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Sample records for registered hiv cases

  1. Case Report: HIV test misdiagnosis

    African Journals Online (AJOL)

    Case Study: HIV test misdiagnosis 124. Case Report: HIV ... A positive rapid HIV test does not require ... 3 College of Medicine - Johns Hopkins Research Project, Blantyre,. Malawi ... test results: a pilot study of three community testing sites.

  2. Subdural hematoma cases identified through a Danish patient register

    DEFF Research Database (Denmark)

    Poulsen, Frantz Rom; Halle, Bo; Pottegård, Anton

    2016-01-01

    PURPOSE: This study aimed to assess the usefulness of Danish patient registers for epidemiological studies of subdural hematoma (SDH) and to describe clinical characteristics of validated cases. METHODS: Using a patient register covering a geographically defined area in Denmark, we retrieved...... use did not vary by SDH type (OR 0.9, 95%CI 0.6-1.2). CONCLUSIONS: Danish patient registers are a useful resource for SDH studies. However, choice of International Classification of Diseases code markedly influences diagnostic validity. Distinction between cSDH and aSDH is not possible based on SDH...

  3. [Problems and prospects of infectious diseases and HIV-infected military personnel register organization].

    Science.gov (United States)

    Bolekhan, V N; Zagorodnikov, G G; Gorichnyĭ, V A; Orlova, E S; Nikolaev, P G

    2014-08-01

    An analysis of regulatory documents of the Ministry of Healthcare and the Ministry of Defence of the Russian Federation related to HIV/AIDS prevention was carried out. The current system of HIV/AIDS detection and registration among military and civil personnel was assessed. Problems and prospects of scientific-and-research laboratory (the register of infectious disease pathology and HIV-infected military personnel) of Scientific-and-research centre at the Kirov Military medical academy were discussed. It is proposed that the main direction of the laboratory activity will be the restoration of up-to-date records of military personnel with HIV/AIDS. This activity will provide the necessary information to responsible specialists of the Main state sanitary and epidemiological surveillance centre and the Main military medical department of the Ministry of Defence of the Russian Federation for the sanitary and epidemiological surveillance for purposeful and economically feasible management decisions in the field of military personnel infection diseases prevention.

  4. Predictors of recurrence in affective disorder. A case register study

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel; Andersen, Per Kragh; Mortensen, P.B.

    1998-01-01

    BACKGROUND: The risk of recurrence in affective disorder is affected by socio-demographic variables such as gender, age at onset and marital status and by illness related factors as the length of previous episodes and the total duration of the illness. The present study investigated how the effect...... of these variables changed with the progression of the illness. METHOD: Using survival analysis, the risk of recurrence was estimated in a case register study including all hospital admissions with primary affective disorder in Denmark during 1971-1993. RESULTS: Totally, 20350 first admission patients had been...... disorder socio-demographic variables such as gender, age at onset and marital status act as risk factors for further recurrence. Later, however, the illness itself seem to follow its own rhythm regardless of prior predictors. LIMITATION: The data relate to re-admissions rather than recurrence...

  5. Retaining early career registered nurses: a case study.

    Science.gov (United States)

    Mills, Jane; Chamberlain-Salaun, Jennifer; Harrison, Helena; Yates, Karen; O'Shea, Andrea

    2016-01-01

    A core objective of the Australian health system is to provide high quality, safe health care that meets the needs of all Australians. To achieve this, an adequate and effective workforce must support the delivery of care. With rapidly changing health care systems and consumer demographics, demand for care is increasing and retention of sufficient numbers of skilled staff is now a critical priority to meet current and future health care demands. Nurses are the largest cohort of professionals within the health workforce. Reducing the rates at which nurses leave the profession and supporting nurses to practice in their profession longer will have beneficial implications for the sustainability of a nursing workforce and, ultimately, to patient outcomes. The aim of the study was to describe and explain early career registered nurses' (ECRNs) experiences and support requirements during the first five years of practice for the purposes of identifying strategies that would support greater retention of ECRNs. A single case study design focused on early career registered nurses (ECRNs) working in a hospital and health service in northern Australia. The research team adopted Djukic et al's definition of ECRNs as "RNs who have practiced for less than 5 years". Data was collected via three individual interviews and two focus groups. Thirty-five ECRNs participated in the study. Qualitative analysis of data generated during interviews and focus groups, identified the key themes of receiving career advice and choice or no choice . Analysis of study data in the context of the broader literature resulted in the researchers identifying six areas of focus for ECRN retention: 1) well-planned, supported and structured transition periods; 2) consideration of rotation through different areas with a six month minimum for skills development; 3) empowering decision making; 4) placement opportunities and choice in decisions of where to work; 5) career advice and support that considers ECRNs

  6. Follow-up and programmatic outcomes of HIV-exposed infants registered in a large HIV centre in Lilongwe, Malawi: 2012-2014.

    Science.gov (United States)

    Ng'ambi, Wingston F; Ade, Serge; Harries, Anthony D; Midiani, Dalitso; Owiti, Philip; Takarinda, Kudakwashe C; Gugsa, Salem; Phiri, Sam

    2016-08-01

    To assess follow-up and programmatic outcomes of HIV-exposed infants at Martin Preuss Centre, Lilongwe, from 2012 to 2014. Retrospective cohort study using routinely collected HIV-exposed infant data. Data were analysed using frequencies and percentages in Stata v.13. Of 1035 HIV-exposed infants registered 2012-2014, 79% were available to be tested for HIV and 76% were HIV-tested either with DNA-PCR or rapid HIV test serology by 24 months of age. Sixty-five infants were found to be HIV-positive and 43% were started on antiretroviral therapy (ART) at different ages from 6 weeks to 24 months. Overall, 48% of HIV-exposed infants were declared lost-to-follow-up in the database. Of these, 69% were listed for tracing; of these, 78% were confirmed as lost-to-follow-up through patient charts; of these, 51% were traced; and of these, 62% were truly not in care, the remainder being wrongly classified. Commonest reasons for being truly not in care were mother/guardian unavailability to bring infants to Martin Preuss Centre, forgetting clinic appointments and transport expenses. Of these 86 patients, 36% were successfully brought back to care and 64% remained lost-to-follow-up. Loss to follow-up remains a huge challenge in the care of HIV-exposed infants. Active tracing facilitates the return of some of these infants to care. However, programmatic data documentation must be urgently improved to better follow-up and link HIV-positive children to ART. © 2016 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

  7. Retention of antiretroviral naïve patients registered in HIV care in a program clinic in Pune, India

    Science.gov (United States)

    Ghate, Manisha V.; Zirpe, Sunil S.; Gurav, Nilam P.; Rewari, Bharat B.; Gangakhedkar, Raman R.; Paranjape, Ramesh S.

    2014-01-01

    Background: Retention in HIV care ensures delivery of services like secondary prevention, timely initiation of treatment, support, and care on a regular basis. The data on retention in pre antiretroviral therapy (ART) care in India is scanty. Materials and Methods: Antiretroviral naïve HIV-infected adult patients registered between January 2011 and March 2012 in HIV care (pre-ART) were included in the study. The follow-up procedures were done as per the national guidelines. Patients who did not report to the clinic for 1 year were considered as pre-ART lost to follow-up (pre-ART LFU). They were contacted either telephonically or by home visits. Logistic regression analysis was done to find out factors associated with pre-ART loss to follow-up. Results: A total of 689 antiretroviral naïve adult patients were registered in the HIV care. Fourteen (2%) patients died and 76 (11%) were LFU till March 2013. The multivariate analysis showed that baseline CD4 count >350 cells/mm3 (P ART LFUs, 35 (46.1%) informed that they would visit the clinic at their convenient time. NGOs that referred 16 female sex workers (FSWs) who were LFU (21.1%) informed that they would make efforts to refer them to the clinic. Conclusion: Higher CD4 count and illiteracy were significantly associated with lower retention in pre-ART care. Developing effective “retention package” for patients and strengthening linkage strategies between key sub-population such as FSWs and ART programming will help to plug the leaky cascade in HIV care. PMID:26396447

  8. CASE STUDY – HIV AND LUNG DISEASE

    African Journals Online (AJOL)

    2011-04-02

    Apr 2, 2011 ... pathology deep to the paraseptal bullae. An intercostal drain tip is seen in the left lateral pleural space. Fig. 2. Axial computed tomography scan on lung windows. Large bilateral paraseptal bullae are demonstrated with residual antero-medial pneumothorax. 37. CASE STUDY – HIV AND LUNG DISEASE ...

  9. HIV Testing among Canadian Tuberculosis Cases from 1997 to 1998

    Directory of Open Access Journals (Sweden)

    Tara Harris

    2006-01-01

    Full Text Available BACKGROUND: Recent evidence suggests a global rise in adult tuberculosis (TB cases associated with HIV/AIDS. The World Health Organization, the United States Centers for Disease Control and Prevention, and the Public Health Agency of Canada advocate universal screening of all TB cases for HIV. The contribution of HIV to the TB burden in Canada remains unclear.

  10. Does provider-initiated HIV testing and counselling lead to higher HIV testing rate and HIV case finding in Rwandan clinics?

    NARCIS (Netherlands)

    Kayigamba, Felix R.; van Santen, Daniëla; Bakker, Mirjam I.; Lammers, Judith; Mugisha, Veronicah; Bagiruwigize, Emmanuel; de Naeyer, Ludwig; Asiimwe, Anita; Schim van der Loeff, Maarten F.

    2016-01-01

    Provider-initiated HIV testing and counselling (PITC) is promoted as a means to increase HIV case finding. We assessed the effectiveness of PITC to increase HIV testing rate and HIV case finding among outpatients in Rwandan health facilities (HF). PITC was introduced in six HFs in 2009-2010. HIV

  11. Tuberculosis and HIV/AIDS dual infection: A Case study for ...

    African Journals Online (AJOL)

    A total of 479 (99%) cases had their HIV test results recorded. The HIV positive cases were 244 (51%). Dual infection: The proportion of TB cases also having HIV/AIDS infection was 51%. The cure rate of smear positive, HIV positive cases was 71%; the cure rate of smear positive, HIV negative case was 85%.The mortality ...

  12. Predictors of loss to follow-up among children registered in an HIV prevention mother-to-child transmission cohort study in Pernambuco, Brazil.

    Science.gov (United States)

    Gouveia, Pedro Alves da Cruz; da Silva, Gerlane Alves Pontes; de Albuquerque, Maria de Fatima Pessoa Militão

    2014-11-27

    Mother-to-child transmission of HIV (MTCT) is the major form of acquiring the disease among children. The loss to follow-up (LTF) of mothers and their children is a problem that affects the effectiveness of programs for the prevention of mother-to-child transmission (PMTCT). The aim of this study is to identify risk factors associated with the LTF of HIV-exposed children in the state of Pernambuco, Brazil. A retrospective cohort study was carried out with 1200 HIV-exposed children born between 2000 and 2009, registered up to the age of 2 months in a public health PMTCT program. Children were considered LTF if they did not return for scheduled visits to monitor infection status. Univariate and multivariate logistic regression analyses were conducted to identify risk factors for LTF. A total of 185 children (15.4%; CI: 95%: 13.4-17.4%) met the case definition of LTF before the determination of serological HIV status. Risk factors independently associated with LTF were mother-child pairs who reside in rural and remote areas (OR 1.86; 95% CI: 1.30-2.66) and mothers who use illicit drugs (OR 1.8; 95% CI: 1.08-3.0). Initiation of the PMTCT during pregnancy was a protective factor for LTF (OR 0.69; 95% CI: 0.49-0.96). The decentralization of support services for HIV-exposed children to other cities in the state seems to be crucial for the accurate monitoring of outcomes. It is also important to introduce additional measures addressing mothers who are drug users so that they remain in the program: an intensive follow-up program that actively searches for absentee mother-child pairs, support from social services and treatment for drug-dependency. The findings of this study highlight the importance of diagnosing mothers as early as possible in order to conduct a more complete follow-up period of the children. Solving the above-mentioned problems is a challenge, which must be overcome so as to improve the quality of PMTCT.

  13. [HIV infection and syphilis prevalence among men who have sex with men receiving voluntary counseling and testing appointed through a web-based registering system and related factors].

    Science.gov (United States)

    Wu, Qiongmiao; Cheng, Weibin; Zhong, Fei; Xu, Huifang; Liu, Qi; Lin, Peng

    2015-05-01

    To understand the human immunodeficiency virus (HIV) infection status and syphilis prevalence among men who have sex with men (MSM) receiving voluntary counseling and testing appointed through a web-based registering system and related factors. The MSM receiving web appointed HIV counseling and testing from 2011 to 2012 in Guangzhou were recruited and a questionnaire survey was conduct among them to obtain the information about their demographic characteristics and sexual behavior. Binary and multivariate logistic regression model were used to identify the factors associated with HIV infection or syphilis prevalence. A total of 4,904 MSM were enrolled in the study, the average age of the MSM was (28.77±7.24) years, and 70.3% of them had high education level; the unmarried MSM accounted for 72.7%. The HIV infection rate and syphilis prevalence were 8.7% and 4.4% respectively. The co-infection rate of HIV and Treponema pallidum was 1.2% (59/4 904). About one in three MSM did not use condom at latest homosexual behavior, 43.5% did not use condoms at each homosexual behavior in the past three months. Lower education level, occupation (worker or farmer), non-consistent condom use at each sex with men in the past three months, receiving HIV test or not and Treponema pallidum infection were associated with HIV infection. Age≥40 years, lower education level, multi male sex partners in the past three months and HIV infection were associated with Treponema pallidum infection. MSM receiving web appointed HIV counseling and testing had high prevalence of risk behaviors and high HIV infection rate, but had low previous HIV testing rate. It is necessary to strengthen the promotion of HIV test through web based appointment and conduct target behavior intervention in older MSM with lower education level.

  14. Randomized controlled trials of HIV/AIDS prevention and treatment in Africa: results from the Cochrane HIV/AIDS Specialized Register.

    Directory of Open Access Journals (Sweden)

    Babalwa Zani

    Full Text Available INTRODUCTION: To effectively address HIV/AIDS in Africa, evidence on preventing new infections and providing effective treatment is needed. Ideally, decisions on which interventions are effective should be based on evidence from randomized controlled trials (RCTs. Our previous research described African RCTs of HIV/AIDS reported between 1987 and 2003. This study updates that analysis with RCTs published between 2004 and 2008. OBJECTIVES: To describe RCTs of HIV/AIDS conducted in Africa and reported between 2004 and 2008. METHODS: We searched the Cochrane HIV/AIDS Specialized Register in September 2009. Two researchers independently evaluated studies for inclusion and extracted data using standardized forms. Details included location of trials, interventions, methodological quality, location of principal investigators and funders. RESULTS: Our search identified 834 RCTs, with 68 conducted in Africa. Forty-three assessed prevention-interventions and 25 treatment-interventions. Fifteen of the 43 prevention RCTs focused on preventing mother-to-child HIV transmission. Thirteen of the 25 treatment trials focused on opportunistic infections. Trials were conducted in 16 countries with most in South Africa (20, Zambia (12 and Zimbabwe (9. The median sample size was 628 (range 33-9645. Methods used for the generation of the allocation sequence and allocation concealment were adequate in 38 and 32 trials, respectively, and 58 reports included a CONSORT recommended flow diagram. Twenty-nine principal investigators resided in the United States of America (USA and 18 were from African countries. Trials were co-funded by different agencies with most of the funding obtained from USA governmental and non-governmental agencies. Nineteen pharmaceutical companies provided partial funding to 15 RCTs and African agencies co-funded 17 RCTs. Ethical approval was reported in 65 trials and informed consent in 61 trials. CONCLUSION: Prevention trials dominate the trial

  15. Tuberculosis in Sulaimaniyah, Iraqi Kurdistan: A Detailed Analysis of Cases Registered in Treatment Centers.

    Science.gov (United States)

    Karadakhy, Kamaran; Othman, Nasih; Ibrahimm, Faredun; Saeed, Akam Ali; Amin, Ari Abdul-Adheem Hama

    2016-01-01

    Tuberculosis (TB) remains a major public health problem especially in low and middle-income countries. The current study was undertaken to estimate the incidence of the disease and describe its epidemiological characteristics in Iraqi Kurdistan. A retrospective study was carried out on cases registered in the directly observed treatment-short course (DOTS) centers in Sulaimaniyah province. Information was collected from the summary reports of all cases registered in 2010 and detailed information was obtained from 307 cases in the main center. During 2010, a total of 530 new and relapsed cases were registered in the DOTS centers amounting to an annual incidence of 31 per 100,000. Over 73% of cases were pulmonary TB and 45% of all cases had positive smear. Most common symptoms were cough (58%), sweating (49%) and fever (48). Almost 43% of patients were diagnosed by direct swab examination, 30% by biopsy and 23% through clinical and radiologic examination. In relation to outcome, 89% of patients were treated successfully, 7% died and 3% defaulted. Mortality rate was 8% in pulmonary infection and 4% in extrapulmonary infection. Old age (65 years and over) was significantly associated with higher odds of death compared to people aged 34 years and younger (OR 6.7, 95% CI 1.3-36.1, P=0.03). The incidence of TB is still high in the Iraqi Kurdistan. The DOTS has been successful in treating the majority of cases but there are areas needing improvement especially record-keeping and patient follow-up during and after treatment.

  16. Completeness and consistency in recording information in the tuberculosis case register, Cambodia, China and Viet Nam.

    Science.gov (United States)

    Hoa, N B; Wei, C; Sokun, C; Lauritsen, J M; Rieder, H L

    2010-10-01

    Tuberculosis (TB) case registers in Cambodia, two provinces in China and in Viet Nam. To determine completeness and consistency of information for quarterly reports on case finding and treatment outcome. A representative sample of TB case registers was selected in Cambodia, in two provinces in China and in Viet Nam. Quarterly reports were reproduced from double-entered, validated data to determine completeness and consistency. The dataset comprised 37,635 patient records in 2 calendar years. Only 0.2%, 3.6% and 1.1% of cases, respectively, in Cambodia, the two China provinces, and Viet Nam did not allow classification for the quarterly report on case finding. If the treatment outcome was reported as cured, it was correct in 99.9%, 85.7%, and 98.5% of the respective three jurisdictions: errors were mostly due to misclassification of completion as cure. Under-reporting of failures was more frequent than over-reporting in Cambodia and Viet Nam, while in the two provinces in China 84% of reported failures did not actually meet the bacteriological criterion. This evaluation demonstrates that recording essential information is exemplary in all three countries. It will be essential to carefully supervise the ability of staff to correctly define TB treatment outcome results in all three countries.

  17. Mania as complication of HIV infection: case reports | Sulyman ...

    African Journals Online (AJOL)

    These case reports highlight the fact that organic mood disorder, manic episode, in HIV infection AIDS might not be uncommon in this part of the world. Patients present with irritable mood rather than euphoria and they respond rapidly to psychotropic medications. Key words: Manic episode, HIV infection; Acquired immune ...

  18. Making the case for directed organ donation to registered donors in Israel.

    Science.gov (United States)

    Siegal, Gil

    2014-01-23

    result of this survey, the conceptual case of DD to other registered donors should be viewed more favorably (while the details should be addressed in future analyses), as DD is not expected to be rejected by the public at the outset. From a normative perspective, it is possible to support an allocation scheme that allows DD to other registered donors, where individual preferences that promote just sharing of the burden (donating organs) as well as the benefits (receiving an organ) of transplantation medicine are respected. Yet, DD to other registered donors should be understood and portrayed as a transition step towards a more communitarian model, and as a signal of solidarity by sharing organs as a public good rather than as an exercise of a quasi-property right.

  19. First UK case report of kidney transplantation from an HIV-infected deceased donor to two HIV-infected recipients.

    Science.gov (United States)

    Nolan, Eileen; Karydis, Nikolaos; Drage, Martin; Hilton, Rachel

    2018-04-01

    Kidney transplantation is now considered the treatment of choice for many human immunodeficiency virus (HIV)-infected patients with end-stage renal disease (ESRD). Graft survival rates using HIV-negative donors and carefully selected HIV-positive ESRD patients are similar to those observed in HIV-uninfected kidney transplant recipients. To address the relative shortfall in donated organs it has been proposed that organs from HIV-infected deceased donors might be allocated to HIV-infected patients on the transplant waiting list. Preliminary experience in South Africa reports promising short-term outcomes in a small number of HIV-infected recipients of kidney transplants from HIV-infected donors. We sought to replicate this experience in the UK by accepting kidney offers from HIV infected deceased donors for patients with HIV-infection on the kidney transplant waiting list. Here we report the UK's first cases of kidney transplantation between HIV-positive donors and recipients.

  20. Patient Enrolment into HIV Care and Treatment within 90 Days of HIV Diagnosis in Eight Rwandan Health Facilities: A Review of Facility-Based Registers

    NARCIS (Netherlands)

    Kayigamba, Felix R.; Bakker, Mirjam I.; Fikse, Hadassa; Mugisha, Veronicah; Asiimwe, Anita; Schim van der Loeff, Maarten F.

    2012-01-01

    Introduction: Access to antiretroviral therapy (ART) has increased greatly in sub-Saharan Africa. However many patients do not enrol timely into HIV care and treatment after HIV diagnosis. We studied enrolment into care and treatment and determinants of non-enrolment in Rwanda. Methods: Data were

  1. The Impact of Comprehensive Case Management on HIV Client Outcomes.

    Directory of Open Access Journals (Sweden)

    Mark Brennan-Ing

    Full Text Available In 1990, New York State instituted Comprehensive Medicaid Case Management, also known as Target Case Management (TCM, for people dealing with multiple comorbid conditions, including HIV. The goal of TCM is to assist clients in navigating the health care system to increase care engagement and treatment adherence for individuals with complex needs. HIV-positive individuals engaged in care are more likely to be virally suppressed, improving clinical outcomes and decreasing chances of HIV transmission. The purpose of this study was to understand the impact of TCM management on outcomes for people with HIV. Data were obtained from Amida Care, which operates not-for-profit managed care Medicaid and Medicare Special Needs Plans (SNPs for HIV clients. Changes in clinical, cost, as well as medical and pharmacy utilization data among TCM clients were examined between January 2011 through September 2012 from the start of case management enrollment through the end of the study period (i.e., up to 6 months after disenrollment. Additionally, CD4 counts were compared between Amida Care TCM clients and non-TCM clients. Notable findings include increased CD4 counts for TCM clients over the one-year study period, achieving parity with non-TCM clients (i.e., Mean CD4 count > 500. When looking exclusively at TCM clients, there were increases in medication costs over time, which were concomitant with increased care engagement. Current findings demonstrate that TCM is able to achieve its goals of improving care engagement and treatment adherence. Subsequent policy changes resulting from the Affordable Care Act and the New York State Medicaid Redesign have made the Health Home the administrator of TCM services. Government entities charged with securing and managing TCM and care coordination for people with HIV should provide thoughtful and reasonable guidance and oversight in order to maintain optimal clinical outcomes for TCM clients and reduce the transmission of

  2. Are the Cochrane group registers comprehensive? A case study of Japanese psychiatry trials

    Directory of Open Access Journals (Sweden)

    McGuire Hugh

    2002-04-01

    Full Text Available Abstract Background Language bias is a form of publication bias and constitutes a serious threat to meta-analyses. The Cochrane Controlled Trials Register is one attempt to remedy this and now contains more than 300,000 citations. However we are still unsure if it provides comprehensive coverage, particularly for non-English trials. Methods We have recently established a comprehensive register of Japanese trials of psychotropic drugs through extensive personal contacts, electronic searches and handsearches. We examined two Cochrane psychiatry group registers against this Japanese database. Results The Japanese register contained 56 reports of randomized controlled trials (RCTs of antidepressants for depression but the Cochrane Depression, Anxiety and Neurosis group register contained 18, with an overlap of only nine. The Japanese register contained 61 reports of RCTs of neuroleptics for schizophrenia and the Cochrane Schizophrenia group register contained 36, with an overlap of only six. Taking account of some duplicate publications, only a quarter to a third of all relevant Japanese RCTs were retrievable from the Cochrane group registers. Conclusions Similar, or worse, yields may be expected with RCTs conducted in other East Asian countries, and in other fields of medicine. What evidence there is suggests that this situation may lead to a systematic over estimate of treatment effect.

  3. Analysis of risk factors for schizophrenia with two different case definitions: a nationwide register-based external validation study.

