M Jeffrey; Blackard, Jason T

    2015-03-01

    Occult hepatitis B is characterized by the absence of hepatitis B surface antigen (HBsAg) but the presence of HBV DNA. Because diagnosis of hepatitis B virus (HBV) typically includes HBsAg detection, occult HBV remains largely undiagnosed. Occult HBV is associated with increased risk of hepatocellular carcinoma, reactivation to chronic HBV during immune suppression, and transmission during blood transfusion and liver transplant. The mechanisms leading to occult HBV infection are unclear, although viral mutations are likely a significant factor. In this study, sera from 394 HIV-positive South Africans were tested for HBV DNA and HBsAg. For patients with detectable HBV DNA, the overlapping surface and polymerase open reading frames (ORFs) were sequenced. Occult-associated mutations-those mutations found exclusively in individuals with occult HBV infection but not in individuals with chronic HBV infection from the same cohort or GenBank references-were identified. Ninety patients (22.8%) had detectable HBV DNA. Of these, 37 had detectable HBsAg, while 53 lacked detectable surface antigen. The surface and polymerase ORFs were cloned successfully for 19 patients with chronic HBV and 30 patients with occult HBV. In total, 235 occult-associated mutations were identified. Ten occult-associated mutations were identified in more than one patient. Additionally, 15 amino acid positions had two distinct occult-associated mutations at the same residue. Occult-associated mutations were common and present in all regions of the surface and polymerase ORFs. Further study is underway to determine the effects of these mutations on viral replication and surface antigen expression in vitro.

  12. Functional analysis of 'a' determinant mutations associated with occult HBV in HIV-positive South Africans.

    Science.gov (United States)

    Powell, Eleanor A; Boyce, Ceejay L; Gededzha, Maemu P; Selabe, Selokela G; Mphahlele, M Jeffrey; Blackard, Jason T

    2016-07-01

    Occult hepatitis B is defined by the presence of hepatitis B virus (HBV) DNA in the absence of hepatitis B surface antigen (HBsAg). Occult HBV is associated with the development of hepatocellular carcinoma, reactivation during immune suppression, and virus transmission. Viral mutations contribute significantly to the occult HBV phenotype. Mutations in the 'a' determinant of HBsAg are of particular interest, as these mutations are associated with immune escape, vaccine escape and diagnostic failure. We examined the effects of selected occult HBV-associated mutations identified in a population of HIV-positive South Africans on HBsAg production in vitro. Mutations were inserted into two different chronic HBV backbones and transfected into a hepatocyte-derived cell line. HBsAg levels were quantified by enzyme-linked immunosorbent assay (ELISA), while the detectability of mutant HBsAg was determined using an HA-tagged HBsAg expression system. Of the seven mutations analysed, four (S132P, C138Y, N146D and C147Y) resulted in decreased HBsAg expression in one viral background but not in the second viral background. One mutation (N146D) led to a decrease in HBsAg detected as compared to HA-tag, indicating that this mutation compromises the ability of the ELISA to detect HBsAg. The contribution of occult-associated mutations to the HBsAg-negative phenotype of occult HBV cannot be determined adequately by testing the effect of the mutation in a single viral background, and rigorous analysis of these mutations is required.

  13. Recruitment of HIV-Positive Women in Research: Discussing Barriers, Facilitators, and Research Personnel’s Knowledge

    Science.gov (United States)

    Loutfy, Mona R; V, Logan Kennedy; Mohammed, Saira; Wu, Wei; Muchenje, Marvelous; Masinde, Khatundi; Salam, Khaled; Soje, Lena; Gregorovich, Sandra; Tharao, Wangari

    2014-01-01

    Background : Women have historically been under-represented in HIV research, partly due to ineffective recruitment strategies. Objective : To improve the existing understanding of recruitment for HIV-positive women based on a province-wide cross-sectional study. Methods : A survey was emailed to all site coordinators who recruited participants in a study involving 490 HIV-positive women living in Ontario, Canada. The survey consisted of questions regarding the important recruitment barriers and successes. Quantitative data were then contextualized within extensive knowledge from research personnel and team members. Results : Completed surveys were received from (89%) site coordinators (34/38) and 98% (31/34) were women. The highest ranked recruitment barriers identified were: sensitivity of the research topic (59%), time/availability constraints (59%), language barriers (53%), HIV disclosure/stigma issues (47%), lack of trust of research personnel (41%), fear of research (41%) and inaccessibility to child care and transportation (41%). The respondents felt that the most important personal attributes for recruitment were research personnel who were respectful (97%), skilled (91%), flexible (88%) and empathetic (88%) and had good communication skills (88%). The most successful recruitment strategies identified were: developing a strong rapport (88%) that was facilitated by an empathetic relationship (100%), acknowledging the sensitive nature of the research topic (94%), providing cash financial compensation (88%), and developing recruitment strategies unique to women (88%). Conclusion : There are differences in the approaches needed for the recruitment of HIV-positive women in research. For successful recruitment of HIV-positive women, a strong rapport between the research personnel and study participants is important. This rapport is facilitated by having study personnel who are respectful, trustworthy, empathetic, and flexible. Population-specific recruitment

  14. Lipodystrophy syndrome and self-assessment of well-being and physical appearance in HIV-positive patients.

    Science.gov (United States)

    Oette, Mark; Juretzko, Petra; Kroidl, Arne; Sagir, Abdurrahman; Wettstein, Matthias; Siegrist, Johannes; Häussinger, Dieter

    2002-09-01

    The lipodystrophy syndrome (LDS) is a growing problem in human immunodeficiency virus (HIV)-positive patients treated with highly active antiretroviral therapy (HAART). It is characterized by alterations of body composition and metabolic abnormalities. The goal of the study was to investigate attitudes toward health condition, well-being, and individual appearance in relation to LDS. Outpatients between July and October 2000 in an HIV-specialized unit at the University Hospital of Düsseldorf, Germany, underwent clinical evaluation and received a standardized written questionnaire. Of 389 patients eligible for analysis, 313 patients returned completed questionnaires (response rate, 80.5%). LDS was observed in 37.7%; the predominant manifestation was lipoatrophy of the face (32.9%). Individuals with and without LDS did not differ significantly in their attitude to the quality of their health condition and the amount of disturbance of their well-being by HIV infection. Participants with LDS felt recognizable as HIV-positive by physical appearance in 30.1%, compared to 18.3% in patients without LDS (p = 0.027). This difference became more pronounced after adjustment for gender, age, stage of disease, CD4 cell count, and duration of HAART (odds ratio, 2.04, 95%-confidence interval [CI] 1.09-3.84). In conclusion, LDS does not seem to disturb the general attitude toward health condition and well-being. However, patients presenting with lipodystrophy are about twice as likely to feel recognizable as HIV-positive by their physical appearance. LDS may thus be perceived as a characteristic mark of being HIV-positive by affected persons. A stigmatizing effect and social disadvantages may be the consequences.

  15. Meningeal Hemangiopericytoma with Intracranial Metastases in an HIV-Positive Male: Case Report and Review of the Literature

    OpenAIRE

    2012-01-01

    Background: Meningeal hemangiopericytoma is a rare, aggressive CNS tumor that tends to invade locally, metastasize, and has a high rate of recurrence. HIV classically increases the risk of 3 AIDS-defining malignancies: Kaposi’s sarcoma, non-Hodgkin’s lymphoma and invasive cervical cancer. More recently, considerable interest has been paid to the link between HIV and a wider range of non-AIDS-defining cancers. An HIV-positive patient with meningeal hemangiopericytoma is described. Case Descrip...

  16. Diagnosis of pulmonary infection with Toxoplasma gondii in immunocompromised HIV-positive patients by real-time PCR

    DEFF Research Database (Denmark)

    Petersen, E.; Edvinsson, B.; Lundgren, Bettina;

    2006-01-01

    The aim of the study presented here was to evaluate the use of PCR for improving the diagnosis of Toxoplasma gondii infection in immunocompromised hosts. Three hundred thirty-two bronchoalveolar lavage (BAL) fluid samples were analyzed by real-time PCR targeting a 529 bp element of T. gondii...... be performed in all immunosuppressed HIV-positive patients with symptoms of a systemic infection of unknown etiology. Trimethoprim-sulfamethoxazole prophylaxis does not exclude concomitant infection with T. gondii....

  17. Modeling the Relationship between Trauma and Psychological Distress among HIV-Positive and HIV-Negative Women

    OpenAIRE

    Delany-Brumsey, A; Joseph, NT; Myers, HF; Ullman, JB; Wyatt, GE

    2013-01-01

    This study investigated the association between cumulative exposure to multiple traumatic events and psychological distress, as mediated by problematic substance use and impaired psychosocial resources. A sample of HIV-positive and HIV-negative women were assessed for a history of childhood and adult sexual abuse and non-sexual trauma as predictors of psychological distress (i.e., depression, non-specific anxiety, and posttraumatic stress), as mediated by problematic alcohol and drug use and ...

  18. Predictors of return rate for an HIV-positive result in a French Voluntary Counseling and Testing centre.

    Science.gov (United States)

    Pahlavan, Golriz; Burdet, Charles; Laouénan, Cédric; Guiroy, Frédérique; Bouscarat, Fabrice; Tosini, William; Yazdanpanah, Yazdan; Bouvet, Elisabeth

    2015-01-01

    Bichat Hospital's free and anonymous Voluntary Counseling and Testing centre in Paris is widely visited, with a high rate of HIV-positive diagnosis. This study proposed, in this centre, to describe the HIV newly-diagnosed patients over an 8-year period and to determinate risk factors for failure to return for a positive result. Higher risk for failure to return was found among the heterosexual subjects regardless of their socio-economic background.

  19. Treatment of anal dysplasia in HIV-positive men who have sex with men in a large AIDS reference centre.

    Science.gov (United States)

    Willems, Nathalie; Libois, Agnès; Nkuize, Marcel; Feoli, Francesco; Delforge, Marc; DeWit, Stéphane

    2017-02-01

    Over the last few decades, incidence of anal cancer among HIV-positive men has been on the rise. In this context, programmes of screening and treatment of anal dysplasia which is a precursor of anal cancer have been developed. The aim of our study was to describe the efficiency, side effects and outcome of anal dysplasia treatment in a population of HIV-positive men who have sex with men (MSM). We performed a retrospective study of HIV-positive MSM who received treatment for anal dysplasia between May 2010 and February 2014 in the Saint-Pierre University Hospital, Brussels. The different treatments used were electrocautery (ECA), infrared coagulation (IRC), surgical treatment and imiquimod. Seventy-three HIV-infected MSM were included in the study, counting 62% of HGAIN. Median age was 41 years. Eighty-one per cent were on HAART. Median CD4 cell count was 525 cell/mm³, and 65% had undetectable viral loads. A total of 139 therapeutic interventions were recorded during the study period, and two-thirds of the enrolled patients received more than one treatment. At 540 days of follow-up, the rate of treatment response was 62%. Fifty per cent of the persistent HGAIN were metachronous lesions. No severe adverse events were recorded but frequent treatment-associated discomfort was reported, such as pain, self-limited bleeding, infection and anal irritation. Treatment of anal dysplasia appears to be safe and to offer short-term efficiency. However, its long-term efficiency remains unknown, especially in the HIV-positive population in which spontaneous clearance is lower and rate of recurrence higher.

  20. Study of Hiv Positive Cases Attending Voluntary Counseling and Testing Centre of Baroda – A Gender Perspective

    Directory of Open Access Journals (Sweden)

    Shaikh Mohsin, Misra Shobha, Rakesh Shah, Sunil Nayak

    2010-12-01

    Full Text Available The global estimates of HIV/AIDS cases and especially the growing number of women and children being infected and affected by it, raises serious concern. In the absence of a vaccine or cure for HIV infection, our only option is to promote awareness and behaviour change for primary prevention of HIV. Aims: 1. To study the socio-demographic characteristic of HIV positive cases. 2. To find out the possible high risk behaviour of having acquired HIV/AIDS and 3. To understand the social support system and gender discrimination. Settings & Design: It is a Cross Sectional Study conducted in VCTC – Baroda. Methods and Material: A semi structured and pretested proforma is used to interview HIV positive patients attending VCTC located at Sayaji Hospital, Vadodara. Prior verbal and written consent was taken before starting each interview. This study included 100 HIV positive cases (>13 years attending VCTC during April-July 2007. Results: The present study included 100 individuals with equal ratio of male and female, 79% were in age group 20-40 years, 92% were literate and 87% were married. In 45 % cases, spouse was HIV positive while 38 % cases didn’t know the HIV status of their spouse. More males presented with history of premarital sex (83 %, extramarital sex (64 %, multiple sex partners (84 % and sexual activity (76 % even after HIV infection. More number of females experienced careless behaviour/neglect (65 % after HIV status disclosure to their spouse while 71 % females experienced careless behaviour from their family. Conclusions: More males were presented with premarital, extramarital sex and multiple sex partners and females were more vulnerable because of male dominance and their economic dependency on others.

  1. Contraception for the HIV-Positive Woman: A Review of Interactions between Hormonal Contraception and Antiretroviral Therapy

    OpenAIRE

    2012-01-01

    Background. Preventing unintended pregnancy in HIV-positive women can significantly reduce maternal-to-child HIV transmission as well as improve the woman's overall health. Hormonal contraceptives are safe and effective means to avoid unintended pregnancy, but there is concern that coadministration of antiretroviral drugs may alter contraceptive efficacy. Materials and Methods. We performed a literature search of PubMed and Ovid databases of articles published between January 1980 and Februar...

  2. 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.

    2015-01-01

    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/mm3; 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. PMID:25681375

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

    OpenAIRE

    Toth, Steven; A. York, Jill; DePinto, Nicholas

    2016-01-01

    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 Ber...

  4. The converging and diverging characteristics of HIV-positive and HIV-negative gay men in the Australian Gay Community Periodic Surveys, 2000-2009.

    Science.gov (United States)

    Holt, Martin; Lee, Evelyn; Prestage, Garrett P; Zablotska, Iryna; de Wit, John; Mao, Limin

    2013-01-01

    To assess the changing health promotion needs of human immunodeficiency virus (HIV)-positive gay men in Australia, we analysed the social and behavioural characteristics of HIV-positive men in the Australian Gay Community Periodic Surveys. We looked at change over time in the characteristics of HIV-positive men (from 2000-2001 to 2008-2009) and compared HIV-positive men with their HIV-negative peers within each time period. Multivariate logistic regression analysis was used to assess independent changes over time within each HIV status group. A total of 21,620 responses were included in the analyses; 10,537 in 2000-2001 and 11,083 in 2008-2009. Between the two time periods, HIV-positive and HIV-negative men became more similar in the following areas: paid employment, sexual identity, number of male sex partners, the likelihood of having a regular male partner and having a seroconcordant regular male partner. The two groups diverged in these areas: age, ethnicity, educational level, social engagement with gay men, types of relationship with regular male partners, likelihood of unprotected anal intercourse with casual male partners and likelihood of HIV disclosure to casual male partners. Workforce participation and educational attainment have improved among HIV-positive gay men since 2000, but they still lag behind their HIV-negative peers in these areas. Because HIV-positive men are an ageing cohort, support services will need to increasingly address issues of HIV, sexuality and ageing with HIV-positive men. The increase in unprotected anal intercourse and HIV disclosure with casual partners means that education and support services will increasingly need to address effective HIV disclosure and non-condom-based risk reduction strategies with both HIV-positive and HIV-negative gay men.

  5. Nonsurgical Management of Severe Osteonecrosis of the Knee in an HIV-Positive Patient: A Case Report

    Directory of Open Access Journals (Sweden)

    Stephanie A. Nixon

    2011-01-01

    Full Text Available Due to the life-prolonging effects of combination antiretroviral therapy, many people with HIV are living longer. However, this enhanced longevity is often mirrored by increased disability resulting from HIV and/or the adverse effects of medication. Management of HIV-positive patients is further complicated by comorbidities related to aging, including bone and joint disorders. In this paper, we describe the nonsurgical management of an HIV-positive patient with premature onset of severe osteonecrosis of the knee. A 50-year-old man who had been HIV-positive for 16 years and on combination antiretroviral therapy for 11 years presented to his family physician with extreme discomfort in his right knee. He was diagnosed with osteonecrosis of the right knee, but resisted total knee arthroplasty because of potential complications under anesthesia related to comorbid advanced liver disease. Instead, a successful combination of non-surgical management strategies was employed by the patient and his health care team.

  6. A qualitative analysis of partner selection, HIV serostatus disclosure, and sexual behaviors among HIV-positive urban men.

    Science.gov (United States)

    Relf, Michael V; Bishop, Tammi L; Lachat, Maryanne F; Schiavone, Deborah B; Pawlowski, Lora; Bialko, Matthew F; Boozer, Diedre L; Dekker, Debra

    2009-06-01

    Using grounded theory, 18 interviews with HIV-positive urban men were conducted to understand their sexual relationships. Analysis of the verbatim transcripts revealed that regardless of age, sexual orientation or race/ethnicity, the participants were "making choices" related to their sexual relationships. Some men were "avoiding sex" whereas others were engaging in "just sex" or having sex in a relationship that was "going somewhere." However, dependent upon the type of sexual relationship, these HIV-positive urban men struggled with issues associated with "disclosure" of serostatus, the sexual "behaviors" in which they engaged, and selecting sexual "partners." Health care providers can facilitate sexual health and well-being among HIV-positive urban men by recognizing that men may be seeking sexual intimacy for different purposes, in different types of relationships, or avoiding it entirely. By exploring these decision-making processes, it is possible to facilitate sexual relationships that prevent new infections as well as manage the dissonance associated with this decision-making associated with disclosure, behaviors and their sexual partners.

  7. HIV-positive patients’ perceptions of care received at a selected antiretroviral therapy clinic in Vhembe district, South Africa

    Directory of Open Access Journals (Sweden)

    Tshifhiwa V. Ndou

    2016-03-01

    Full Text Available Background: Patients’ experiences are a reflection of what has happened during the care process and, therefore, provide information about the performance of health care professional workers. They refer to the process of care provision at the antiretroviral therapy (ART sites.Aim and setting: This article explored the perceptions of HIV-positive patients of care received at the Gateway Clinic of the regional hospital that provides antiretroviral treatment in the Vhembe district.Methods: A qualitative, explorative and descriptive design was used. A non-probability, convenient sampling method was used to select 20 HIV-positive patients who were above 18 years of age. In-depth individual interviews were used to collect data. Data were analysed through Tech’s open coding method.Results: One theme and two sub-themes emerged, namely positive experiences related to the environment and attitudes of health professionals, and negative experiences concerning the practices by health care providers.Conclusion: Patients’ perceptions of quality of, and satisfaction with, health care may affect health outcomes. Recommendations are made to consider, practice and strengthen the protocols, the standard operating procedures and the principles of infection control in the health facilities.Keywords: Human Immunodeficiecy Virus, Antiretroviral Treatment, HIV positive, Limpopo

  8. Cervical screening in HIV-positive women in the East of England: recent CD4 as the predictive risk factor.

    Science.gov (United States)

    Davies, Olubanke; Rajamanoharan, Sasikala; Balachandran, Thambiah

    2015-11-01

    This study examines the relationship between CD4 count and cervical cytological abnormality in HIV-positive women attending two district general hospital genitourinary medicine clinics in the East of England. It aims to determine whether the rate of cervical cytological abnormalities differs in HIV-positive women with CD4 count >350 cells/µl and those with CD4 count ≤350 cells/µl; and to compare the rates of abnormalities with that of the general population. We retrospectively reviewed data from a cross-sectional audit undertaken between December 2010 and December 2011 and analysed them using multivariable statistics. There was a significant association between recent CD4 count ≤350 cells/µl and cervical cytological abnormality (p 350 cells/µl had abnormal cervical smear results, compared with 6.6% of the general population in the screening period 2010-11 and 7.2% of the general population in the screening period 2009-10. In our study population of women with recent CD4 counts >350 cells/µl, the proportions of mild, moderate and severe dysplasia were also similar to national figures. This raises important questions about the cost effectiveness of blanket annual screening for HIV-positive women.