    Science.gov (United States)

    Sørensen, Holger J; Larsen, Janne T; Mors, Ole; Nordentoft, Merete; Mortensen, Preben B; Petersen, Liselotte

    2015-03-01

    Different case definitions of schizophrenia have been used in register based research. However, no previous study has externally validated two different case definitions of schizophrenia against a wide range of risk factors for schizophrenia. We investigated hazard ratios (HRs) for a wide range of risk factors for ICD-10 DCR schizophrenia using a nationwide Danish sample of 2,772,144 residents born in 1955-1997. We compared one contact only (OCO) (the case definition of schizophrenia used in Danish register based studies) with two or more contacts (TMC) (a case definition of at least 2 inpatient contacts with schizophrenia). During the follow-up, the OCO definition included 15,074 and the TMC 7562 cases; i.e. half as many. The TMC case definition appeared to select for a worse illness course. A wide range of risk factors were uniformly associated with both case definitions and only slightly higher risk estimates were found for the TMC definition. Choosing at least 2 inpatient contacts with schizophrenia (TMC) instead of the currently used case definition would result in almost similar risk estimates for many well-established risk factors. However, this would also introduce selection and include considerably fewer cases and reduce power of e.g. genetic studies based on register-diagnosed cases only. Copyright © 2015 Elsevier B.V. All rights reserved.

  4. Phocomelia in an HIV infected baby: Case report | Udo | Nigerian ...

    African Journals Online (AJOL)

    Phocomelia in an HIV infected baby: Case report. JJ Udo, SO Ochigbo, OE Ikpeme, TE Nlemadim. Abstract. No Abstract. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · http://dx.doi.org/10.4314/njp.v40i4.16 · AJOL African Journals Online. HOW TO USE ...

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

    African Journals Online (AJOL)

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

  6. [Applying the Modified Delphi Technique to Develop the Role of HIV Case Managers and Essential Nursing Competencies in HIV Care].

    Science.gov (United States)

    Ko, Nai-Ying; Hsieh, Chia-Yin; Chen, Yen-Chin; Tsai, Chen-Hsi; Liu, Hsiao-Ying; Liu, Li-Fang

    2015-08-01

    Since 2005, the Taiwan Centers for Disease Control (Taiwan CDC) initiated an HIV case management program in AIDS-designated hospitals to provide integrative services and risk-reduction counseling for HIV-infected individuals. In light of the increasingly complex and highly specialized nature of clinical care, expanding and improving competency-based professional education is important to enhance the quality of HIV/AIDS care. The aim of this study was to develop the essential competency framework for HIV care for HIV case managers in Taiwan. We reviewed essential competencies of HIV care from Canada, the United Kingdom, and several African countries and devised descriptions of the roles of case managers and of the associated core competencies for HIV care in Taiwan. The modified Delphi technique was used to evaluate the draft framework of these roles and core competencies. A total of 15 HIV care experts were invited to join the expert panel to review and rank the draft framework. The final framework consisted of 7 roles and 27 competencies for HIV case managers. In Round 1, only 3 items did not receive consensus approval from the experts. After modification based on opinions of the experts, 7 roles and 27 competencies received 97.06% consensus approval in Round 2 and were organized into the final framework for HIV case managers. These roles and associated core competencies were: HIV Care Expert (9 competencies), Communicator (1 competency), Collaborator (4 competencies), Navigator (2 competencies), Manager (4 competencies), Advocate (2 competencies), and Professional (5 competencies). The authors developed an essential competency framework for HIV care using the consensus of a multidisciplinary expert panel. Curriculum developers and advanced nurses and practitioners may use this framework to support developments and to ensure a high quality of HIV care.

  7. Locating People Diagnosed With HIV for Public Health Action: Utility of HIV Case Surveillance and Other Data Sources.

    Science.gov (United States)

    Padilla, Mabel; Mattson, Christine L; Scheer, Susan; Udeagu, Chi-Chi N; Buskin, Susan E; Hughes, Alison J; Jaenicke, Thomas; Wohl, Amy Rock; Prejean, Joseph; Wei, Stanley C

    Human immunodeficiency virus (HIV) case surveillance and other health care databases are increasingly being used for public health action, which has the potential to optimize the health outcomes of people living with HIV (PLWH). However, often PLWH cannot be located based on the contact information available in these data sources. We assessed the accuracy of contact information for PLWH in HIV case surveillance and additional data sources and whether time since diagnosis was associated with accurate contact information in HIV case surveillance and successful contact. The Case Surveillance-Based Sampling (CSBS) project was a pilot HIV surveillance system that selected a random population-based sample of people diagnosed with HIV from HIV case surveillance registries in 5 state and metropolitan areas. From November 2012 through June 2014, CSBS staff members attempted to locate and interview 1800 sampled people and used 22 data sources to search for contact information. Among 1063 contacted PLWH, HIV case surveillance data provided accurate telephone number, address, or HIV care facility information for 239 (22%), 412 (39%), and 827 (78%) sampled people, respectively. CSBS staff members used additional data sources, such as support services and commercial people-search databases, to locate and contact PLWH with insufficient contact information in HIV case surveillance. PLWH diagnosed surveillance than were PLWH diagnosed ≥1 year ago ( P = .002), and the benefit from using additional data sources was greater for PLWH with more longstanding HIV infection ( P surveillance cannot provide accurate contact information, health departments can prioritize searching additional data sources, especially for people with more longstanding HIV infection.

  8. Severe Allergic Reactions to Food in Norway: A Ten Year Survey of Cases Reported to the Food Allergy Register

    Directory of Open Access Journals (Sweden)

    Eliann Egaas

    2011-07-01

    Full Text Available The Norwegian Food Allergy Register was established at the Norwegian Institute of Public Health in 2000. The purpose of the register is to gain information about severe allergic reactions to food in Norway and to survey food products in relation to allergen labelling and contamination. Cases are reported on a voluntary basis by first line doctors, and submitted together with a serum sample for specific IgE analysis. The register has received a total of 877 reports from 1 July, 2000 to 31 December, 2010. Two age groups, small children and young adults are over-represented, and the overall gender distribution is 40:60 males-females. The legumes lupine and fenugreek have been identified as two “new” allergens in processed foods and cases of contamination and faults in production of processed foods have been revealed. The highest frequency of food specific IgE is to hazelnuts and peanuts, with a marked increase in reactions to hazelnuts during the last three years. The Food Allergy Register has improved our knowledge about causes and severity of food allergic reactions in Norway. The results show the usefulness of population based national food allergy registers in providing information for health authorities and to secure safe food for individuals with food allergies.

  9. Severe allergic reactions to food in Norway: a ten year survey of cases reported to the food allergy register.

    Science.gov (United States)

    Namork, Ellen; Fæste, Christiane K; Stensby, Berit A; Egaas, Eliann; Løvik, Martinus

    2011-08-01

    The Norwegian Food Allergy Register was established at the Norwegian Institute of Public Health in 2000. The purpose of the register is to gain information about severe allergic reactions to food in Norway and to survey food products in relation to allergen labelling and contamination. Cases are reported on a voluntary basis by first line doctors, and submitted together with a serum sample for specific IgE analysis. The register has received a total of 877 reports from 1 July, 2000 to 31 December, 2010. Two age groups, small children and young adults are over-represented, and the overall gender distribution is 40:60 males-females. The legumes lupine and fenugreek have been identified as two "new" allergens in processed foods and cases of contamination and faults in production of processed foods have been revealed. The highest frequency of food specific IgE is to hazelnuts and peanuts, with a marked increase in reactions to hazelnuts during the last three years. The Food Allergy Register has improved our knowledge about causes and severity of food allergic reactions in Norway. The results show the usefulness of population based national food allergy registers in providing information for health authorities and to secure safe food for individuals with food allergies.

  10. Admission characteristics, diagnoses and outcomes of HIV-infected patients registered in an ambulatory HIV-care programme in western Kenya.

    Science.gov (United States)

    Siika, A M; Ayuo, P O; Sidle, Mwangi J E; Wools-Kaloustian, K; Kimaiyo, S N; Tierney, W M

    2008-11-01

    To determine admissions diagnosis and outcomes of HIV-infected patients attending AMPATH ambulatory HIV-care clinics. Prospective cohort study. Academic Model for Prevention and Treatment of HIV/ AIDS (AMPATH) ambulatory HIV-care clinic in western Kenya. Between January 2005 and December 2006, 495 HIV-infected patients enrolled in AMPATH were admitted. Median age at admission was 38 years (range: 19-74), 62% females, 375 (76%) initiated cART a median 56 days (range: 1-1288) before admission. Majority (53%) had pre-admission CD4 counts 200 cells/ml. Common admissions diagnoses were: tuberculosis (27%); pneumonia (15%); meningitis (11%); diarrhoea (11%); malaria (6%); severe anaemia (4%); and toxoplasmosis (3%). Deaths occurred in 147 (30%) patients who enrolled at AMPATH a median 44 days (range: 1-711) before admission and died a median 41 days (range: 1-713) after initiating cART. Tuberculosis (27%) and meningitis (14%) were the most common diagnoses in the deceased. Median admission duration was six days (range: 1-30) for deceased patients and eight days (range: 1-44) for survivors (P=0.0024). Deceased patients enrolled in AMPATH or initiated cART more recently, had lower CD4 counts and were more frequently lost to follow-up than survivors (P<0.05 for each comparison). Initiation of cART before admission and clinic appointment adherence were independent predictors of survival. Although high mortality rate is seen in HIV-infected in-patients, those initiating cART before admission were more likely to survive.

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

    Directory of Open Access Journals (Sweden)

    Estela Soria-López

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

  12. Utility of local health registers in measuring perinatal mortality: a case study in rural Indonesia.

    Science.gov (United States)

    Burke, Leona; Suswardany, Dwi Linna; Michener, Keryl; Mazurki, Setiawaty; Adair, Timothy; Elmiyati, Catur; Rao, Chalapati

    2011-03-17

    Perinatal mortality is an important indicator of obstetric and newborn care services. Although the vast majority of global perinatal mortality is estimated to occur in developing countries, there is a critical paucity of reliable data at the local level to inform health policy, plan health care services, and monitor their impact. This paper explores the utility of information from village health registers to measure perinatal mortality at the sub district level in a rural area of Indonesia. A retrospective pregnancy cohort for 2007 was constructed by triangulating data from antenatal care, birth, and newborn care registers in a sample of villages in three rural sub districts in Central Java, Indonesia. For each pregnancy, birth outcome and first week survival were traced and recorded from the different registers, as available. Additional local death records were consulted to verify perinatal mortality, or identify deaths not recorded in the health registers. Analyses were performed to assess data quality from registers, and measure perinatal mortality rates. Qualitative research was conducted to explore knowledge and practices of village midwives in register maintenance and reporting of perinatal mortality. Field activities were conducted in 23 villages, covering a total of 1759 deliveries that occurred in 2007. Perinatal mortality outcomes were 23 stillbirths and 15 early neonatal deaths, resulting in a perinatal mortality rate of 21.6 per 1000 live births in 2007. Stillbirth rates for the study population were about four times the rates reported in the routine Maternal and Child Health program information system. Inadequate awareness and supervision, and alternate workload were cited by local midwives as factors resulting in inconsistent data reporting. Local maternal and child health registers are a useful source of information on perinatal mortality in rural Indonesia. Suitable training, supervision, and quality control, in conjunction with computerisation to

  13. The South London and Maudsley NHS Foundation Trust Biomedical Research Centre (SLAM BRC case register: development and descriptive data

    Directory of Open Access Journals (Sweden)

    Denis Mike

    2009-08-01

    Full Text Available Abstract Background Case registers have been used extensively in mental health research. Recent developments in electronic medical records, and in computer software to search and analyse these in anonymised format, have the potential to revolutionise this research tool. Methods We describe the development of the South London and Maudsley NHS Foundation Trust (SLAM Biomedical Research Centre (BRC Case Register Interactive Search tool (CRIS which allows research-accessible datasets to be derived from SLAM, the largest provider of secondary mental healthcare in Europe. All clinical data, including free text, are available for analysis in the form of anonymised datasets. Development involved both the building of the system and setting in place the necessary security (with both functional and procedural elements. Results Descriptive data are presented for the Register database as of October 2008. The database at that point included 122,440 cases, 35,396 of whom were receiving active case management under the Care Programme Approach. In terms of gender and ethnicity, the database was reasonably representative of the source population. The most common assigned primary diagnoses were within the ICD mood disorders (n = 12,756 category followed by schizophrenia and related disorders (8158, substance misuse (7749, neuroses (7105 and organic disorders (6414. Conclusion The SLAM BRC Case Register represents a 'new generation' of this research design, built on a long-running system of fully electronic clinical records and allowing in-depth secondary analysis of both numerical, string and free text data, whilst preserving anonymity through technical and procedural safeguards.

  14. Impact of ART on TB case fatality stratified by CD4 count for HIV-positive TB patients in Cape Town, South Africa (2009-2011).

    Science.gov (United States)

    Kaplan, Richard; Caldwell, Judy; Middelkoop, Keren; Bekker, Linda-Gail; Wood, Robin

    2014-08-15

    To identify determinants of tuberculosis (TB) case fatality including the impact of antiretroviral therapy (ART) at different CD4 thresholds for HIV-positive adult and adolescent TB patients. Through a retrospective analysis of the electronic TB database, we identified the HIV status of newly registered patients aged ≥15 years. Multivariable Cox proportional hazard models were used to determine the risk factors for TB case fatality in these patients. In 2009, 2010, and 2011, 25,841, 26,104, and 25,554 newly registered adult TB patients were treated in primary health care clinics in Cape Town, of whom 49.7%, 50.4%, and 50.9% were HIV positive. ART uptake increased over 3 years from 43% to 64.9%, and case fatality of the HIV-positive patients decreased from 7.0% to 5.8% (P ART had a substantial decrease in case fatality. The difference in case fatality between patients on ART and not on ART was most pronounced at low CD4 counts with the positive influence of ART noted up to a CD4 count threshold of 350 cells per cubic millimeter (P ART uptake, in 2011, 21% of the patients with CD4 counts ART during TB treatment. This study showed a relatively poor uptake of ART among severely immune-compromised TB patients. Patients with CD4 counts ART during TB treatment, and ART initiation should be prioritized for this category of patients.

  15. Making the case for directed organ donation to registered donors in Israel

    OpenAIRE

    Siegal, Gil

    2014-01-01

    Background The number of deceased donor organ donations in Israel is lower than average when compared to other Western World countries. To address the organ gap, the 2008 Organ Transplantation Law provides new interventions, including important incentives to donors (and their families). The most notable of these was granting priority to registered donors (i.e., people on the waiting list who signed a donor card). The current study presents the normative arguments as well as the first document...

  16. Cerebral venous sinus thrombosis in HIV-infected patients: report of 2 cases.

    Science.gov (United States)

    Mwita, Julius Chacha; Baliki, Kgomotso; Tema, Ludo

    2013-01-01

    Infection with the human immunodeficiency virus (HIV) is associated with increased risk of cerebrovascular disease; however Cerebral Venous Sinus Thrombosis (CVST) is rarely associated with HIV-related cerebrovascular events. We describe two cases of HIV-positive patients who, at the same time, presented to our hospital with deep cerebral venous thrombosis and stroke.

  17. Case Report: HIV transmission to an infant from cross nursing | Ntia ...

    African Journals Online (AJOL)

    Various infant feeding options have been recommended by the World Health Organization (WHO) to reduce MTCT of HIV infection. The use of a cross-nurse who is documented HIV-negative is one of such options though not widely practiced. We present a case of HIV infection in an infant acquired through wetnursed.

  18. Cauda equina enhancing lesion in a HIV-positive patient. Case report and literature revision.

    Directory of Open Access Journals (Sweden)

    Pasquale De Bonis

    2011-10-01

    Full Text Available We describe the case a spinal cord localization of neurological toxoplasmosis in a HIV-positive patient with Burkitt lymphoma, previously treated with chemotherapy and immunotherapy. This complication occurred while patient was in complete remission of lymphoma, with CD4+ T cell count of 270 /ml, undetectable HIV viremia, and despite the trimethoprim/ sulfamethoxazole prophylaxis. Indeed, we hypothesize that in our patient neurologic toxoplasmosis has been fostered more by previous immuno-chemotherapy than by HIV- related immunodeficiency. On the whole, this case suggests that parameters usually employed to predict the risk for opportunistic infections in HIV-positive people might not apply to patients with HIV-related lymphomas.

  19. Revised surveillance case definition for HIV infection--United States, 2014.

    Science.gov (United States)

    2014-04-11

    Following extensive consultation and peer review, CDC and the Council of State and Territorial Epidemiologists have revised and combined the surveillance case definitions for human immunodeficiency virus (HIV) infection into a single case definition for persons of all ages (i.e., adults and adolescents aged ≥13 years and children aged case now accommodate new multitest algorithms, including criteria for differentiating between HIV-1 and HIV-2 infection and for recognizing early HIV infection. A confirmed case can be classified in one of five HIV infection stages (0, 1, 2, 3, or unknown); early infection, recognized by a negative HIV test within 6 months of HIV diagnosis, is classified as stage 0, and acquired immunodeficiency syndrome (AIDS) is classified as stage 3. Criteria for stage 3 have been simplified by eliminating the need to differentiate between definitive and presumptive diagnoses of opportunistic illnesses. Clinical (nonlaboratory) criteria for defining a case for surveillance purposes have been made more practical by eliminating the requirement for information about laboratory tests. The surveillance case definition is intended primarily for monitoring the HIV infection burden and planning for prevention and care on a population level, not as a basis for clinical decisions for individual patients. CDC and the Council of State and Territorial Epidemiologists recommend that all states and territories conduct case surveillance of HIV infection using this revised surveillance case definition.

  20. Participants' safety versus confidentiality: A case study of HIV research.

    Science.gov (United States)

    Leyva-Moral, Juan Manuel; Feijoo-Cid, Maria

    2017-05-01

    Background When conducting qualitative research, participants usually share lots of personal and private information with the researcher. As researchers, we must preserve participants' identity and confidentiality of the data. Objective To critically analyze an ethical conflict encountered regarding confidentiality when doing qualitative research. Research design Case study. Findings and discussion one of the participants in a study aiming to explain the meaning of living with HIV verbalized his imminent intention to commit suicide because of stigma of other social problems arising from living with HIV. Given the life-threatening situation, the commitment related to not disclosing the participant's identity and/or the content of the interview had to be broken. To avoid or prevent suicide, the therapist in charge of the case was properly informed about the participant's intentions. One important question arises from this case: was it ethically appropriate to break the confidentiality commitment? Conclusion confidentiality could be broken if a life-threatening event is identified during data collection and participants must know that. This has to be clearly stated in the informed consent form.

  1. HIV lipodystrophy case definition using artificial neural network modelling

    DEFF Research Database (Denmark)

    Ioannidis, John P A; Trikalinos, Thomas A; Law, Matthew

    2003-01-01

    OBJECTIVE: A case definition of HIV lipodystrophy has recently been developed from a combination of clinical, metabolic and imaging/body composition variables using logistic regression methods. We aimed to evaluate whether artificial neural networks could improve the diagnostic accuracy. METHODS......: The database of the case-control Lipodystrophy Case Definition Study was split into 504 subjects (265 with and 239 without lipodystrophy) used for training and 284 independent subjects (152 with and 132 without lipodystrophy) used for validation. Back-propagation neural networks with one or two middle layers...... were trained and validated. Results were compared against logistic regression models using the same information. RESULTS: Neural networks using clinical variables only (41 items) achieved consistently superior performance than logistic regression in terms of specificity, overall accuracy and area under...

  2. Evaluation of the WHO clinical case definition for pediatric HIV infection in Bloemfontein, South Africa.

    Science.gov (United States)

    van Gend, Christine L; Haadsma, Maaike L; Sauer, Pieter J J; Schoeman, Cornelius J

    2003-06-01

    The WHO clinical case definition for pediatric HIV infection has been designed to be used in countries where diagnostic laboratory resources are limited. We evaluated the WHO case definition to determine whether it is a useful instrument to discriminate between HIV-positive and HIV-negative children. In addition, clinical features not included in this case definition were recorded. We recorded clinical data from 300 consecutively admitted children in a state hospital in Bloemfontein, South Africa, and tested these children for HIV infection. A total of 222 children were included in the study; 69 children (31.1 per cent) were HIV positive. The sensitivity of the WHO case definition in this study was 14.5 per cent, the specificity was 98.6 per cent. Apart from weight loss and generalized dermatitis, the signs of the WHO case definition were significantly more often seen in HIV-positive than in HIV-negative children. Of the clinical signs not included in the WHO case definition, marasmus and hepatosplenomegaly especially occurred more frequently in HIV-positive children. Based on these findings we composed a new case definition consisting of four signs: marasmus, hepatosplenomegaly, oropharyngeal candidiasis, and generalized lymphadenopathy. HIV infection is suspected in a child presenting with at least two of these four signs. The sensitivity of this case definition was 63.2 per cent, the specificity was 96.0 per cent. We conclude that in this study the WHO case definition was not a useful instrument to discriminate between HIV-positive and HIV-negative children, mainly because its sensitivity was strikingly low. The simplified case definition we propose, proved to be more sensitive than the WHO case definition (63.2 vs. 14.5 per cent), whilst its specificity remained high.

  3. Determinants of Desire for Children among HIV-Positive Women in the Afar Region, Ethiopia: Case Control Study.

    Directory of Open Access Journals (Sweden)

    Fatimetu Mohammed

    Full Text Available The desire for a child in Ethiopian society is normal. Among HIV positive women, due to the risk of MTCT, it is imperative to understand factors influencing women's desire for children. This study aimed at assessing factors associated with desire for children among HIV-positive women in two selected hospitals of Afar Regional State, Ethiopia.A facility based case-control study was conducted among 157 cases (with a desire and 157 controls of HIV positive individuals registered in the selected health facilities. The participants were selected by random sampling technique. Data were collected using face-to-face interview and was analyzed using logistic regression.Factors found to be independently associated with desire for children were age categories of 20-24 years (OR = 6.22, 1.29-10.87 and 25-29 years (OR = 14.6, 3.05-21.60, being married (OR = 5.51, 2.19-13.54, Afar ethnicity (OR 6.93, 1.19-12.14, having HIV-positive children (OR 0.23, 0.09-0.63, duration on ART more than one year (3.51, 1.68-9.05, CD4 count greater than 350 (OR 4.83, 1.51-7.27 and discussion of reproductive health issues with health providers (OR 0.31, 0.12-0.51.Women who were young, married, Afar, those who received ART more than one year, and had CD4 count >350 were more likely to have a desire for children.Health care workers at ART clinic should openly discuss about the reproductive options for the women living with HIV/AIDS.

  4. Acute HIV Infection in Pregnancy: The Case for Third Trimester Rescreening

    Directory of Open Access Journals (Sweden)

    Jocelyn Wertz

    2011-01-01

    Full Text Available Combination testing with anti-HIV Elisa and Western blot is both sensitive and specific for diagnosis of established HIV-1 infection but could not detect acute HIV infection (AHI. AHI is a time of extremely high viral load, which may correlate to increased risk of horizontal or vertical transmission. Thus, early identification of AHI could allow for interventions to decrease transmission. However, recognition of AHI can be challenging as symptoms could be absent or nonspecific, therefore, AHI is often not detected, particularly in pregnancy. We present a case report of AHI in a pregnant woman who presented with headache and fever. She tested negative for HIV in the first trimester and at time of AHI at 26 3/7 weeks by anti-HIV Elisa, but was diagnosed with AHI based on an HIV RNA viral load of 434,000 copies/mL. This report presents a case for improved awareness of AHI in pregnancy, and the need for repeat HIV testing in late pregnancy, and highlighted that early detection of AHI might be possible with adding HIV RNA testing at time of standard anti-HIV Elisa screening test in pregnancy. Novel laboratory approaches including pooling of sera for HIV RNA could reduce the cost of HIV RNA testing.