  9. Assessment of atherosclerosis using carotid ultrasonography in a cohort of HIV-positive patients treated with protease inhibitors.

    Science.gov (United States)

    Seminari, E; Pan, A; Voltini, G; Carnevale, G; Maserati, R; Minoli, L; Meneghetti, G; Tinelli, C; Testa, S

    2002-06-01

    Lipid disorders associated with the use of protease inhibitors (PI) may be a risk factor for premature atherosclerosis development. The aim of this study is to evaluate the extent of carotid intima media thickness (IMT) among HIV-positive patients treated with PI containing regimens compared to PI-naïve and HIV-negative subjects. We analysed plasma lipid levels and carotid IMT in 28 HIV-positive patients treated with protease inhibitors (PIs) for a mean of 28.7 months (range 18-43) and in two control groups constituted, respectively, by 15 HIV-positive naïve patients and 16 HIV-negative subjects, that were matched for age, risk factors for HIV infection, cigarette smoke use and CD4+ cell count. PI-treated patients had higher triglyceride, HDL and apo B levels than controls. Carotid IMT was significantly increased in PI-treated patients compared to naïve or HIV-negative subjects. A correlation between cholesterol HDL, triglyceride and ApoB levels and IMT was observed among the entire cohort. Plasma lipid alterations were associated with an increased IMT and intima media thickening was more pronounced in PI-treated patients than in the two control groups. Periodical evaluation of blood lipid profile and, if required, the use of lipid-lowering agents is advisable. Moreover, physicians should address concurrent risk factor for atherosclerosis that can be modified, including smoking, hypertension, obesity and sedentary life-style.

  10. An observational study of comorbidity and healthcare utilisation among HIV-positive patients aged 50 years and over.

    Science.gov (United States)

    Patel, Roshani; Moore, Thomas; Cooper, Vanessa; McArdle, Conor; Perry, Nicky; Cheek, Elizabeth; Gainsborough, Nicola; Fisher, Martin

    2016-07-01

    The number of HIV-positive people aged ≥50 years is rising each year. We measured the prevalence of non-infectious illnesses and their risk factors and described healthcare use in this UK population. A cross-sectional, observational study was conducted at an outpatient HIV specialist clinic in south east England. Patients age ≥50 years were invited to complete questionnaires measuring demographics, non-infectious illnesses, medication use, lifestyle and healthcare utilisation. The response rate was 67%. Of 299 participants, 84% reported ≥1 comorbid condition and 61% reported ≥2 (multimorbidity). Most commonly reported were high cholesterol, sexual dysfunction, hypertension and depression. In multivariate analyses, age, number of years HIV-positive and duration of antiretroviral therapy remained significant predictors of comorbidity when controlling for lifestyle factors (exercise, smoking and use of recreational drugs and alcohol). Use of non-HIV healthcare services was associated with increasing comorbidity, a longer duration of HIV and recreational drug use. The majority of HIV-patients aged ≥50 years reported multiple comorbidities and this was associated with polypharmacy and increased use of non-HIV services. Further research examining the quality, safety and patient experience of healthcare is needed to inform development of services to optimally meet the needs of older HIV-positive patients.

  11. Life-threatening digoxin toxicity due to drug-drug interactions in an HIV-positive man.

    Science.gov (United States)

    Yoganathan, Kathir; Roberts, Beth; Heatley, Martyn K

    2017-03-01

    Drug-drug interactions with corticosteroids, causing Cushing's syndrome with secondary adrenal suppression, are well known in HIV patients. Corticosteroids are widely prescribed in the HIV-positive population. However, digoxin is rarely used in HIV patients; hence, digoxin toxicity due to drug-drug interaction is not widely recognised. Nevertheless, this practice might change in the future as HIV cohorts of patients are ageing, due to the successful treatment of HIV infection with combination antiretroviral therapy. We report a case of digoxin toxicity in an HIV-positive 51-year-old man, due to a combination of drug-drug interaction and renal impairment. The first case report of digoxin toxicity due to drug-drug interaction with ritonavir in an HIV-positive woman was published in 2003. To the best of our knowledge, no similar case report has since been published in the literature. This case alerts the profession to the importance of drug-drug interaction and highlights the clinical features of digoxin toxicity.

  12. Management of an extrasphincteric fistula in an HIV-positive patient by using fibrin glue: a case report with tips and tricks

    Directory of Open Access Journals (Sweden)

    Sapalidis Konstantinos

    2010-02-01

    Full Text Available Abstract Background Individuals with impaired immunity are at higher risk of perianal diseases. Concerning complex anal fistulas impaired healing and complication rates are also higher. Definitive treatment of a fistula aims controlling the purulent discharge and prevents its recurrence. It depends mainly on the trajectory of the fistula and the underlying disease. We present a case of a HIV-positive patient with a complex extrasphincteric anal fistula who was treated successfully with fibrin glue application. We further, discuss tips and tricks when applying fibrin glue as plugging material in complex anal fistulas. Case presentation A sixty-one-year-old HIV-positive male referred to us for warts and extrasphincteric fistula. Because of the patients' immunological status, we opted against surgery and recommended fibrin glue plugging. The patient was discharged the same day. A follow-up examination was performed 5 days after the initial fibrin glue application showing that the fistula canal was obstructed. Three months and a year post-intervention the fistula tract remains closed. Conclusion The best treatment for a disease gives at least the same result with the other treatments with minimised risk for the life of the patient and minimal application effort. Conservative closure of fistula with fibrin plugging is simple, safe and with less morbidity than surgery. Our patient was successfully treated without endangering his life despite his precarious medical state. Not everybody believes in the effectiveness of fibrin glue application, however we consider this solution in cases of complex fistulas at least as primary procedure in special populations such as the immunosupressed.

  13. A rapid assessment of post-disclosure experiences of urban HIV-positive and HIV-negative school-aged children in Kenya

    Directory of Open Access Journals (Sweden)

    Grace Gachanja

    2015-06-01

    Full Text Available There has been limited involvement of HIV-negative children in HIV disclosure studies; most studies conducted on the effects of disclosure on children have been with HIV-positive children and HIV-positive mother-child dyads. Seven HIV-positive and five HIV-negative children participated in a larger study conducted to understand the lived experiences of HIV-positive parents and their children during the disclosure process in Kenya. In this study, the experiences of these 12 children after receiving disclosure of their own and their parents’ illnesses respectively are presented. Each child underwent an in-depth qualitative semi-structured digitally recorded interview. The recorded interviews were transcribed and loaded into NVivo8 for phenomenological data analysis. Five themes emerged from the data, indicating that HIV-positive and negative children appear to have differing post-disclosure experiences revolving around acceptance of illness, stigma and discrimination, medication consumption, sexual awareness, and use of coping mechanisms. Following disclosure, HIV-negative children accepted their parents’ illnesses within a few hours to a few weeks; HIV-positive children took weeks to months to accept their own illnesses. HIV-negative children knew of high levels of stigma and discrimination within the community; HIV-positive children reported experiencing indirect incidences of stigma and discrimination. HIV-negative children wanted their parents to take their medications, stay healthy, and pay their school fees so they could have a better life in the future; HIV-positive children viewed medication consumption as an ordeal necessary to keep them healthy. HIV-negative children wanted their parents to speak to them about sexual-related matters; HIV-positive children had lingering questions about relationships, use of condoms, marriage, and childbearing options. All but one preadolescent HIV-positive child had self-identified a person to speak

  14. A rapid assessment of post-disclosure experiences of urban HIV-positive and HIV-negative school-aged children in Kenya.

    Science.gov (United States)

    Gachanja, Grace

    2015-01-01

    There has been limited involvement of HIV-negative children in HIV disclosure studies; most studies conducted on the effects of disclosure on children have been with HIV-positive children and HIV-positive mother-child dyads. Seven HIV-positive and five HIV-negative children participated in a larger study conducted to understand the lived experiences of HIV-positive parents and their children during the disclosure process in Kenya. In this study, the experiences of these 12 children after receiving disclosure of their own and their parents' illnesses respectively are presented. Each child underwent an in-depth qualitative semi-structured digitally recorded interview. The recorded interviews were transcribed and loaded into NVivo8 for phenomenological data analysis. Five themes emerged from the data, indicating that HIV-positive and negative children appear to have differing post-disclosure experiences revolving around acceptance of illness, stigma and discrimination, medication consumption, sexual awareness, and use of coping mechanisms. Following disclosure, HIV-negative children accepted their parents' illnesses within a few hours to a few weeks; HIV-positive children took weeks to months to accept their own illnesses. HIV-negative children knew of high levels of stigma and discrimination within the community; HIV-positive children reported experiencing indirect incidences of stigma and discrimination. HIV-negative children wanted their parents to take their medications, stay healthy, and pay their school fees so they could have a better life in the future; HIV-positive children viewed medication consumption as an ordeal necessary to keep them healthy. HIV-negative children wanted their parents to speak to them about sexual-related matters; HIV-positive children had lingering questions about relationships, use of condoms, marriage, and childbearing options. All but one preadolescent HIV-positive child had self-identified a person to speak with for social support

  15. Measuring health-related quality of life of HIV-positive adolescents in resource-constrained settings.

    Directory of Open Access Journals (Sweden)

    Caroline Masquillier

    Full Text Available BACKGROUND AND OBJECTIVES: Access to antiretroviral treatment among adolescents living with HIV (ALH is increasing. Health-related quality of life (HRQOL is relevant for monitoring the impact of the disease on both well-being and treatment outcomes. However, adequate screening tools to assess HRQOL in low-resource settings are scarce. This study aims to fill this research gap, by 1 assessing the psychometric properties and reliability of an Eastern African English version of a European HRQOL scale for adolescents (KIDSCREEN and 2 determining which version of the KIDSCREEN (52-, 27- and 10-item version is most suitable for low-resource settings. METHODS: The KIDSCREEN was translated into Eastern African English, Luganda (Uganda and Dholuo (Kenya according to standard procedures. The reconciled version was administered in 2011 to ALH aged 13-17 in Kenya (n = 283 and Uganda (n = 299. All three KIDSCREEN versions were fitted to the data with confirmatory factor analysis (CFA. After comparison, the most suitable version was adapted based on the CFA outcomes utilizing the results of previous formative research. In order to develop a general HRQOL factor, a second-order measurement model was fitted to the data. RESULTS: The CFA results showed that without adjustments, the KIDSCREEN cannot be used for measuring the HRQOL of HIV-positive adolescents. After comparison, the most suitable version for low-resource settings--the 27-item version--was adapted further. The introduction of a negative wording factor was required for the Dholuo model. The Dholuo (CFI: 0.93; RMSEA: 0.039 and the Luganda model (CFI: 0.90; RMSEA: 0.052 showed a good fit. All cronbach's alphas of the factors were 0.70 or above. The alpha value of the Dholuo and Lugandan HRQOL second-order factor was respectively 0.84 and 0.87. CONCLUSIONS: The study showed that the adapted KIDSCREEN-27 is an adequate tool for measuring HRQOL in low-resource settings with high HIV prevalence.

  16. Measuring health-related quality of life of HIV-positive adolescents in resource-constrained settings.

    Science.gov (United States)

    Masquillier, Caroline; Wouters, Edwin; Loos, Jasna; Nöstlinger, Christiana

    2012-01-01

    Access to antiretroviral treatment among adolescents living with HIV (ALH) is increasing. Health-related quality of life (HRQOL) is relevant for monitoring the impact of the disease on both well-being and treatment outcomes. However, adequate screening tools to assess HRQOL in low-resource settings are scarce. This study aims to fill this research gap, by 1) assessing the psychometric properties and reliability of an Eastern African English version of a European HRQOL scale for adolescents (KIDSCREEN) and 2) determining which version of the KIDSCREEN (52-, 27- and 10-item version) is most suitable for low-resource settings. The KIDSCREEN was translated into Eastern African English, Luganda (Uganda) and Dholuo (Kenya) according to standard procedures. The reconciled version was administered in 2011 to ALH aged 13-17 in Kenya (n = 283) and Uganda (n = 299). All three KIDSCREEN versions were fitted to the data with confirmatory factor analysis (CFA). After comparison, the most suitable version was adapted based on the CFA outcomes utilizing the results of previous formative research. In order to develop a general HRQOL factor, a second-order measurement model was fitted to the data. The CFA results showed that without adjustments, the KIDSCREEN cannot be used for measuring the HRQOL of HIV-positive adolescents. After comparison, the most suitable version for low-resource settings--the 27-item version--was adapted further. The introduction of a negative wording factor was required for the Dholuo model. The Dholuo (CFI: 0.93; RMSEA: 0.039) and the Luganda model (CFI: 0.90; RMSEA: 0.052) showed a good fit. All cronbach's alphas of the factors were 0.70 or above. The alpha value of the Dholuo and Lugandan HRQOL second-order factor was respectively 0.84 and 0.87. The study showed that the adapted KIDSCREEN-27 is an adequate tool for measuring HRQOL in low-resource settings with high HIV prevalence.

  17. Bias in medicine: a survey of medical student attitudes towards HIV-positive and marginalized patients in Russia, 2010

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    Damir A Bikmukhametov

    2012-09-01

    Full Text Available Background: Russia has a substantial HIV epidemic which is poised to escalate in the coming years. The increases in prevalence of HIV will result in increased healthcare needs by a medical system with limited experience with HIV. A healthcare provider's attitude towards a patient plays a significant role in determining the patient's health-related behaviours and medical outcomes. Previous studies have identified negative attitudes of medical students towards people living with HIV. Studying the prevalence of such attitudes is of particular interest, as medical students represent the future workforce and also as the schooling years present a unique opportunity to nurture bias-free healthcare providers. The study measures prevalence of prejudicial attitudes towards HIV-positive and HIV-negative patients who belong to marginalized subgroups. Methods: The cross-sectional survey was conducted among medical students of a Russian medical university. Of 500 students surveyed, 436 provided sufficient data to be included in the analysis. Prejudicial attitudes were defined as reluctance to provide medical care to a specified hypothetical patient. Nine hypothetical HIV-positive and HIV-negative patients were proposed: physicians, injecting drug users, commercial sex workers, men who have sex with men and a patient HIV-positive due to blood transfusion. A log-binomial regression solved using generalized estimating equations was utilized to identify factors associated with reluctance to treat. Results: Prevalence of reluctance to provide medical care to HIV-positive patients in marginalized subgroups was high (ranging from 26.4% up to 71.9%, compared to a maximum of 7.5% if a patient was an HIV-negative physician. Students in their clinical years reported more negative attitudes than preclinical students. In general, female students were less willing to provide care than their male counterparts. Conclusions: Prejudicial attitudes about HIV-positive patients

  18. Association between engagement in-care and mortality in HIV-positive persons

    Science.gov (United States)

    Sabin, Caroline A.; Howarth, Alison; Jose, Sophie; Hill, Teresa; Apea, Vanessa; Morris, Steve; Burns, Fiona

    2017-01-01

    Objective: To assess associations between engagement in-care and future mortality. Design: UK-based observational cohort study. Methods: HIV-positive participants with more than one visit after 1 January 2000 were identified. Each person-month was classified as being in or out-of-care based on the dates of the expected and observed next care visits. Cox models investigated associations between mortality and the cumulative proportion of months spent in-care (% IC, lagged by 1 year), and cumulative %IC prior to antiretroviral therapy (ART) in those attending clinic for more than 1 year, with adjustment for age, CD4+/viral load, year, sex, infection mode, ethnicity, and receipt/type of ART. Results: The 44 432 individuals (27.8% women; 50.5% homosexual, 28.9% black African; median age 36 years) were followed for a median of 5.5 years, over which time 2279 (5.1%) people died. Higher %IC was associated with lower mortality both before [relative hazard 0.91 (95% confidence interval 0.88–0.95)/10% higher, P = 0.0001] and after [0.90 (0.87–0.93), P = 0.0001] adjustment. Adjustment for future CD4+ changes revealed that the association was explained by poorer CD4+ cell counts in those with lower %IC. In total 8730 participants under follow-up for more than 1 year initiated ART of whom 237 (2.7%) died. Higher values of %IC prior to ART initiation were associated with a reduced risk of mortality before [0.29 (0.17–0.47)/10%, P = 0.0001] and after [0.36 (0.21–0.61)/10%, P = 0.0002] adjustment; the association was again explained by poorer post-ART CD4+/ viral load in those with lower pre-ART %IC. Conclusions: Higher levels of engagement in-care are associated with reduced mortality at all stages of infection, including in those who initiate ART. PMID:28060018

  19. Outcomes of HIV-positive patients lost to follow-up in African treatment programmes.

    Science.gov (United States)

    Zürcher, Kathrin; Mooser, Anne; Anderegg, Nanina; Tymejczyk, Olga; Couvillon, Margaret J; Nash, Denis; Egger, Matthias

    2017-04-01

    The retention of patients on antiretroviral therapy (ART) is key to achieving global targets in response to the HIV epidemic. Loss to follow-up (LTFU) can be substantial, with unknown outcomes for patients lost to ART programmes. We examined changes in outcomes of patients LTFU over calendar time, assessed associations with other study and programme characteristics and investigated the relative success of different tracing methods. We performed a systematic review and logistic random-effects meta-regression analysis of studies that traced adults or children who started ART and were LTFU in sub-Saharan African treatment programmes. The primary outcome was mortality, and secondary outcomes were undocumented transfer to another programme, treatment interruption and the success of tracing attempts. We included 32 eligible studies from 12 countries in sub-Saharan Africa: 20 365 patients LTFU were traced, and 15 708 patients (77.1%) were found. Compared to telephone calls, tracing that included home visits increased the probability of success: the adjusted odds ratio (aOR) was 9.35 (95% confidence interval [CI] 1.85-47.31). The risk of death declined over calendar time (aOR per 1-year increase 0.86, 95% CI 0.78-0.95), whereas undocumented transfers (aOR 1.13, 95% CI 0.96-1.34) and treatment interruptions (aOR 1.31, 95% CI 1.18-1.45) tended to increase. Mortality was lower in urban than in rural areas (aOR 0.59, 95% CI 0.36-0.98), but there was no difference in mortality between adults and children. The CD4 cell count at the start of ART increased over time. Mortality among HIV-positive patients who started ART in sub-Saharan Africa, were lost to programmes and were successfully traced has declined substantially during the scale-up of ART, probably driven by less severe immunodeficiency at the start of therapy. © 2017 John Wiley & Sons Ltd.