  5. Excess mortality in people with mental illness: findings from a Northern Italy psychiatric case register.

    Science.gov (United States)

    Starace, Fabrizio; Mungai, Francesco; Baccari, Flavia; Galeazzi, Gian Maria

    2018-03-01

    People with mental disorders show mortality rates up to 22.2 times higher than that of the general population. In spite of progressive increase in life expectancy observed in the general population, the mortality gap of people suffering from mental health problems has gradually widened. The aim of this paper was to study mortality rates in people suffering from mental illness in a cohort of people (16,981 subjects) in the local mental health register of the province of Modena during the decade 2006-2015. Standardized Mortality Ratios (SMRs) were calculated to compare the mortality of people with mental disorders to the mortality of people living in the province of Modena and the excess of mortality was studied in relation to the following variables: gender, age group, diagnosis and causes of death. In addition, Poisson regression analysis was performed to study the association between patient characteristics and mortality. An overall excess mortality of 80% was found in subjects under the care of mental health services as compared to the reference population (SMR = 1.8, 95% CI 1.7-1.9). Subjects in the 15-44 year group presented the highest SMR (9.2, 95% CI 6.9-11.4). The most prevalent cause of death was cancer (28.1% of deaths). At the Poisson regression, the diagnosis "Substance abuse and dependence" showed the highest relative risk (RR) (4.00). Moreover, being male, single, unemployed and with a lower qualification was associated with higher RRs. Our study confirms that subjects with mental illness have higher SMR. Noteworthy, the overall higher risk of mortality was observed in the younger age group.

  6. A CASE OF RENAL DISEASE IN HIV INFECTED PATIENT

    Directory of Open Access Journals (Sweden)

    Ni Made Vina Septiani

    2013-11-01

    Full Text Available Normal 0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4 Kidney diseases in human immunodeficiency virus (HIV infected patients has been been fourth leading cause of death after sepsis, pneumonia, and liver disease. HIV-associated nephropathy (HIVAN is the most common. We report a case, a male patient, 48 years, who experienced shortness of breath, cough and intermittent fever and has been reported as HIV positive, without previous antiretroviral treatment and last CD4+ count is 89 cells/mm3. There are elevated BUN and SC from day to day during treatment and proteinuria +2 as a sign of kidney disease with normal blood pressure and there was no edema. Patients given an antibiotic and ACE inhibitors as antiproteinuria. Patients with suspicion of HIVAN in this case can progress very rapidly and causes progressive decline in renal function. Prognosis of patients with HIVAN if not handled properly will develop end stage renal disease (ESRD in 1-4 months and had a mortality rate 4.7 times higher than HIV patients without renal impairment. /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

  7. [HIV infection in the Stavropol' region].

    Science.gov (United States)

    Filonenko, N G; Isaev, V P; Pelikh, N L

    2001-01-01

    The data on the dynamics of HIV infection in the Stavropol Territory beginning with 1987 are given. The situation became aggravated after 1996, and its sharp deterioration occurred in 2000 when 138 cases of HIV infection were detected and the area of this infection increased. In most cases patients became infected beyond the borders of the territory. About a half of the new cases of HIV infection registered in 2000 were detected in Ingushetia and Chechnya. The leading factor in the spread of HIV infection was the use of drugs by injection. The main trends of the prophylactic work are presented.

  8. Osteopaenia and Osteonecrosis in HIV Infection: Report of Two Cases

    African Journals Online (AJOL)

    HAART) in the treatment of human immunodeficiency virus (HIV) infection has significantly ... The consequence of longer survival has manifested increasing rates of co-morbid diseases and aroused interest in the interaction of HIV and aging The ...

  9. The case for indicator condition-guided HIV screening

    DEFF Research Database (Denmark)

    Lazarus, J V; Hoekstra, M; Raben, D

    2013-01-01

    One-half of the estimated 2.5 million people who now live with HIV in the World Health Organization (WHO) European Region are still diagnosed late. A central question is which clinical scenarios should trigger an HIV test recommendation in order to avoid late presentation. Drawing on the work...... of the HIV Indicator Diseases across Europe Study (HIDES), new guidance brings together in one place a list of the conditions that should result in an HIV screening recommendation....

  10. The Case for Adolescent HIV Vaccination in South Africa

    OpenAIRE

    Moodley, Nishila; Gray, Glenda; Bertram, Melanie

    2016-01-01

    Abstract Despite comprising 0.7% of the world population, South Africa is home to 18% of the global human immunodeficiency virus (HIV) prevalence. Unyielding HIV subepidemics among adolescents threaten national attempts to curtail the disease burden. Should an HIV vaccine become available, establishing its point of entry into the health system becomes a priority. This study assesses the impact of school-based HIV vaccination and explores how variations in vaccine characteristics affect cost-e...

  11. Young Registered Nurses' Intention to Leave the Profession and Professional Turnover in Early Career: A Qualitative Case Study

    Science.gov (United States)

    Salanterä, Sanna

    2013-01-01

    In a time of global nursing shortages an alarming number of young registered nurses have expressed a willingness to leave the profession. In this qualitative case study we investigate in depth why young nurses leave nursing profession and reeducate themselves for a new career. The study is based on longitudinal interviews of three young registered nurses in Finland. These nurses were first interviewed between December 2006 and May 2007, when they were 29–32 years old and having an intention to leave the profession. The second interview took place four years later, from January 2011 to March 2011 when all of them had made the transition to a new career. Data were analyzed in two stages. In the first stage, comprehensive career story narratives were formed on the basis of the interviews. In the second stage, emerging themes in these stories were compared, contrasted, and interpreted in the context of the overall career histories. Nursing as a second career choice and demanding work content as well as poor practice environment and the inability to identify with the stereotypical images of nurses were main themes that emerged from these career stories. The results of this interpretative qualitative study reflect a shift toward insights into understanding professional turnover as a complex and long-lasting process. PMID:24027640

  12. Young registered nurses' intention to leave the profession and professional turnover in early career: a qualitative case study.

    Science.gov (United States)

    Flinkman, Mervi; Isopahkala-Bouret, Ulpukka; Salanterä, Sanna

    2013-01-01

    In a time of global nursing shortages an alarming number of young registered nurses have expressed a willingness to leave the profession. In this qualitative case study we investigate in depth why young nurses leave nursing profession and reeducate themselves for a new career. The study is based on longitudinal interviews of three young registered nurses in Finland. These nurses were first interviewed between December 2006 and May 2007, when they were 29-32 years old and having an intention to leave the profession. The second interview took place four years later, from January 2011 to March 2011 when all of them had made the transition to a new career. Data were analyzed in two stages. In the first stage, comprehensive career story narratives were formed on the basis of the interviews. In the second stage, emerging themes in these stories were compared, contrasted, and interpreted in the context of the overall career histories. Nursing as a second career choice and demanding work content as well as poor practice environment and the inability to identify with the stereotypical images of nurses were main themes that emerged from these career stories. The results of this interpretative qualitative study reflect a shift toward insights into understanding professional turnover as a complex and long-lasting process.

  13. Das sprachliche Register (Speech Registers)

    Science.gov (United States)

    Hess-Luttich, Ernest W. B.

    1974-01-01

    The linguistic behavior of a given individual varies; he will on different occasions speak (or write) differently according to what may be roughly described as different social situations: he will use a number of different registers. The application of such registers both in the field of text analysis and in the preparation of teaching materials…

  14. Platelet function and HIV: a case-control study.

    LENUS (Irish Health Repository)

    Satchell, Claudette S

    2010-03-13

    Cardiovascular disease and myocardial infarction are of increasing concern in HIV-infected populations. Although platelets mediate arterial thrombosis, central to myocardial infarction, data on platelet function in HIV infection are lacking. We hypothesized that HIV-infected patients would have altered platelet reactivity.

  15. Hiv-Associated Pulmonary Hypertension: Case Report | Shavadia ...

    African Journals Online (AJOL)

    With the advent of highly active antiretroviral therapy, there has been a significant change in the epidemiology of pulmonary disease in HIV/AIDS. The relative prevalence of non-infectious manifestations is likely to rise. HIV associated pulmonary hypertension (HIV-PH), albeit low prevalence, is associated with significant ...

  16. Placental vascular complications in HIV-infected pregnant women: a case-control study

    OpenAIRE

    CANLORBE, Geoffroy

    2012-01-01

    Background: Data from international literature suggest a link between HIV infection and placental vascular complications during pregnancy. Current studies on the subject are conflicting.Objective: The aim of the study was to evaluate the incidence of placental vascular complications during pregnancy among HIV+ and HIV- patients.Study Design: It is a single-center case-control study comparing the rates of gestational hypertension, preeclampsia, eclampsia and vascular intrauterine growth retard...

  17. Lymph nodes cytology in HIV seropositive cases with haematological alterations

    Directory of Open Access Journals (Sweden)

    Neelima Tirumalasetti

    2014-01-01

    Full Text Available Background & objectives: Lymphadenopathy and haematological alterations are the earliest manifestations with other associated opportunistic infections and malignancies. Hence, there is a need for simple investigations like fine needle aspiration cytology (FNAC for evaluation of HIV lymphadenopathy and a haemogram to interpret the haematological alterations. This study was undertaken to analyze the cytological patterns of lymph node lesions in HIV/AIDS patients, to compare with available clinico-pathological and haematological parameters to segregate lymphadenopathy cases for further evaluation. Methods: In the present study, 129 HIV seropositive patients were included. Lymph node aspirates were stained routinely with hematoxylin and eosin and Ziehl-Neelsen (Z-N stains. Special stains and cultures were done in selected patients. Peripheral smears were taken from all the patients and CD4 counts were recorded. Tuberculous lymphadenitis was further categorized. Acid fast bacilli (AFB grading was done on Z-N positive smears. Each lesion was compared with CD4 counts, WHO clinical staging and haematological picture. Results: Cytological diagnosis in 129 patients included tuberculous (n=54, 41.9%, reactive lymphadenopathy (n=46, 35.6%, suppurative (n=16, 12.4% lymphadenitis, non-Hodgkin′s lymphoma (n=4, 3.1%, and Hodgkin′s lymphoma, secondary deposits, other granulomatous lesions, and cryptoccocal lymphadenitis in one patient each. The predominant cytomorphological pattern in tuberculous lymphadenitis was caseous necrosis + epithelioid granuloma formation (51.85%. Grade 2+ Z-N grading was noted in 62.96 per cent of AFB positive smears. CD4 counts showed a descending pattern with progression of WHO clinical staging. Cytopenia was more common in WHO clinical stage IV disease. Interpretation & conclusions: Lymph node cytology was found to be a useful tool for segregating lymphadenopathy cases for further evaluation and for identification of

  18. Predictors of natural and unnatural mortality among patients with personality disorder: evidence from a large UK case register.

    Directory of Open Access Journals (Sweden)

    Marcella Lei-Yee Fok

    Full Text Available People with personality disorder have reduced life expectancy, yet, within this population, little is known about the clinical predictors of natural and unnatural deaths. We set out to investigate this, using a large cohort of secondary mental health patients with personality disorder.We identified patients with an ICD-10 diagnosis of personality disorder, aged ≥15 years in a large secondary mental healthcare case register. The case register was linked to national mortality tracing. Using Cox regression, we modelled the effect of a number of pre-specified clinical variables on all-cause, natural cause and unnatural cause mortality.2,440 patients were identified. Eighty-five deaths (3.5% of cohort occurred over a 5-year observation period, of which over 50% were from natural causes. All-cause mortality was associated with alcohol or drug use (adjusted Hazard Ratio [aHR] 2.3; 95% CI 1.3-4.1, physical illness (aHR 1.9; 95% CI 1.0-3.6, and functional impairment (aHR 1.9; 95% CI 1.0-3.6. Natural cause mortality was associated with mild problems of alcohol or drug use (aHR 3.4; 95% CI 1.5-7.4, and physical illness (aHR 2.4; 95% CI 1.0-5.6. Unnatural cause mortality was associated only with severe alcohol or drug use (aHR 3.1; 95% CI 1.3-7.3.Alcohol and drug use, physical illness, and functional impairment are predictors of mortality in individuals with personality disorder. Clinicians should be aware of the existence of problems in these domains, even at mild levels, when assessing the needs of patients with personality disorder.

  19. An association between initiation of selective serotonin reuptake inhibitors and suicide - a nationwide register-based case-crossover study.

    Directory of Open Access Journals (Sweden)

    Charlotte Björkenstam

    Full Text Available BACKGROUND: Treatment with selective serotonin reuptake inhibitors (SSRI is one of the most common treatments for depression. It is however not clear whether or not there is an increased short-term suicide risk during initiation with SSRI. METHODS: A register-based nationwide case-crossover study including 5,866 suicides, 1,698 women and 4,168 men, from the Death Register 2007-2010 in Sweden. SSRI initiation was defined as a dispensed prescription of SSRI within 28 days prior to the date of suicide with no previous dispensed prescription of SSRI within 4 months prior that prescription. The control period took place one year earlier. Odds ratio (OR was estimated using conditional logistic regression. RESULT: During the 28 day period prior to suicide 48 women and 138 men were exposed to SSRI initiation (while not being exposed in the control period and 22 women and 43 men were exposed in the control period (while not being exposed in the case period. The OR for suicide after initiation with SSRI was 2.7 (95% CI: 1.6-44 for women, and 4.3 (95% CI: 3.0-6.1 for men. The highest OR was found 8-11 days after initiation with SSRI 9.7 (95% CI: 3.0-31.7 for women and men combined. CONCLUSION: The main limitation in this study is confounding by indication, but the descriptive question is however not confounded by indication. Together with plausible biological mechanisms and previous clinical and epidemiological observations our findings, linking initiation of SSRI to increased short-term suicide risk, deserve further attention specifically in the clinical setting.

  20. Case mix adjustment of health outcomes, resource use and process indicators in childbirth care: a register-based study.

    Science.gov (United States)

    Mesterton, Johan; Lindgren, Peter; Ekenberg Abreu, Anna; Ladfors, Lars; Lilja, Monica; Saltvedt, Sissel; Amer-Wåhlin, Isis

    2016-05-31

    Unwarranted variation in care practice and outcomes has gained attention and inter-hospital comparisons are increasingly being used to highlight and understand differences between hospitals. Adjustment for case mix is a prerequisite for meaningful comparisons between hospitals with different patient populations. The objective of this study was to identify and quantify maternal characteristics that impact a set of important indicators of health outcomes, resource use and care process and which could be used for case mix adjustment of comparisons between hospitals. In this register-based study, 139 756 deliveries in 2011 and 2012 were identified in regional administrative systems from seven Swedish regions, which together cover 67 % of all deliveries in Sweden. Data were linked to the Medical birth register and Statistics Sweden's population data. A number of important indicators in childbirth care were studied: Caesarean section (CS), induction of labour, length of stay, perineal tears, haemorrhage > 1000 ml and post-partum infections. Sociodemographic and clinical characteristics deemed relevant for case mix adjustment of outcomes and resource use were identified based on previous literature and based on clinical expertise. Adjustment using logistic and ordinary least squares regression analysis was performed to quantify the impact of these characteristics on the studied indicators. Almost all case mix factors analysed had an impact on CS rate, induction rate and length of stay and the effect was highly statistically significant for most factors. Maternal age, parity, fetal presentation and multiple birth were strong predictors of all these indicators but a number of additional factors such as born outside the EU, body mass index (BMI) and several complications during pregnancy were also important risk factors. A number of maternal characteristics had a noticeable impact on risk of perineal tears, while the impact of case mix factors was less pronounced for

  1. A Comprehensive HIV Stigma-reduction and Wellness-enhancement Community Intervention: A Case Study.

    NARCIS (Netherlands)

    French, H.; Greeff, M.; Watson, M.J.; Doak, C.M.

    2014-01-01

    We describe the implementation of a comprehensive HIV stigma-reduction and wellness-enhancement community intervention that focused on people living with HIV (PLWH), as well as people living close to them (PLC) from six designated groups. A holistic multiple case study design was used in urban and

  2. Unconsented HIV testing in cases of occupational exposure: ethics, law, and policy.

    Science.gov (United States)

    Cowan, Ethan; Macklin, Ruth

    2012-10-01

    Postexposure prophylaxis (PEP) has substantially reduced the risk of acquiring human immunodeficiency virus (HIV) after an occupational exposure; nevertheless, exposure to HIV remains a concern for emergency department providers. According to published guidelines, PEP should be taken only when source patients are HIV-positive or have risk factors for HIV. Initiating PEP when source patients are uninfected puts exposed persons at risk from taking toxic drugs with no compensating benefit. Forgoing PEP if the source is infected results in increased risk of acquiring HIV. What should be done if source patients refuse HIV testing? Is it justifiable to test the blood of these patients over their autonomous objection? The authors review current law and policy and perform an ethical analysis to determine if laws permitting unconsented testing in cases of occupational exposure can be ethically justified. © 2012 by the Society for Academic Emergency Medicine.

  3. Diagnosing HIV “window phase” in routine laboratory: a teaching case

    Directory of Open Access Journals (Sweden)

    Roberta Valentina Marotta

    2011-12-01

    Full Text Available Human immunodeficiency virus (HIV is the causative agent of acquired immunodeficiency syndrome (AIDS. It is a retrovirus that inserts itself into the host’s DNA and use the host – cell’s replication mechanisms for its own perpetuation. Two distinct species of HIV (HIV 1 and HIV 2 have been identified and they have a different global distribution. In this paper we describe a case of HIV early infection in an italian man of fourty years old. From this example we want to stress the importance to consider with high attention the validation of a negative index of HIV antibodies.We advise to follow this procedure that allows to avoid the risk to report a false negative.

  4. A register-based case-control study of health care utilization and costs in binge-eating disorder.

    Science.gov (United States)

    Watson, Hunna J; Jangmo, Andreas; Smith, Tosha; Thornton, Laura M; von Hausswolff-Juhlin, Yvonne; Madhoo, Manisha; Norring, Claes; Welch, Elisabeth; Wiklund, Camilla; Larsson, Henrik; Bulik, Cynthia M

    2018-05-01

    Capturing trends in healthcare utilization may help to improve efficiencies in the detection and diagnosis of illness, to plan service delivery, and to forecast future health expenditures. For binge-eating disorder (BED), issues include lengthy delays in detection and diagnosis, missed opportunities for recognition and treatment, and morbidity. The study objective was to compare healthcare utilization and expenditure in people with and without BED. A case-control design and nationwide registers were used. All individuals diagnosed with BED at eating disorder clinics in Sweden between 2005 and 2009 were included (N = 319, 97% female, M age = 22 years). Ten controls (N = 3190) were matched to each case on age-, sex-, and location of birth. Inpatient, hospital-based outpatient, and prescription medication utilization and expenditure were analyzed up to eight years before and four years after the index date (i.e., date of diagnosis of the BED case). Cases had significantly higher inpatient, hospital-based outpatient, and prescription medication utilization and expenditure compared with controls many years prior to and after diagnosis of BED. Utilization and expenditure for controls was relatively stable over time, but for cases followed an inverted U-shape and peaked at the index year. Care for somatic conditions normalized after the index year, but care for psychiatric conditions remained significantly higher. Individuals with BED had substantially higher healthcare utilization and costs in the years prior to and after diagnosis of BED. Since previous research shows a delay in diagnosis, findings indicate clear opportunities for earlier detection and clinical management. Training of providers in detection, diagnosis, and management may help curtail morbidity. A reduction in healthcare utilization was observed after BED diagnosis. This suggests that earlier diagnosis and treatment could improve long-term health outcomes and reduce the economic burden

  5. Simplifying consent for HIV testing is associated with an increase in HIV testing and case detection in highest risk groups, San Francisco January 2003-June 2007.

    Directory of Open Access Journals (Sweden)

    Nicola M Zetola

    2008-07-01

    Full Text Available Populations at highest risk for HIV infection face multiple barriers to HIV testing. To facilitate HIV testing procedures, the San Francisco General Hospital Medical Center eliminated required written patient consent for HIV testing in its medical settings in May 2006. To describe the change in HIV testing rates in different hospital settings and populations after the change in HIV testing policy in the SFDH medical center, we performed an observational study using interrupted time series analysis.Data from all patients aged 18 years and older seen from January 2003 through June 2007 at the San Francisco Department of Public Health (SFDPH medical care system were included in the analysis. The monthly HIV testing rate per 1000 had patient-visits was calculated for the overall population and stratified by hospital setting, age, sex, race/ethnicity, homelessness status, insurance status and primary language.By June 2007, the average monthly rate of HIV tests per 1000 patient-visits increased 4.38 (CI, 2.17-6.60, p<0.001 over the number predicted if the policy change had not occurred (representing a 44% increase. The monthly average number of new positive HIV tests increased from 8.9 (CI, 6.3-11.5 to 14.9 (CI, 10.6-19.2, p<0.001, representing a 67% increase. Although increases in HIV testing were seen in all populations, populations at highest risk for HIV infection, particularly men, the homeless, and the uninsured experienced the highest increases in monthly HIV testing rates after the policy change.The elimination of the requirement for written consent in May 2006 was associated with a significant and sustained increase in HIV testing rates and HIV case detection in the SFDPH medical center. Populations facing the higher barriers to HIV testing had the highest increases in HIV testing rates and case detection in response to the policy change.

  6. Early life risk factors for testicular cancer: a case-cohort study based on the Copenhagen School Health Records Register.

    Science.gov (United States)

    Piltoft, Johanne Spanggaard; Larsen, Signe Benzon; Dalton, Susanne Oksbjerg; Johansen, Christoffer; Baker, Jennifer L; Cederkvist, Luise; Andersen, Ingelise

    2017-02-01

    One established risk factors for testicular cancer is cryptorchidism. However, it remains unclear whether cryptorchidism is a risk factor in itself or whether the two conditions share common causes in early life (estrogen hypothesis), such as birth weight and birth order. The objective of this study is to utilize data from the Copenhagen School Health Records Register (CSHRR) to evaluate cryptorchidism, birth weight and birth order as risk factors for testicular cancer. The study population consisted of 408 cases of testicular cancer identified by a government issued identification number linkage of the entire CSHRR with the Danish Cancer Registry and a random subsample of 4819 males from the CSHRR. The study design was case-cohort and the period of follow-up between 2 April 1968 and 31 December 2003. Cryptorchidism was significantly associated with testicular cancer in crude analyses [hazard ratio (HR) = 3.60, 95% CI 2.79-4.65]. Birth weight was inversely associated with testicular cancer and no clear association with birth order was observed. The positive association between cryptorchidism and testicular cancer was only slightly attenuated controlling for birth weight and birth order and stratified on birth cohort (HR = 3.46, 95% CI 2.67-4.48). This study confirmed the robustness of the association between cryptorchidism and testicular cancer even after adjustment for birth weight and birth order. Furthermore, the study showed an inverse association between birth weight and testicular cancer.

  7. Challenges faced by young persons living with HIV: The case of ...

    African Journals Online (AJOL)

    Challenges faced by young persons living with HIV: The case of children on the ... Journal of Social Development in Africa ... to 34 randomly selected children who were beneficiaries of an initiative called the Community Outreach Programme.

  8. HIV/AIDS Management and The Mobile Workforce: A Case Study of ...

    African Journals Online (AJOL)

    HIV/AIDS Management and The Mobile Workforce: A Case Study of Security Forces in Namibia. ... Rwanda Journal ... Conclusively, it is recommended that management should henceforth adopt strategic management approach to managing ...

  9. STI patients are effective recruiters of undiagnosed cases of HIV: results of a social contact recruitment study in Malawi.

    Science.gov (United States)

    Rosenberg, Nora E; Kamanga, Gift; Pettifor, Audrey E; Bonongwe, Naomi; Mapanje, Clement; Rutstein, Sarah E; Ward, Michelle; Hoffman, Irving F; Martinson, Francis; Miller, William C

    2014-04-15

    Patients with newly diagnosed HIV may be part of social networks with elevated prevalence of undiagnosed HIV infection. Social network recruitment by persons with newly diagnosed HIV may efficiently identify undiagnosed cases of HIV infection. We assessed social network recruitment as a strategy for identifying undiagnosed cases of HIV infection. In a sexually transmitted infection (STI) clinic in Lilongwe, Malawi, 3 groups of 45 "seeds" were enrolled: STI patients with newly diagnosed HIV, STI patients who were HIV-uninfected, and community controls. Seeds were asked to recruit up to 5 social "contacts" (sexual or nonsexual). Mean number of contacts recruited per group was calculated. HIV prevalence ratios (PRs) and number of contacts needed to test to identify 1 new case of HIV were compared between groups using generalized estimating equations with exchangeable correlation matrices. Mean number of contacts recruited was 1.3 for HIV-infected clinic seeds, 1.8 for HIV-uninfected clinic seeds, and 2.3 for community seeds. Contacts of HIV-infected clinic seeds had a higher HIV prevalence (PR: 3.2, 95% confidence interval: 1.3 to 7.8) than contacts of community seeds, but contacts of HIV-uninfected clinic seeds did not (PR: 1.1, 95% confidence interval: 0.4 to 3.3). Results were similar when restricted to nonsexual contacts. To identify 1 new case of HIV, it was necessary to test 8 contacts of HIV-infected clinic seeds, 10 contacts of HIV-uninfected clinic seeds, and 18 contacts of community seeds. Social contact recruitment by newly diagnosed STI patients efficiently led to new HIV diagnoses. Research to replicate findings and guide implementation is needed.