  20. EFFICACY OF METHADONE MAINTENANCE TREATMENT AMONG HIV POSITIVE AND HIV NEGATIVE HEROIN ADDICTS%不同HIV感染状况的海洛因成瘾者的美沙酮维持治疗效果

    Institute of Scientific and Technical Information of China (English)

    李杏莉; 谭红专; 欧秋英; 陈梦施; 张恒

    2011-01-01

    Objective:To explore the efficacy of methadone maintenance treatment (MMT) among HIV positive and HIV negative heroin addicts. Methods: Information of the patients at baseline and follow -up and daily treatment were collected from the 7 MMT clinics opened in the first two batches in Hunan Province. Retention rate,average treatment time and efficacy were analyzed. Results; (1) The retention rates of 6 and 12 months among HIV positive and HIV negative patients were 79.7%, 59. 3% and 70.5% ,47.7% ,respectively, which showed significant difference between the two groups. (2) There was no significant improvement in employment, but significant improvement observed in the relationship with the families for the HIV positive patients after 6 months on MMT. (3 ) The risk behaviors decreased obviously in both HIV positive and negative groups after 6 months on MMT. But HIV positive patients had lower rates in condom use than HIV negative patients. Conclusion: HIV positive heroin addicts have higher probability in MMT retention than HIV negative patients. It is meaningful and important to recruit more eligible HIV positive heroin addicts to accept MMT.%目的:探讨不同HIV感染状况的海洛因成瘾者的美沙酮维持治疗效果,为针对性干预措施提供依据.方法:收集湖南省前两批开诊的7个美沙酮门诊中接受治疗的HIV+和HIVˉ海洛因成瘾者的一般情况以及日常治疗信息,分析不同感染状况患者治疗时间、治疗维持率及治疗效果.结果:(1)随访1a发现,HIV+患者6、12个月的维护治疗率分别是79.7%和59.3%;HIVˉ患者6、12个月的维持治疗率分别为70.5%和47.7%;两组患者两时点的维持率差异有统计学意义.(2)HIV+患者治疗后“工作”改善不明显,与家人关系改善明显.(3)治疗6个月后两组患者高危行为明显减少,但在性行为安全套使用上HIV+患者改善不如HIVˉ患者显著.结论:HIV+患者较HIVˉ患者倾向于更长时间维持在MMT治

  1. Group Training of Stress Management vs. Group Cognitive-Behavioral Therapy in Reducing Depression, Anxiety and Perceived Stress Among HIV-Positive Men

    OpenAIRE

    Hemmati Sabet, Akbar; Khalatbari, Javad; Abbas Ghorbani, Maryam; Haghighi, Mohammad; Ahmadpanah, Mohammad

    2013-01-01

    Objective: To compare the effectiveness of group training of stress management with cognitive-behavioral therapy (CBT) in reducing depression, anxiety and stress perceived among HIV-positive men. Methods:Inthis semi-experimental study, three groups of HIV-positive men (CBT group, stress management group, and control group) including 15 patients in each group were compared regarding depression, anxiety, and stress using pre-test and post-test tools. Results: Both interventions (CBT and stress ...

  2. Does pregnancy increase the risk of ART-induced hepatotoxicity among HIV-positive women?

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    Susie Huntington

    2014-11-01

    Full Text Available Introduction: High rates of hepatotoxicity have been observed among HIV-positive pregnant women using antiretroviral therapy (ART. However, the extent to which pregnancy affects the risk of ART-induced hepatotoxicity is unclear since studies in this area have generated conflicting results. Material and Methods: Combined data from the UK Collaborative HIV Cohort (UK CHIC study and the UK and Ireland National Study of HIV in Pregnancy and Childhood (NSHPC were used. Alanine aminotransferase (ALT data were assessed according to the Division of AIDS toxicity guidelines to identify factors associated with liver enzyme elevation (LEE (grade 1–4. Women starting ART in 2000–11 aged 16–49 years were included irrespective of pregnancy status at ART start. Cox proportional hazards were used to assess the associations between fixed (ethnicity, exposure group, HBV/HCV co-infection, prior ART use, and age, year, pregnancy status, viral load and CD4 count at ART start and time-dependent covariates (pregnancy status, age, year, CD4 count, viral load, duration on ART and the risk of LEE. Results: Of the 3426 women included, one-quarter (25.0%, n=857 were pregnant during follow-up and 14.4% (n=492 started ART during pregnancy. The rate of LEE was 15/100 person-years (PY during pregnancy and 6.1/100 PY outside pregnancy. The risk of LEE was increased during pregnancy (adjusted hazard ratio (aHR 1.61 [1.26–2.06], p<0.001, including in secondary analysis excluding 493 women pregnant when starting ART. Other factors independently associated with LEE were lower CD4 count (<250 cells/mm3 vs. 251–350 cells/mm3 aHR 1.25 [1.02–1.54], p=0.03, HBV/HCV co-infection (aHR 1.94 [1.58–2.39], p<0.001, HIV acquired via injecting drug use (aHR 1.61 [1.15–2.24], p=0.01 vs. heterosexually and calendar year (aHR 1.05 [1.02–1.08], p<0.001 per one year increase. Three ART drugs were associated with increased risk of LEE (efavirenz aHR 1.27 [1.06–1.50], p-value 0

  3. Atypical squamous cells, cannot exclude high grade squamous intraepithelial (ASC-H in HIV-positive women

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    Michelow Pam

    2010-01-01

    Full Text Available Objective: South Africa has very high rates of both HIV infection and cervical pathology. The management of ASC-H is colposcopy and directed biopsy, but with so many women diagnosed with HSIL and a dearth of colposcopy centres in South Africa, women with cytologic diagnosis of ASC-H may not be prioritized for colposcopy. The aim of this study was to determine if HIV-positive women with a cytologic diagnosis of ASC-H should undergo immediate colposcopy or whether colposcopy can be delayed, within the context of an underfunded health care setting with so many competing health needs. Materials and Methods: A computer database search was performed from the archives of an NGO-administered clinic that offers comprehensive HIV care. All women with a cytologic diagnosis of ASC-H on cervical smears from September 2005 until August 2009 were identified. Histologic follow up was sought in all patients. Results: A total of 2111 cervical smears were performed and 41 diagnosed as ASC-H (1.94%. No histologic follow up data was available in 15 cases. Follow up histologic results were as follows: three negative (11.5%, five koilocytosis and/ or CIN1 (19.2%, ten CIN2 (38.5% and eight CIN3 (30.8%. There were no cases of invasive carcinoma on follow up. Conclusion: The current appropriate management of HIV-positive women in low-resource settings with a diagnosis of ASC-H on cervical smear is colposcopy, despite the costs involved. In the future and if cost-effective in developing nations, use of novel markers may help select which HIV-positive women can be managed conservatively and which ones referred for more active treatment. More research in this regard is warranted.

  4. Conceptualisations of masculinity and self-reported medication adherence among HIV-positive Latino men in Los Angeles, California, USA.

    Science.gov (United States)

    Galvan, Frank H; Bogart, Laura M; Wagner, Glenn J; Klein, David J; Chen, Ying-Tung

    2014-06-01

    HIV-positive Latino men have been found to have poorer medication adherence compared to Whites. This study sought to identify how cultural conceptualisations of masculinity are associated with self-reported medication adherence among Latino men. A total of 208 HIV-positive men reported the number of doses of antiretroviral medication missed in the previous seven days (dichotomised at 100% adherence versus less). Conceptualisations of masculinity consisted of traditional machismo (e.g., power and aggressive attitudes, which are normally associated with negative stereotypes of machismo) and caballerismo (e.g., fairness, respect for elders and the importance of family). Multivariate logistic regression was used to identify factors associated with adherence. The mean adherence was 97% (SD = 6.5%; range = 57-100%). In all, 77% of the participants reported 100% adherence in the previous seven days. Caballerismo was associated with a greater likelihood (OR = 1.77; 95% CI: 1.08-2.92; p = 0.03) and machismo with a lower likelihood (OR = 0.60; 95% CI: 0.38-0.95; p = 0.03) of medication adherence. In addition, higher medication side-effects were found to be associated with a lower likelihood (OR = 0.59; 95% CI: 0.43-0.81; p = 0.001) of medication adherence. These findings reinforce the importance of identifying cultural factors that may affect medication adherence among HIV-positive Latino men resident in the USA.

  5. Closing the gap: increases in life expectancy among treated HIV-positive individuals in the United States and Canada.

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    Hasina Samji

    Full Text Available Combination antiretroviral therapy (ART has significantly increased survival among HIV-positive adults in the United States (U.S. and Canada, but gains in life expectancy for this region have not been well characterized. We aim to estimate temporal changes in life expectancy among HIV-positive adults on ART from 2000-2007 in the U.S. and Canada.Participants were from the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD, aged ≥20 years and on ART. Mortality rates were calculated using participants' person-time from January 1, 2000 or ART initiation until death, loss to follow-up, or administrative censoring December 31, 2007. Life expectancy at age 20, defined as the average number of additional years that a person of a specific age will live, provided the current age-specific mortality rates remain constant, was estimated using abridged life tables.The crude mortality rate was 19.8/1,000 person-years, among 22,937 individuals contributing 82,022 person-years and 1,622 deaths. Life expectancy increased from 36.1 [standard error (SE 0.5] to 51.4 [SE 0.5] years from 2000-2002 to 2006-2007. Men and women had comparable life expectancies in all periods except the last (2006-2007. Life expectancy was lower for individuals with a history of injection drug use, non-whites, and in patients with baseline CD4 counts <350 cells/mm(3.A 20-year-old HIV-positive adult on ART in the U.S. or Canada is expected to live into their early 70 s, a life expectancy approaching that of the general population. Differences by sex, race, HIV transmission risk group, and CD4 count remain.

  6. The impact of gender norms on condom use among HIV-positive adults in KwaZulu-Natal, South Africa.

    Science.gov (United States)

    Fladseth, Kristin; Gafos, Mitzy; Newell, Marie Louise; McGrath, Nuala

    2015-01-01

    Critical to preventing the spread of HIV is promoting condom use among HIV-positive individuals. Previous studies suggest that gender norms (social and cultural constructions of the ways that women and men are expected to behave) may be an important determinant of condom use. However, the relationship has not been evaluated among HIV-positive women and men in South Africa. We examined gender norms and condom use at last sex among 550 partnerships reported by 530 sexually-active HIV-positive women (372) and men (158) who had sought care, but not yet initiated antiretroviral therapy in a high HIV-prevalence rural setting in KwaZulu-Natal, South Africa between January 2009 and March 2011. Participants enrolled in the cohort study completed a baseline questionnaire that detailed their socio-demographic characteristics, socio-economic circumstances, religion, HIV testing history and disclosure of HIV status, stigma, social capital, gender norms and self-efficacy. Gender norms did not statistically differ between women and men (p = 0.18). Overall, condoms were used at last sex in 58% of partnerships. Although participants disclosed their HIV status in 66% of the partnerships, 60% did not have knowledge of their partner's HIV status. In multivariable logistic regression, run separately for each sex, women younger than 26 years with more equitable gender norms were significantly more likely to have used a condom at last sex than those of the same age group with inequitable gender norms (OR = 8.88, 95% CI 2.95-26.75); the association between condom use and gender norms among women aged 26+ years and men of all ages was not statistically significant. Strategies to address gender inequity should be integrated into positive prevention interventions, particularly for younger women, and supported by efforts at a societal level to decrease gender inequality.

  7. The impact of gender norms on condom use among HIV-positive adults in KwaZulu-Natal, South Africa.

    Directory of Open Access Journals (Sweden)

    Kristin Fladseth

    Full Text Available Critical to preventing the spread of HIV is promoting condom use among HIV-positive individuals. Previous studies suggest that gender norms (social and cultural constructions of the ways that women and men are expected to behave may be an important determinant of condom use. However, the relationship has not been evaluated among HIV-positive women and men in South Africa. We examined gender norms and condom use at last sex among 550 partnerships reported by 530 sexually-active HIV-positive women (372 and men (158 who had sought care, but not yet initiated antiretroviral therapy in a high HIV-prevalence rural setting in KwaZulu-Natal, South Africa between January 2009 and March 2011. Participants enrolled in the cohort study completed a baseline questionnaire that detailed their socio-demographic characteristics, socio-economic circumstances, religion, HIV testing history and disclosure of HIV status, stigma, social capital, gender norms and self-efficacy. Gender norms did not statistically differ between women and men (p = 0.18. Overall, condoms were used at last sex in 58% of partnerships. Although participants disclosed their HIV status in 66% of the partnerships, 60% did not have knowledge of their partner's HIV status. In multivariable logistic regression, run separately for each sex, women younger than 26 years with more equitable gender norms were significantly more likely to have used a condom at last sex than those of the same age group with inequitable gender norms (OR = 8.88, 95% CI 2.95-26.75; the association between condom use and gender norms among women aged 26+ years and men of all ages was not statistically significant. Strategies to address gender inequity should be integrated into positive prevention interventions, particularly for younger women, and supported by efforts at a societal level to decrease gender inequality.

  8. Immune Response to Standard Dose of Hepatitis B Vaccine in HIV Positive Clients of Kermanshah Behavioral Diseases Counseling Center

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    H. Montazeripour

    2006-06-01

    Full Text Available Background and Aims: Coinfection eventuality of HIV and HBV infection and having common transmission ways has turned Hepatitis B into a major health concern among HIV positive cases. The increasing number of HIV infected patients and their relevant problems, especially opportunistic infections, demands for Hepatitis B vaccination. This study, therefore was conducted to evaluate the immune response against hepatitis B vaccine and related factors among HIV positive cases and probable approaches to improve its level.Methods: In this cross -sectional study, 169 HIV positive cases who were Kermanshah's Behavioral Disease Counseling Center's clients, with negative HBsAg and HBcAb ,were vaccinated against hepatitis B virus with a 20µg of recombinant HBsAg at 0-1-6 month schedule in deltoid region. A month after the last shot, their HBsAg titer was measured. Titers higher than 10 Iu/ml were considered as a suitable immune response. Data included in this study were: age, gender, CD4 count, antiretroviral treatment history, hepatitis C coinfection and injecting drug abuse. Then these data were analyzed through X2 testResults: Among 169 under study cases, immune response was overally 52.7% and this rate was 51.9% for males and 66.7% for females (P=0.313. Immune response was 54.3%, 44.3%, 45.3% in CD4 count>500, 200-499, and <200/mm3 respectively (P=0.039. In cases with and without antiretroviral treatment the immune response was 81.8% and 50.6%, respectively (P=0.045%Conclusions: In this study the CD4 count and history of antiretroviral therapy correlation with immune response level was significant, but other factors like age, HCV co-infection, drug abusing, and gender were ineffective factors in immune response to HBV vaccine. Therefore, early vaccination among cases with higher CD4 count and cases under antiretroviral treatment seems necessary

  9. Punitive policing and associated substance use risks among HIV-positive people in Russia who inject drugs.

    Science.gov (United States)

    Lunze, Karsten; Raj, Anita; Cheng, Debbie M; Quinn, Emily K; Bridden, Carly; Blokhina, Elena; Walley, Alexander Y; Krupitsky, Evgeny; Samet, Jeffrey H

    2014-01-01

    Drug law enforcement is part of the HIV risk environment among people who inject drugs (PWID). Punitive policing practices such as extrajudicial arrests for needle possession and police planting of drugs have been described anecdotally in Russia, but these experiences and their associations with risky drug behaviours have not been quantified. This study aims to quantify the burden of extrajudicial police arrests among a cohort of HIV-positive PWID in Russia and to explore its links to drug-related health outcomes. In a cross-sectional study of 582 HIV-positive people with lifetime injection drug use (IDU) in St. Petersburg, Russia, we estimated the prevalence of self-reported extrajudicial police arrests. We used multiple logistic regression to evaluate associations between arrests and the following outcomes: overdose, recent IDU and receptive needle sharing. This cohort's mean age was 29.8 years, 60.8% were male; 75.3% reported non-fatal drug overdose, 50.3% recent IDU and 47.3% receptive needle sharing. Extrajudicial arrests were reported by more than half (60.5%, 95% confidence interval [CI]: 56.5-64.5) and were associated with higher odds of non-fatal drug overdose (AOR 1.52, 95% CI: 1.02-2.25) but not with recent IDU (AOR 1.17, arrests were associated with receptive needle sharing (AOR 1.84, 95% CI: 1.09-3.09). Extrajudicial police arrests were common among this cohort of Russian HIV-positive PWID and associated with non-fatal overdose and, among those with recent IDU, receptive needle sharing. As a part of the HIV risk environment of PWIDs, these practices might contribute to HIV transmission and overdose mortality. Further research is needed to relate these findings to the operational environment of law enforcement and to better understand how police interventions among PWIDs can improve the HIV risk environment.

  10. Long-term outcomes of oral rehabilitation with dental implants in HIV-positive patients: A retrospective case series.

    Science.gov (United States)

    Gay-Escoda, C; Pérez-Álvarez, D; Camps-Font, O; Figueiredo, R

    2016-05-01

    The existing information on oral rehabilitations with dental implants in VIH-positive patients is scarce and of poor quality. Moreover, no long-term follow-up studies are available. Hence, the aims of this study were to describe the long-term survival and success rates of dental implants in a group of HIV-positive patients and to identify the most common postoperative complications, including peri-implant diseases. A retrospective case series of HIV-positive subjects treated with dental implants at the School of Dentistry of the University of Barcelona (Spain) was studied. Several clinical parameters were registered, including CD4 cell count, viral load and surgical complications. Additionally, the patients were assessed for implant survival and success rates and for the prevalence of peri-implant diseases. A descriptive statistical analysis of the data was performed. Nine participants (57 implants) were included. The patients' median age was 42 years (IQR=13.5 years). The implant survival and success rates were 98.3% and 68.4%, respectively, with a mean follow-up of 77.5 months (SD=16.1 months). The patient-based prevalence of peri-implant mucositis and peri-implantitis were 22.2% and 44.4% respectively at the last appointment. Patients that attended regular periodontal maintenance visits had significantly less mean bone loss than non-compliant patients (1.3 mm and 3.9 mm respectively). Oral rehabilitation with dental implants in HIV-positive patients seems to provide satisfactory results. In order to reduce the considerably high prevalence of peri-implant diseases, strict maintenance programmes must be implemented.