  10. Understanding the drivers of interprofessional collaborative practice among HIV primary care providers and case managers in HIV care programmes.

    Science.gov (United States)

    Mavronicolas, Heather A; Laraque, Fabienne; Shankar, Arti; Campbell, Claudia

    2017-05-01

    Care coordination programmes are an important aspect of HIV management whose success depends largely on HIV primary care provider (PCP) and case manager collaboration. Factors influencing collaboration among HIV PCPs and case managers remain to be studied. The study objective was to test an existing theoretical model of interprofessional collaborative practice and determine which factors play the most important role in facilitating collaboration. A self-administered, anonymous mail survey was sent to HIV PCPs and case managers in New York City. An adapted survey instrument elicited information on demographic, contextual, and perceived social exchange (trustworthiness, role specification, and relationship initiation) characteristics. The dependent variable, perceived interprofessional practice, was constructed from a validated scale. A sequential block wise regression model specifying variable entry order examined the relative importance of each group of factors and of individual variables. The analysis showed that social exchange factors were the dominant drivers of collaboration. Relationship initiation was the most important predictor of interprofessional collaboration. Additional influential factors included organisational leadership support of collaboration, practice settings, and frequency of interprofessional meetings. Addressing factors influencing collaboration among providers will help public health programmes optimally design their structural, hiring, and training strategies to foster effective social exchanges and promote collaborative working relationships.

  11. A Strong Case for Viral Genetic Factors in HIV Virulence

    Directory of Open Access Journals (Sweden)

    Joshua T. Herbeck

    2011-03-01

    Full Text Available HIV infections show great variation in the rate of progression to disease, and the role of viral genetic factors in this variation had remained poorly characterized until recently. Now a series of four studies [1–4] published within a year has filled this important gap and has demonstrated a robust effect of the viral genotype on HIV virulence.

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

    African Journals Online (AJOL)

    AJRH Managing Editor

    However SRHR policies, strategic plans and programmes ... changes in sexual behaviour with increased knowledge ... intercourse remains the main mode of HIV .... country, married to a 34 year old travel agent with .... as the treatment of choice for ED in HIV-infected ..... image: A handbook of theory, research, and clinical.

  13. Monitoring linked epidemics: the case of tuberculosis and HIV.

    Directory of Open Access Journals (Sweden)

    María S Sánchez

    Full Text Available BACKGROUND: The tight epidemiological coupling between HIV and its associated opportunistic infections leads to challenges and opportunities for disease surveillance. METHODOLOGY/PRINCIPAL FINDINGS: We review efforts of WHO and collaborating agencies to track and fight the TB/HIV co-epidemic, and discuss modeling--via mathematical, statistical, and computational approaches--as a means to identify disease indicators designed to integrate data from linked diseases in order to characterize how co-epidemics change in time and space. We present R(TB/HIV, an index comparing changes in TB incidence relative to HIV prevalence, and use it to identify those sub-Saharan African countries with outlier TB/HIV dynamics. R(TB/HIV can also be used to predict epidemiological trends, investigate the coherency of reported trends, and cross-check the anticipated impact of public health interventions. Identifying the cause(s responsible for anomalous R(TB/HIV values can reveal information crucial to the management of public health. CONCLUSIONS/SIGNIFICANCE: We frame our suggestions for integrating and analyzing co-epidemic data within the context of global disease monitoring. Used routinely, joint disease indicators such as R(TB/HIV could greatly enhance the monitoring and evaluation of public health programs.

  14. HIV testing, antiretroviral therapy, and treatment outcomes in new cases of tuberculosis in Brazil, 2011

    Directory of Open Access Journals (Sweden)

    Ana Torrens

    Full Text Available ABSTRACT Objective To assess the implementation of HIV-related interventions for patients with tuberculosis (TB, as well as TB treatment outcomes in patients coinfected with HIV in Brazil in 2011. Methods This was a cross-sectional, operational research study of HIV-related interventions among TB cases and the sociodemographic and clinical characteristics of TB-HIV coinfected patients. It also used a retrospective cohort design to determine the association between antiretroviral therapy (ART and favorable TB treatment outcomes. The source of data was a linkage of 2011 administrative health databases used by the National TB and HIV/AIDS Programs. Results Of 73 741 new cases of TB reported, 63.6% (46 865 patients were tested for HIV; 10.3% were positive. Of patients with HIV, 45.9% or 3 502 were on ART. TB favorable outcome was achieved in 63.1% or 2 205 coinfected patients on ART and in only 35.4% or 1 459 of those not on ART. On multivariate analysis, the relative risk for the association between ART and TB treatment success was 1.72 (95% Confidence Interval = 1.64–1.81. Conclusions The linkage between national TB and HIV datasets has created a convenient baseline for ongoing monitoring of HIV testing, ART use, and TB treatment outcomes among coinfected patients. The low rates of HIV screening and ART use in 2011 need to be improved. The association between ART and treatment success adds to the evidence supporting timely initiation of ART for all patients with TB-HIV coinfection.

  15. A case report of hearing loss post use of hydroxychloroquine in a HIV-infected patient

    OpenAIRE

    Khalili, Hossein; Dastan, Farzaneh; Dehghan Manshadi, Seyed Ali

    2014-01-01

    Objective A case with reversible symmetrical sensorineural hearing loss following hydroxychloroquine therapy is described. Case summary A 57-year-old, human immunodeficiency virus (HIV) positive man was referred to the HIV clinic of Imam Khomeini Hospital, Tehran with chief complaint of bilateral slowly progressive hearing loss starting from two months ago. The man had history of rheumatoid arthritis diagnosed from 3 months ago and was administered hydroxychloroquine 200 mg and prednisolone 5...

  16. Severe manifestation of psoriasis in a HIV infected patient: a case report

    Directory of Open Access Journals (Sweden)

    Alper Gunduz

    2015-12-01

    Full Text Available The human immunodeficiency virus (HIV epidemic in Turkey reveals a slow progression and at the end of November 2015, the total official number was reported to be 11,109 cases. Approximately 90% of HIV patients develop some type of skin disease. Especially patients with psoriasis and HIV infection often present with more severe and treatment-refractory cutaneous disease. Herein, we describe a case of a patient with previously known psoriasis worsened by HIV infection. A 37-year-old housewife was admitted to our clinic with previously known psoriasis worsened during the last two years with conversion to erythrodermic psoriasis which was not controlled even by PUVA, methotrexate and systemic cyclosporine. The patient had positive HIV antibody test. HIV RNA viral load was 120.000 copy/ml and CD4 count 88/ mm3 . She also had oral candidiasis and Pneumocystis jirovecii pneumonia. The patient received antiretroviral treatment including tenofovir/emtricitabine and lopinavir/ritonavir. Symptoms resolved gradually within one month with almost complete impovement of her erythrodermic psoriasis. . Four years later the patient was still on tenofovir/emtricitabine and lopinavir/ritonavir without concomitant spesific psoriasis treatment. Psoriasis manifestations can be severe in AIDS patients. Clinicians face diagnostic and therapeutic difficulties when psoriasis coexists with HIV infection. The HIV test should be considered in patients affected by severe erythrodermic psoriasis and resistant to conventional and biological treatments. [Dis Mol Med 2015; 3(4.000: 43-45

  17. Shifting Patterns of the HIV Epidemic in Southwest China: A Case Study Based on Sentinel Surveillance, 1995-2012.

    Science.gov (United States)

    Chow, Eric P F; Gao, Liangmin; Chen, Liang; Jing, Jun; Zhang, Lei

    2015-06-01

    The HIV epidemic is experiencing a rapid shift in transmission profile in China. This study aims to examine the changes in magnitude, transmission pattern, and trend of the HIV epidemic in a typical Southwest Chinese prefecture over the period of 1995-2012. HIV surveillance data from the web-based reporting system were analyzed during this period. We investigated the temporal trends in the changing characteristics of HIV transmission, the HIV disease burden in key affected populations, and assessed the impacts on HIV disease progression due to scale-up of antiretroviral treatment. A total of 3556 HIV/AIDS cases were reported in Yuxi prefecture, Yunnan, over the study period. The number of HIV tests conducted has dramatically increased from 1041 in 1995 to 247,859 in 2012, resulting in a substantial increase in HIV diagnoses from 11 cases to 327 cases over the same period. Since 2005, cumulatively 1250 eligible people living with HIV (PLHIV) have received combination antiretroviral therapy which reduced AIDS disease progression from 9.0% (95% CI: 6.7-11.4%) in 1995 to 0.1% (0-0.3%) in 2012 (ptrend=0.0002). The primary mode of HIV transmission has been shifted from injection sharing (71.9% diagnoses in 1995-2004) to unsafe sexual contacts (82.6% diagnoses in 2012). Yuxi prefecture is experiencing a concentrated but shifting HIV epidemic. Scale-up of HIV testing is essential to effective sentinel surveillance and enhancing early diagnosis and treatment in PLHIV.

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

    African Journals Online (AJOL)

    AJRH Managing Editor

    young (< 30 years old) and in long-term heterosexual relationships. With increased ... HAART, the prevalence and potential impact of sexual dysfunction are certain to be significant. There is ..... dysfunction among HIV infected men and women.

  19. Intensified tuberculosis case finding among hiv-infected individuals

    African Journals Online (AJOL)

    2011-10-02

    burden ... active TB (and in need of treatment) or being free of TB disease (and warranting ... following symptoms – current cough, fever, weight loss or night sweats (CFWS) .... and stand-alone HIV testing services. The WHO ...

  20. Do antidepressants increase the risk of mania and bipolar disorder in people with depression? A retrospective electronic case register cohort study

    NARCIS (Netherlands)

    Patel, Rashmi; Reiss, Peter; Shetty, Hitesh; Broadbent, Matthew; Stewart, Robert; McGuire, Philip; Taylor, Matthew

    2015-01-01

    Objectives To investigate the association between antidepressant therapy and the later onset of mania/bipolar disorder. Design Retrospective cohort study using an anonymised electronic health record case register. Setting South London and Maudsley National Health Service (NHS) Trust (SLaM), a large

  1. Unusual primary HIV infection with colonic ulcer complicated by hemorrhagic shock: a case report

    Directory of Open Access Journals (Sweden)

    Emonet Stephane

    2010-08-01

    Full Text Available Abstract Introduction Timely diagnosis of primary HIV infection is important to prevent further transmission of HIV. Primary HIV infection may take place without symptoms or may be associated with fever, pharyngitis or headache. Sometimes, the clinical presentation includes aseptic meningitis or cutaneous lesions. Intestinal ulceration due to opportunistic pathogens (cytomegalovirus, Epstein-Barr virus, Toxoplasma gondii has been described in patients with AIDS. However, although invasion of intestinal lymphoid tissue is a prominent feature of human and simian lentivirus infections, colonic ulceration has not been reported in acute HIV infection. Case description A 42-year-old Caucasian man was treated with amoxicillin-clavulanate for pharyngitis. He did not improve, and a rash developed. History taking revealed a negative HIV antibody test five months previously and unprotected sex with a male partner the month before admission. Repeated tests revealed primary HIV infection with an exceptionally high HIV-1 RNA plasma concentration (3.6 × 107 copies/mL and a low CD4 count (101 cells/mm3, seven percent of total lymphocytes. While being investigated, the patient had a life-threatening hematochezia. After angiographic occlusion of a branch of the ileocaecal artery and initiation of antiretroviral therapy, the patient became rapidly asymptomatic and could be discharged. Colonoscopy revealed a bleeding colonic ulcer. We were unable to identify an etiology other than HIV for this ulcer. Conclusion This case adds to the known protean manifestation of primary HIV infection. The lack of an alternative etiology, despite extensive investigations, suggests that this ulcer was directly caused by primary HIV infection. This conclusion is supported by the well-described extensive loss of intestinal mucosal CD4+ T cells associated with primary HIV infection, the extremely high HIV viral load observed in our patient, and the rapid improvement of the ulcer after

  2. Bladder Cancer in HIV-infected Adults: An Emerging Issue? Case-Reports and Systematic Review.

    Directory of Open Access Journals (Sweden)

    Sylvain Chawki

    Full Text Available Non-AIDS-related malignancies now represent a frequent cause of death among HIV-infected patients. Albeit bladder cancer is one of the most common malignancies worldwide, it has been rarely reported among HIV-infected patients. We wished to assess the prevalence and characteristics of bladder cancer in HIV-infected patients.We conducted a single center retrospective study from 1998 to 2013 in a university hospital in Paris. Cases of bladder cancer among HIV-infected patients were identified using the electronic records of the hospital database and of the HIV-infected cohort. Patient characteristics and outcomes were retrieved from patients charts. A systematic review of published cases of bladder cancers in patients with HIV-infection was also performed.During the study period we identified 15 HIV-infected patients (0.2% of the cohort with a bladder cancer. Patients were mostly men (73% and smokers (67%, with a median age of 56 years at cancer diagnosis. Bladder cancer was diagnosed a median of 14 years after HIV-infection. Most patients were on ART (86% with median current and nadir CD4 cell counts of 506 and 195 cells/mm3, respectively. Haematuria (73% was the most frequent presenting symptom and HPV-associated lesions were seen in 6/10 (60% patients. Histopathology showed transitional cell carcinoma in 80% and a high proportion of tumors with muscle invasion (47% and high histologic grade (73%. One-year survival rate was 74.6%. The systematic review identified 13 additional cases of urothelial bladder cancers which shared similar features.Bladder cancers in HIV-infected patients remain rare but may occur in relatively young patients with a low nadir CD4 cell count, have aggressive pathological features and can be fatal.

  3. Primary breast lymphoma: a consideration in an HIV patient when a mass is discovered by screening mammography: a case report.

    Science.gov (United States)

    Akinwande, Olagoke K; Paley, Robert

    2008-12-11

    Primary Breast lymphoma is a rare lesion that has been reported in patients without HIV. However, Primary Breast lymphoma occurring in a patient with HIV has rarely been reported despite the fact that HIV infection is known to increase the propensity to develop certain types of lymphoma. We report a case of an HIV patient with breast lymphoma that was discovered by screening mammography while presenting our argument for more cautionary management in this patient population.

  4. Benign lymphoepithelial cysts of the parotid glands in HIV-positive patients. A case report

    International Nuclear Information System (INIS)

    Piqueras, R.M.; Marco, S.F.; Lazaro, S.; Gonzlez, M.

    1997-01-01

    Benign parotid lymphoepithelial cysts (BPLEC) with cervical lymph node involvement are a recently reported radiological sign of HIV infection in head and neck in patients ar risk for developing AIDS. These cysts lesions present in the parotid glands of HIV-positive individuals and are associated with cervical lymph node involvement. We present a case of BPLEC in a HIV-positive patients that was studied by ultrasound and computerized tomography. The diagnosis was confirmed by ultrasound-guided percutaneous biopsy. We describe the radiological signs of this lesion as detected by the imaging techniques employed and we establish the differential diagnosis. (Author) 14 refs

  5. Rethinking the Poverty-disease Nexus: the Case of HIV/AIDS in South Africa.

    Science.gov (United States)

    Pienaar, Kiran

    2017-09-01

    While it is well-established that poverty and disease are intimately connected, the nature of this connection and the role of poverty in disease causation remains contested in scientific and social studies of disease. Using the case of HIV/AIDS in South Africa and drawing on a theoretically grounded analysis, this paper reconceptualises disease and poverty as ontologically entangled. In the context of the South African HIV epidemic, this rethinking of the poverty-disease dynamic enables an account of how social forces such as poverty become embodied in the very substance of disease to produce ontologies of HIV/AIDS unique to South Africa.

  6. Pregnancy in a renal transplant recipient with HIV-1 infection: a case report.

    Science.gov (United States)

    Agüero, Fernando; Cofan, Frederic; Fortuny, Claudia; Lopez, Marta; Manzardo, Christian; Lonca, Montserrat; Oppenheimer, Frederic; Moreno, Asuncion; Campistol, Josep M; Miro, Jose M

    2016-01-01

    We report the first case of a pregnancy in a renal transplant recipient with HIV infection. She underwent renal transplantation in 2005 and became pregnant in 2009. The patient underwent vaginal delivery and a healthy full-term, female baby was born. Almost 6 years after delivery, both mother and child were doing well. The management of concurrent renal transplantation, HIV infection and pregnancy was extremely challenging. Women with HIV infection who have undergone renal transplantation should be accurately informed of the potential health risks for them and their offspring. Multidisciplinary teams are mandatory in order to properly manage these patients.

  7. Disseminated tuberculosis presenting as mesenteric and cerebral abscess in HIV infection: case report

    Directory of Open Access Journals (Sweden)

    Vinay Pandit

    Full Text Available Disseminated tuberculosis in HIV infection involves multiple organs. Pulmonary and lymph node involvement are the commonest form of tuberculosis in HIV infection [1, 2]. Other forms of tuberculosis in the absence of lung and lymph node involvement are rare. Various forms of abdominal [3, 4] and neurological [5, 6] tubercular involvement in HIV infection have been reported. But tuberculosis presenting simultaneously with mesenteric and brain abscess has not been reported yet. We report a case of disseminated tuberculosis presenting as mesenteric and cerebral abscess in a HIV case without involving lung and lymph nodes. Bone marrow smears and fine needle aspiration cytology (FNAC from mesenteric lesion were positive for acid fast bacilli (AFB and the diagnosis of tuberculosis was confirmed by positive polymerase chain reaction (PCR. He responded well to treatment with anti tubercular drugs.

  8. The role of community conversations in facilitating local HIV competence: case study from rural Zimbabwe.

    Science.gov (United States)

    Campbell, Catherine; Nhamo, Mercy; Scott, Kerry; Madanhire, Claudius; Nyamukapa, Constance; Skovdal, Morten; Gregson, Simon

    2013-04-17

    This paper examines the potential for community conversations to strengthen positive responses to HIV in resource-poor environments. Community conversations are an intervention method through which local people work with a facilitator to collectively identify local strengths and challenges and brainstorm potential strategies for solving local problems. We conducted 18 community conversations (with six groups at three points in time) with a total of 77 participants in rural Zimbabwe (20% HIV positive). Participants were invited to reflect on how they were responding to the challenges of HIV, both as individuals and in community groups, and to think of ways to better support openness about HIV, kindness towards people living with HIV and greater community uptake of HIV prevention and treatment. Community conversations contributed to local HIV competence through (1) enabling participants to brainstorm concrete action plans for responding to HIV, (2) providing a forum to develop a sense of common purpose in relation to implementing these, (3) encouraging and challenging participants to overcome fear, denial and passivity, (4) providing an opportunity for participants to move from seeing themselves as passive recipients of information to active problem solvers, and (5) reducing silence and stigma surrounding HIV. Our discussion cautions that community conversations, while holding great potential to help communities recognize their potential strengths and capacities for responding more effectively to HIV, are not a magic bullet. Poverty, poor harvests and political instability frustrated and limited many participants' efforts to put their plans into action. On the other hand, support from outside the community, in this case the increasing availability of antiretroviral treatment, played a vital role in enabling communities to challenge stigma and envision new, more positive, ways of responding to the epidemic.

  9. HIV Prevention After Discontinuing Pre-Exposure Prophylaxis: Conclusions From a Case Study

    Directory of Open Access Journals (Sweden)

    Kai J. Jonas

    2018-05-01

    Full Text Available Pre-exposure prophylaxis (PrEP with tenofovir disoproxil fumarate in combination with emtricitabine (FTC is a highly effective form of HIV prevention. Endeavors of health-care providers and activists in many countries over the world are directed at making access to PrEP possible, or increasing PrEP use among men-who-have-sex-with-men (MSM. We argue while this effort is necessary, we also need to consider modes of HIV prevention after a period of PrEP use. PrEP uptake is not a one-way street, meaning that individuals may discontinue PrEP use, either voluntarily and involuntarily. Voluntary discontinued PrEP use in conjunction with decreased or no HIV risk exposure is unproblematic, but involuntary discontinuations with continuous high level of HIV risk exposure calls for tailored post-PrEP use HIV prevention. We present a case study of an MSM individual who discontinued PrEP for medical reasons (renal function and seroconverted soon afterward, to illustrate the need for tailored HIV prevention post-PrEP. Furthermore, we provide additional contexts of PrEP discontinuation leading to populations that are in need for post-PrEP types of HIV prevention. Subsequently, we present suggestions for modes of post-PrEP HIV prevention based on knowledge–communication–choice model. Community organization and health-care providers should consider and prepare their HIV prevention consulting protocols for such types of clients and add post-PrEP HIV prevention measures to their consulting offer.

  10. Case report: mechanisms of HIV elite control in two African women.

    Science.gov (United States)

    Moosa, Yumna; Tanko, Ramla F; Ramsuran, Veron; Singh, Ravesh; Madzivhandila, Mashudu; Yende-Zuma, Nonhlanhla; Abrahams, Melissa-Rose; Selhorst, Philippe; Gounder, Kamini; Moore, Penny L; Williamson, Carolyn; Abdool Karim, Salim S; Garrett, Nigel J; Burgers, Wendy A

    2018-01-25

    The majority of people living with HIV require antiretroviral therapy (ART) for controlling viral replication, however there are rare HIV controllers who spontaneously and durably control HIV in the absence of treatment. Understanding what mediates viral control in these individuals has provided us with insights into the immune mechanisms that may be important to induce for a vaccine or functional cure for HIV. To date, few African elite controllers from high incidence settings have been described. We identified virological controllers from the CAPRISA 002 cohort of HIV-1 subtype C infected women in KwaZulu Natal, South Africa, two (1%) of whom were elite controllers. We examined the genetic, clinical, immunological and virological characteristics of these two elite HIV controllers in detail, to determine whether they exhibit features of putative viral control similar to those described for elite controllers reported in the literature. In this case report, we present clinical features, CD4 + T cell and viral load trajectories for two African women over 7 years of HIV infection. Viral load became undetectable 10 months after HIV infection in Elite Controller 1 (EC1), and after 6 weeks in Elite Controller 2 (EC2), and remained undetectable for the duration of follow-up, in the absence of ART. Both elite controllers expressed multiple HLA Class I and II haplotypes previously associated with slower disease progression (HLA-A*74:01, HLA-B*44:03, HLA-B*81:01, HLA-B*57:03, HLA-DRB1*13). Fitness assays revealed that both women were infected with replication competent viruses, and both expressed higher mRNA levels of p21, a host restriction factor associated with viral control. HIV-specific T cell responses were examined using flow cytometry. EC1 mounted high frequency HIV-specific CD8+ T cell responses, including a B*81:01-restricted Gag TL9 response. Unusually, EC2 had evidence of pre-infection HIV-specific CD4+ T cell responses. We identified some features typical of

  11. Maxillary Sinus Kaposi Sarcoma: Case Report in an HIV-Negative Patient with Thymoma

    Directory of Open Access Journals (Sweden)

    Bernardo Carvalho Araújo

    2017-01-01

    Full Text Available Introduction. Kaposi sarcoma is an angioproliferative disorder that requires infection with human herpesvirus 8 (HHV-8 for its development. The majority of cases are associated with HIV infection or other immunocompromising conditions. Thymomas are occasionally associated to cytopenia, which may alter the patients’ immune responses. Methods. Case report using clinical records. Results. Case report of a 46-year-old male patient diagnosed with thymoma and myasthenia gravis. The patient was referred to an otolaryngology consultation with complaints of facial pain in the right malar region, interpreted as an acute sinusitis. Following examination, an expansive maxillary sinus mass was found, and endoscopic surgery was undertaken. After careful investigation, it was diagnosed as a Kaposi sarcoma. Conclusions. It is thought to be the first described case of a maxillary sinus Kaposi sarcoma in an HIV-negative patient. Thus, this entity has to be considered in the differential diagnosis of sinus masses, even in non-HIV patients.