  11. Prevalence and patterns of Moringa oleifera use among HIV positive patients in Zimbabwe: a cross-sectional survey

    Science.gov (United States)

    Monera, Tsitsi Grace; Maponga, Charles Chiedza

    2016-01-01

    Supplementation of conventional medicines with herbs is increasing globally, including among people infected with HIV. Yet there is little data systematically describing the prevalence and patterns of this supplementation and on which counseling scripts can be based. Moringa oleifera is an herb found in the tropics and sub-tropics commonly used for medicinal and nutritional purposes. This survey determined the prevalence and patterns of use of M. oleifera among HIV positive patients. The study was a cross-sectional survey. HIV-infected adults were enrolled from an opportunistic infections clinic of a referral hospital. Using a previously piloted researcher administered questionnaire; patients who reported to the clinic over three months were interviewed about their use of herbal medicines. The focus was on M. oleifera use, and included plant part, dosage, prescribers and the associated medical conditions. Sixty-eight percent (68%) of the study participants consumed M. oleifera. Of these, 81% had commenced antiretroviral drugs. Friends or relatives were the most common source of a recommendation for use of the herb (69%). Most (80%) consumed M. oleifera to boost the immune system. The leaf powder was mainly used, either alone or in combination with the root and/or bark. M. oleifera supplementation is common among HIV positive people. Because it is frequently prescribed by non-professionals and taken concomitantly with conventional medicine, it poses a potential risk for herb-drug interactions. Further experimental investigations into its effect on drug metabolism and transport would be useful in improving clinical outcome of HIV positive patients.

  12. Long-term outcomes of oral rehabilitation with dental implants in HIV-positive patients: A retrospective case series

    Science.gov (United States)

    Gay-Escoda, Cosme; Pérez-Álvarez, Débora; Camps-Font, Octavi

    2016-01-01

    Background The existing information on oral rehabilitations with dental implants in VIH-positive patients is scarce and of poor quality. Moreover, no long-term follow-up studies are available. Hence, the aims of this study were to describe the long-term survival and success rates of dental implants in a group of HIV-positive patients and to identify the most common postoperative complications, including peri-implant diseases. Material and Methods A retrospective case series of HIV-positive subjects treated with dental implants at the School of Dentistry of the University of Barcelona (Spain) was studied. Several clinical parameters were registered, including CD4 cell count, viral load and surgical complications. Additionally, the patients were assessed for implant survival and success rates and for the prevalence of peri-implant diseases. A descriptive statistical analysis of the data was performed. Results Nine participants (57 implants) were included. The patients’ median age was 42 years (IQR=13.5 years). The implant survival and success rates were 98.3% and 68.4%, respectively, with a mean follow-up of 77.5 months (SD=16.1 months). The patient-based prevalence of peri-implant mucositis and peri-implantitis were 22.2% and 44.4% respectively at the last appointment. Patients that attended regular periodontal maintenance visits had significantly less mean bone loss than non-compliant patients (1.3 mm and 3.9 mm respectively). Conclusions Oral rehabilitation with dental implants in HIV-positive patients seems to provide satisfactory results. In order to reduce the considerably high prevalence of peri-implant diseases, strict maintenance programmes must be implemented. Key words:HIV infection, dental implants, oral implantology, complications, peri-implantitis, peri-implant diseases. PMID:26946205

  13. Prevalence and patterns of Moringa oleifera use among HIV positive patients in Zimbabwe: a cross-sectional survey

    Directory of Open Access Journals (Sweden)

    Tsitsi Grace Monera

    2012-03-01

    Full Text Available Supplementation of conventional medicines with herbs is increasing globally, including among people infected with HIV. Yet there is little data systematically describing the prevalence and patterns of this supplementation and on which counseling scripts can be based. Moringa oleifera is an herb found in the tropics and sub-tropics commonly used for medicinal and nutritional purposes. This survey determined the prevalence and patterns of use of M. oleifera among HIV positive patients. The study was a cross-sectional survey. HIV-infected adults were enrolled from an opportunistic infections clinic of a referral hospital. Using a previously piloted researcher administered questionnaire; patients who reported to the clinic over three months were interviewed about their use of herbal medicines. The focus was on M. oleifera use, and included plant part, dosage, prescribers and the associated medical conditions. Sixty-eight percent (68% of the study participants consumed M. oleifera. Of these, 81% had commenced antiretroviral drugs. Friends or relatives were the most common source of a recommendation for use of the herb (69%. Most (80% consumed M. oleifera to boost the immune system. The leaf powder was mainly used, either alone or in combination with the root and/or bark. M. oleifera supplementation is common among HIV positive people. Because it is frequently prescribed by non-professionals and taken concomitantly with conventional medicine, it poses a potential risk for herb-drug interactions. Further experimental investigations into its effect on drug metabolism and transport would be useful in improving clinical outcome of HIV positive patients.

  14. Performance of the Cellslide® automated liquid-based cytology system amongst HIV-positive women

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    Pamela Michelow

    2016-02-01

    Full Text Available Background: Many women undergoing cervical screening as part of a national South African screening programme may be positive for HIV. The performance of liquid-based cytology (LBC on samples from HIV-positive women needs to be determined.Objectives: The performance of the Cellslide® automated LBC system was evaluated as a possible alternative to conventional cytology in a national cervical cancer screening programme.Methods: Split samples from 348 HIV-positive women attending an HIV treatment clinic in Johannesburg, South Africa were examined by conventional cytology and monolayer LBC methods. All samples were stained, examined and reported in the same manner. Cytotechnologists were blinded to the conventional smear diagnosis if the LBC smear was screened and vice versa.Results: The same percentage of inadequate smears (1.4% was obtained by conventional cytology and LBC. Atypical squamous cells of undetermined significance were observed in 5.2% of conventional smears and 4.0% of LBC smears. Low-grade squamous intraepithelial lesions were found in 35.6% of conventional smears and 32.7% of LBC smears. Only one conventional smear was categorised as atypical squamous cells – cannot exclude a high-grade lesion, whereas five such cases were identified on LBC. High-grade squamous intraepithelial lesions were seen in 21.6% of conventional smears and 23.3% LBC smears. No invasive carcinoma was identified.Conclusion: The performance of the Cellslide® LBC system was similar to that of conventional cytology in this population of high-risk HIV-positive women, indicating that it may be introduced successfully as part of a cervical cancer screening programme.

  15. A Retrospective Cohort Study of Treatment Outcome among HIV positive and HIV negative TB patients in Chandigarh, India

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    Shveta Saini

    2016-06-01

    Full Text Available Background: Tuberculosis (TB and the HIV epidemics have been well known previously but now these are emerging as a combined epidemic to pose new public health challenges. TB is the most common opportunistic infection found among HIV positive individuals. Aims & Objective: To find the prevalence of HIV infection among the TB patients diagnosed and put on treatment under RNTCP. 2. To assess their treatment outcomes in Chandigarh. Material & Methods: The present study was designed as a retrospective cohort study among the adult population (>18 years in Chandigarh from April 2012 - March 2014. All the TB patients registered for treatment at the 17 DMCs of Chandigarh, during this period were taken as the study population. The treatment outcome among TB-HIV co-infected patients was compared with those having only Tuberculosis. Results: From 1st April 2012 - 31st March 2013, a total of 3,551 patients were registered under RNTCP for treatment of tuberculosis. Among the total patients put on DOTS (3,551, 63.2% (2,246 were males and 36.7% (1,305 were females.  A total of 3,516 TB patients had their blood tested for HIV. Out of these patients, 88 (2.47% were tested positive for HIV. HIV positive status was also found to be significantly associated with occurrence of extra pulmonary tuberculosis (X2= 17.42; df 2; p 0.0001. Category – II treatment was found to be slightly more among the HIV positive TB patients as compared to the HIV negative patients. From the total sample, 2.19% (78 patients were later diagnosed as having drug resistant tuberculosis with only one (01 patient being co-infected with HIV. Out of all the TB-HIV co-infected patients, 29.55% were declared cured at the end of the treatment. A total of 63.64% of co-infected patients had completed their treatment. Death as an outcome was significantly associated with HIV positive status (1.14% as compared to HIV negative patients. Conclusion: Integration of TB-HIV collaborative activities at

  16. Incidence and predictors of pregnancy among a cohort of HIV-positive women initiating antiretroviral therapy in Mbarara, Uganda.

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    Angela Kaida

    Full Text Available Many people living with HIV in sub-Saharan Africa desire biological children. Implementation of HIV prevention strategies that support the reproductive goals of people living with HIV while minimizing HIV transmission risk to sexual partners and future children requires a comprehensive understanding of pregnancy in this population. We analyzed prospective cohort data to determine pregnancy incidence and predictors among HIV-positive women initiating antiretroviral therapy (ART in a setting with high HIV prevalence and fertility.Participants were enrolled in the Uganda AIDS Rural Treatment Outcomes (UARTO cohort of HIV-positive individuals initiating ART in Mbarara. Bloodwork (including CD4 cells/mm(3, HIV viral load and questionnaires (including socio-demographics, health status, sexual behavior, partner dynamics, HIV history, and self-reported pregnancy were completed at baseline and quarterly. Our analysis includes 351 HIV-positive women (18-49 years who enrolled between 2005-2011. We measured pregnancy incidence by proximal and distal time relative to ART initiation and used multivariable Cox proportional hazards regression analysis (with repeated events to identify baseline and time-dependent predictors of pregnancy post-ART initiation.At baseline (pre-ART initiation, median age was 33 years [IQR: 27-37] and median prior livebirths was four [IQR: 2-6]. 38% were married with 61% reporting HIV-positive spouses. 73% of women had disclosed HIV status to a primary sexual partner. Median baseline CD4 was 137 cells/mm(3 [IQR: 81-207]. At enrolment, 9.1% (31/342 reported current pregnancy. After ART initiation, 84 women experienced 105 pregnancies over 3.8 median years of follow-up, yielding a pregnancy incidence of 9.40 per 100 WYs. Three years post-ART initiation, cumulative probability of at least one pregnancy was 28% and independently associated with younger age (Adjusted Hazard Ratio (AHR: 0.89/year increase; 95%CI: 0.86-0.92 and HIV

  17. Respiratory Failure Associated with the Lipodystrophy Syndrome in an HIV-Positive Patient with Compromised Lung Function

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    Natasha Press

    2001-01-01

    Full Text Available Protease inhibitors, used as treatment in human immunodeficiency virus (HIV infection, are associated with a syndrome of peripheral lipodystrophy, central adiposity, hyperlipidemia and insulin resistance. An HIV-positive patient with chronic obstructive pulmonary disease is presented who developed the lipodystrophy syndrome that is associated with the use of protease inhibitors. It is postulated that the lipodystrophy syndrome further compromised his lung function, leading to respiratory failure. Patients who have pulmonary disease and are taking protease inhibitors require monitoring of clinical status and pulmonary function tests.

  18. A survey of ATRIPLA use in clinical practice as first-line therapy in HIV-positive persons in Europe

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    Mocroft, A; Reiss, P; Rakhmanova, A

    2014-01-01

    ATRIPLA is licensed for use only in HIV-positive persons whose viral loads therapy (ART) in EuroSIDA using a web-based survey performed in Autumn 2012. 96/112 clinics (85.7 %) completed the survey. Recommendations...... when initiating first-line ART was TRUVADA plus efavirenz in 36 (37.5 %), ATRIPLA in 35 (36.5 %), a different first-line regimen in 12 clinics (12.5 %), and no recommendation in 7 clinics (7.3 %). ATRIPLA was commonest in Northern (15/21 clinics; 71.4 %), and least common in Eastern Europe (2....../31 clinics; 6.5 %; p therapy, despite EMA recommendations....

  19. Bilateral axillary masses mimicking as accessory breast with multiple fibroadenoma and bilateral gigantomastia in HIV-positive patient.

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    Singh, Saumya; Mishra, Anand K; Tewari, S; Kumar, Sanjeev

    2013-06-24

    Accessory breast is a rare entity that can present as asymptomatic masses or can cause symptoms like heaviness, pain, restriction of arm movement and limitation in daily pursuits with allied apprehension and anxiety for the patient. We present a case of bilateral axillary masses mimicking as accessory breast with multiple fibroadenoma in a 28 years, nulliparous, Indian woman who is HIV positive, which proves to be a diagnostic dilemma. Excisional biopsy was diagnostic. The rarity of such cases imposes challenges on the management in terms of diagnosis, prognosis and therapeutic options.

  20. Perceptions of HIV-related health services in Zambia for people with disabilities who are HIV-positive

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    Stephanie A Nixon

    2014-04-01

    Full Text Available Introduction: Despite the emerging body of literature on increased vulnerability to HIV among people with disabilities (PWDs, there is a dearth of evidence related to experiences of PWDs who have become HIV-positive. This priority was identified by a disability advocacy organization in Lusaka, Zambia, where the prevalence of HIV and of disability is each approximately 15%. The purpose of this study was to explore perceptions and experiences of HIV-related health services for PWDs who are also living with HIV in Lusaka, Zambia. Methods: This qualitative, interpretive study involved in-depth, semi-structured, one-on-one interviews with two groups of participants in Lusaka, Zambia: 21 PWDs who had become HIV-positive, and 11 people working in HIV and/or disability. PWDs had physical, hearing, visual and/or intellectual impairments. Interviews were conducted in English, Nyanja, Bemba or Zambian sign language. Descriptive and thematic analyses were conducted by a multidisciplinary, international research team. Results: Participants described their experiences with HIV-related health services in terms of the challenges they faced. In particular, they encountered three main challenges while seeking care and treatment: (1 disability-related discrimination heightened when seeking HIV services, (2 communication barriers and related concerns with confidentiality, and (3 movement and mobility challenges related to seeking care and collecting antiretroviral therapy. These experiences were further shaped by participants’ profound concerns about poverty and unmet basic needs. Discussion: This study demonstrates how PWDs who are HIV-positive have the same HIV care, treatment and support needs as able-bodied counterparts, but face avoidable barriers to care. Many challenges mirror concerns identified with HIV prevention, suggesting that efforts to promote inclusion and reduce stigma could have widespread benefits. Conclusions: Despite the growing body of

  1. Knowledge of HIV transmission and condom use among HIV-positive heterosexual men and women in Guatemala

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    Delgado Hurtado Juan J

    2011-12-01

    Full Text Available Abstract Background The prevalence of HIV/AIDS in Guatemala among the general population is 0.79%, and 94% of transmission is directly related to sexual contact. Studies have been conducted on high- prevalence HIV-positive populations (men who have sex with men, commercial sex workers and prisoners. Heterosexual transmission has gained importance in the epidemic in Central America. To our knowledge, no study addressing knowledge of mechanisms of HIV transmission and condom use has been done on HIV-positive heterosexual men and women. Methods A closed-ended structured interview that addressed knowledge of mechanisms of HIV transmission and condom use was conducted on 283 heterosexual HIV-positive men (54.8% and women (45.2% outpatients who attend the Roosevelt Hospital's Clinic of Infectious Diseases in Guatemala City. Differences between selected characteristics were examined for significance using the Chi-square test. A multiple logistic regression was done to determine socio-demographic variables associated with inconsistent condom use. Results Of the interviewed persons, 68.5% were either living with a partner or married, and 94.3% were currently using antiretroviral therapy. Most respondents knew the mechanisms of transmission of HIV. 81.7% and 87.3% reported always using a condom with their regular and casual sexual partner in the past year, respectively. There was no statistically difference in condom use according to the patient's formal education, gender, type of partner (regular or casualor number of sexual partners. According to the interviewees, 72% of sexual partners in the past year were either HIV negative or of an unknown serostatus. Potentially, these HIV-negative persons are at risk of contracting the virus. Among the main reasons given for not using a condom were: "my partner did not want to use a condom"; and "the condom irritates or makes my partner uncomfortable". Conclusions Since no socio-demographic or sexual behavior

  2. Testing Comprehensive Models of Disclosure of Sexual Orientation in HIV-Positive Latino Men Who Have Sex with Men (MSM)

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    Lechuga, Julia; Zea, María Cecilia

    2012-01-01

    Individuals who disclose their sexual orientation are more likely to also disclose their HIV status. Disclosure of HIV-serostatus is associated with better health outcomes. The goal of this study was to build and test comprehensive models of sexual orientation that included 8 theory-informed predictors of disclosure to mothers, fathers, and closest friends in a sample of HIV-positive Latino gay and bisexual men. US acculturation, gender non-conformity to hegemonic masculinity in self-presentation, comfort with sexual orientation, gay community involvement, satisfaction with social support, sexual orientation and gender of the closest friend emerged as significant predictors of disclosure of sexual orientation. PMID:22690708

  3. Infant feeding among HIV-positive mothers and the general population mothers: comparison of two cross-sectional surveys in Eastern Uganda

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    Tylleskär Thorkild

    2009-05-01

    Full Text Available Abstract Background Infant feeding recommendations for HIV-positive mothers differ from recommendations to mothers of unknown HIV-status. The aim of this study was to compare feeding practices, including breastfeeding, between infants and young children of HIV-positive mothers and infants of mothers in the general population of Uganda. Methods This study compares two cross-sectional surveys conducted in the end of 2003 and the beginning of 2005 in Eastern Uganda using analogous questionnaires. The first survey consisted of 727 randomly selected general-population mother-infant pairs with unknown HIV status. The second included 235 HIV-positive mothers affiliated to The Aids Support Organisation, TASO. In this article we compare early feeding practices, breastfeeding duration, feeding patterns with dietary information and socio-economic differences in the two groups of mothers. Results Pre-lacteal feeding was given to 150 (64% infants of the HIV-positive mothers and 414 (57% infants of general-population mothers. Exclusive breastfeeding of infants under the age of 6 months was more common in the general population than among the HIV-positive mothers (186 [45%] vs. 9 [24%] respectively according to 24-hour recall. Mixed feeding was the most common practice in both groups of mothers. Solid foods were introduced to more than half of the infants under 6 months old among the HIV-positive mothers and a quarter of the infants in the general population. Among the HIV-positive mothers with infants below 12 months of age, 24 of 90 (27% had stopped breastfeeding, in contrast to 9 of 727 (1% in the general population. The HIV-positive mothers were poorer and had less education than the general-population mothers. Conclusion In many respects, HIV-positive mothers fed their infants less favourably than mothers in the general population, with potentially detrimental effects on both the child's nutrition and the risk of HIV transmission. Mixed feeding and pre

  4. Self-reported history of Pap-smear in HIV-positive women in Northern Italy: a cross-sectional study

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    Ghinelli Florio

    2010-06-01

    Full Text Available Abstract Background The incidence of invasive cervical cancer in HIV-positive women is higher than in the general population. There is evidence that HIV-positive women do not participate sufficiently in cervical cancer screening in Italy, where cervical cancer is more than 10-fold higher in women with AIDS than in the general population. The aim of the present study was to evaluate the history of Pap-smear in HIV-positive women in Italy in recent years. We also examined the sociodemographic, clinical, and organizational factors associated with adherence to cervical cancer screening. Methods A cross-sectional study was conducted between July 2006 and June 2007 in Emilia-Romagna region (Northern Italy. All HIV-positive women who received a follow-up visit in one of the 10 regional infectivology units were invited to participate. History of Pap-smear, including abnormal smears and subsequent treatment, was investigated through a self-administered anonymous questionnaire. The association between lack of Pap-smear in the year preceding the interview and selected characteristics was assessed by means of odds ratios (OR and 95% confidence intervals adjusted for study centre and age. Results A total of 1,002 HIV-positive women were interviewed. Nine percent reported no history of Pap-smear, and 39% had no Pap-smear in the year prior to the date of questionnaire (last year. The lack of Pap-smear in the last year was significantly associated with age Three hundred five (34% women reported a previous abnormal Pap-smear, and of the 178 (58% referred for treatment, 97% complied. Conclusions In recent years the self-reported history of Pap-smear in HIV-positive women, in some public clinics in Italy, is higher than previously reported, but further efforts are required to make sure cervical cancer screening is accessible to all HIV-positive women.