  12. Registered partnerships

    CERN Multimedia

    Staff Association

    2015-01-01

    In recent decades, family patterns have changed significantly. National laws have taken these changes into account, recognizing new forms of unions, different to heterosexual marriage. Indeed, recently some countries have given the possibility to same-sex couples to enter into various forms of unions. Staff regulations of international organizations are not directly affected by national laws, but in the context of diversity policies, the lack of recognition of these new forms of unions, may appear to discriminate based on sexual orientation and to limit the freedom of choosing marital status. A study by the International Service for Remunerations and Pensions (iSRP) of the OECD in January 2015 (PROS Report (1015) 04) shows that in comparison with other international organizations, CERN offers the least favorable social conditions for its Staff with in a registered partnership. As part of the Five-year review in 2015, it is important that CERN aligns itself with the practice of these other organizations...

  13. 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.

  14. Characterization of drug susceptibility of Mycobacterium tuberculosis isolated from new cases of tuberculosis concurrent with HIV infection

    Directory of Open Access Journals (Sweden)

    G. V. Panov

    2015-01-01

    Full Text Available The paper characterizes drug susceptibility in Mycobacterium tuberculosis isolated from new cases of tuberculosis concurrent with HIV infection. The investigators have studied the spectrum of drug resistance in Mycobacterium tuberculosis isolated from new cases of tuberculosis concurrent with and without HIV infection (172 and 309 clinical isolates, respectively. There are differences in the rate of primary drug resistance to antituberculosis drugs in patients with and without HIV infection (59 and 43.5% of the cases, respectively. The HIV-infected have also shown high rifampicin resistance rates in Mycobacterium tuberculosis (41.7%. The reasons for these differences are as yet unknown and call for further investigation.

  15. PYOMYOSITIS IN HIV: A SERIES OF 12 CASES

    African Journals Online (AJOL)

    2013-12-02

    Dec 2, 2013 ... Background: Pyomyositis is a bacterial infection of the large skeletal muscles presenting with muscle pain and swelling. ... Bacterial pyomyositis among HIV infected persons typically occurred in those with end ... like septic shock, endocarditis, pneumonia, pericarditis, brain abscess, septic arthritis and ...

  16. Cerebellar Toxoplasmosis in HIV/AIDS: A Case Report | Emeka ...

    African Journals Online (AJOL)

    BACKGROUND: Toxoplasma encephalitis is a common presentation of Toxoplasma gondii infection of the central nervous system in the late stage of human immunodeficiency viral (HIV) infection. The definitive diagnosis requires demonstration of toxoplasma in brain tissue. However, neuroradiologic demonstration (using ...

  17. Autoimmune hepatitis in HIV: Case report | Kamau | East African ...

    African Journals Online (AJOL)

    We present a middle aged lady positive HIV who developed liver disease one year after initiation of anti-retroviral therapy (ART). Laboratory and histo pathology finding supported a diagnosis of autoimmune hepatitis (AIH). She responded well to immuno-suppressive therapy and is currently doing well on maintenance ...

  18. case study persistent pleural effusion in an hiv patient treated

    African Journals Online (AJOL)

    A 31-year-old woman presented to the oncology clinic at. Tygerberg Hospital in November 2003 with grade 3 dyspnoea and a dry cough for 2 weeks. She was known to be HIV-positive and had received 8 months' treatment at a primary health care facility for pulmonary tuberculosis. There was no other history of note.

  19. Sociodemographic differences among HIV-positive and HIV-negative recently pregnant women in Mexico City: A case-control study.

    Science.gov (United States)

    Aguilar-Zapata, Daniel; Piñeirúa-Menéndez, Alicia; Volkow-Fernández, Patricia; Rodríguez-Zulueta, Patricia; Ramos-Alamillo, Ubaldo; Cabrera-López, Teresita; Martin-Onraet, Alexandra

    2017-07-01

    National HIV preventive programs in Mexico focus on high-risk groups that do not consider women, apart from prenatal screening. Nonetheless, the epidemic in women is growing, and there is a need to better understand sociodemographic factors in women living with HIV (WLH). We performed a case-control study in Mexico City, including HIV+ and HIV- women with a recent pregnancy to compare their sociodemographic characteristics and describe the circumstances of diagnosis in HIV+ women, as well as prenatal screening frequency in both groups. Fifty cases and 102 controls were interviewed. HIV+ women were more frequently the only economic support of the family (20% vs 0%, P history of sexually transmitted diseases, substance abuse, history of violence, and civil status. Only 6% of controls were tested for HIV during prenatal follow-up. WLH in this study faced important social vulnerability. Targeting women living in these social contexts might increase early diagnosis and could tailor HIV prevention strategies. Prenatal coverage needs to be improved and should represent a national priority.

  20. 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.

  1. Do antidepressants increase the risk of mania and bipolar disorder in people with depression? A retrospective electronic case register cohort study

    OpenAIRE

    Patel, Rashmi; Reiss, Peter; Shetty, Hitesh; Broadbent, Matthew; Stewart, Robert; McGuire, Philip; Taylor, Matthew

    2015-01-01

    Objectives To investigate the association between antidepressant therapy and the later onset of mania/bipolar disorder.Design Retrospective cohort study using an anonymised electronic health record case register.Setting South London and Maudsley National Health Service (NHS) Trust (SLaM), a large provider of inpatient and community mental healthcare in the UK.Participants 21 012 adults presenting to SLaM between 1 April 2006 and 31 March 2013 with unipolar depression.Exposure Prior antidepres...

  2. Normalisation of cerebrospinal fluid biomarkers parallels improvement of neurological symptoms following HAART in HIV dementia – case report

    Directory of Open Access Journals (Sweden)

    Blennow Kaj

    2006-09-01

    Full Text Available Abstract Background Since the introduction of HAART the incidence of HIV dementia has declined and HAART seems to improve neurocognitive function in patients with HIV dementia. Currently, HIV dementia develops mainly in patients without effective treatment, though it has also been described in patients on HAART and milder HIV-associated neuropsychological impairment is still frequent among HIV-1 infected patients regardless of HAART. Elevated cerebrospinal fluid (CSF levels of markers of neural injury and immune activation have been found in HIV dementia, but neither of those, nor CSF HIV-1 RNA levels have been proven useful as diagnostic or prognostic pseudomarkers in HIV dementia. Case presentation We report a case of HIV dementia (MSK stage 3 in a 57 year old antiretroviral naïve man who was introduced on zidovudine, lamivudine and ritonavir boosted indinavir, and followed with consecutive lumbar punctures before and after two and 15 months after initiation of HAART. Improvement of neurocognitive function was paralleled by normalisation of CSF neural markers (NFL, Tau and GFAP levels and a decline in CSF and serum neopterin and CSF and plasma HIV-1 RNA levels. Conclusion The value of these CSF markers as prognostic pseudomarkers of the effect of HAART on neurocognitive impairment in HIV dementia ought to be evaluated in longitudinal studies.

  3. A Case of Cutaneous Plasmablastic Lymphoma in HIV/AIDS with Disseminated Cryptococcus

    Directory of Open Access Journals (Sweden)

    Jun Gong

    2013-01-01

    Full Text Available We present a case of a patient with HIV/AIDS who presented with a tender left lower extremity cutaneous mass over a site of previous cryptococcal infection and was found to have plasmablastic lymphoma (PBL. The incidence of PBL is estimated to account for less than 5% of all cases of non-Hodgkin lymphoma (NHL in HIV-positive individuals. In fact, there were only two reports of extraoral PBL at the time of a 2003 review. PBL in HIV-positive individuals is an aggressive malignancy that tends to occur in middle-aged males with low CD4 counts, high viral loads, and chronic HIV infection. The definitive diagnosis can be made with biopsy which typically shows malignant lymphoid cells that stain positive for plasma cell markers and negative for B-cell markers. The most common treatment is chemotherapy with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP or CHOP-like regimens, but the overall survival rate is poor despite its relative responsiveness to chemotherapy. This case highlights the challenges that remain in improving clinical outcomes, the importance of antiretroviral therapy and HIV disease control, and a potential association between a chronic inflammatory state caused by disseminated Cryptococcus and tumorigenesis in individuals with PBL.

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

    DEFF Research Database (Denmark)

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

    1999-01-01

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

  5. [A pediatric case of HIV who diagnosed by virtue of disseminated cryptococcus infection].

    Science.gov (United States)

    Acar, Manolya; Sütçü, Murat; Aktürk, Hacer; Hançerli Törün, Selda; Karagöz, Nurinisa; Beka, Hayati; Yekeler, Ensar; Ağaçfidan, Ali; Salman, Nuran; Somer, Ayper

    2016-07-01

    Cryptococcus neoformans is an important opportunistic pathogen that causes serious mortality and morbidity in AIDS patients. Although its incidence has decreased with proper antiretroviral treatment (ART), it is still a major concern in areas with low socioeconomic HIV endemic countries with poor sources of therapy. In our country, pediatric HIV infection and so, HIV-related opportunistic infections are very rare. In order to pay attention to this unusual collaboration; herein, we presented a pediatric case who was diagnosed with HIV and disseminated cryptococcus infection concomitantly. A 6.5-year-old previously healthy girl has admitted to our hospital with the complaints of prolonged fever, cough and hemoptysis. On her physical examination she had oral candidiasis, generalized lymphadenopathy and hepatosplenomegaly. Laboratory findings were as follows; white blood cell count: 3170 µL (neutrophil: 2720 µL, lymphocyte: 366 µL), hemoglobin level: 7.8 gr/dl, hematocrit: 25.5% platelets: 170.000 µL, CRP: 15.2 mg/L and serum IgG level: 1865 mg/dl. Her anti-HIV test yielde,d positive result and confirmed by Western blot assay, together with a high viral load (HIV-RNA: 3.442.000 copies/ml). She was started ART (lamivudine, zidovudine and lopinavir/ritonavir combination) with the diagnosis of stage 3 HIV infection (AIDS). Posteroanterior chest radiograph showed mediastinal extension and nodular parenchyma. Since the patient was suspected to have pulmonary tuberculosis based on the clinical and radiological findings, empirical antituberculosis therapy was started. Because of the insistance of fever, three different blood specimens, bone marrow and gastric aspirates were collected for culture, in which all of them yielded C.neoformans growth. She was then diagnosed as disseminated cryptococcosis and treated with liposomal amphotericin B and fluconazole successfully. Although pediatric HIV infection is usually diagnosed secondary to maternal disease, it can rarely be

  6. [Analysis on HIV-1 subtypes and transmission clusters in newly reported HIV/AIDS cases in Yiwu, Zhejiang Province, 2016].

    Science.gov (United States)

    Zhang, J F; Yao, J M; Fan, Q; Chen, W J; Pan, X H; Ding, X B; Yang, J Z; Fu, T

    2017-12-10

    Objective: To understand the characteristics of distribution on HIV-1 subtypes and the transmission clusters in Yiwu in Zhejiang province. Methods: A cross-sectional study of molecular epidemiology was carried out on newly reported HIV/AIDS cases in Yiwu. RNA was extracted from 168 plasma samples, followed by RT-PCR and nest-PCR for pol gene amplification, sequencing, phylogenetic tree construction used for analyzing the subtypes and transmission clusters. Mutations on drug resistance was analyzed by CPR 6.0 online tool. Results: Subjects were mainly males (86.3%, 145/168), with average age as (39.1±13.4) years old and most of them were migrants (66.7%, 112/168). The major routes of transmission included homosexual (51.2%, 86/168) and heterosexual (48.8%, 82/168) contacts. The rate of success for sequence acquisition was 89.9% (151/168). The dominant subtypes showed as CRF01_AE (74, 49.0%) and CRF07_BC (64, 42.4%), followed by CRF08_BC (5, 3.3%), CRF55_01B (3, 2.0%), each case of subtype B, CRF45_cpx, CRF59_01B, CRF85_BC and URF (B/C). CRF45_cpx and CRF85_BC were discovered the first time in Zhejiang province. Twenty-six transmission clusters involving 65 cases were found, with the total clustered rate as 43.0% (65/151), in which the CRF01_AE clustered rate appeared as 54.1% (40/74), higher than that of CRF07_BC (21/64, 32.8%). The average size of cluster was 2.5 cases/cluster, with average size of cluster in CRF01_AE patients infected through heterosexual transmission as the largest (3.5 cases/cluster). The prevalence of transmitted drug resistance was 4.6% (7/151). Seven cases with surveillance drug resistant mutations (SDRM) were found, including 5 cases of M46L (3.3%), and one case of F77L or Y181C. Conclusion: HIV genetic diversity and a variety of transmission clusters had been noticed in this study area (Yiwu). Programs on monitoring the subtypes and transmission clusters should be continued and strengthened.

  7. [Status of marriage and HIV transmission between couples in newly reported HIV cases before diagnosis was made, among men who have sex with men in China, 2014].

    Science.gov (United States)

    Li, J; Han, J; Xu, J; Tang, H L; Mao, Y R

    2017-06-10

    Objective: To analyze the status of marriage and HIV transmission between couples in newly reported HIV cases before diagnoses were made, among men who have sex with men (MSM) in China. Methods: Baseline and follow-up information related to newly reported cases in 2014 were collected from the Chinese HIV/AIDS Comprehensive Response Information Management System. Infected MSM who were older than 22 years of age were included in this study. HIV cases were divided into sero-concordant or sero-discordant group, according to the HIV status of the couple who were tested 180 days post-diagnosis. Multivariate logistic regression method was used to analyze the potential factors associated with HIV transmission between couples before diagnosis was made. Results: A total of 5 081 (22.7 % ) of the HIV infected MSM who had couples, were included in this study. A total of 3 715 cases had their couples tested 180 days after the diagnosis was made. 7.6 % (282) had positive couples. Results from the multivariate logistic regression analysis showed that factors as: older than 60 ( OR =2.64, 95 % CI : 1.50-4.65) years of age, being minorities ( OR =1.93, 95 % CI : 1.13-3.29), having CD(4)(+)T cells less than 500 cells/μl (<200: OR =2.91, 95 %CI : 1.82-4.65; 200-349: OR =1.98, 95 %CI : 1.22-3.23; 350-500: OR =1.69, 95 %CI : 1.00-2.86), with self-reported unsafe behaviors ( OR =1.92, 95 % CI : 1.44-2.58) etc. , were more likely to transmit HIV to their couples before the diagnosis was made. Conclusion: Behavior interventions and early HIV testing should be promoted, especially among those MSM who had couples, to avoid inter-spousal transmission.

  8. Using High-Impact HIV Prevention to Achieve the National HIV/AIDS Strategic Goals in Miami-Dade County, Florida: A Case Study.

    Science.gov (United States)

    Carey, James W; LaLota, Marlene; Villamizar, Kira; McElroy, Tamara; Wilson, M Maximillion; Garcia, Jersey; Sandrock, Robert; Taveras, Janelle; Candio, Darline; Flores, Stephen A

    2015-01-01

    : In response to the release of the National HIV/AIDS Strategy, the Centers for Disease Control and Prevention developed the "Enhanced Comprehensive HIV Prevention Planning" project, which provided support to health departments in 12 Metropolitan Statistical Areas with the highest AIDS prevalence to strengthen local HIV programs. We describe a case study of how 1 Metropolitan Statistical Area, Miami-Dade County, developed and implemented a locally tailored plan. Examples include actions to reinforce local partnerships and identify neighborhoods with highest unmet needs, an improved condom distribution system to assist local HIV care providers, collaboration with local stakeholders to establish a new walk-in center for transgender client needs, and overcoming incompatibilities in health department and Ryan White Program computer record systems to facilitate faster and more efficient patient services. These examples show how jurisdictions both within Florida and elsewhere can create low-cost and sustainable activities tailored to improve local HIV prevention needs.

  9. Impact of global health governance on country health systems: the case of HIV initiatives in Nigeria.

    Science.gov (United States)

    Chima, Charles Chikodili; Homedes, Nuria

    2015-06-01

    Three global health initiatives (GHIs) - the US President's Emergency Plan for AIDS Relief, the Global Fund to Fight AIDS, Tuberculosis and Malaria, and the World Bank Multi-Country HIV/AIDS Program - finance most HIV services in Nigeria. Critics assert that GHIs burden fragile health systems in resource-poor countries and that health system limitations in these countries constrain the achievement of the objectives of GHIs. This study analyzed interactions between HIV GHIs and the Nigerian Health System and explored how the impact of the GHIs could be optimized. A country case study was conducted using qualitative methods, including: semi-structured interviews, direct observation, and archival review. Semi-structured interviews were held with key informants selected to reach a broad range of stakeholders including policymakers, program managers, service providers, representatives of donor agencies and their implementing partners; the WHO country office in Nigeria; independent consultants; and civil society organizations involved in HIV work. The fieldwork was conducted between June and August 2013. HIV GHIs have had a mixed impact on the health system. They have enhanced availability of and access to HIV services, improved quality of services, and strengthened health information systems and the role of non-state actors in health care. On the negative end, HIV donor funding has increased dependency on foreign aid, widened disparities in access to HIV services, done little to address the sustainability of the services, crowded out non-HIV health services, and led to the development of a parallel supply management system. They have also not invested significantly in the production of new health workers and have not addressed maldistribution problems, but have rather contributed to internal brain drain by luring health workers from the public sector to non-governmental organizations and have increased workload for existing health workers. There is poor policy direction

  10. Socio-cultural factors affecting the spread of HIV/AIDS in Africa: a case study.

    Science.gov (United States)

    Dada-Adegbola, H O

    2004-06-01

    There is a disproportionate share of AIDS cases over the years in Africa. This has occurred in racial and ethnic minority populations, a finding likely related to social, economic and cultural factors. Certain socio-cultural and religious practices such as polygamy and giving a daughter away in marriage without considering the social life of the man are likely contributory factors to the higher prevalence of HIV/AIDS in women in this part of the world. This is illustrated with a case of Mr. M. S. who married two wives within four months interval, having lived a promiscuous life before marriage. One of the wives was a virgin at the time of marriage. Neither of wives had any symptoms suggestive of STD or HIV before marriage, however, the three of them tested positive to HIV-1 following a visit to the special treatment clinic. He had genital herpes and his two wives also had vulvovaginal candidiasis, genital herpes and condyloma accuminata (genital warts). The husband would not want his HIV status declared to the wives. There is therefore a need to enact law on pre-marriage HIV screening for intending couples. Couple Pre-and post-test counseling must be encouraged and promoted. In addition, women should be empowered to negotiate safer sex.

  11. Cauda equina enhancing lesion in a HIV-positive patient. Case report and literature revision.

    Directory of Open Access Journals (Sweden)

    Luigi Maria Larocca

    2011-01-01

    Full Text Available

    We describe the case a spinal cord localization of neurological toxoplasmosis in a HIV-positive patient with Burkitt lymphoma, previously treated with chemotherapy and immunotherapy. This complication occurred while patient was in complete remission of lymphoma, with CD4+ T cell count of 270 /ml, undetectable HIV viremia, and despite the trimethoprim/ sulfamethoxazole prophylaxis. Indeed, we hypothesize that in our patient neurologic toxoplasmosis has been fostered more by previous immuno-chemotherapy than by HIV- related immunodeficiency. On the whole, this case suggests that parameters usually employed to predict the risk for opportunistic infections in HIV-positive people might not apply to patients with HIV-related lymphomas.

  12. Trends in suicide risk associated with hospitalized psychiatric illness: a case-control study based on danish longitudinal registers

    DEFF Research Database (Denmark)

    Qin, Ping; Nordentoft, Merete; Hansen Høyer, Eyd

    2006-01-01

    longitudinal registers. Data were analyzed using conditional logistic regression. RESULTS: This study shows that the reduction in suicide rate is generally faster among individuals with a history of psychiatric admission than among individuals without such a history. However, this substantial reduction...... at the time of suicide or the index date, the reduction in suicide rate is relatively slower. Such trends hold for all diagnostic groups. Further analyses stratified by age indicate that the faster reduction in suicide rate associated with history of hospitalized psychiatric illness is more pronounced among...

  13. The impact of possession on legality of mortgage registered on a building under construction: With case law

    Directory of Open Access Journals (Sweden)

    Vicković Tanja

    2016-01-01

    Full Text Available The expansion of the subject of a mortgage to buildings under construction is a considerable step forward in regulating mortgages. It is not possible to register ownership rights on buildings under construction. A person acquiring ownership does not have the possibility to protect his rights. Acquiring ownership rights to a building under construction is tied to possession. This is detrimental to the principle of publicity which in turn erodes the principle of reliance. Validity of the mortgage is tied to the possession over the mortgaged real estate at the time of its registration. Such position of the courts challenges the very essence of mortgage.

  14. [Survival time of HIV/AIDS cases and related factors in Beijing, 1995-2015].

    Science.gov (United States)

    Li, Y; Wang, J; He, S F; Chen, J; Lu, H Y

    2017-11-10

    Objective: To analyze the survival time of HIV/AIDS cases and related factors in Beijing from 1995 to 2015. Methods: A retrospective cohort study was conducted to analyze the data of 12 874 HIV/AIDS cases. The data were collected from Chinese HIV/AIDS Comprehensive Information Management System. Life table method was applied to calculate the survival proportion, and Cox proportion hazard regression model were used to identify the factors related with survival time. Results: Among 12 874 HIV/AIDS cases, 303 (2.4%) died of AIDS related diseases; 9 346 (72.6%) received antiretroviral therapy. The average survival time was 226.5 months (95 %CI : 223.0-230.1), and the survival rates of 1, 5, 10, and 15 years were 98.2%, 96.4%, 93.2%, and 91.9% respectively. Multivariate Cox proportion hazard regression model showed that AIDS phase ( HR =1.439, 95 %CI : 1.041-1.989), heterosexual transmission ( HR =1.646, 95 %CI : 1.184-2.289), being married ( HR =2.186, 95 %CI : 1.510-3.164); older age (≥60 years) at diagnosis ( HR =6.608, 95 %CI : 3.546-12.316); lower CD(4)(+)T cell counts at diagnosis (<350 cells/μl) ( HR =8.711, 95 %CI : 5.757-13.181); receiving no antiretroviral therapy (ART) ( HR =18.223, 95 %CI : 13.317-24.937) were the high risk factors influencing the survival of AIDS patients compared with HIV phase, homosexual transmission, being unmarried, younger age (≤30 years), higher CD(4)(+)T cell count (≥350 cell/μl) and receiving ART. Conclusion: The average survival time of HIV/AIDS cases was 226.5 months after diagnoses. Receiving ART, higher CD(4)(+)T cell counts at the first test, HIV phase, younger age, being unmarried and the homosexual transmission were related to the longer survival time of HIV/AIDS cases. Receiving no ART, the lower CD(4)(+)T cell counts at the first test, AIDS phase, older age, being married and heterosexual transmission indicated higher risk of death due to AIDS.

  15. Modelling and Control of HIV/AIDS Propagation - A Case Study of ...

    African Journals Online (AJOL)

    Modelling and Control of HIV/AIDS Propagation - A Case Study of the Ashanti Region of Ghana. ... Open Access DOWNLOAD FULL TEXT ... in the Ashanti Region of Ghana for the period 1982 to 2001 with a view to assessing the level and impact of the pandemic as well as the effectiveness of the existing control measures.

  16. Oral histoplasmosis associated with candidiasis in HIV-infected patients: a report of two cases.

    Science.gov (United States)

    Nittayananta, W; Kumplanont, P; Srisintorn, S; Akkayanont, P; Chungpanich, S; Teanpaisan, R; Chareonwatanan, M; Nuntanaranont, T

    1997-04-26

    Oral histoplasmosis, a rare condition, is reported in two HIV-infected patients. The lesions showed different characteristics. One was an ulcerative lesion presenting as the only manifestation of the disease. The other was nodular, with disseminated histoplasmosis. In both cases infection with Candida was also noted within the lesions.

  17. Cerebral Toxoplasmosis in HIV/AIDS: A case report | Bedu-Addo ...

    African Journals Online (AJOL)

    This is a case of HIV infection with cerebral toxoplasmosis. Cerebral toxoplasmosis is an AIDS- related infection and is one of the causes of CNS mass lesions in AIDS. A 36-year-old male was admitted at Komfo Anokye Teaching Hospital (KATH) for a week. He had focal seizures for which he was treated as an “epileptic” ...