  5. HIV, gender, race, sexual orientation, and sex work: a qualitative study of intersectional stigma experienced by HIV-positive women in Ontario, Canada.

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    Carmen H Logie

    2011-11-01

    Full Text Available BACKGROUND: HIV infection rates are increasing among marginalized women in Ontario, Canada. HIV-related stigma, a principal factor contributing to the global HIV epidemic, interacts with structural inequities such as racism, sexism, and homophobia. The study objective was to explore experiences of stigma and coping strategies among HIV-positive women in Ontario, Canada. METHODS AND FINDINGS: We conducted a community-based qualitative investigation using focus groups to understand experiences of stigma and discrimination and coping methods among HIV-positive women from marginalized communities. We conducted 15 focus groups with HIV-positive women in five cities across Ontario, Canada. Data were analyzed using thematic analysis to enhance understanding of the lived experiences of diverse HIV-positive women. Focus group participants (n = 104; mean age = 38 years; 69% ethnic minority; 23% lesbian/bisexual; 22% transgender described stigma/discrimination and coping across micro (intra/interpersonal, meso (social/community, and macro (organizational/political realms. Participants across focus groups attributed experiences of stigma and discrimination to: HIV-related stigma, sexism and gender discrimination, racism, homophobia and transphobia, and involvement in sex work. Coping strategies included resilience (micro, social networks and support groups (meso, and challenging stigma (macro. CONCLUSIONS: HIV-positive women described interdependent and mutually constitutive relationships between marginalized social identities and inequities such as HIV-related stigma, sexism, racism, and homo/transphobia. These overlapping, multilevel forms of stigma and discrimination are representative of an intersectional model of stigma and discrimination. The present findings also suggest that micro, meso, and macro level factors simultaneously present barriers to health and well being--as well as opportunities for coping--in HIV-positive women's lives

  6. Electrocautery ablation of high-grade anal squamous intraepithelial lesions in HIV-negative and HIV-positive men who have sex with men.

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    Marks, Douglas K; Goldstone, Stephen E

    2012-03-01

    Anal squamous cell carcinoma (ASCC) incidence has been rising over the past decade, most dramatically in HIV-positive men who have sex with men (MSM). We aimed to identify a novel in-office approach for ablating high-grade anal intraepithelial neoplasia (HGAIN), the believed precursor lesion to ASCC. We performed a retrospective analysis of medical records from a New York City surgical practice, identifying patients with HGAIN treated with electrocautery ablation (ECA) and followed for at least 5 months with high-resolution anoscopy, biopsies, and/or cytology. We sought to determine HGAIN recurrence and progression to ASCC after ECA. Two hundred thirty-two MSM, 132 HIV positive and 100 HIV negative, with median follow-up of 19.0 and 17.5 months, respectively, met inclusion criterion. In HIV-negative and HIV-positive MSM, the probability of curing a lesion after first ECA was 85% and 75%, respectively. Over follow-up, 53% of HIV-negative and 61% of HIV-positive patients recurred. After first and second ECA, HIV-positive MSM were 1.28 times (P = 0.16) and 2.34 times (P = 0.009) more likely to recur than HIV-negative MSM. The majority of recurrence was due to development of additional lesions at untreated sites (metachronous recurrence). One patient (0.4%) developed ASCC. At last visit, 83% of HIV-negative and 69% of HIV-positive patients were HGAIN free. ECA is an effective treatment for HGAIN, with fewer patients progressing to ASCC than predicted with expectant management. HIV-positive patients are significantly more likely to recur than HIV-negative patients.

  7. HIV Positive Diagnosis During Pregnancy Increases Risk of IPV Postpartum Among Women with No History of IPV in Their Relationship.

    Science.gov (United States)

    Groves, Allison K; Reyes, H Luz McNaughton; Moodley, Dhayendre; Maman, Suzanne

    2017-07-24

    There has been limited study of whether and for whom physical intimate partner violence (IPV) is a consequence of an HIV-positive diagnosis. Per the diathesis stress model, the consequences of HIV infection may be worse for women with a history of IPV. We hypothesize that the positive association between HIV diagnosis in pregnancy and postpartum IPV will be exacerbated for women with a history of IPV. Data come from a prospective cohort study with 1015 participants who completed a baseline antenatal and 9-month postpartum visit. Using logistic regression analyses, we found a statistically significant interaction between HIV diagnosis, history of IPV and postpartum IPV (AOR: 0.40, 95% CI 0.17-0.96). The findings were in the opposite direction as expected: HIV-diagnosis was not associated with IPV for women with a history of IPV (AOR: 2.17, 95% CI 1.06, 4.42). However, HIV-positive women without a history of IPV faced more than two times the risk of incident postpartum IPV than HIV-negative women (AOR: 2.17, 95% CI 1.06, 4.42). Interventions to reduce incident and ongoing IPV during the perinatal period are needed.

  8. Epidemiology of HPV in HIV-Positive and HIV-Negative Fertile Women in Cameroon, West Africa

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    Andrew J. Desruisseau

    2009-01-01

    Full Text Available Background. HPV types vary by country and HIV status. There are no data on the prevalent HPV genotypes from Cameroon. Methods. We conducted a cross-sectional, observational study on 65 Cameroonian women. Samples were sent for HPV genotyping and Thin Prep analyses. Results. 41 out of 61 samples tested (67.2% had HPV subtypes detected. The most common high risk types encountered were: 45 (24.6% and 58 (21.5%. HIV-positive women were more likely to test positive for any HPV (P=.014, have more than one HPV subtype (P=.003, and to test positive for the high risk subtypes (P=.007. Of those with high risk HPV, HIV-positive women were more likely to have Thin Prep abnormalities than HIV-negative women (P=.013. Conclusions. Oncogenic HPV subtypes 45 and 58 were more prevalent than those subtypes carried in the quadrivalent vaccine. Further studies are needed to assess whether the current vaccine will be effective in this region.

  9. Providers’ Perspectives on Provision of Family Planning to HIV-Positive Individuals in HIV Care in Nyanza Province, Kenya

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    Sara J. Newmann

    2013-01-01

    Full Text Available Objective. To inform an intervention integrating family planning into HIV care, family planning (FP knowledge, attitudes and practices, and perspectives on integrating FP into HIV care were assessed among healthcare providers in Nyanza Province, Kenya. Methods. Thirty-one mixed-method, structured interviews were conducted among a purposive sample of healthcare workers (HCWs from 13 government HIV care facilities in Nyanza Province. Structured questions and case scenarios assessed contraceptive knowledge, training, and FP provision experience. Open-ended questions explored perspectives on integration. Data were analyzed descriptively and qualitatively. Results. Of the 31 HCWs interviewed, 45% reported previous FP training. Few providers thought long-acting methods were safe for HIV-positive women (19% viewed depot medroxyprogesterone acetate as safe and 36% viewed implants and intrauterine contraceptives as safe; fewer felt comfortable recommending them to HIV-positive women. Overall, providers supported HIV and family planning integration, yet several potential barriers were identified including misunderstandings about contraceptive safety, gendered power differentials relating to fertility decisions, staff shortages, lack of FP training, and contraceptive shortages. Conclusions. These findings suggest the importance of considering issues such as patient flow, provider burden, commodity supply, gender and cultural issues affecting FP use, and provider training in FP/HIV when designing integrated FP/HIV services in high HIV prevalence areas.

  10. Modafinil and armodafinil treatment for fatigue for HIV-positive patients with and without chronic hepatitis C.

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    Rabkin, J G; McElhiney, M C; Rabkin, R

    2011-02-01

    Fatigue is prevalent among patients with hepatitis C virus (HCV) and with HIV/AIDS but there are no established fatigue treatments for either condition or their combination. We analysed data from three trials of modafinil or armodafinil for HIV-positive patients with fatigue, including 36 co-infected with HCV, to compare treatment response and safety parameters related to HCV status. One hundred and twenty patients received active drug and 70 were randomized to placebo. Fatigue response rate to modafinil/armodafinil was 100% for patients with HCV (18/18) and 73% (74/102) for patients without HCV. Placebo response rate was 28% (5/18) and 29% (15/52), respectively. Depressive symptoms improved only when energy improved. Viral load declined from baseline after 12 and 26 weeks of active medication. CD4 cell count did not change, nor did alanine transaminase and aspartate aminotransferase for patients with HCV. Patients with haematocrit below the reference range responded, as well as patients whose values were within the reference range. Modafinil and armodafinil appear effective and well tolerated for treating fatigue among both HCV-positive and HCV-negative patients with HIV/AIDS, suggesting that they may hold promise for HIV-positive patients considering alpha interferon/ribavirin treatment for HCV. Further investigation in a focused trial is warranted.

  11. Use of the Vectra polyetherurethaneurea graft for dialysis access in HIV-positive patients with end-stage renal disease.

    Science.gov (United States)

    Schild, A Frederick; Perez, Eduardo A; Gillaspie, Erin; Patel, Asha R; Noicely, Karlene; Baltodano, Neyton

    The primary objective of this study was to establish the safety, efficacy, infection rate, and patency of the Vectra graft (polyetherurethaneurea) for dialysis access in patients diagnosed with human immunodeficiency virus (HIV) and end-stage renal disease. The Vectra graft has a unique self-sealing property; therefore we hypothesize that these patients will have fewer infections. A Vectra graft was implanted in 30 consecutive HIV-positive patients without sufficient veins for an autologous fistula. These surgeries were carried out over a 2.5-year period. Primary graft patency was 42% at 12 months and 3 (10%) of the grafts developed infection. This rate of graft infection was less (10% vs 45%) than both our prior experience and published reports using polytetrafluorothene bridge grafts. The unique self-sealing property of the Vectra graft minimizes the development of perigraft hematoma with repetitive needle cannulation and in the immunosuppressed HIV-positive patient, may account for the observed decrease in dialysis access infection.

  12. Methamphetamine use among newly diagnosed HIV-positive young men in North Carolina, United States, from 2000 to 2005.

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    Christopher B Hurt

    Full Text Available BACKGROUND: Methamphetamine (MA is a new arrival to the Southeastern United States (US. Incidence of HIV is also increasing regionally, but data are limited regarding any association between this trend and MA use. We examined behavioral data from North Carolina (NC residents newly diagnosed with HIV, collected by the Department of Health between 2000-2005. PRINCIPAL FINDINGS: Among 1,460 newly diagnosed HIV-positive young men, an increasing trend was seen from 2000-2005 in MA use (p = 0.01, total n = 20. In bivariate analyses, users of MA had significantly greater odds of reporting other substance use, including alcohol, powder or crack cocaine, marijuana, and methylenedioxymethamphetamine (MDMA, "ecstasy". They were also more likely to have reported sexual activity while traveling outside NC; sex with anonymous partners; and previous HIV testing. In a predictive model, MA use had a negative association with nonwhite race, and strong positive associations with powder cocaine, "ecstasy," or intravenous drug use and being a university student. CONCLUSIONS: Similar to trends seen in more urban parts of the US, MA use among newly diagnosed, HIV-positive young men is increasing in NC. These data are among the first to demonstrate this relationship in a region with a burgeoning epidemic of MA use. Opportunities exist for MA-related HIV risk-reduction interventions whenever young men intersect the healthcare system.

  13. Overcoming Barriers to Family Planning through Integration: Perspectives of HIV-Positive Men in Nyanza Province, Kenya

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    Rachel L. Steinfeld

    2013-01-01

    Full Text Available This study explored barriers to and facilitators of using family planning services among HIV-positive men in Nyanza Province, Kenya. From May to June 2010, in-depth interviews were conducted with 30 men receiving care at 15 HIV clinics. The key barriers to the use of family planning included concerns about side effects of contraceptives, lack of knowledge about contraceptive methods, myths and misconceptions including fear of infertility, structural barriers such as staffing shortages at HIV clinics, and a lack of male focus in family planning methods and service delivery. The integration of family planning into HIV clinics including family planning counseling and education was cited as an important strategy to improve family planning receptivity among men. Integrating family planning into HIV services is a promising strategy to facilitate male involvement in family planning. Integration needs to be rigorously evaluated in order to measure its impact on unmet need for contraception among HIV-positive women and their partners and assure that it is implemented in a manner that engages both men and women.

  14. Epidemiology of HPV in HIV-Positive and HIV-Negative Fertile Women in Cameroon, West Africa

    Science.gov (United States)

    Desruisseau, Andrew J.; Schmidt-Grimminger, Delf; Welty, Edith

    2009-01-01

    Background. HPV types vary by country and HIV status. There are no data on the prevalent HPV genotypes from Cameroon. Methods. We conducted a cross-sectional, observational study on 65 Cameroonian women. Samples were sent for HPV genotyping and Thin Prep analyses. Results. 41 out of 61 samples tested (67.2%) had HPV subtypes detected. The most common high risk types encountered were: 45 (24.6%) and 58 (21.5%). HIV-positive women were more likely to test positive for any HPV (P = .014), have more than one HPV subtype (P = .003), and to test positive for the high risk subtypes (P = .007). Of those with high risk HPV, HIV-positive women were more likely to have Thin Prep abnormalities than HIV-negative women (P = .013). Conclusions. Oncogenic HPV subtypes 45 and 58 were more prevalent than those subtypes carried in the quadrivalent vaccine. Further studies are needed to assess whether the current vaccine will be effective in this region. PMID:20169094

  15. 'It's like the treasure': beliefs associated with semen among young HIV-positive and HIV-negative gay men.

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    Schilder, Arn J; Orchard, Treena R; Buchner, Christopher S; Miller, Mary Lou; Fernandes, Kim A; Hogg, Robert S; Strathdee, Steffanie A

    2008-10-01

    This paper examines cultural and social meanings associated with semen, along with related issues of unprotected receptive anal intercourse, HIV seroconversion, treatment optimism and viraemia. The findings are derived from qualitative interviews conducted with 12 HIV-positive young gay men and 12 HIV-negative counterparts who participated in a prospective cohort study in Vancouver, Canada. Focussing on the narratives of young gay men, the analysis reveals a diverse range of knowledge, values and functions of semen, especially in relation to its exchange. Beliefs about semen appeared to differ by HIV serostatus and were linked with intimacy, identity and pleasure, particularly among the HIV-positive men. Against dominant representations of semen in relation to issues of loss, anxiety and infertility, this unique study sheds much needed light on its role within the cultural construction of sexuality among gay men. As such, these narratives are of direct importance to primary and secondary HIV prevention, including condom promotion and the development of rectal microbicides.

  16. Relationship between food insecurity and mortality among HIV-positive injection drug users receiving antiretroviral therapy in British Columbia, Canada.

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    Aranka Anema

    Full Text Available OBJECTIVES: Little is known about the potential impact of food insecurity on mortality among people living with HIV/AIDS. We examined the potential relationship between food insecurity and all-cause mortality among HIV-positive injection drug users (IDU initiating antiretroviral therapy (ART across British Columbia (BC. METHODS: Cross-sectional measurement of food security status was taken at participant ART initiation. Participants were prospectively followed from June 1998 to September 2011 within the fully subsidized ART program. Cox proportional hazard models were used to ascertain the association between food insecurity and mortality, controlling for potential confounders. RESULTS: Among 254 IDU, 181 (71.3% were food insecure and 108 (42.5% were hungry. After 13.3 years of median follow-up, 105 (41.3% participants died. In multivariate analyses, food insecurity remained significantly associated with mortality (adjusted hazard ratio [AHR] = 1.95, 95% CI: 1.07-3.53, after adjusting for potential confounders. CONCLUSIONS: HIV-positive IDU reporting food insecurity were almost twice as likely to die, compared to food secure IDU. Further research is required to understand how and why food insecurity is associated with excess mortality in this population. Public health organizations should evaluate the possible role of food supplementation and socio-structural supports for IDU within harm reduction and HIV treatment programs.

  17. Contraception for the HIV-Positive Woman: A Review of Interactions between Hormonal Contraception and Antiretroviral Therapy

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    Jennifer A. Robinson

    2012-01-01

    Full Text Available Background. Preventing unintended pregnancy in HIV-positive women can significantly reduce maternal-to-child HIV transmission as well as improve the woman’s overall health. Hormonal contraceptives are safe and effective means to avoid unintended pregnancy, but there is concern that coadministration of antiretroviral drugs may alter contraceptive efficacy. Materials and Methods. We performed a literature search of PubMed and Ovid databases of articles published between January 1980 and February 2012 to identify English-language reports of drug-drug interactions between hormonal contraceptives (HCs and antiretroviral drugs (ARVs. We also reviewed the FDA prescribing information of contraceptive hormone preparations and antiretrovirals for additional data and recommendations. Results. Twenty peer-reviewed publications and 42 pharmaceutical package labels were reviewed. Several studies of combined oral contraceptive pills (COCs identified decreased serum estrogen and progestin levels when coadministered with certain ARVs. The contraceptive efficacy of injectable depot medroxyprogesterone acetate (DMPA and the levonorgestrel intrauterine system (LNG-IUS were largely unaffected by ARVs, while data on the contraceptive patch, ring, and implant were lacking. Conclusions. HIV-positive women should be offered a full range of hormonal contraceptive options, with conscientious counseling about possible reduced efficacy of COCs and the contraceptive implant when taken with ARVs. DMPA and the LNG-IUS maintain their contraceptive efficacy when taken with ARVs.

  18. The HIV Prison Paradox: Agency and HIV-Positive Women's Experiences in Jail and Prison in Alabama.

    Science.gov (United States)

    Sprague, Courtenay; Scanlon, Michael L; Radhakrishnan, Bharathi; Pantalone, David W

    2017-08-01

    Incarcerated women face significant barriers to achieve continuous HIV care. We employed a descriptive, exploratory design using qualitative methods and the theoretical construct of agency to investigate participants' self-reported experiences accessing HIV services in jail, in prison, and post-release in two Alabama cities. During January 2014, we conducted in-depth interviews with 25 formerly incarcerated HIV-positive women. Two researchers completed independent coding, producing preliminary codes from transcripts using content analysis. Themes were developed iteratively, verified, and refined. They encompassed (a) special rules for HIV-positive women: isolation, segregation, insults, food rationing, and forced disclosure; (b) absence of counseling following initial HIV diagnosis; and (c) HIV treatment impediments: delays, interruption, and denial. Participants deployed agentic strategies of accommodation, resistance, and care-seeking to navigate the social world of prison and HIV services. Findings illuminate the "HIV prison paradox": the chief opportunities that remain unexploited to engage and re-engage justice-involved women in the HIV care continuum.

  19. Status of prevention of parent to child transmission services among HIV-positive mothers from rural South India

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    Anbarasi Subramaniyan

    2014-01-01

    Full Text Available Background: Tamil Nadu comes under group I high-prevalence state, with <1% prevalence of HIV infection in ante-natal women but above 5% prevalence in high-risk group. One of the ways to control HIV/AIDS in India is through prevention of parent to child transmission (PPTCT, the success of which lies in the utilization of services. Materials and Methods: A descriptive qualitative study was conducted to explore the status of utilization of PPTCT services by rural HIV-positive mothers, in the Gingee Block of Villupuram district, Tamil Nadu. All the mothers who tested positive between June 2006 and May 2010 were interviewed in-depth using an interview guide. Results: There were 21 HIV-positive mothers during this period, 19 of whom gave consent for the study. Thirteen out of 19 mothers (68% received Nevirapine prophylaxis, while 15 out of 20 infants born to these mothers (75% received Nevirapine syrup. During the study period, it was found that 61% of the mothers were not compliant to antiretroviral therapy (ART. Conclusion: Poor access to the ART centers was reflected in majority of the cases (79%. There is a pressing need to improve access to quality PPTCT services especially during the intranatal period.

  20. Social media use and HIV transmission risk behavior among ethnically diverse HIV-positive gay men: results of an online study in three U.S. states.

    Science.gov (United States)

    Hirshfield, Sabina; Grov, Christian; Parsons, Jeffrey T; Anderson, Ian; Chiasson, Mary Ann

    2015-10-01

    Though Black and Hispanic men who have sex with men (MSM) are at an increased risk for HIV, few HIV risk reduction interventions that target HIV-positive MSM, and even fewer that use technology, have been designed to target these groups. Despite similar rates of social media and technology use across racial/ethnic groups, online engagement of minority MSM for HIV prevention efforts is low. Since minority MSM tend to have less representation in online HIV prevention studies, the goals of this online anonymous study of HIV-positive gay-identified men were to test the feasibility of conducting targeted recruitment by race/ethnicity and sexual orientation, to assess technology and social media use, and to assess global HIV transmission risk. In 2011, an anonymous online survey was conducted among 463 members of an HIV-positive personals website. Emails were sent to a subset of HIV-positive male members who self-identified as gay. While 57 % were White, substantial proportions of participants were Black (20 %) or Hispanic (18 %). Median age was 46 (range 18-79). Men who reported using 3 or more websites or apps to meet sex partners were significantly more likely to report anal intercourse (AOR 4.43, p anal sex (CAS) (AOR 2.70, p gay men. Efficacy trials of technology-based HIV prevention interventions targeting high-risk minority HIV-positive MSM are warranted.

  1. Ethical and Scientific Issues Surrounding Solid Organ Transplantation in Hiv-Positive Patients: Absence of Evidence Is Not Evidence of Absence

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    Timothy Christie

    2006-01-01

    Full Text Available End-stage liver disease is emerging as a leading cause of death among HIV-positive patients. Historically, an HIV diagnosis was a contraindication for a liver transplant; however, because of the efficacy of highly active antiretroviral therapy (HAART, HIV-positive patients have one-year, two-year, and three-year post-transplantation survival rates similar to that of HIV-negative patients. Based on this evidence, HIV-positive patients are now considered eligible for transplantation. However, newly emerging guidelines include the stipulation that HIV-positive patients must be on HAART to be placed on a waiting list for transplantation. The purpose of the present paper is to evaluate the scientific and ethical probity of requiring HIV-positive patients to be on HAART as a condition for being on a liver transplant waiting list. It is argued that the emphasis should be placed on the probability of post-transplantation HAART tolerance, and that concerns about pretransplantation HAART tolerance are of secondary importance.

  2. Early uptake of HIV clinical care after testing HIV-positive during home-based testing and counseling in western Kenya.

    Science.gov (United States)

    Medley, Amy; Ackers, Marta; Amolloh, Manase; Owuor, Patrick; Muttai, Helen; Audi, Beryl; Sewe, Manquins; Laserson, Kayla

    2013-01-01

    Home-based HIV testing and counseling (HBTC) has the potential to increase access to HIV testing. However, the extent to which HBTC programs successfully link HIV-positive individuals into clinical care remains unclear. To determine factors associated with early enrollment in HIV clinical care, adult residents (aged ≥13 years) in the Health and Demographic Surveillance System in Kisumu, Kenya were offered HBTC. All HIV-positive residents were referred to nearby HIV clinical care centers. Two to four months after HBTC, peer educators conducted home visits to consenting HIV-positive residents. Overall, 9,895 (82 %) of 12,035 residents accepted HBTC; 1,087 (11 %) were HIV-positive; and 737 (68 %) received home visits. Of those receiving home visits, 42 % reported HIV care attendance. Factors associated with care attendance included: having disclosed, living with someone attending HIV care, and wanting to seek care after diagnosis. Residents who reported their current health as excellent or who doubted their HBTC result were less likely to report care attendance. While findings indicate that HBTC was well-received in this setting, less than half of HIV-positive individuals reported current care attendance. Identification of effective strategies to increase early enrollment and retention in HIV clinical care is critical and will require coordination between testing and treatment program staff and systems.

  3. A survey of healthcare workers' attitude towards their HIV positive coworkers in A- level hospitals in Beijing%北京市三甲医院医务人员对感染HIV的医务人员的态度

    Institute of Scientific and Technical Information of China (English)

    邬娜; 钮文异

    2011-01-01

    目的 调查分析北京市三甲医院医务人员,对于感染艾滋病病毒(HIV)的医务人员的态度.方法 采用方便抽样的方法,对北京市三甲医院的医务人员进行自填式问卷调查,并做描述性分析.结果 共调查医务人员392名,69.6%的人从未接受过HIV抗体检测,56.4%的人同意应该对医务人员强制进行HIV抗体检测,68.4%的人同意感染HIV的医务人员不能进行侵入性操作,40.8%的人同意感染HIV的医务人员在进行侵入性操作前,应该向病人说明自己的病情.以上四部分的态度与HIV暴露防护知识的相关系数没有统计学意义.结论 大部分医务人员从未接受过HIV抗体检测,是否在医务人员中进行HIV抗体检测、对感染HIV的医务人员的从业规范做出相关规定,还需要进一步的研究论证.%Objective To investigate the healthcare workers' (HCWs) attitude towards their HIV positive co-workers in A-level hospitals in Beijing. Methods Information was collected from HCWs who were selected by convenience sampling in two A-level hospitals in Beijing. The questionnaires covered the experience of having HIV antibody test, the attitude towards other HIV positive HCWs, universal HIV test among HCWs, restrictions on performing clinical procedures and disclosure of their health conditions to patients. Descriptive analysis was used. Results Among the 392 HCWs respondents, 69. 6% never tested their HIV conditions; 56. 4% agreed that mandatory HIV testing for HCWs was necessary; 68. 4% agreed that invasive procedures should not be performed by infected HCWs ; 40. 8% of respondents agreed that HIV positive conditions should be disclosed to the patients before invasive procedures were performed. The above attitudes showed no correlation with the knowledge of HIV protection. Conclusions Most of the HCWs have never tested their HIV conditions before. Whether universal HIV testing among HCWs is necessary and whether working guideline is to be

  4. Interactive "Video Doctor" counseling reduces drug and sexual risk behaviors among HIV-positive patients in diverse outpatient settings.

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    Paul Gilbert

    Full Text Available BACKGROUND: Reducing substance use and unprotected sex by HIV-positive persons improves individual health status while decreasing the risk of HIV transmission. Despite recommendations that health care providers screen and counsel their HIV-positive patients for ongoing behavioral risks, it is unknown how to best provide "prevention with positives" in clinical settings. Positive Choice, an interactive, patient-tailored computer program, was developed in the United States to improve clinic-based assessment and counseling for risky behaviors. METHODOLOGY AND FINDINGS: We conducted a parallel groups randomized controlled trial (December 2003-September 2006 at 5 San Francisco area outpatient HIV clinics. Eligible patients (HIV-positive English-speaking adults completed an in-depth computerized risk assessment. Participants reporting substance use or sexual risks (n = 476 were randomized in stratified blocks. The intervention group received tailored risk-reduction counseling from a "Video Doctor" via laptop computer and a printed Educational Worksheet; providers received a Cueing Sheet on reported risks. Compared with control, fewer intervention participants reported continuing illicit drug use (RR 0.81, 95% CI: 0.689, 0.957, p = 0.014 at 3 months; and RR 0.65, 95% CI: 0.540, 0.785, p<0.001 at 6 months and unprotected sex (RR 0.88, 95% CI: 0.773, 0.993, p = 0.039 at 3 months; and RR 0.80, 95% CI: 0.686, 0.941, p = 0.007 at 6 months. Intervention participants reported fewer mean days of ongoing illicit drug use (-4.0 days vs. -1.3 days, p = 0.346, at 3 months; and -4.7 days vs. -0.7 days, p = 0.130, at 6 months than did controls, and had fewer casual sex partners at (-2.3 vs. -1.4, p = 0.461, at 3 months; and -2.7 vs. -0.6, p = 0.042, at 6 months. CONCLUSIONS: The Positive Choice intervention achieved significant cessation of illicit drug use and unprotected sex at the group-level, and modest individual-level reductions in days of ongoing drug use and

  5. Factors influencing CD4 cell count in HIV-positive pregnant women in a secondary health center in Lagos, Nigeria

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    Akinbami AA

    2015-04-01

    Full Text Available Akinsegun A Akinbami,1 Abidoye Gbadegesin,2 Sarah O Ajibola,3 Ebele I Uche,1 Adedoyin O Dosunmu,1 Adewumi Adediran,4 Adekunle Sobande2 1Department of Haematology and Blood Transfusion, 2Department Of Obstetrics and Gynaecology, College of Medicine, Lagos State University, Ikeja, Lagos, Nigeria; 3Department of Haematology and Immunology, Ben-Carson School of Medicine, Babcock University, Ilisan, Ogun State, Nigeria; 4Department of Haematology and Blood Transfusion, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Lagos, Nigeria Background: Immunity in pregnancy is physiologically compromised, and this may affect CD4 count levels. It is well-established that several factors affect CD4 count level in pregnancy. This study aimed to determine the mean and reference range of CD4 count in human immunodeficiency virus (HIV-positive pregnant women in Lagos, Nigeria. Methods: A retrospective study was carried out at antenatal clinics of the Maternal and Child Center of a secondary health center in Lagos State, Nigeria. Records of HIV-positive pregnant women at various gestational ages, including CD4+ cell count at booking, packed cell volume (PCV at booking and labor, gestational age at delivery, and infant weight and sex were retrieved. The descriptive data was given as mean ± standard deviation (SD. Pearson's chi-squared test and correlation were used for analytical assessment. Results: Data were retrieved for a total of 143 patients. The mean age was 31.15±3.78 years. The mean PCV was 31.01%±3.79% at booking and 30.49%±4.80% during labor. The mean CD4 count was 413.87±212.09 cells/µL, with a range of 40 to 1,252 cells/µL. The mean infant weight was 3.05±0.45 kg, with a range of 2 to 5 kg. Age of the mother, gestational age, and PCV at booking were not statistically significantly associated with CD4 count. Conclusion: Maternal age, gestational age, and PCV at booking had no significant effects on CD4+ cell count levels in

  6. Contraceptive use and unmet need for family planning among HIV positive women on antiretroviral therapy in Kumasi, Ghana.

    Science.gov (United States)

    Laryea, Dennis Odai; Amoako, Yaw Ampem; Spangenberg, Kathryn; Frimpong, Ebenezer; Kyei-Ansong, Judith

    2014-10-11

    A key strategy for minimizing HIV infection rates especially via reduction of Mother- to-Child transmission is by reducing the unmet need for family planning. In Ghana, the integration of family planning services into Antiretroviral Therapy services for persons living with HIV/AIDS has largely been ignored. We set out to measure the prevalence of modern methods of contraception, the unmet need for family planning and to identify factors associated with the use of modern methods of contraception among HIV positive women on anti retroviral therapy. This was a descriptive cross sectional study of HIV positive women in their reproductive ages accessing care at an adult Antiretroviral Therapy Clinic in Kumasi, Ghana. Data was collected using a structured questionnaire. Data analysis was conducted using Epi Info version 7.1.2.0. A total of 230 women were included in the study. Fifty six percent were in the 30-39 year age group. The mean age (SD) was 36.3 (5.4) years. While 53.5% of respondents desired to have children, partner desire for children was reported by 54.6% of respondents with partners. About 74% had received information on contraception from their provider. 42.6% of participants and/or their partners were using a contraception method at the time of study; the male condom (79.6%) being the most commonly used method. The estimated unmet need for contraception was 27.8%. Contraceptive use was strongly associated with partner knowledge of HIV status (AOR = 3.64; 95% CI 1.36-9.72; p = 0.01) and use of a contraceptive method prior to diagnosis of HIV (AOR = 6.1; 2.65-14.23; p Contraceptive Prevalence is high among HIV positive women in Kumasi compared with the general Ghanaian population. Despite this, there still is a high unmet need for family planning in this population. We recommend continuous education on contraceptives use to HIV patients accessing HAART services to further increase contraceptive uptake.

  7. Smoking and anal high-risk human papillomavirus DNA loads in HIV-positive men who have sex with men.

    Science.gov (United States)

    Wieland, Ulrike; Hellmich, Martin; Wetendorf, Janna; Potthoff, Anja; Höfler, Daniela; Swoboda, Jochen; Fuchs, Wolfgang; Brockmeyer, Norbert; Pfister, Herbert; Kreuter, Alexander

    2015-10-01

    HIV-positive men who have sex with men (MSM) have an increased risk for anal human papillomavirus (HPV) infection, anal high-grade intraepithelial lesions (HSIL), and anal cancer. Smoking is associated with abnormal anal cytology and with an increased risk for anal cancer. We collected 3736 intraanal swabs from 803 HIV-positive MSM who participated in an anal cancer screening program between October 2003 and August 2014. HPV prevalence, anal cytology and HPV DNA load of high-risk (HR) HPV-types 16, 18, 31 and 33 of non-smokers and smokers were compared. HPV-typing was performed by alpha-HPV genus-specific PCR and hybridization with 38 type-specific probes using a multiplex genotyping assay. In samples positive for HPV16, 18, 31, or 33, HPV DNA loads were determined by type-specific real-time PCRs and expressed as HPV DNA copies per betaglobin gene copy. At baseline, HR-HPV DNA (80.5 vs. 89.0%, p=0.001), HPV16 DNA (41.6 vs. 52.3%, p=0.003), HPV18 DNA (15.5 vs. 26.0%, panal dysplasia (LSIL+HSIL; 51.5 vs. 58.4%, p=0.045) and HSIL (17.2 vs. 22.7%, p=0.048) were detected more frequently in smokers compared to non-smokers. Throughout the study period 32.7% of non-smokers and 39.9% of smokers developed HSIL (p=0.011), and three smokers developed anal cancer. Considering swabs from the entire study period (median HPV load value per patient per cytology grade), smokers with normal anal cytology had significantly higher HPV16 loads (median 0.29 vs. 0.87, n=201, p=0.007) and cumulative high-risk-HPV loads (median 0.53 vs. 1.08, n=297, p=0.004) than non-smokers. Since elevated HR-HPV DNA loads are associated with an increased risk for HPV-induced anogenital cancers, HPV-infected HIV-positive MSM should be counseled to refrain from smoking. Additionally, for smokers, shorter anal cancer screening intervals than for non-smokers may be appropriate.

  8. Jarisch-Herxheimer reaction among HIV-positive patients with early syphilis: azithromycin versus benzathine penicillin G therapy

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    Mao-Song Tsai

    2014-08-01

    Full Text Available Introduction: The Jarisch-Herxheimer reaction, a febrile inflammatory reaction that often occurs after the first dose of chemotherapy in spirochetal diseases, may result in deleterious effects to patients with neurosyphilis and to pregnant women. A single 2-g oral dose of azithromycin is an alternative treatment to benzathine penicillin G for early syphilis in areas with low macrolide resistance. With its potential anti-inflammatory activity, the impact of azithromycin on the incidence of the Jarisch-Herxheimer reaction in HIV-positive patients with early syphilis has rarely been investigated. Methods: In HIV-positive patients with early syphilis, the Jarisch-Herxheimer reaction was prospectively investigated using the same data collection form in 119 patients who received benzathine penicillin G between 2007 and 2009 and 198 who received azithromycin between 2012 and 2013, when shortage of benzathine penicillin G occurred in Taiwan. Between 2012 and 2013, polymerase chain reaction (PCR assay was performed to detect Treponema pallidum DNA in clinical specimens, and PCR restriction fragment length polymorphism of the 23S ribosomal RNA was performed to detect point mutations (2058G or A2059G that are associated with macrolide resistance. Results: The overall incidence of the Jarisch-Herxheimer reaction was significantly lower in patients receiving azithromycin than those receiving benzathine penicillin G (14.1% vs. 56.3%, p<0.001. The risk increased with higher rapid plasma reagin (RPR titres (adjusted odds ratio [AOR] per 1-log2 increase, 1.21; confidence interval [CI], 1.04–1.41, but decreased with prior penicillin therapy for syphilis (AOR, 0.37; 95% CI, 0.19–0.71 and azithromycin treatment (AOR, 0.15; 95% CI, 0.08–0.29. During the study period, 310 specimens were obtained from 198 patients with syphilis for PCR assays, from whom T. pallidum was identified in 76 patients, one of whom (1.3% was found to be infected with T. pallidum

  9. Prevalence of postnatal depression and associated factors among HIV-positive women in primary care in Nkangala district, South Africa

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    K Peltzer

    2011-12-01

    Full Text Available Background. The prevalence of postpartum depression in South Africa is high, but there is lack of prevalence data on postnatal depression among HIV-infected women. Aim. The aim of this study was to determine the prevalence of depressed mood and associated factors in postnatal HIV-positive women in primary care facilities in Nkangala district, Mpumalanga, South Africa. Methods. This cross-sectional study was carried out on 607 HIV-positive postnatal women in 48 primary health care clinics and community health centres in Nkangala district. Postnatal women were recruited by systematic sampling (every consecutive patient over a period of 2 months. Demographic and other data were obtained from all the women who responded to a questionnaire in the local language on male involvement, HIV test disclosure, delivery and infant profile, infant HIV diagnosis, stigma, discrimination, postnatal depression, attendance of support groups and social support. Results. Overall, 45.1% of women reported a depressed mood in the postnatal period. Depressed mood in a multivariable analysis was significantly associated with internalised stigma (odds ratio (OR 1.12, 95% confidence interval (CI 1.05 - 1.19; p=0.000, discrimination experiences (OR 1.22, CI 1.03 - 1.46; p=0.023, lack of social support (OR 0.86, CI 0.74 - 0.99; p=0.037 and having had an STI in the past 12 months (OR 2.22, CI 1.21 - 4.04; p=0.010. There were no statistically significant correlations between the Edinburgh Postnatal Depression Scale (EPDS scores of the women and age, marital status, level of education, employment status and number of own children. Conclusion. Depressed mood is common among HIV-positive postpartum women. This is significantly associated with lack of social support, stigma and discrimination. Routine screening to identify those currently depressed or at risk of depression should be integrated into postnatal care settings to target those most needing intervention.

  10. Effects of cigarette smoking and nicotine dependence on adherence to antiretroviral therapy among HIV-positive patients in Vietnam.