  18. False-negative syphilis treponemal enzyme immunoassay results in an HIV-infected case-patient.

    Science.gov (United States)

    Katz, Alan R; Komeya, Alan Y; Tomas, Juval E

    2017-06-01

    We present a case report of a false-negative syphilis treponemal enzyme immunoassay test result in an HIV-infected male. While treponemal tests are widely considered to be more sensitive and specific than non-treponemal tests, our findings point to potential challenges using the reverse sequence syphilis screening algorithm.

  19. Myocardial uptake in HIV Lymphoma - A case study

    International Nuclear Information System (INIS)

    Watson, T.N.; Hain, S.F.; Freund, J.

    1997-01-01

    Full text: A 25-year-old male presented to the HIV unit with acute abdominal pain, diarrhoea, malnutrition, dehydration, abdominal distension and haematokzia. CT followed by colonscopic cultures indicated large cell Iymphoma located in the sigmoid. Bone marrow biopsy showed no evidence of Iymphoma. There were no cardiac symptoms. The patient was then referred for a radionuclide gallium scan. The patient was injected with 370 MBq of 67 Ga-citrate. At 72 hours post injection, anterior and posterior sweeps, right and left lateral skull views and a SPECT of the chest were performed. The following day, an anterior abdomen view was collected and a SPECT of the abdomen was performed. Diffuse 67 Ga-citrate accumulation was seen in the myocardium and in the bowel. Radionuclide photopeaks were found to be consistent with gallium. Uptake in the liver was notably decreased, presumably due to concurrent massive blood transfusion for pancytopaenia. Further investigation of the heart was suggested. Owing to the tumour load of the bowel, the patient was immediately treated with chemotherapy without further investigation of the heart. The patient returned for a follow-up 67 Ga-citrate scan three months later. Gallium-67-citrate uptake remained present in the myocardium and the bowel, with both being less intense than in the previous scan. The liver now appears normal. The patient re-presented to the Emergency Department two days post completion of chemotherapy with cardiac tamponade secondary to pericardial effusion, which was drained and cytology showed Iymphoma cells. Lymphoma of the myocardium is not unusual in HIV patients and should not be overlooked or left un investigated as a simple HIV infection

  20. Myocardial uptake in HIV Lymphoma - A case study

    Energy Technology Data Exchange (ETDEWEB)

    Watson, T.N.; Hain, S.F.; Freund, J. [St Vincents Hospital, Sydney, NSW (Australia). Department of Nuclear Medicine

    1997-12-01

    Full text: A 25-year-old male presented to the HIV unit with acute abdominal pain, diarrhoea, malnutrition, dehydration, abdominal distension and haematokzia. CT followed by colonscopic cultures indicated large cell Iymphoma located in the sigmoid. Bone marrow biopsy showed no evidence of Iymphoma. There were no cardiac symptoms. The patient was then referred for a radionuclide gallium scan. The patient was injected with 370 MBq of {sup 67}Ga-citrate. At 72 hours post injection, anterior and posterior sweeps, right and left lateral skull views and a SPECT of the chest were performed. The following day, an anterior abdomen view was collected and a SPECT of the abdomen was performed. Diffuse {sup 67}Ga-citrate accumulation was seen in the myocardium and in the bowel. Radionuclide photopeaks were found to be consistent with gallium. Uptake in the liver was notably decreased, presumably due to concurrent massive blood transfusion for pancytopaenia. Further investigation of the heart was suggested. Owing to the tumour load of the bowel, the patient was immediately treated with chemotherapy without further investigation of the heart. The patient returned for a follow-up {sup 67}Ga-citrate scan three months later. Gallium-67-citrate uptake remained present in the myocardium and the bowel, with both being less intense than in the previous scan. The liver now appears normal. The patient re-presented to the Emergency Department two days post completion of chemotherapy with cardiac tamponade secondary to pericardial effusion, which was drained and cytology showed Iymphoma cells. Lymphoma of the myocardium is not unusual in HIV patients and should not be overlooked or left un investigated as a simple HIV infection

  1. Cancer of the penis associated with HIV: a report of three cases presenting at the CHU cocody, ivory coast.

    Science.gov (United States)

    Konan, P G; Vodi, C C; Dekou, A H; Fofana, A; Gowé, E E; Manzan, K

    2015-11-16

    We describe three cases of advanced penile cancer associated with HIV infection. Advanced penile cancer associated with VIH infection were discovered in three patients aged respectively 47, 56 and 40. The prognosis was extremely poor. Two patients died without receiving any treatment and one patient was lost to follow-up after refusing all treatment proposed. There appears to be a link between HIV infection and penile cancer with concomitant HIV infection worsening the prognosis of the disease.

  2. The Oral HIV/AIDS Research Alliance: updated case definitions of oral disease endpoints.

    Science.gov (United States)

    Shiboski, C H; Patton, L L; Webster-Cyriaque, J Y; Greenspan, D; Traboulsi, R S; Ghannoum, M; Jurevic, R; Phelan, J A; Reznik, D; Greenspan, J S

    2009-07-01

    The Oral HIV/AIDS Research Alliance (OHARA) is part of the AIDS Clinical Trials Group (ACTG), the largest HIV clinical trials organization in the world. Its main objective is to investigate oral complications associated with HIV/AIDS as the epidemic is evolving, in particular, the effects of antiretrovirals on oral mucosal lesion development and associated fungal and viral pathogens. The OHARA infrastructure comprises: the Epidemiologic Research Unit (at the University of California San Francisco), the Medical Mycology Unit (at Case Western Reserve University) and the Virology/Specimen Banking Unit (at the University of North Carolina). The team includes dentists, physicians, virologists, mycologists, immunologists, epidemiologists and statisticians. Observational studies and clinical trials are being implemented at ACTG-affiliated sites in the US and resource-poor countries. Many studies have shared end-points, which include oral diseases known to be associated with HIV/AIDS measured by trained and calibrated ACTG study nurses. In preparation for future protocols, we have updated existing diagnostic criteria of the oral manifestations of HIV published in 1992 and 1993. The proposed case definitions are designed to be used in large-scale epidemiologic studies and clinical trials, in both US and resource-poor settings, where diagnoses may be made by non-dental healthcare providers. The objective of this article is to present updated case definitions for HIV-related oral diseases that will be used to measure standardized clinical end-points in OHARA studies, and that can be used by any investigator outside of OHARA/ACTG conducting clinical research that pertains to these end-points.

  3. Unmatched Case-Control Study on Late Presentation of HIV Infection in Santiago, Cape Verde (2004-2011).

    Science.gov (United States)

    Moreira, António L; Fronteira, Inês; Augusto, Gonçalo Figueiredo; Martins, Maria Rosario O

    2016-03-15

    Access to free antiretroviral therapy (ART) in Sub-Saharan Africa has been steadily increasing over the past decade. However, the success of large-scale ART programmes depends on timely diagnosis and early initiation of HIV care. This study characterizes late presenters to HIV care in Santiago (Cape Verde) between 2004 and 2011, and identifies factors associated with late presentation for care. We defined late presentation as persons presenting to HIV care with a CD4 count below 350 cells/mm³. An unmatched case-control study was conducted using socio-demographic and behavioural data of 368 individuals (191 cases and 177 controls) collected through an interviewer-administered questionnaire, comparing HIV patients late and early presented to care. Logistic regression was performed to estimate odds ratio and 95% confidence intervals. Results show that 51.9% were late presenters for HIV. No differences were found in gender distribution, marital status, or access to health services between cases and controls. Participants who undertook an HIV test by doctor indication were more likely to present late compared with those who tested for HIV by their own initiative. Also, individuals taking less time to initiate ART are more likely to present late. This study highlights the need to better understand reasons for late presentation to HIV care in Cape Verde. People in older age groups should be targeted in future approaches focused on late presenters to HIV care.

  4. Unmatched Case-Control Study on Late Presentation of HIV Infection in Santiago, Cape Verde (2004–2011)

    Science.gov (United States)

    Moreira, António L.; Fronteira, Inês; Augusto, Gonçalo Figueiredo; Martins, Maria Rosario O.

    2016-01-01

    Access to free antiretroviral therapy (ART) in Sub-Saharan Africa has been steadily increasing over the past decade. However, the success of large-scale ART programmes depends on timely diagnosis and early initiation of HIV care. This study characterizes late presenters to HIV care in Santiago (Cape Verde) between 2004 and 2011, and identifies factors associated with late presentation for care. We defined late presentation as persons presenting to HIV care with a CD4 count below 350 cells/mm3. An unmatched case-control study was conducted using socio-demographic and behavioural data of 368 individuals (191 cases and 177 controls) collected through an interviewer-administered questionnaire, comparing HIV patients late and early presented to care. Logistic regression was performed to estimate odds ratio and 95% confidence intervals. Results show that 51.9% were late presenters for HIV. No differences were found in gender distribution, marital status, or access to health services between cases and controls. Participants who undertook an HIV test by doctor indication were more likely to present late compared with those who tested for HIV by their own initiative. Also, individuals taking less time to initiate ART are more likely to present late. This study highlights the need to better understand reasons for late presentation to HIV care in Cape Verde. People in older age groups should be targeted in future approaches focused on late presenters to HIV care. PMID:26999167

  5. Preventing HIV with young people: a case study from Zambia.

    Science.gov (United States)

    Gordon, Gill; Mwale, Vincent

    2006-11-01

    The US President's Emergency Plan for AIDS Relief (PEPFAR) is funding thousands of community-based organisations, international NGOs and government services in high HIV prevalence countries to persuade young people to abstain from sex until marriage (Abstinence, Behaviour Change, Youth--ABY). This paper describes how this strategy is being implemented in Zambia, and community responses to it. It is derived from published information and observations and discussions in the Eastern Province in 2005-2006. A few NGOs have challenged the strategy, but many took the funds and are paying large numbers of peer educators to promote abstinence only. Messages are rife that condoms have holes or don't work sufficiently well to make them worth using. Condom promotion materials have been replaced. Service providers refuse to give condoms to young people. Young people who had attended sexuality and life skills programmes that gave them accurate information are rejecting inaccurate messages and demanding condoms. Without this education, however, inaccurate messages will spread quickly. It is not possible to promote condoms only for high risk people without stigmatising both the people and condoms, and it also jeopardises promoting condom use for contraception. Everything possible must be done to reduce negative messages about condoms. Everyone involved in HIV/AIDS needs to reflect on their own work in relation to this new climate and ensure that all prevention options are widely available, correct information is given and condoms are available for everyone who needs them.

  6. Get Connected: an HIV prevention case management program for men and women leaving California prisons.

    Science.gov (United States)

    Myers, Janet; Zack, Barry; Kramer, Katie; Gardner, Mick; Rucobo, Gonzalo; Costa-Taylor, Stacy

    2005-10-01

    Individuals leaving prison face challenges to establishing healthy lives in the community, including opportunities to engage in behavior that puts them at risk for HIV transmission. HIV prevention case management (PCM) can facilitate linkages to services, which in turn can help remove barriers to healthy behavior. As part of a federally funded demonstration project, the community-based organization Centerforce provided 5 months of PCM to individuals leaving 3 state prisons in California. Program effects were measured by assessing changes in risk behavior, access to services, reincarnation, and program completion. Although response rates preclude definitive conclusions, HIV risk behavior did decrease. Regardless of race, age, or gender, those receiving comprehensive health services were significantly more likely to complete the program. PCM appears to facilitate healthy behavior for individuals leaving prison.

  7. Reducing post-tonsillectomy haemorrhage rates through a quality improvement project using a Swedish National quality register: a case study.

    Science.gov (United States)

    Odhagen, Erik; Sunnergren, Ola; Söderman, Anne-Charlotte Hessén; Thor, Johan; Stalfors, Joacim

    2018-03-24

    Tonsillectomy (TE) is one of the most frequently performed ENT surgical procedures. Post-tonsillectomy haemorrhage (PTH) is a potentially life-threatening complication of TE. The National Tonsil Surgery Register in Sweden (NTSRS) has revealed wide variations in PTH rates among Swedish ENT centres. In 2013, the steering committee of the NTSRS, therefore, initiated a quality improvement project (QIP) to decrease the PTH incidence. The aim of the present study was to describe and evaluate the multicentre QIP initiated to decrease PTH rates. Six ENT centres, all with PTH rates above the Swedish average, participated in the 7-month quality improvement project. Each centre developed improvement plans describing the intended changes in clinical practice. The project's primary outcome variable was the PTH rate. Process indicators, such as surgical technique, were also documented. Data from the QIP centres were compared with a control group of 15 surgical centres in Sweden with similarly high PTH rates. Data from both groups for the 12 months prior to the start of the QIP were compared with data for the 12 months after the QIP. The QIP centres reduced the PTH rate from 12.7 to 7.1% from pre-QIP to follow-up; in the control group, the PTH rate remained unchanged. The QIP centres also exhibited positive changes in related key process indicators, i.e., increasing the use of cold techniques for dissection and haemostasis. The rates of PTH can be reduced with a QIP. A national quality register can be used not only to identify areas for improvement but also to evaluate the impact of subsequent improvement efforts and thereby guide professional development and enhance patient outcomes.

  8. HPV types, HIV and invasive cervical carcinoma risk in Kampala, Uganda: a case-control study

    Directory of Open Access Journals (Sweden)

    Kleter Bernhard

    2011-06-01

    Full Text Available Abstract Background While the association of human papillomavirus (HPV with cervical cancer is well established, the influence of HIV on the risk of this disease in sub-Saharan Africa remains unclear. To assess the risk of invasive cervical carcinoma (ICC associated with HIV and HPV types, a hospital-based case-control study was performed between September 2004 and December 2006 in Kampala, Uganda. Incident cases of histologically-confirmed ICC (N=316 and control women (N=314, who were visitors or care-takers of ICC cases in the hospital, were recruited. Blood samples were obtained for HIV serology and CD4 count, as well as cervical samples for HPV testing. HPV DNA detection and genotyping was performed using the SPF10/DEIA/LiPA25 technique which detects all mucosal HPV types by DEIA and identifies 25 HPV genotypes by LiPA version 1. Samples that tested positive but could not be genotyped were designated HPVX. Odds ratios (OR and 95% confidence intervals (CI were calculated by logistic regression, adjusting for possible confounding factors. Results For both squamous cell carcinoma (SCC and adenocarcinoma of the cervix, statistically significantly increased ORs were found among women infected with HPV, in particular single HPV infections, infections with HPV16-related types and high-risk HPV types, in particular HPV16, 18 and 45. For other HPV types the ORs for both SCC and adenocarcinoma were not statistically significantly elevated. HIV infection and CD4 count were not associated with SCC or adenocarcinoma risk in our study population. Among women infected with high-risk HPV types, no association between HIV and SCC emerged. However, an inverse association with adenocarcinoma was observed, while decrease in CD4 count was not associated with ICC risk. Conclusions The ORs for SCC and adenocarcinoma were increased in women infected with HPV, in particular single HPV infections, infections with HPV16- and 18-related types, and high-risk HPV types

  9. Reductions in Transmission Risk Behaviors in HIV-Positive Clients Receiving Prevention Case Management Services: Findings from a Community Demonstration Project

    Science.gov (United States)

    Gasiorowicz, Mari; Llanas, Michelle R.; DiFranceisco, Wayne; Benotsch, Eric G.; Brondino, Michael J.; Catz, Sheryl L.; Hoxie, Neil J.; Reiser, William J.; Vergeront, James M.

    2005-01-01

    Prevention case management (PCM) for HIV-infected persons is an HIV risk reduction intervention designed to assist clients who are aware of their HIV infection and who continue to engage in risk transmission behaviors. PCM combines individual risk reduction counseling with case management to address the psychosocial factors affecting HIV…

  10. EFAVIRENZ-INDUCED GYNAECOMASTIA IN HIV INFECTED MALES: A REPORT OF 2 CASES

    Directory of Open Access Journals (Sweden)

    Ishwar Sidappa Hasabi

    2016-08-01

    Full Text Available Highly Active Antiretroviral Therapy (HAART has been a major leap in the treatment of HIV. HAART has improved both morbidity and mortality in HIV patients. Of late, the cases of gynaecomastia are increasing secondary to initiation of ART. Efavirenz-induced gynaecomastia still remains underreported. CASE PRESENTATION We hereby report two cases of Efavirenz-induced Gynaecomastia in young males with median duration of 12 months on Efavirenz after valid written consent. CONCLUSION Efavirenz is being used as a first line regimen drug for ART initiation and also when patient has tuberculosis as opportunistic infection. Hence, the side effects of Efavirenz should be addressed and proper guidelines should be framed to manage the same.

  11. 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.

  12. 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.

  13. Breast cancer and HIV in the era of highly active antiretroviral therapy: two case reports and review of the literature.

    Science.gov (United States)

    Latif, Naeem; Rana, Fauzia; Guthrie, Troy

    2011-01-01

    The incidence of human immunodeficiency virus (HIV) infection is rising in US women; however its impact on breast cancer incidence, stage at presentation, response and treatment toxicity remains unknown. To address the impact of HIV infection and use of highly active antiretroviral therapy (HAART) on the natural history of breast cancer we present two cases of breast cancer in HIV-infected women and also review the literature. A literature search was done on Medline using the key words HIV/AIDS, breast cancer, and HAART therapy, restricted to English language. There were mostly case reports and one large series of 20 cases reported by Hurley et al. Data concerning the impact of HIV infection and HAART therapy regarding pathogenesis, stage at presentation, tumor type, response, and toxicity associated with treatment were reviewed. The literature review shows that the breast cancer incidence is either same or less in HIV-infected patients compared to the general population. However, the patients with HIV infection present with more advanced stage and aggressive disease, and they also have poor chemotherapy tolerance. The impact of HAART on breast cancer incidence in HIV-infected patients is still unclear. © 2010 Wiley Periodicals, Inc.

  14. HIV quality report cards: impact of case-mix adjustment and statistical methods.

    Science.gov (United States)

    Ohl, Michael E; Richardson, Kelly K; Goto, Michihiko; Vaughan-Sarrazin, Mary; Schweizer, Marin L; Perencevich, Eli N

    2014-10-15

    There will be increasing pressure to publicly report and rank the performance of healthcare systems on human immunodeficiency virus (HIV) quality measures. To inform discussion of public reporting, we evaluated the influence of case-mix adjustment when ranking individual care systems on the viral control quality measure. We used data from the Veterans Health Administration (VHA) HIV Clinical Case Registry and administrative databases to estimate case-mix adjusted viral control for 91 local systems caring for 12 368 patients. We compared results using 2 adjustment methods, the observed-to-expected estimator and the risk-standardized ratio. Overall, 10 913 patients (88.2%) achieved viral control (viral load ≤400 copies/mL). Prior to case-mix adjustment, system-level viral control ranged from 51% to 100%. Seventeen (19%) systems were labeled as low outliers (performance significantly below the overall mean) and 11 (12%) as high outliers. Adjustment for case mix (patient demographics, comorbidity, CD4 nadir, time on therapy, and income from VHA administrative databases) reduced the number of low outliers by approximately one-third, but results differed by method. The adjustment model had moderate discrimination (c statistic = 0.66), suggesting potential for unadjusted risk when using administrative data to measure case mix. Case-mix adjustment affects rankings of care systems on the viral control quality measure. Given the sensitivity of rankings to selection of case-mix adjustment methods-and potential for unadjusted risk when using variables limited to current administrative databases-the HIV care community should explore optimal methods for case-mix adjustment before moving forward with public reporting. Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2014. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  15. 10-year survival of total ankle arthroplasties: a report on 780 cases from the Swedish Ankle Register.

    Science.gov (United States)

    Henricson, Anders; Nilsson, Jan-Åke; Carlsson, Ake

    2011-12-01

    There is an ongoing need to review large series of total ankle replacements (TARs) for monitoring of changes in practice and their outcome. 4 national registries, including the Swedish Ankle Register, have previously reported their 5-year results. We now present an extended series with a longer follow-up, and with a 10-year survival analysis. Records of uncemented 3-component TARs were retrospectively reviewed, determining risk factors such as age, sex, and diagnosis. Prosthetic survival rates were calculated with exchange or removal of components as endpoint-excluding incidental exchange of the polyethylene meniscus. Of the 780 prostheses implanted since 1993, 168 (22%) had been revised by June 15, 2010. The overall survival rate fell from 0.81 (95% CI: 0.79-0.83) at 5 years to 0.69 (95% CI: 0.67-0.71) at 10 years. The survival rate was higher, although not statistically significantly so, during the latter part of the period investigated. Excluding the STAR prosthesis, the survival rate for all the remaining designs was 0.78 at 10 years. Women below the age of 60 with osteoarthritis were at a higher risk of revision, but age did not influence the outcome in men or women with rheumatoid arthritis. Revisions due to technical mistakes at the index surgery and instability were undertaken earlier than revisions for other reasons. The results have slowly improved during the 18-year period investigated. However, we do not believe that the survival rates of ankle replacements in the near future will approach those of hip and knee replacements-even though improved instrumentation and design of the prostheses, together with better patient selection, will presumably give better results.

  16. Empirical evidence for synchrony in the evolution of TB cases and HIV+ contacts among the San Francisco homeless.

    Directory of Open Access Journals (Sweden)

    Mojdeh Mohtashemi

    Full Text Available The re-emergence of tuberculosis (TB in the mid-1980s in many parts of the world, including the United States, is often attributed to the emergence and rapid spread of human immunodeficiency virus (HIV and acquired immunodeficiency syndrome (AIDS. Although it is well established that TB transmission is particularly amplified in populations with high HIV prevalence, the epidemiology of interaction between TB and HIV is not well understood. This is partly due to the scarcity of HIV-related data, a consequence of the voluntary nature of HIV status reporting and testing, and partly due to current practices of screening high risk populations through separate surveillance programs for HIV and TB. The San Francisco Department of Public Health, TB Control Program, has been conducting active surveillance among the San Francisco high-risk populations since the early 1990s. We present extensive TB surveillance data on HIV and TB infection among the San Francisco homeless to investigate the association between the TB cases and their HIV+ contacts. We applied wavelet coherence and phase analyses to the TB surveillance data from January 1993 through December 2005, to establish and quantify statistical association and synchrony in the highly non-stationary and ostensibly non-periodic waves of TB cases and their HIV+ contacts in San Francisco. When stratified by homelessness, we found that the evolution of TB cases and their HIV+ contacts is highly coherent over time and locked in phase at a specific periodic scale among the San Francisco homeless, but no significant association was observed for the non-homeless. This study confirms the hypothesis that the dynamics of HIV and TB are significantly intertwined and that HIV is likely a key factor in the sustenance of TB transmission among the San Francisco homeless. The findings of this study underscore the importance of contact tracing in detection of HIV+ individuals that may otherwise remain undetected, and

  17. Timing of entry to care by newly diagnosed HIV cases before and after the 2010 New York State HIV testing law.

    Science.gov (United States)

    Gordon, Daniel E; Bian, Fuqin; Anderson, Bridget J; Smith, Lou C

    2015-01-01

    Prompt entry to care after HIV diagnosis benefits the infected individual and reduces the likelihood of further transmission of the virus. The New York State HIV Testing Law of 2010 requires diagnosing providers to refer persons newly diagnosed with HIV to follow-up medical care. This study used routinely collected HIV-related laboratory data from the New York State HIV surveillance system to assess whether the fraction of newly diagnosed cases entering care within 90 days of diagnosis increased after the implementation of the law. Laboratory data on 23,302 newly diagnosed cases showed that entry to care within 90 days rose steadily from 72.0% in 2007 to 85.4% in 2012. The rise was observed across all race/ethnic groups, ages, transmission risk groups, sexes, and regions of residence. Logistic regression analyses of entry to care pre-law and post-law, controlling for demographic characteristics, transmission risk, and geographic area, indicate that percentage of newly diagnosed cases entering care within 90 days grew more rapidly in the post-law period. This is consistent with a positive effect of the law on entry to care.

  18. Revealed willingness-to-pay versus standard cost-effectiveness thresholds: Evidence from the South African HIV Investment Case.