    Science.gov (United States)

    Nguyen, Nhung T P; Tran, Bach X; Hwang, Lu Y; Markham, Christine M; Swartz, Michael D; Vidrine, Jennifer I; Phan, Huong T T; Latkin, Carl A; Vidrine, Damon J

    2016-01-01

    Cigarette smoking is increasingly recognized as an indicator for inferior adherence to antiretroviral therapy (ART) among HIV-positive patients. Given the limited body of work on this issue, we aimed to explore the relations between cigarette smoking, nicotine dependence, and ART adherence in Vietnam. A cross-sectional study of 1050 HIV-positive people was conducted from January to September 2013 in Hanoi (the capital) and Nam Dinh (a rural city). Adherence to ART during the last 30 days was measured by the 100-point visual analog scale (VAS). Smoking history and nicotine dependence (Fagerstrom Test of Nicotine Dependence) were self-reported by participants. Multiple logistic regression was performed to examine the association of current smoking and nicotine dependence with ART nonadherence. Using the established VAS cut point of 95 to indicate adequate adherence, the prevalence of ART nonadherence was 30.9%. Approximately 35.5% of the sample reported current smoking. No association between smoking status and ART nonadherence was found. However, participants with greater nicotine dependence (OR = 1.1, 95%CI = 1.0-1.2 per unit increase) were more likely to be nonadherent. Also, individuals who were female (OR = 1.70, 95%CI = 1.19-2.42), receiving ART in Nam Dinh (OR = 1.6, 95%CI = 1.1-2.4), and currently feeling anxiety (OR = 1.6, 95% CI = 1.2-2.1) had a higher likelihood of ART nonadherence. Additionally, current smokers reporting current pain (OR = 1.9, 95%CI = 1.2-3.1) were more likely to be nonadherent. Conversely, protective factors included living with a spouse/partner (OR = 0.5, 95%CI = 0.3-0.7) and having more than a high school education (OR = 0.4, 95%CI = 0.1-1.0). Given the high prevalence of suboptimal adherence and current smoking among HIV-positive patients, screening for smoking status and nicotine dependence during ART treatment may help to improve patients' adherence to medication. More efforts

  11. Impaired progenitor cell function in HIV-negative infants of HIV-positive mothers results in decreased thymic output and low CD4 counts

    DEFF Research Database (Denmark)

    Nielsen, S D; Jeppesen, D L; Kolte, L

    2001-01-01

    and fetal thymic organ cultures (FTOCs). Lower naive CD4 counts (459.3 +/- 68.9 vs 1128.9 +/- 146.8 cells/microL, P mothers were found (frequency of CD4(+) cells with TRECs was 3.6% +/- 0.7% compared with 14.3% +/- 2.2% in controls, P ...). In combination with lower red blood cell counts in infants of HIV-positive mothers, this finding suggested impairment of progenitor cell function. Indeed, progenitors from infants of HIV-positive mothers had decreased cloning efficiency (15.7% +/- 2.6% vs 55.8% +/- 15.9%, P =.009) and seemed to generate fewer T...... cells in FTOCs. In conclusion, lower numbers of naive CD4(+) cells and reduced thymic output in HIV-negative infants of HIV-positive mothers may be due to impaired progenitor cell function....

  12. High HIV prevalence, suboptimal HIV testing, and low knowledge of HIV-positive serostatus among injection drug users in St. Petersburg, Russia.

    Science.gov (United States)

    Niccolai, Linda M; Toussova, Olga V; Verevochkin, Sergei V; Barbour, Russell; Heimer, Robert; Kozlov, Andrei P

    2010-08-01

    The purpose of this analysis was to estimate human immunodeficiency virus (HIV) prevalence and testing patterns among injection drug users (IDUs) in St. Petersburg, Russia. HIV prevalence among 387 IDUs in the sample was 50%. Correlates of HIV-positive serostatus included unemployment, recent unsafe injections, and history/current sexually transmitted infection. Seventy-six percent had been HIV tested, but only 22% of those who did not report HIV-positive serostatus had been tested in the past 12 months and received their test result. Correlates of this measure included recent doctor visit and having been in prison or jail among men. Among the 193 HIV-infected participants, 36% were aware of their HIV-positive serostatus. HIV prevalence is high and continuing to increase in this population. Adequate coverage of HIV testing has not been achieved, resulting in poor knowledge of positive serostatus. Efforts are needed to better understand motivating and deterring factors for HIV testing in this setting.

  13. Effect of antiretroviral therapy on clinical and immunologic disease progression in HIV positive children: One-year follow-up study

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    Ankur Patel

    2012-01-01

    Full Text Available Objective: To study the effect of antiretroviral therapy (ART on clinical, immunologic, and nutritional progression of disease in human immunodeficiency virus (HIV-infected children for 1 year. Materials and Methods: The study included 54 children aged 1.5-15 years who registered at the ART center, Surat, from August 2007 to August 2009. During the study period, the children were followed-up at 6 monthly intervals up to 1 year after starting ART. World Health Organization (WHO clinical staging and CD4 cell count as per national guidelines, and nutritional status were used to measure clinical and immunologic progression of disease up to 1 year. Results: Out of 54 children, mother-to-child transmission was reported in 96.2% children; for 74% of the children, both parents were HIV positive. All the children were classified according to WHO clinical staging into 4 stages and as per CD4 cell count (%, followed up at 6 and 12 months and the benefits with ART reported. At 12 months follow-up, 15% of the study group children had died. Both mean CD4 count and a relative percentage showed significant increase (P < 0.01 in the study group 1 year after ART. Conclusion: The present study reports benefits of ART in terms of clinical and immunologic progression of disease, nutritional status of HIV-infected children after 1 year of ART.

  14. Trouble with bleeding: risk factors for acute hepatitis C among HIV-positive gay men from Germany--a case-control study.

    Directory of Open Access Journals (Sweden)

    Axel J Schmidt

    Full Text Available OBJECTIVES: To identify risk factors for hepatitis C among HIV-positive men who have sex with men (MSM, focusing on potential sexual, nosocomial, and other non-sexual determinants. BACKGROUND: Outbreaks of hepatitis C virus (HCV infections among HIV-positive MSM have been reported by clinicians in post-industrialized countries since 2000. The sexual acquisition of HCV by gay men who are HIV positive is not, however, fully understood. METHODS: Between 2006 and 2008, a case-control study was embedded into a behavioural survey of MSM in Germany. Cases were HIV-positive and acutely HCV-co-infected, with no history of injection drug use. HIV-positive MSM without known HCV infection, matched for age group, served as controls. The HCV-serostatus of controls was assessed by serological testing of dried blood specimens. Univariable and multivariable regression analyses were used to identify factors independently associated with HCV-co-infection. RESULTS: 34 cases and 67 controls were included. Sex-associated rectal bleeding, receptive fisting and snorting cocaine/amphetamines, combined with group sex, were independently associated with case status. Among cases, surgical interventions overlapped with sex-associated rectal bleeding. CONCLUSIONS: Sexual practices leading to rectal bleeding, and snorting drugs in settings of increased HCV-prevalence are risk factors for acute hepatitis C. We suggest that sharing snorting equipment as well as sharing sexual partners might be modes of sexual transmission. Condoms and gloves may not provide adequate protection if they are contaminated with blood. Public health interventions for HIV-positive gay men should address the role of blood in sexual risk behaviour. Further research is needed into the interplay of proctosurgery and sex-associated rectal bleeding.

  15. Risk factors for anal human papillomavirus infection type 16 among HIV-positive men who have sex with men in San Francisco

    Science.gov (United States)

    Hernandez, Alexandra L.; Efird, Jimmy T.; Holly, Elizabeth A.; Berry, J. Michael; Jay, Naomi; Palefsky, Joel M.

    2015-01-01

    Background and Objective HIV-positive men who have sex with men (MSM) are at high risk of anal cancer compared with the general population. Human papillomavirus (HPV) infection, particularly HPV 16, is causally associated with anal cancer. However, risk factors for anal HPV 16 infection are poorly understood. We determined the prevalence and risk factors for anal HPV 16 infection in a population of HIV-positive MSM, most of whom were being treated with antiretroviral therapy. Design Cross-sectional data from the baseline visit of a 4-year prospective cohort study. Methods 348 HIV-positive MSM were recruited in San Francisco and received a detailed sexual behavior risk-factor questionnaire. An anal swab was used to collect specimens for HPV type-specific DNA testing using L1 HPV DNA PCR. We used log-binomial multivariable models to determine risk factors for anal HPV 16 infection. Results 92% of HIV-positive MSM had at least one anal HPV type, 80% had at least one oncogenic HPV type and 42% had HPV 16. Non-Hispanic white race and higher level of education were associated with a decreased risk of HPV 16 infection. A higher number of total male partners was associated with HPV 16 (RR: 1.6, 95%CI 1.1–2.4, p=0.01) for 201–1000 partners compared with 1–200. Injection drug use (IDU) was independently associated with anal HPV 16 infection (RR: 1.5, 95%CI 1.2–1.9, p=0.003). Conclusions The prevalence of anal HPV infection, including HPV 16, is high in HIV-positive MSM. HIV-positive MSM should be counseled about the risk associated with increased partners and IDU. PMID:23614994

  16. A preliminary study of spiritual self-schema (3-S(+)) therapy for reducing impulsivity in HIV-positive drug users.

    Science.gov (United States)

    Margolin, Arthur; Schuman-Olivier, Zev; Beitel, Mark; Arnold, Ruth M; Fulwiler, Carl E; Avants, S Kelly

    2007-10-01

    The purpose of this study was twofold. First, pretreatment correlations are presented among impulsivity, intoxicant use, HIV risk behavior, spirituality, and motivation in a sample of 38 HIV-positive drug users. Second, treatment outcomes are presented from a preliminary study of spiritual self-schema (3-S(+)) therapy - a manual-guided psychotherapy integrating cognitive and Buddhist psychologies - for increasing motivation for abstinence, HIV prevention, and medication adherence. Impulsivity was negatively correlated with spiritual practices and motivation for recovery, and was positively related to intoxicant use and HIV risk behavior. Relative to a standard care comparison condition, patients completing 3-S(+) therapy reported greater decreases in impulsivity and intoxicant use, and greater increases in spiritual practices and motivation for abstinence, HIV prevention, and medication adherence.

  17. Cause-Specific Mortality in HIV-Positive Patients Who Survived Ten Years after Starting Antiretroviral Therapy

    DEFF Research Database (Denmark)

    Trickey, Adam; May, Margaret T; Vehreschild, Jorg-Janne

    2016-01-01

    years 656/13,011 (5%) patients died. Older age, male sex, injecting drug use transmission, AIDS, and low CD4 count and detectable viral replication ten years after starting combination antiretroviral therapy were associated with higher subsequent mortality. CD4 count at ART start did not predict......OBJECTIVES: To estimate mortality rates and prognostic factors in HIV-positive patients who started combination antiretroviral therapy between 1996-1999 and survived for more than ten years. METHODS: We used data from 18 European and North American HIV cohort studies contributing...... to the Antiretroviral Therapy Cohort Collaboration. We followed up patients from ten years after start of combination antiretroviral therapy. We estimated overall and cause-specific mortality rate ratios for age, sex, transmission through injection drug use, AIDS, CD4 count and HIV-1 RNA. RESULTS: During 50,593 person...

  18. Personal values and meaning in the use of methamphetamine among HIV-positive men who have sex with men.

    Science.gov (United States)

    Chartier, Maggie; Araneta, Angela; Duca, Lindsey; McGlynn, Lawrence M; Gore-Felton, Cheryl; Goldblum, Peter; Koopman, Cheryl

    2009-04-01

    Our aim with this qualitative study was to understand the role of personal values, meaning, and impact of drug use among HIV-positive men who have sex with men (MSM) who struggle with methamphetamine use. Participants were 22 MSM recruited from an ethnically diverse county in the San Francisco Bay area of California. Grounded theory was used to analyze the data collected in individual interviews. Emergent constructs of context, meaning, and perceived impact were identified and are described in a theoretical narrative format. The importance of broadening our understanding of HIV and methamphetamine addiction and their interaction is highlighted. This study contributes to the understanding of the complexity of methamphetamine use within the specific population of MSM living with HIV/ AIDS, and suggests possible directions for addressing important maintaining factors like adaptive use and enhancing factors that could contribute to an individual's ability to make better choices based on meaning and personal values.

  19. Management of mental health disorders and central nervous system sequelae in HIV-positive children and adolescents

    Directory of Open Access Journals (Sweden)

    R Nassen

    2014-09-01

    Full Text Available HIV-positive children and adolescents are at increased risk of both central nervous system (CNS sequelae and mental disorders owing to a number of factors, including the impact of HIV infection on the brain, social determinants of health (e.g. poverty and orphanhood and psychosocial stressors related to living with HIV. Every effort should be made to identify perinatally HIV-infected children and initiate them on antiretroviral therapy early in life. HIV clinicians should ideally screen for mental health and neurocognitive problems, as part of the routine monitoring of children attending antiretroviral clinics. This guideline is intended as a reference tool for HIV clinicians to support the early identification, screening and management of mental health disorders and/or CNS impairment in children and adolescents. This guideline covers mental disorders (section 1 and HIV-associated neurocognitive disorders (section 2 among children and adolescents.  

  20. Unusual immunophenotypic variant of large B-cell lymphoma associated with HHV-8 and EBV in an HIV positive patient

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    Roberto Ruiz-Cordero, MD

    2015-06-01

    Full Text Available Human herpesvirus type 8, also known as Kaposi's sarcoma-associated herpesvirus (HHV-8/KSHV has been associated with several lymphoproliferative disorders including Kaposi's sarcoma, primary effusion lymphoma (PEL, cases of multicentric Castleman's disease (MCD including plasmablastic lymphoma associated with MCD, and germinotropic lymphoproliferative disorder. These lymphoproliferative disorders, with the exception of the latter, usually arise in HIV-positive or profoundly immunosuppressed patients. Herein, we describe an unusual large B-cell lymphoma in a 43 year-old male infected with HIV who presented with multiple lymphadenopathies. The tumor cells were positive for EBV, HHV-8/KSHV, CD20 (small subset, PAX5, and IgM and negative for CD138, and IgG. This lymphoma is difficult to classify following the 2008 WHO criteria and expands the current spectrum of viral-associated lymphomas.

  1. Detection and quantification of EBV, HHV-6 and CMV DNA in the gastrointestinal tract of HIV-positive patients.

    Science.gov (United States)

    Falasca, F; Maida, P; Gaeta, A; Verzaro, S; Mezzaroma, I; Fantauzzi, A; Donato, G; Bonci, E; Castilletti, C; Antonelli, G; Turriziani, O

    2014-12-01

    Human herpes viruses (HHVs) have been frequently detected in the gastrointestinal (GI) tract and may contribute to the development of gastric cancer. In the present study, the detection rate and viral load of Epstein Barr virus (EBV), HHV-6 and Cytomegalovirus (CMV) were assessed in the GI tract of human immunodeficiency virus (HIV) positive patients and of uninfected patients. The analysis revealed a significantly higher detection rate of EBV and HHV-6 in HIV-infected individuals than in uninfected subjects (88.5 vs 63%; p = 0.03). Moreover, EBV DNA load was significantly higher in the stomach of HIV patients than in controls. These data suggest that the HIV infection status may increase the persistence of these viruses in the GI compartment. Intriguingly, CMV DNA was undetectable in all biopsy specimens analyzed.

  2. Inhaled corticosteroid use in HIV-positive individuals taking protease inhibitors: a review of pharmacokinetics, case reports and clinical management.

    Science.gov (United States)

    Saberi, P; Phengrasamy, T; Nguyen, D P

    2013-10-01

    As a consequence of inhibition of the hepatic cytochrome P450 3A4 isozyme, treatment with HIV protease inhibitors can result in significant drug-drug interactions. One noteworthy interaction is between protease inhibitors and inhaled or intranasal corticosteroids. This interaction can result in adrenal insufficiency and iatrogenic Cushing's syndrome (with symptoms such as rapid weight gain, obesity, facial hirsutism and swelling), as well as hypertension, osteoporosis and decreased CD4 cell count. In this paper, we review and unite pharmacokinetic data, case reports and current research regarding this drug-drug interaction in order to suggest options for the clinical management of HIV-positive patients requiring treatment with protease inhibitors and inhaled or intranasal corticosteroids.

  3. Ethnic diversity and patterns of infection of a UK HIV-positive patient population outwith major conurbations.

    Science.gov (United States)

    Aiken, A R A; Lever, A M L

    2010-12-01

    We surveyed the HIV-positive population attending a major teaching hospital sited outwith a major conurbation. Eighty-five percent of homosexually acquired infections were contracted within the UK and 91% of heterosexually acquired infections were contracted outside of the UK. A strikingly wide range of nationalities (45) and countries of origin of infection were represented within a relatively small patient population. Most patients were non-UK-born immigrants. A high proportion of illegal immigrants were identified within which there was a high proportion lost to follow-up. This degree of ethnic diversity and domiciliary instability is rarely a feature of non-HIV populations in this setting and imposes additional demands on delivery of care and health-care planning.

  4. Relational contexts in adjustment to pregnancy of HIV-positive women: relationships, social support and personal adjustment.

    Science.gov (United States)

    Pereira, Marco; Canavarro, Maria Cristina

    2009-03-01

    Relational contexts are a central issue in most people's lives, and people usually rely on the support of others in everyday circumstances. Social support, as a relational context, could have a positive influence on personal adjustment, and is particularly relevant in the psychological well-being of HIV patients. Guided by the Convoy Model of social networks, in a sample of 31 HIV-positive pregnant women we try to assess the role of social support and social network in the adjustment to pregnancy. Profile analysis suggests a greater importance of social support provided by the partner and both parents, especially the support provided by the mother. At the same time, it seems to highlight the buffering hypothesis of social support, which could be understood as a protection factor in the adjustment of HIV-infected women' to pregnancy.

  5. Timing of pregnancy, postpartum risk of virologic failure and loss to follow-up among HIV-positive women.

    Science.gov (United States)

    Onoya, Dorina; Sineke, Tembeka; Brennan, Alana T; Long, Lawrence; Fox, Matthew P

    2017-07-17

    We assessed the association between the timing of pregnancy with the risk of postpartum virologic failure and loss from HIV care in South Africa. This is a retrospective cohort study of 6306 HIV-positive women aged 15-49 at antiretroviral therapy (ART) initiation, initiated on ART between January 2004 and December 2013 in Johannesburg, South Africa. The incidence of virologic failure (two consecutive viral load measurements of >1000 copies/ml) and loss to follow-up (>3 months late for a visit) during 24 months postpartum were assessed using Cox proportional hazards modelling. The rate of postpartum virologic failure was higher following an incident pregnancy on ART [adjusted hazard ratio 1.8, 95% confidence interval (CI): 1.1-2.7] than among women who initiated ART during pregnancy. This difference was sustained among women with CD4 cell count less than 350 cells/μl at delivery (adjusted hazard ratio 1.8, 95% CI: 1.1-3.0). Predictors of postpartum virologic failure were being viremic, longer time on ART, being 25 or less years old and low CD4 cell count and anaemia at delivery, as well as initiating ART on stavudine-containing or abacavir-containing regimen. There was no difference postpartum loss to follow-up rates between the incident pregnancies group (hazard ratio 0.9, 95% CI: 0.7-1.1) and those who initiated ART in pregnancy. The risk of virologic failure remains high among postpartum women, particularly those who conceive on ART. The results highlight the need to provide adequate support for HIV-positive women with fertility intention after ART initiation and to strengthen monitoring and retention efforts for postpartum women to sustain the benefits of ART.

  6. A STUDY TO DETERMINE THE PREVALENCE OF CARDIAC DISEASE IN HIV POSITIVE PATIENTS IN A TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Purushottam Rao

    2015-03-01

    Full Text Available INTRODUCTION : Acquired immune deficiency syndrome was recognized as an emerging disease only in the early 1980’s. The disease has rapidly established itself throughout the world and may persist well into the 21 st century. Infectio n with human immunodeficiency virus is one of the leading causes of acquired heart disease and specifically of symptomatic heart failure. The cardiac complications of HIV infection tend to occur late in the disease and as patients with HIV infection are li ving longer , they are at risk of developing chronic diseases including coronary artery disease. Hence , clinicians should identify the risk factors for such disease and also be aware of the various cardiovascular manifestations of HIV infection. AIM AND OBJ ECTIVES : To find out prevalence of cardiac disease by correlating clinical findings and echocardiographic changes in HIV positive patients. MATERIALS AND METHOD : It is an observation type of study done in the Department of Medicine and anti retroviral ther apy centre , King George Hospital , Visakhapatnam , Andhra Pradesh. It is a Tertiary Care Hospital. Fifty patients who were detected to be HIV positive were included in the study after fulfilling the inclusion and exclusion criteria. RESULTS : In this study , 1 5 patients constituting 30% of the total patients in the study had echocardiographic changes suggestive of cardiac disease with varied manifestations. CONCLUSION : Prevalence of heart disease increases with the duration of HIV illness. Patients with heart disease can be asymptomatic in early stages of the disease. So , periodic electrocardiographic and echocardiographic evaluation should be done at regular intervals from the time of diagnosis of HIV disease

  7. Outcome of tuberculosis treatment in HIV-positive adults diagnosed through active versus passive case-finding

    Directory of Open Access Journals (Sweden)

    Taye T. Balcha

    2015-03-01

    Full Text Available Background: The World Health Organization strongly recommends regular screening for tuberculosis (TB in HIV-positive individuals. Objective: To compare the outcome of anti-tuberculosis treatment (ATT in HIV-positive adults diagnosed with TB through active case-finding (ACF or passive case-finding (PCF. Design: Antiretroviral therapy (ART-naïve adults diagnosed with TB were included from two prospective cohort studies conducted in Ethiopia between September 2010 and March 2013. The PCF cohort was based at out-patient TB clinics, whereas participants in the ACF cohort were actively screened for TB by bacteriological sputum testing (smear microscopy, Xpert MTB/RIF assay, and liquid culture without pre-selection on the basis of symptoms and signs. Outcomes of ATT were compared between participants in the two cohorts; characteristics at diagnosis and predictors of adverse outcomes were analysed. Results: Among 439 TB/HIV co-infected participants, 307 and 132 belonged to PCF and ACF cohorts, respectively. Compared with the ACF participants, hemoptysis, conjunctival pallor, bedridden status, and low mid upper-arm circumference (MUAC were significantly more common in participants identified through PCF. Sputum smear-positivity rates among pulmonary TB cases were 44.2% and 21.1% in the PCF and ACF cohorts, respectively (p<0.001. Treatment success was ascertained in 247 (80.5% of the participants in the PCF cohort and 102 (77.2% of the participants in the ACF cohorts (p=0.223. Low MUAC (p=0.001 independently predicted mortality in the participants in both cohorts. Conclusion: Although patients identified through ACF had less advanced TB disease, ATT outcome was similar to the patients identified through PCF. To achieve a better outcome, case management in ACF strategy should be strengthened through enhanced patient-centred counselling and adherence support.

  8. Periodontal status in HIV-positive individuals and its possible correlation with CD4+T cell count

    Directory of Open Access Journals (Sweden)

    K Asif

    2012-01-01

    Full Text Available Background : Infection with human immunodeficiency virus (HIV results in loss of immunologic functions, especially those coordinated by CD4+ T-helper cells and consequent impairment of immune response. Periodontal disease has been associated with HIV infection, and HIV infection has been considered a modifier of periodontal disease. Aim: The aim of this study was to report the severity of periodontal disease in HIV-positive individuals and its association between clinical periodontal indices and CD4+T-cell count. Materials and Methods: 25 HIV-positive individuals were recruited and medical history was recorded. To evaluate periodontal disease, clinical attachment loss (CAL, oral hygiene index (OHI, and gingival bleeding index (GI were recorded. Immune suppression was measured by peripheral blood CD4+T cells/mm 3 as analyzed by flow cytometry. Statistical Analysis: Association between CD4+ T levels and clinical parameters were determined using correlation coefficient test. Results: When all subjects were evaluated, a negative correlation was obtained between CD4+ T-cell count and clinical attachment loss (r = -0.68226. In individuals with CD4+cell counts <200 cells/ mm 3 , a negative correlation was obtained between clinical attachment loss (-0.35467 and GI (-0.35202. In patients with CD4 count <200, a negative correlation was obtained between CAL (-0.30361, GI (-0.29711, and OHI (-0.14669. Conclusion: Immune suppression in combination with risk factors may increase progression of periodontal disease. Hence, these individuals should practice better oral hygiene and regular follow-up.

  9. [Rapid development of anemia in a HIV-positive patient with alpha-thalassemia after zidovudine therapy].

    Science.gov (United States)

    Altinbaş, Akif; Ozkaya, Gülşen; Büyükaşik, Yahya; Unal, Serhat

    2007-07-01

    Anemia, which may develop due to direct effect of the virus or indirect effect of zidovudine a widely used antiviral agent for the treatment, is not an uncommon complication in human immundeficiency virus (HIV) infections. In this report, a 26 years old male HIV positive patient who developed rapid anemia in the HAART (Highly active anti-retroviral therapy) protocol including zidovudine, was presented. The patient has been followed since May 2003 without anti-retroviral therapy. He was diagnosed as alpha-thalassemia trait, because of the low mean red blood cell volume (MCV), high red blood cell count and living in an Mediterranian country. However, no treatment for thalassemia had been given in this period, since the other laboratory findings [hemoglobin, hematocrit, red cell distribution width index (RDWI), iron and iron binding capacity, transferrin saturation and ferritin levels] were normal. During the follow-up of patient, HAART protocol with zidovudine, lamivudine and indinavir, was started depending on the findings of low CD4+ T-cell count (443/mm3) and high HIV serum load (1,330,000 copies/ml). In the second month of the therapy the hemoglobin level decreased to 12.9 gr/dL, and then to 9.9 gr/dL in the fourth month, while it was 14.5 gr/dL before anti-retroviral therapy. Although the patient had no hemolysis findings, and his serum folic acid level was normal, folbiol treatment was initiated with the possibility of the presence of folic acid deficiency at cellular level. Anemia resolved with folic acid replacement without discontinuation of zidovudine or a reduction in dosage. It was thought that the presence of alpha-thalassemia co-morbidity has facilitated the development of anti-retroviral-induced anemia in this patient. As a result, it is concluded that thalassemia should be considered in the differential diagnosis of anemia in HIV positive patients, especially for the ones from Mediterranian countries.

  10. Sexual protection behavior in HIV-positive gay men: testing a modified information-motivation-behavioral skills model.

    Science.gov (United States)

    Nöstlinger, Christiana; Nideröst, Sibylle; Platteau, Tom; Müller, Matthias C; Staneková, Danica; Gredig, Daniel; Roulin, Christophe; Rickenbach, Martin; Colebunders, Robert

    2011-08-01

    This study on determinants of sexual protection behavior among HIV-positive gay men used the empirically tested information-motivation-behavioral skills (IMB) model. HIV-specific variables were added to the model to determine factors decisive for condom use with steady and casual partners. Data were collected using an anonymous, standardized self-administered questionnaire. Study participants were recruited at HIV outpatient clinics associated with the Eurosupport Study Group and the Swiss HIV Cohort Study. To identify factors associated with condom use, backward elimination regression analyses were performed. Overall, 838 HIV-infected gay men from 14 European countries were included in this analysis. About 53% of them reported at least one sexual contact with a steady partner; 62.5% had sex with a casual partner during the last 6 months. Forty-three percent always used condoms with steady partners and 44% with casual partners. High self-efficacy and subjective norms in favor of condom-use were associated with increased condom use with casual and steady partners, whereas feeling depressed was associated with decreased condom use with casual partners. Condoms were used less often with HIV-positive partners. Self-efficacy as an important behavioral skill to perform protection behavior was influenced by lower perceived vulnerability, higher subjective norms, and more positive safer sex attitudes. The IMB-model constructs appeared to be valid; however, not all the model predictors could be determined as hypothesized. Besides the original IMB constructs, HIV-specific variables, including sexual partners' serostatus and mental health, explained condom use. Such factors should be considered in clinical interventions to promote "positive prevention."

  11. TB Meningitis in HIV-Positive Patients in Europe and Argentina: Clinical Outcome and Factors Associated with Mortality

    Directory of Open Access Journals (Sweden)

    Anne Marie W. Efsen

    2013-01-01

    Full Text Available Objectives. The study aimed at describing characteristics and outcome of tuberculous meningitis (TBM in HIV-positive patients and comparing these parameters with those of extrapulmonary TB (TBEP and pulmonary TB (TBP. Methods. Kaplan-Meier estimation and Poisson regression models were used to assess the mortality following TB diagnosis and to evaluate potential prognostic factors for the 3 groups of TB patients separately. Results. A total of 100 patients with TBM, 601 with TBEP, and 371 TBP were included. Patients with TBM had lower CD4 cell counts and only 17.0% received antiretroviral therapy (ART at TB diagnosis. The cumulative probability of death at 12 months following TB was 51.2% for TBM (95% CI 41.4–61.6%, 12.3% for TBP (8.9–15.7%, and 19.4% for TBEP (16.1–22.6 (P<0.0001; log-rank test. For TBM, factors associated with a poorer prognosis were not being on ART (adjusted incidence rate ratio (aIRR 4.00 (1.72–9.09, a prior AIDS diagnosis (aIRR=4.82 (2.61–8.92, and receiving care in Eastern Europe (aIRR=5.41 (2.58–11.34. Conclusions. TBM among HIV-positive patients was associated with a high mortality rate, especially for patients from Eastern Europe and patients with advanced HIV-infection, which urgently calls for public health interventions to improve both TB and HIV aspects of patient management.

  12. Effect of smoking on lung function, respiratory symptoms and respiratory diseases amongst HIV-positive subjects: a cross-sectional study

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    Thabane Lehana

    2010-03-01

    Full Text Available Abstract Background Smoking prevalence in human immunodeficiency virus (HIV positive subjects is about three times of that in the general population. However, whether the extremely high smoking prevalence in HIV-positive subjects affects their lung function is unclear, particularly whether smoking decreases lung function more in HIV-positive subjects, compared to the general population. We conducted this study to determine the association between smoking and lung function, respiratory symptoms and diseases amongst HIV-positive subjects. Results Of 120 enrolled HIV-positive subjects, 119 had an acceptable spirogram. Ninety-four (79% subjects were men, and 96 (81% were white. Mean (standard deviation [SD] age was 43.4 (8.4 years. Mean (SD of forced expiratory volume in one second (FEV1 percent of age, gender, race and height predicted value (%FEV1 was 93.1% (15.7%. Seventy-five (63% subjects had smoked 24.0 (18.0 pack-years. For every ten pack-years of smoking increment, %FEV1 decreased by 2.1% (95% confidence interval [CI]: -3.6%, -0.6%, after controlling for gender, race and restrictive lung function (R2 = 0.210. The loss of %FEV1 in our subjects was comparable to the general population. Compared to non-smokers, current smokers had higher odds of cough, sputum or breathlessness, after adjusting for highly active anti-retroviral therapy (HAART use, odds ratio OR = 4.9 (95% CI: 2.0, 11.8. However respiratory symptom presence was similar between non-smokers and former smokers, OR = 1.0 (95% CI: 0.3, 2.8. All four cases of COPD (chronic obstructive pulmonary disease had smoked. Four of ten cases of restrictive lung disease had smoked (p = 0.170, and three of five asthmatic subjects had smoked (p = 1.000. Conclusions Cumulative cigarette consumption was associated with worse lung function; however the loss of %FEV1 did not accelerate in HIV-positive population compared to the general population. Current smokers had higher odds of respiratory symptoms

  13. Women, Men, and Machines.

    Science.gov (United States)

    Form, William; McMillen, David Byron

    1983-01-01

    Data from the first national study of technological change show that proportionately more women than men operate machines, are more exposed to machines that have alienating effects, and suffer more from the negative effects of technological change. (Author/SSH)

  14. Mulheres HIV positivas, reprodução e sexualidade Reproduction and sexuality in HIV-positive women, Brazil

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    Naila JS Santos

    2002-08-01

    ambiente de apoio para essas mulheres e seus parceiros, propiciando às pessoas com HIV/Aids condições de conhecer, discutir e realizar opções conscientes no que concerne às decisões reprodutivas e sua sexualidade.OBJECTIVE: To assess sexual and reproductive health needs of HIV-positive women and factors that affect their access to prevention, safer sex practices and treatment and to appraise their ability of making informed choices concerning motherhood. METHODS: This exploratory study was conducted among women of an outpatient clinic in a reference center for STD/AIDS in the city of São Paulo, Brazil, in 1997. A consecutive non-probabilistic sample of 148 HIV-positive women was investigated. The exclusion criteria included those aged under 18 years and who were physically unable. Data were collected using structured interviews. Statistical analysis was performed using Chi-square test and t-test. RESULTS: The participants' mean age was 32 years old. As for education, 92 women (62.2% had completed elementary school and 12.2% had attended university. The median number of lifetime sexual partners was 4, and half of the interviewees were still sexually active after diagnosed HIV-positive. Of the total, 76% had children and 21% were still thinking about having children in future. Having many children, alive and living with their mothers were determinant factors for not wanting any more children. It was found no association between wanting children, risk perception, partner's serologic status, contraceptive use and other factors. After getting HIV infected, there was a substantial change in the contraceptive methods used. CONCLUSIONS: HIV infection did not change women's desire for having children. HIV-positive women's sexual and reproductive rights need to be discussed and respected in health care settings. Compliance to medication and safe sex practices are essential but difficult to meet requiring both counseling and support. Couples' counseling on reproductive

  15. Cancer incidence and all-cause mortality in HIV-positive patients in Northeastern Algeria before and during the era of highly active antiretroviral therapy

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    Karima Chaabna

    2016-01-01

    Conclusions: Since 1998, the proportion of HIV-positive patients treated with HAART increased, reaching 84% in 2010, all-cause mortality decreased, and cancer remained rare. However, almost all patients who died during the study seemed to be diagnosed at a late stage of the disease, emphasizing the need for earlier diagnosis of HIV in Algeria.

  16. Impaired progenitor cell function in HIV-negative infants of HIV-positive mothers results in decreased thymic output and low CD4 counts

    DEFF Research Database (Denmark)

    Nielsen, S D; Jeppesen, D L; Kolte, L

    2001-01-01

    Hematologic and immunologic functions were examined in 19 HIV-negative infants of HIV-positive mothers and 19 control infants of HIV-negative mothers. Control infants were selected to match for gestational age, weight, and mode of delivery. Cord blood was obtained from all infants and used for flow...... and fetal thymic organ cultures (FTOCs). Lower naive CD4 counts (459.3 +/- 68.9 vs 1128.9 +/- 146.8 cells/microL, P HIV-positive mothers were found (frequency of CD4(+) cells with TRECs was 3.6% +/- 0.7% compared with 14.3% +/- 2.2% in controls, P ...). In combination with lower red blood cell counts in infants of HIV-positive mothers, this finding suggested impairment of progenitor cell function. Indeed, progenitors from infants of HIV-positive mothers had decreased cloning efficiency (15.7% +/- 2.6% vs 55.8% +/- 15.9%, P =.009) and seemed to generate fewer T...

  17. Regional differences in AIDS and non-AIDS related mortality in HIV-positive individuals across Europe and Argentina: the EuroSIDA study

    NARCIS (Netherlands)

    Reekie, J.; Kowalska, J.D.; Karpov, I.; Rockstroh, J.; Karlsson, A.; Rakhmanova, A.; Horban, A.; Kirk, O.; Lundgren, J.D.; Mocroft, A.; Burger, D.M.

    2012-01-01

    BACKGROUND: Differences in access to care and treatment have been reported in Eastern Europe, a region with one of the fastest growing HIV epidemics, compared to the rest of Europe. This analysis aimed to establish whether there are regional differences in the mortality rate of HIV-positive individu

  18. Development of a definition for Rapid Progression (RP) of renal function in HIV-positive persons: the D:A:D study

    NARCIS (Netherlands)

    Kamara, D.A.; Ryom, L.; Ross, M.; Kirk, O.; Reiss, P.; Morlat, P.; Moranne, O.; Fux, C.A.; Mocroft, A.; Sabin, C.; Lundgren, J.D.; Smith, C.J.; Koopmans, P.P.; Keuter, M.; Ven, A.J.A.M. van der; Hofstede, H.J.M. ter; Dofferhoff, A.S.M.; Warris, A.; Crevel, R. van

    2014-01-01

    BACKGROUND: No consensus exists on how to define abnormally rapid deterioration in renal function (Rapid Progression, RP). We developed an operational definition of RP in HIV-positive persons with baseline estimated glomerular filtration rate (eGFR) >90 ml/min/1.73 m2 (using Cockcroft Gault) in t

  19. Antiretroviral drug-related liver mortality among HIV-positive persons in the absence of hepatitis B or C virus coinfection

    DEFF Research Database (Denmark)

    Kovari, Helen; Sabin, Caroline A; Ledergerber, Bruno

    2013-01-01

    Liver diseases are the leading causes of death in human immunodeficiency virus (HIV)-positive persons since the widespread use of combination antiretroviral treatment (cART). Most of these deaths are due to hepatitis C (HCV) or B (HBV) virus coinfections. Little is known about other causes. Prolo...

  20. Regional differences in AIDS and non-AIDS related mortality in HIV-positive individuals across Europe and Argentina: the EuroSIDA study

    NARCIS (Netherlands)

    Reekie, J.; Kowalska, J.D.; Karpov, I.; Rockstroh, J.; Karlsson, A.; Rakhmanova, A.; Horban, A.; Kirk, O.; Lundgren, J.D.; Mocroft, A.; Burger, D.M.

    2012-01-01

    BACKGROUND: Differences in access to care and treatment have been reported in Eastern Europe, a region with one of the fastest growing HIV epidemics, compared to the rest of Europe. This analysis aimed to establish whether there are regional differences in the mortality rate of HIV-positive individu