    Science.gov (United States)

    Meyer-Rath, Gesine; van Rensburg, Craig; Larson, Bruce; Jamieson, Lise; Rosen, Sydney

    2017-01-01

    The use of cost-effectiveness thresholds based on a country's income per capita has been criticized for not being relevant to decision making, in particular in middle-income countries such as South Africa. The recent South African HIV Investment Case produced an alternative cost-effectiveness threshold for HIV prevention and treatment interventions based on estimates of life years saved and the country's committed HIV budget. We analysed the optimal mix of HIV interventions over a baseline of the current HIV programme under the committed HIV budget for 2016-2018. We calculated the incremental cost-effectiveness ratio (ICER) as cost per life-year saved (LYS) of 16 HIV prevention and treatment interventions over 20 years (2016-2035). We iteratively evaluated the most cost effective option (defined by an intervention and its coverage) over a rolling baseline to which the more cost effective options had already been added, thereby allowing for diminishing marginal returns to interventions. We constrained the list of interventions to those whose combined cost was affordable under the current HIV budget. Costs are presented from the government perspective, unadjusted for inflation and undiscounted, in 2016 USD. The current HIV budget of about $1.6 billion per year was sufficient to pay for the expansion of condom availability, medical male circumcision, universal treatment, and infant testing at 6 weeks to maximum coverage levels, while also implementing a social and behavior change mass media campaign with a message geared at increasing testing uptake and reducing the number of sexual partners. The combined ICER of this package of services was $547/ LYS. The ICER of the next intervention that was above the affordability threshold was $872/LYS. The results of the South African HIV Investment Case point to an HIV cost-effectiveness threshold based on affordability under the current budget of $547-872 per life year saved, a small fraction of the country's GDP per capita of

  19. [HIV-1 infection after occupational accidents in the State of Amazonas: first reported case].

    Science.gov (United States)

    Lucena, Noaldo Oliveira de; Pereira, Flávio Ribeiro; Barros, Flávio Silveira de; Silva, Nélson Barbosa da; Alexandre, Márcia Almeida de Araújo; Castilho, Márcia da Costa; Alecrim, Maria das Graças Costa

    2011-10-01

    The medical care of occupational accidents in Tropical Medicine Foundation Dr. Heitor Dourado (FMT-HVD), involving blood and body fluids, started routinely in 1999. The objective of this report is to emphasize the importance of the measures used for the control of accidents with biological material. This study is carried out after a detailed epidemiological investigation confirmed one case of human immunodeficiency virus (HIV) seroconversion after an occupational accident involving bodily fluids and sharp instruments.

  20. Cytomegalovirus retinitis and HIV: Case reviews from KwaZulu ...

    African Journals Online (AJOL)

    untreated, CMV retinitis can progress to retinal detachment with ... 1 Centre for the AIDS Programme of Research in South Africa (CAPRISA), Doris .... [18] Ocular TB .... patients for publication of these case reviews and accompanying images.

  1. Paper 5: Surveillance of multiple congenital anomalies: implementation of a computer algorithm in European registers for classification of cases

    DEFF Research Database (Denmark)

    Garne, Ester; Dolk, Helen; Loane, Maria

    2011-01-01

    Surveillance of multiple congenital anomalies is considered to be more sensitive for the detection of new teratogens than surveillance of all or isolated congenital anomalies. Current literature proposes the manual review of all cases for classification into isolated or multiple congenital anomal...

  2. A situational analysis of HIV and AIDS in Pakistan

    Directory of Open Access Journals (Sweden)

    Sarwar Muhammad

    2011-04-01

    Full Text Available Abstract HIV (Human immunodeficiency virus transmission has been reduced by protected sex and screening of blood products and other body fluids in the developed countries. It has been reported that Pakistan is at high risk of HIV/AIDS infection but presently the prevalence rate is considerably low. The number of reported cases of HIV/AIDS in Pakistan has been continuously increasing since 1987. By 2010 the total number of registered cases has reached to 6000 and this figure is on the rise with the passage of time. Some serious strategies must be implemented to control this deadly disease.

  3. Hypersensitivity Reaction Associated with Abacavir Therapy in an Indian HIV Patient - A Case Report.

    Science.gov (United States)

    Janardhanan, Manju; Amberkar V, Mohan Babu; Vidyasagar, Sudha; Kumari K, Meena; Holla, Sadhana N

    2014-09-01

    The most important and unique adverse effect of abacavir (ABC) is fatal hypersensitivity reaction (HSR). The objective of this report is to describe a case of ABC induced HSR that occurred in an Indian HIV patient during treatment. Although this adverse effect is not uncommon, it is perhaps underreported or has never been reported so far in an Indian case scenario. A 44-year-old known case of HIV-1 was admitted in view of his worsening condition and very low CD4 cell counts 3 cells/μL. He was on anti-retroviral therapy since three years but not regular. On the basis of treatment failure, non-compliance and progressive low CD4 counts, the anti HIV regime was switched over to abacavir 600 mg+ atazanavir/ ritonavir 300mg/100mg Two weeks after ABC therapy he presented with maculopapular rash, headache and signs of hepatic damage (serum AST, ALP and ALT increased to 3-4 fold) suggestive of hypersensitivity reaction. As we know discontinuation of the drug is the ultimate litmus test to confirm diagnosis of drug induced adverse reaction. We did confirm ABC induced HSR by de-challenge wherein, rash disappeared within 2-3 days and LFT came back to normal within 5 days. However, no rechallenge was done. HSR was more in favour of ABC because atazanavir failed to produce any similar reaction after re-challenge.

  4. The Social Development Dimension Of The Nursing Profession In Managing HIV Cases

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    Sri Wahyuni

    2015-02-01

    Full Text Available ABSTRACT In this study the researcher attempted to understand and explain to explore the social development dimension of the nurse professions in managing HIV cases. Specifically the study sought to answer the following questions 1 what is the profile of the key informants with regards to HIV Patients age gender education and socio economics status Nurses age gender no of years of work experiences specific to HIV social workers age gender and no of years of work experiences specific to HIV. 2 What are lived experiences of key informants on social development dimension of the helping process HIV patients Nurses and Social Workers 3 What social development model can be designed in managing HIV cases 4 What policy recommendations can be developed pertaining to development dimension in managing HIV cases. This study utilized qualitative approach. The phenomenology was used to explore and describe HIV patients through their lived experiences in a selected rehabilitation center in Sukabumi West Java Indonesia the nurses and social workers. The approach developed an understanding of the experiences as perceived by the key informants. Qualitative research aims to collect a deep understanding of human behavior. Survey checklists In-depth interviews repertory grid and dendogram were utilized in the data gathering procedure data presentations and data analyses. The informants of this study were focused on nurses social workers and HIV Patients in the rehabilitation center the Directorate General for Social Rehabilitation Social Ministries of the Republic of Indonesia the school nurses Ministry of Health Community Health Centers that carry out community health care program-specific examination of VCT. Generally the findings of the research conducted by qualitative research methods in a statement obtained significant categories and themes that emerged is significant for the statement is feeling sad angry when patients get HIV diagnosis the process of

  5. Migration of Spanish nurses 2009-2014. Underemployment and surplus production of Spanish nurses and mobility among Spanish registered nurses: A case study.

    Science.gov (United States)

    Galbany-Estragués, Paola; Nelson, Sioban

    2016-11-01

    After the financial crisis of 2008, increasing numbers of nurses from Spain are going abroad to work. To examine the health and workforce policy trends in Spain between 2009 and 2014 and to analyze their correlation with the migration of nurses. Single embedded case study. We examined data published by: Health Statistics, Organization for Economic Cooperation and Development (1996 to 2013); Ministry of Education, Culture and Sports (2006 to 2013); Ministry of Employment and Social Security (2009 to 2014); Ministry of Health, Social Services and Equality (1997 to 2014); and National Institute of Statistics (1976 to 2014). In addition to reviewing the scholarly literature on the topic in Spanish and English, we also examined Spanish mobility laws and European directives. We used the Organization for Economic Cooperation and Development definition of "professionally active nurses" which defines practising nurses and other nurses as those for whom their education is a prerequisite for employment as a nurse. Moreover, we used the term "nursing graduate" as defined by Spanish Ministry of Education to describe those who have obtained a recognized qualification in nursing in a given year, the term "registered nurses" is defined by Spanish law as nurses registered in the Nurses Associations and "unemployed nurses" are those without work and registered as seeking employment. A transformation of the Spanish health system has reduced the number of employed nurses per capita since 2010. Moreover, reductions in public spending, labour market reforms and widespread unemployment have affected nurses in two ways: first by increasing the number of applicants per vacancy between 2009 and 2013, and second, by an increase in casual positions. However, despite the poor job market and decreasing job security, the number of registered nurses and nursing graduates in Spain per year has continued to grow, increasing the pressure on the labour market. Spain is transforming from a stable

  6. Predictors of HIV positivity among pregnant women presenting for obstetric care in South India - a case-control study.

    Science.gov (United States)

    Solomon, Eileen; Visnegarwala, Fehmida; Philip, Philimol; Alexander, Glory

    2011-10-01

    Feminization of the HIV epidemic in India has increasingly burdened the public health infrastructure to provide prevention of mother-to-child transmission (PMTCT) services. A mere 20% of pregnant women in the country receive HIV counseling and testing. One of the strategies, for expansion of PMTCT services is to ascertain an accurate identification of HIV-positive pregnant women. Thus, we sought to characterize a demographic profile of pregnant women at high-risk for HIV infection. We performed a retrospective case-control study. We included as cases, all HIV-positive women identified in a PMTCT program implemented in 23 charitable faith-based hospitals in four states in South India over a period of 75 months, starting in January 2003. Thus a total of 320 HIV-positive cases were frequency matched using stratified random sampling to 365 HIV-negative pregnant women presenting for antenatal care during the same time period. Cases and controls were compared using Chi-square test for categorical variables and Student's t-test for continuous variables. Multivariate step-wise logistic regression analysis was performed. On multivariate analysis, following factors were independently predictive of HIV positivity: age ≤25 years (odds ratio [OR] 0.50; confidence interval [CI] 0.33-0.76; p = 0.001); illiteracy (OR 4.89; CI 2.79-8.57; p women presenting for antenatal care in the Indian setting. This type of profiling of HIV-positive pregnant women may help expand PMTCT services in a focused and cost-effective manner in India.

  7. Efficient and equitable HIV prevention: A case study of male circumcision in South Africa

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    Verguet Stéphane

    2013-01-01

    Full Text Available Abstract Background We determine efficient, equitable and mixed efficient-equitable allocations of a male circumcision (MC intervention reducing female to male HIV transmission in South Africa (SA, as a case study of an efficiency-equity framework for resource allocation in HIV prevention. Methods We present a mathematical model developed with epidemiological and cost data from the nine provinces of SA. The hypothetical one-year-long MC intervention with a budget of US$ 10 million targeted adult men 15–49 years of age in SA. The intervention was evaluated according to two criteria: an efficiency criterion, which focused on maximizing the number of HIV infections averted by the intervention, and an equity criterion (defined geographically, which focused on maximizing the chance that each male adult individual had access to the intervention regardless of his province. Results A purely efficient intervention would prevent 4,008 HIV infections over a year. In the meantime, a purely equitable intervention would avert 3,198 infections, which represents a 20% reduction in infection outcome as compared to the purely efficient scenario. A half efficient-half equitable scenario would prevent 3,749 infections, that is, a 6% reduction in infection outcome as compared to the purely efficient scenario. Conclusions This paper provides a framework for resource allocation in the health sector which incorporates a simple equity metric in addition to efficiency. In the specific context of SA with a MC intervention for the prevention of HIV, incorporation of geographical equity only slightly reduces the overall efficiency of the intervention.

  8. Potential cost-effectiveness of schistosomiasis treatment for reducing HIV transmission in Africa--the case of Zimbabwean women.

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    Martial L Ndeffo Mbah

    Full Text Available Epidemiological data from Zimbabwe suggests that genital infection with Schistosoma haematobium may increase the risk of HIV infection in young women. Therefore, the treatment of Schistosoma haematobium with praziquantel could be a potential strategy for reducing HIV infection. Here we assess the potential cost-effectiveness of praziquantel as a novel intervention strategy against HIV infection.We developed a mathematical model of female genital schistosomiasis (FGS and HIV infections in Zimbabwe that we fitted to cross-sectional data of FGS and HIV prevalence of 1999. We validated our epidemic projections using antenatal clinic data on HIV prevalence. We simulated annual praziquantel administration to school-age children. We then used these model predictions to perform a cost-effectiveness analysis of annual administration of praziquantel as a potential measure to reduce the burden of HIV in sub-Saharan Africa.We showed that for a variation of efficacy between 30-70% of mass praziquantel administration for reducing the enhanced risk of HIV transmission per sexual act due to FGS, annual administration of praziquantel to school-age children in Zimbabwe could result in net savings of US$16-101 million compared with no mass treatment of schistosomiasis over a ten-year period. For a variation in efficacy between 30-70% of mass praziquantel administration for reducing the acquisition of FGS, annual administration of praziquantel to school-age children could result in net savings of US$36-92 million over a ten-year period.In addition to reducing schistosomiasis burden, mass praziquantel administration may be a highly cost-effective way of reducing HIV infections in sub-Saharan Africa. Program costs per case of HIV averted are similar to, and under some conditions much better than, other interventions that are currently implemented in Africa to reduce HIV transmission. As a cost-saving strategy, mass praziquantel administration should be prioritized

  9. Forensic application of phylogenetic analyses - Exploration of suspected HIV-1 transmission case.

    Science.gov (United States)

    Siljic, Marina; Salemovic, Dubravka; Cirkovic, Valentina; Pesic-Pavlovic, Ivana; Ranin, Jovan; Todorovic, Marija; Nikolic, Slobodan; Jevtovic, Djordje; Stanojevic, Maja

    2017-03-01

    inherent limitations of the applied methods, we cannot unambiguously prove that HIV-1 transmission occurred directly between two individuals. Further exploration of the known and suspected transmission cases is needed in order to define methodologies and establish their reliability. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  10. Social marketing's unique contribution to mental health stigma reduction and HIV testing: two case studies.

    Science.gov (United States)

    Thackeray, Rosemary; Keller, Heidi; Heilbronner, Jennifer Messenger; Dellinger, Laura K Lee

    2011-03-01

    Since its inception in 2005, articles in Health Promotion Practice's social marketing department have focused on describing social marketing's unique contributions and the application of each to the practice of health promotion. This article provides a brief review of six unique features (marketing mix, consumer orientation, segmentation, exchange, competition, and continuous monitoring) and then presents two case studies-one on reducing stigma related to mental health and the other a large-scale campaign focused on increasing HIV testing among African American youth. The two successful case studies show that social marketing principles can be applied to a wide variety of topics among various population groups.

  11. Birth characteristics and Wilms tumors in children in the Nordic countries: a register-based case-control study.

    Science.gov (United States)

    Schüz, Joachim; Schmidt, Lisbeth Samsø; Kogner, Per; Lähteenmäki, Päivi M; Pal, Niklas; Stokland, Tore; Schmiegelow, Kjeld

    2011-05-01

    Little is known about causes of Wilms tumor. Because of the young age at diagnosis, several studies have looked at various birth characteristics. We conducted a registry-based case-control study involving 690 cases of Wilms tumor aged 0-14 years, occurring in Denmark, Finland, Norway or Sweden during 1985-2006, individually matched to five controls drawn randomly from the Nordic childhood population. Information on birth characteristics was obtained from the population-based medical birth registries. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) using conditional logistic regression analysis. We observed a distinct association between Wilms tumor and high birth weight (≥4 kg) for girls (OR 1.97, CI 1.50-2.59) but not for boys (1.04, 0.78-1.38); overall, the OR was 1.43 (1.17-1.74). Among girls, risk increased by 28% (15-42%) per 500 g increase in birth weight. Large-for-gestational age girls also had a higher risk (2.48, 1.51-4.05), whereas no effect was seen for boys (1.12, 0.60-2.07). An association was seen with Apgar score at 5 min birth order. In our large-scale, registry-based study, we confirmed earlier observations of an association between high birth weight and risk of Wilms tumor, but we found an effect only in girls. The higher risk of infants with low Apgar score might reflect hypoxia causing cell damage, adverse side effects of neonatal treatment or reverse causation as low Apgar score might indicate the presence of a tumor. Copyright © 2010 UICC.

  12. Hepatic Enzyme Alterations in HIV Patients on Antiretroviral Therapy: A Case-Control Study in a Hospital Setting in Ghana.

    Science.gov (United States)

    Osakunor, Derick Nii Mensah; Obirikorang, Christian; Fianu, Vincent; Asare, Isaac; Dakorah, Mavis

    2015-01-01

    Diagnosing hepatic injury in HIV infection can be a herculean task for clinicians as several factors may be involved. In this study, we sought to determine the effects of antiretroviral therapy (ART) and disease progression on hepatic enzymes in HIV patients. A case-control study conducted from January to May 2014 at the Akwatia Government Hospital, Eastern region, Ghana, The study included 209 HIV patients on ART (designated HIV-ART) and 132 ART-naive HIV patients (designated HIV-Controls). Data gathered included demography, clinical history and results of blood tests for hepatic enzymes. We employed the Fisher's, Chi-square, unpaired t-test and Pearson's correlation in analysis, using GraphPad Prism and SPSS. A P value 0.05). There was a significant positive correlation between hepatic enzymes (ALP, ALT, AST and GGT) for both groups (p enzymes for both groups was small. Antiretroviral therapy amongst this population has minimal effects on hepatic enzymes and does not suggest modifications in therapy. Hepatic injury may occur in HIV, even in the absence of ART and other traditional factors. Monitoring of hepatic enzymes is still important in HIV patients.

  13. Perceptions of Private Sector towards the Pollutant Release and Transfer Register: A Case Study on Petrochemical Industry in the Map Ta Phut Industrial Estate, Rayong, Thailand

    Directory of Open Access Journals (Sweden)

    Marie Kondo

    2013-01-01

    Full Text Available Under the Rio Declaration and Agenda 21 from the United Nations Conference on Environment and Development in 1992 as well as other international agreements, Thailand is currently in the process of adopting the Pollutant Release and Transfer Register (PRTR through a pilot project in Rayong province with assistance from the Japan International Cooperation Agency (JICA. This research aimed to study perceptions of private sector towards the PRTR through a case study on petrochemical industry in the Map Ta Phut Industrial Estate. Through semi-structured questionnaires and in-depth interviews, the study found that the petrochemical industry viewed that benefits of the PRTR for the government and civil society is quite clear, while each petrochemical company has different understanding on such benefit for private sector to be as sustainable industrial management. Various incentive measures and concerns on the PRTR were also indicated in this study.

  14. Young people's risk of suicide attempts after contact with a psychiatric department - a nested case-control design using Danish register data

    DEFF Research Database (Denmark)

    Christiansen, Erik; Juul Larsen, Kim

    2012-01-01

    discharge from last contact with a psychiatric department. The risk of suicide attempt is highest for children and adolescents suffering from personality disorders, depression and substance use disorders. Children and adolescents with previous contact with a psychiatric department and parental income......Background:  There seems to be an increased risk of children and adolescents committing or attempting suicide after contact with a psychiatric department. Children and adolescents living in families with low socio-economic status (SES) might have an especially increased suicide attempt risk....... Methods:  A complete extraction of Danish register data for every individual born in the period 1983-1989 was made. Of these 403,431 individuals, 3,465 had attempted suicide. In order to control for confounder effects from gender, age and calendar-time, a nested case-control study was designed. A total...

  15. HIV and childhood disability: a case-controlled study at a paediatric antiretroviral therapy centre in Lilongwe, Malawi.

    Science.gov (United States)

    Devendra, Akash; Makawa, Atupele; Kazembe, Peter N; Calles, Nancy R; Kuper, Hannah

    2013-01-01

    As paediatric antiretroviral therapy (ART) is rapidly scaled up in Southern Africa, Human Immunodeficiency Virus (HIV) infection is becoming a chronic illness. Children growing up with HIV may begin to encounter disabilities. The relationship between HIV, disability and the need for rehabilitation has added an additional element that needs to be addressed by paediatric HIV treatment programmes. 1) Estimate the prevalence of disabilities in HIV-infected and HIV-uninfected children in Lilongwe, Malawi. 2) Examine types of disability and associated clinical and socio-demographic factors. 3) Identify needs, opportunities and barriers for rehabilitation in Malawi. A case-controlled study of 296 HIV-infected children aged 2-9 years attending an ART centre in Lilongwe (cases) and their uninfected siblings (controls) was conducted. Disability was assessed using the WHO Ten Question Screen (TQS). Socio-demographic and clinical data were collected using a parent-proxy questionnaire and medical records. Of 296 case and control pairs recruited, 33% (98) versus 7% (20) screened positive for a disability (OR 8.4, 4.4-15.7) respectively. Of these 98 HIV-infected cases, 6%, 36%, 33%, 53%, 46% and 6% had a vision, hearing; physical, learning/comprehension, speech or seizure-related disability respectively and 51% had multiple coexisting disabilities. HIV-infected cases with a disability were more likely to be WHO stage III or IV at enrolment (71% vs. 52%, OR 2.7, 1.5-4.2), to have had TB (58% vs. 39%, OR 2.3, 1.4-3.8) and to have below-average school grades (18% vs. 2%, OR 11.1, 2.2-54.6) than those without. Sixty-seven percent of cases with a disability had never attended any rehabilitative service. Twenty-nine percent of caregivers reported facing stigma and discrimination because of the child's disability. This study reveals the magnitude of disability among HIV-infected children and the large unmet need for rehabilitation services. This expanding issue demands further

  16. HIV and childhood disability: a case-controlled study at a paediatric antiretroviral therapy centre in Lilongwe, Malawi.

    Directory of Open Access Journals (Sweden)

    Akash Devendra

    Full Text Available BACKGROUND: As paediatric antiretroviral therapy (ART is rapidly scaled up in Southern Africa, Human Immunodeficiency Virus (HIV infection is becoming a chronic illness. Children growing up with HIV may begin to encounter disabilities. The relationship between HIV, disability and the need for rehabilitation has added an additional element that needs to be addressed by paediatric HIV treatment programmes. STUDY OBJECTIVES: 1 Estimate the prevalence of disabilities in HIV-infected and HIV-uninfected children in Lilongwe, Malawi. 2 Examine types of disability and associated clinical and socio-demographic factors. 3 Identify needs, opportunities and barriers for rehabilitation in Malawi. METHODS: A case-controlled study of 296 HIV-infected children aged 2-9 years attending an ART centre in Lilongwe (cases and their uninfected siblings (controls was conducted. Disability was assessed using the WHO Ten Question Screen (TQS. Socio-demographic and clinical data were collected using a parent-proxy questionnaire and medical records. RESULTS: Of 296 case and control pairs recruited, 33% (98 versus 7% (20 screened positive for a disability (OR 8.4, 4.4-15.7 respectively. Of these 98 HIV-infected cases, 6%, 36%, 33%, 53%, 46% and 6% had a vision, hearing; physical, learning/comprehension, speech or seizure-related disability respectively and 51% had multiple coexisting disabilities. HIV-infected cases with a disability were more likely to be WHO stage III or IV at enrolment (71% vs. 52%, OR 2.7, 1.5-4.2, to have had TB (58% vs. 39%, OR 2.3, 1.4-3.8 and to have below-average school grades (18% vs. 2%, OR 11.1, 2.2-54.6 than those without. Sixty-seven percent of cases with a disability had never attended any rehabilitative service. Twenty-nine percent of caregivers reported facing stigma and discrimination because of the child's disability. CONCLUSION: This study reveals the magnitude of disability among HIV-infected children and the large unmet need for

  17. Progressive disseminated histoplasmosis in the HIV population in Europe in the HAART era. Case report and literature review

    DEFF Research Database (Denmark)

    Martin-Iguacel, R; Kurtzhals, J; Jouvion, G

    2014-01-01

    a case of a patient with HIV and PDH highlighting the possible diagnostic difficulties that may arise in a non-endemic area and review the literature of histoplasmosis in the context of HIV infection with special focus on Europe. DISCUSSION: When cellular immunity wanes (usually at CD4 T...... the prognosis. CONCLUSION: European infectious diseases physicians, microbiologists and pathologists must be aware of histoplasmosis, particularly when facing HIV-infected immigrants from endemic areas. This is increasingly important due to migration and travel activities from these areas....

  18. BASHH 2016 UK national audit and survey of HIV testing, risk assessment and follow-up: case note audit.

    Science.gov (United States)

    Bhaduri, Sumit; Curtis, Hilary; McClean, Hugo; Sullivan, Ann K

    2018-01-01

    This national audit demonstrated discrepancies between actual practice and that indicated by clinic policies following enquiry about alcohol, recreational drugs and chemsex use. Clinics were more likely to enquire about risk behaviour if this was clinic policy or routine practice. Previous testing was the most common reason for refusing HIV testing, although 33% of men who have sex with men had a prior test of more than three months ago. Of the group declining due to recent exposure in the window period, 21/119 cases had an exposure within the four weeks prior to presentation, but had a previous risk not covered by previous testing. Recommendations include provision of risk assessments for alcohol, recreational drug use and chemsex, documenting reasons for HIV test refusal, provision of HIV point-of-care testing, follow-up for cases at higher risk of HIV and advice about community testing or self-sampling/testing.

  19. Risk for attempted suicide in children and youths after contact with somatic hospitals: a Danish register based nested case-control study.

    Science.gov (United States)

    Christiansen, E; Stenager, E

    2012-03-01

    A range of studies have found an association between some somatic diseases and increased risk of suicide and attempted suicide. These studies are mostly analyses of adult populations and illnesses related to adulthood. To study the risk of attempted suicide in children and youths with a somatic diagnosis, and to assess a possible association from a somatic perspective. From a cohort of 403 431 individuals (born 1983-89), 3465 children and youths who had attempted suicide were identified. Each case was matched with 20 population controls. 72 765 children and youths constituted the case-control population. All data were obtained from national population registers and analysed in a nested case-control design. Contact of children and youths with a somatic hospital is correlated with increased risk of attempted suicide; the risk peaks in the time immediately after contact. Risk factors were treatment for injury caused by violence, epilepsy, asthma and malformation for males; and spontaneous and medical abortions, treatment for injury caused by violence, epilepsy, asthma, insulin dependent diabetes mellitus and malformation for females. Not all the mentioned diagnoses were significant in the adjusted model. Based on the results of the study a strategy to minimise the risk of attempted suicide among children and youths must be implemented. The strategy should mainly focus on children at high risk-that is, children from families with low socioeconomic status, and children with a psychiatric history, a history of previous suicide attempts and with an unstable somatic disease subsequently causing many admissions.

  20. Tuberculous disseminated lymphadenopathy in an immunocompetent non-HIV patient: a case report

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    Karadonta Argiroula-Vasiliki

    2009-12-01

    Full Text Available Abstract Introduction In cases of patients with disseminated lymphadenopathy, the differential diagnosis has to include both benign and malignant causes, including sarcoidosis, metastatic disease, lymphoma and, although rarely present, tuberculosis. Tuberculosis is still one of the most frequently occurring infectious diseases worldwide. However, disseminated mycobacterial lymphadenitis is rare in immunocompetent patients. Case presentation We present the case of a 56-year-old Caucasian Greek male, who was immunocompetent and HIV negative, with a two-month history of recurring fever, loss of appetite and disseminated lymphadenopathy. The patient was diagnosed with mycobacterial lymphadenopathy. Conclusion This case highlights the need for suspicion in order to identify mycobacterial infection in patients with generalized lymphadenopathy, since misdiagnosis is possible and may lead to fatal complications for the patient.

  1. Institutionalizing provider-initiated HIV testing and counselling for children: an observational case study from Zambia.

    Science.gov (United States)

    Mutanga, Jane N; Raymond, Juliette; Towle, Megan S; Mutembo, Simon; Fubisha, Robert Captain; Lule, Frank; Muhe, Lulu

    2012-01-01

    Provider-initiated testing and counselling (PITC) is a priority strategy for increasing access for HIV-exposed children to prevention measures, and infected children to treatment and care interventions. This article examines efforts to scale-up paediatric PITC at a second-level hospital located in Zambia's Southern Province, and serving a catchment area of 1.2 million people. Our retrospective case study examined best practices and enabling factors for rapid institutionalization of PITC in Livingstone General Hospital. Methods included clinical observations, key informant interviews with programme management, and a desk review of hospital management information systems (HMIS) uptake data following the introduction of PITC. After PITC roll-out, the hospital experienced considerably higher testing uptake. In a 36-month period following PITC institutionalization, of total inpatient children eligible for PITC (n = 5074), 98.5% of children were counselled, and 98.2% were tested. Of children tested (n = 4983), 15.5% were determined HIV-infected; 77.6% of these results were determined by DNA polymerase chain reaction (PCR) testing in children under the age of 18 months. Of children identified as HIV-infected in the hospital's inpatient and outpatient departments (n = 1342), 99.3% were enrolled in HIV care, including initiation on co-trimoxazole prophylaxis. A number of good operational practices and enabling factors in the Livingstone General Hospital experience can inform rapid PITC institutionalization for inpatient and outpatient children. These include the placement of full-time nurse counsellors at key areas of paediatric intake, who interface with patients immediately and conduct testing and counselling. They are reinforced through task-shifting to peer counsellors in the wards. Nurse counsellor capacity to draw specimen for DNA PCR for children under 18 months has significantly enhanced early infant diagnosis. The hospital's bolstered antiretroviral

  2. Institutionalizing provider-initiated HIV testing and counselling for children: an observational case study from Zambia.

    Directory of Open Access Journals (Sweden)

    Jane N Mutanga

    Full Text Available BACKGROUND: Provider-initiated testing and counselling (PITC is a priority strategy for increasing access for HIV-exposed children to prevention measures, and infected children to treatment and care interventions. This article examines efforts to scale-up paediatric PITC at a second-level hospital located in Zambia's Southern Province, and serving a catchment area of 1.2 million people. METHODS AND PRINCIPAL FINDINGS: Our retrospective case study examined best practices and enabling factors for rapid institutionalization of PITC in Livingstone General Hospital. Methods included clinical observations, key informant interviews with programme management, and a desk review of hospital management information systems (HMIS uptake data following the introduction of PITC. After PITC roll-out, the hospital experienced considerably higher testing uptake. In a 36-month period following PITC institutionalization, of total inpatient children eligible for PITC (n = 5074, 98.5% of children were counselled, and 98.2% were tested. Of children tested (n = 4983, 15.5% were determined HIV-infected; 77.6% of these results were determined by DNA polymerase chain reaction (PCR testing in children under the age of 18 months. Of children identified as HIV-infected in the hospital's inpatient and outpatient departments (n = 1342, 99.3% were enrolled in HIV care, including initiation on co-trimoxazole prophylaxis. A number of good operational practices and enabling factors in the Livingstone General Hospital experience can inform rapid PITC institutionalization for inpatient and outpatient children. These include the placement of full-time nurse counsellors at key areas of paediatric intake, who interface with patients immediately and conduct testing and counselling. They are reinforced through task-shifting to peer counsellors in the wards. Nurse counsellor capacity to draw specimen for DNA PCR for children under 18 months has significantly enhanced early

  3. Measles mimicking HIV seroconversion syndrome: a case report

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    Brook Gary

    2010-02-01

    Full Text Available Abstract Introduction Measles is on the rise in the United Kingdom and must be considered in the differential diagnosis of any patient presenting with fever and rash. As a highly infectious disease, identified patients must be isolated in the hospital setting. Case presentation A 28-year-old Polish woman presented ill to the accident and emergency department of a district general hospital. She had painful genital ulceration, oral soreness, fever, and a facial rash. She became hypoxic within 24 hours of presentation and began to tire, thus requiring noninvasive ventilation. Her respiratory symptoms were out of proportion to the findings of her chest radiograph, which remained virtually normal. Human immunodeficiency virus seroconversion syndrome complicated by Pneumocystis carinii pneumonia was high among the differential diagnoses. She was given cotrimoxazole, high-dose steroids, broad spectrum antibiotics, and anti fungal cover. Human immunodeficiency virus polymerase chain reaction came back as negative and her symptoms resolved within 10 days of presentation. She was taken off all treatment and discharged home feeling well. Serological measles was confirmed as part of a viral screen, but its clinical suspicion was low. Conclusion The presentation of measles in this patient was unique and atypical. With its incidence rising in the United Kingdom, measles must be increasingly considered as a differential diagnosis in patients presenting with fever and rash.

  4. Familial aggregation of arthritis-related diseases in seropositive and seronegative rheumatoid arthritis: a register-based case-control study in Sweden.

    Science.gov (United States)

    Frisell, Thomas; Hellgren, Karin; Alfredsson, Lars; Raychaudhuri, Soumya; Klareskog, Lars; Askling, Johan

    2016-01-01

    Our objective was to estimate the risk of developing rheumatoid arthritis (RA) associated with a family history of non-RA arthritis-related diseases. This familial co-aggregation is of clinical interest since it is often encountered when assessing family history of RA specifically, but also informative on the genetic overlap between these diseases. Since anticitrullinated peptide antibodies/rheumatoid factor (RF)-positive and RF-negative RA have both specific and shared genetic factors, the familial co-aggregation was assessed separately for seropositive and seronegative disease. Nested case-control study in prospectively recorded Swedish total population data. The Multi-Generation Register identified first-degree relatives. RA and arthritis-related diseases were ascertained through the nationwide patient register. RA serology was based on International Classification of Diseases tenth revision coded diagnoses, mainly reflecting RF. Familial risks were calculated using conditional logistic regression. Results were replicated using the Swedish rheumatology register. Familial co-aggregation was found between RA and every studied arthritis-related disease, but the magnitude varied widely, from juvenile idiopathic arthritis (JIA) (seropositive RA OR=3.98 (3.01 to 5.26); seronegative RA OR=5.70 (3.47 to 9.36)) to osteoarthritis (seropositive RA OR=1.03 (1.00 to 1.06); seronegative RA OR=1.05 (1.00 to 1.09)). The familial co-aggregation pattern of non-RA arthritis-related diseases was overall similar for seropositive and seronegative RA. Among those with family history of RA, relatives' other arthritis-related diseases conferred little or no additional risk. Although family history of several arthritis-related diseases may be useful to predict RA (eg, lupus and JIA), others (eg, osteoarthritis and arthralgia) are less useful. Seropositive and seronegative RA had rather similar familial co-aggregation patterns with arthritis-related diseases, suggesting that the two RA

  5. HIV sero.prevalence among adult with newly diagnosed pulmonary ...

    African Journals Online (AJOL)

    Materials and Methods: New patients registered with the DOTS clinic meeting TB case definition, diagnosed based on findings suggestive of pulmonary tuberculosis (PTB) on clinical and radiological examination (chest X.ray), and sputum testing for AFB (acid fast bacilli) were offered provider initiated HIV counseling and ...

  6. Investigation of Speech Impairments in A Child with HIV: The Study of Phonological Processes: Case Report

    Directory of Open Access Journals (Sweden)

    Zahra Ilkhani

    2017-03-01

    Full Text Available Human immunodeficiency virus (HIV is a viral disease with immunodeficiency in human. So, it can involve different areas such as language, speech, motor and memory. The present research, as a case report, introducing the characteristics of phonological processes of a child who had Aids and lived in a nursery through referring and professional assessing in a speech therapy clinic. The child was a 4 year old boy who was in HIV base on blood test. Speech skills was assessed based on DEAP and language assessment was analyzed according to TOLD-P3. He talked with single word. He used two words sentences rarely. According to language assessment (TOLD-P3, semantic, syntax and phonology features were tested. So he was in emerging language stage. Also his expressive language was lower than his perceive language. In addition, based on DEAP-P test, phonological process of substitution type has been recognized most. Also, the most of the substitution phonological process which accrued have been velar fronting. This study showed that the most phonological process in a child with HIV was the process of substitution. It may be a risk factor for decreasing speech intelligibility. With regard to the results of the present research that showed that the subject had the disorder and there are limited researches in this area,

  7. Pneumocystis Pneumonia in Non-HIV Pregnant Women Receiving Chemotherapy for Malignant Lymphoma: Two Case Reports

    Directory of Open Access Journals (Sweden)

    Yuki Fukutani

    2017-01-01

    Full Text Available Pneumocystis pneumonia (PCP is a life-threatening opportunistic infection that sometimes occurs in immunocompromised patients with human immunodeficiency virus (HIV. Here, we report two extremely rare cases of PCP in non-HIV pregnant women who underwent chemotherapy for malignant lymphoma. Case  1 is a 34-year-old primigravida who was diagnosed with Hodgkin’s lymphoma. She received ABVD chemotherapy and developed PCP at 37 weeks of gestation. After the onset of PCP, emergent cesarean section was performed due to a nonreassuring fetal status. Case  2 is a 31-year-old multigravida with diffuse large B-cell lymphoma who was administered R-CHOP chemotherapy. At 34 weeks of gestation, she complained of dyspnea and developed PCP. She delivered her baby vaginally immediately after the onset of symptoms. Both patients were treated with sulfamethoxazole-trimethoprim (ST and recovered shortly thereafter. The babies’ courses were also uneventful. PCP remains a serious cause of death, especially in non-HIV patients, and, therefore, appropriate prophylaxis and a prompt diagnosis are imperative.

  8. National Register Historic Districts

    Data.gov (United States)

    Iowa State University GIS Support and Research Facility — The National Register Historic District layer is a shape file showing the boundaries of Historic Districts that are listed on the National Register of Historic Places.

  9. The impact of methicillin-resistant S. aureus on length of stay, readmissions and costs: a register based case-control study of patients hospitalized in Norway

    Directory of Open Access Journals (Sweden)

    A. Elizabeth S. Andreassen

    2017-07-01

    Full Text Available Abstract Background Patients with methicillin-resistant S. aureus (MRSA are thought to incur additional costs for hospitals due to longer stay and contact isolation. The aim of this study was to assess the costs associated with MRSA in Norwegian hospitals. Methods Analyses were based on data fromSouth-Eastern Norway for the year 2012 as registered in the Norwegian Surveillance System for Communicable Diseases and the Norwegian Patient Registry. We used a matched case-control method to compare MRSA diagnosed inpatients with non-MRSA inpatients in terms of length of stay, readmissions within 30 days from discharge, as well as the Diagnosis-Related Group (DRG based costs. Results Norwegian patients with MRSA stayed on average 8 days longer in hospital than controls, corresponding to a ratio of mean duration of 2.08 (CI 95%, 1.75–2.47 times longer.A total of 14% of MRSA positive inpatients were readmitted compared to 10% among controls. However, the risk of readmission was not significantly higher for patients with MRSA. DRG based hospital costs were 0.37 (95% CI, 0.19–0.54 times higher among cases than controls, with a mean cost of EUR13,233(SD 26,899 and EUR7198(SD 18,159 respectively. Conclusion The results of this study indicate that Norwegian patients with MRSA have longer hospital stays, and higher costs than those without MRSA.

  10. 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.

  11. HIV/AIDS, beersellers and critical community health psychology in Cambodia: a case study.

    Science.gov (United States)

    Lubek, Ian; Lee, Helen; Kros, Sarath; Wong, Mee Lian; Van Merode, Tiny; Liu, James; McCreanor, Tim; Idema, Roel; Campbell, Catherine

    2014-01-01

    This case study illustrates a participatory framework for confronting critical community health issues using 'grass-roots' research-guided community-defined interventions. Ongoing work in Cambodia has culturally adapted research, theory and practice for particular, local health-promotion responses to HIV/AIDS, alcohol abuse and other challenges in the community of Siem Reap. For resource-poor communities in Cambodia, we recycle such 'older' concepts as 'empowerment' and 'action research'. We re-imagine community health psychology, when confronted with 'critical', life-and-death issues, as adjusting its research and practices to local, particular ontological and epistemological urgencies of trauma, morbidity and mortality.

  12. Information needs of case managers caring for persons living with HIV.

    Science.gov (United States)

    Schnall, Rebecca; Cimino, James J; Currie, Leanne M; Bakken, Suzanne

    2011-05-01

    The goals of this study were to explore the information needs of case managers who provide services to persons living with HIV (PLWH) and to assess the applicability of the Information Needs Event Taxonomy in a new population. The study design was observational with data collection via an online survey. Responses to open-ended survey questions about the information needs of case managers (n=94) related to PLWH of three levels of care complexity were categorized using the Information Needs Event Taxonomy. The most frequently identified needs were related to patient education resources (33%), patient data (23%), and referral resources (22%) accounting for 79% of all (N=282) information needs. Study limitations include selection bias, recall bias, and a relatively narrow focus of the study on case-manager information needs in the context of caring for PLWH. The study findings contribute to the evidence base regarding information needs in the context of patient interactions by: (1) supporting the applicability of the Information Needs Event Taxonomy and extending it through addition of a new generic question; (2) providing a foundation for the addition of context-specific links to external information resources within information systems; (3) applying a new approach for elicitation of information needs; and (4) expanding the literature regarding addressing information needs in community-based settings for HIV services.

  13. Extensive virologic and immunologic characterization in an HIV-infected individual following allogeneic stem cell transplant and analytic cessation of antiretroviral therapy: A case study.

    Science.gov (United States)

    Cummins, Nathan W; Rizza, Stacey; Litzow, Mark R; Hua, Stephane; Lee, Guinevere Q; Einkauf, Kevin; Chun, Tae-Wook; Rhame, Frank; Baker, Jason V; Busch, Michael P; Chomont, Nicolas; Dean, Patrick G; Fromentin, Rémi; Haase, Ashley T; Hampton, Dylan; Keating, Sheila M; Lada, Steven M; Lee, Tzong-Hae; Natesampillai, Sekar; Richman, Douglas D; Schacker, Timothy W; Wietgrefe, Stephen; Yu, Xu G; Yao, Joseph D; Zeuli, John; Lichterfeld, Mathias; Badley, Andrew D

    2017-11-01

    Notwithstanding 1 documented case of HIV-1 cure following allogeneic stem cell transplantation (allo-SCT), several subsequent cases of allo-SCT in HIV-1 positive individuals have failed to cure HIV-1 infection. The aim of our study was to describe changes in the HIV reservoir in a single chronically HIV-infected patient on suppressive antiretroviral therapy who underwent allo-SCT for treatment of acute lymphoblastic leukemia. We prospectively collected peripheral blood mononuclear cells (PBMCs) by leukapheresis from a 55-year-old man with chronic HIV infection before and after allo-SCT to measure the size of the HIV-1 reservoir and characterize viral phylogeny and phenotypic changes in immune cells. At day 784 post-transplant, when HIV-1 was undetectable by multiple measures-including PCR measurements of both total and integrated HIV-1 DNA, replication-competent virus measurement by large cell input quantitative viral outgrowth assay, and in situ hybridization of colon tissue-the patient consented to an analytic treatment interruption (ATI) with frequent clinical monitoring. He remained aviremic off antiretroviral therapy until ATI day 288, when a low-level virus rebound of 60 HIV-1 copies/ml occurred, which increased to 1,640 HIV-1 copies/ml 5 days later, prompting reinitiation of ART. Rebounding plasma HIV-1 sequences were phylogenetically distinct from proviral HIV-1 DNA detected in circulating PBMCs before transplantation. The main limitations of this study are the insensitivity of reservoir measurements, and the fact that it describes a single case. allo-SCT led to a significant reduction in the size of the HIV-1 reservoir and a >9-month-long ART-free remission from HIV-1 replication. Phylogenetic analyses suggest that the origin of rebound virus was distinct from the viruses identified pre-transplant in the PBMCs.

  14. Cognitive and psychosocial development of HIV pediatric patients receiving highly active anti-retroviral therapy: a case-control study

    Directory of Open Access Journals (Sweden)

    Theodoridou Maria

    2010-12-01

    Full Text Available Abstract Background The psychosocial development of pediatric HIV patients has not been extensively evaluated. The study objectives were to evaluate whether emotional and social functions are differentially associated with HIV-related complications. Methods A matched case-control study design was conducted. The case group (n = 20 consisted of vertically infected children with HIV (aged 3-18 years receiving HAART in Greece. Each case was matched with two randomly selected healthy controls from a school-based population. CNS imaging and clinical findings were used to identify patients with HIV-related neuroimaging abnormalities. The Wechsler Intelligence Scale III and Griffiths Mental Abilities Scales were applied to assess cognitive abilities. The age specific Strengths and Difficulties Questionnaire was used to evaluate emotional adjustment and social skills. The Fisher's exact test, student's t-test, and Wilcoxon rank sum test were used to compare categorical, continuous, and ordinal scores, respectively, of the above scales between groups. Results HIV patients without neuroimaging abnormalities did not differ from patients with neuroimaging abnormalities with respect to either age at HAART initiation (p = 0.306 or months of HAART treatment (p = 0.964. While HIV patients without neuroimaging abnormalities had similar cognitive development with their healthy peers, patients with neuroimaging abnormalities had lower mean General (p = 0.027 and Practical (p = 0.042 Intelligence Quotient scores. HIV patients without neuroimaging abnormalities had an increased likelihood of both Abnormal Emotional Symptoms (p = 0.047 and Hyperactivity scores (p = 0.0009. In contrast, HIV patients with neuroimaging abnormalities had an increased likelihood of presenting with Abnormal Peer Problems (p = 0.033. Conclusions HIV patients without neuroimaging abnormalities are more likely to experience maladjustment with respect to their emotional and activity spheres

  15. Evaluation of epidemiological, clinical, and laboratory features and mortality of 144 HIV/AIDS cases in Turkey.

    Science.gov (United States)

    Ozdemir, Burcu; Yetkin, Meltem A; Bastug, Aliye; But, Ayşe; Aslaner, Halide; Akinci, Esragul; Bodur, Hurrem

    2018-03-22

    Background The number of HIV/AIDS cases in Turkey is increasing rapidly, as is the number of cases worldwide. The aim of this study is to evaluate the characteristics of the clinical and laboratory findings and epidemiological features of HIV/AIDS patients to obtain useful data on the epidemic type and transmission routes associated with Turkey and to identify risk factors for mortality. Methods The patient records of 144 HIV-infected patients who were admitted to our clinic between 2000 and 2015 were analyzed retrospectively. Results Most of the cases (55%) were diagnosed due to the detection of anti-HIV-positive individuals without clinical symptoms. The mean CD4 + lymphocyte count on first admission was 108 cells/μL for those admitted before 2009 and 265 cells/μL for those admitted after 2009 (p = 0.003). When the pre- and post-2009 groups were compared for the status of the disease, 55.6 and 44.4% of patients were in the AIDS stage, respectively (p = 0.04). The most noted opportunistic infection was mycobacterial, and throughout the follow-up, 31.2% of the cases were fatal. Conclusions Early diagnosis of HIV infection can have a direct impact on prognosis and survival. Therefore, screening laboratory investigations should be extended, particularly in high-risk groups.

  16. Tobacco Smoking and Tuberculosis among Men Living with HIV in Johannesburg, South Africa: A Case-Control Study.

    Directory of Open Access Journals (Sweden)

    Liza Bronner Murrison

    Full Text Available Although there is ample evidence that smoking increases the risk of tuberculosis (TB, the magnitude of impact on TB risk among HIV-infected persons is poorly described. Given that a high proportion of patients with TB are co-infected with HIV in South Africa, the risks arising from the intersection of smoking, TB, and HIV/AIDS have key relevance for tobacco control policies.To evaluate the association of pulmonary tuberculosis (PTB with current tobacco smoking among men with HIV in South Africa.Case-control study of antiretroviral therapy naïve men with confirmed HIV-infection in Johannesburg. Cases had laboratory-confirmed PTB and controls had no evidence of active TB. Participants were interviewed to collect detailed smoking histories.We enrolled 146 men diagnosed with PTB and 133 controls. Overall, 33% of participants were currently smoking, defined as smoking a cigarette within 2 months (34% cases vs. 32% controls, p = 0.27. Median CD4 count was lower (60 vs. 81 cells/mm3, P = 0.03 and median viral load was higher (173 vs. 67 copies/ul per thousand, P<0.001 among cases versus controls. In adjusted analyses, current smoking tripled the odds of PTB (aOR 3.2; 95%CI: 1.3-7.9, P = 0.01 and former smoking nearly doubled the odds of PTB (aOR 1.8; 95%CI 0.8-4.4, P = 0.18 compared to never smoking.Males with HIV that smoke are at greater odds for developing PTB than non-smokers. Extensive smoking cessation programs are needed to reduce odds of TB and promote health among adults living with HIV.

  17. Index case finding facilitates identification and linkage to care of children and young persons living with HIV/AIDS in Malawi.

    Science.gov (United States)

    Ahmed, Saeed; Sabelli, Rachael A; Simon, Katie; Rosenberg, Nora E; Kavuta, Elijah; Harawa, Mwelura; Dick, Spencer; Linzie, Frank; Kazembe, Peter N; Kim, Maria H

    2017-08-01

    Evaluation of a novel index case finding and linkage-to-care programme to identify and link HIV-infected children (1-15 years) and young persons (>15-24 years) to care. HIV-infected patients enrolled in HIV services were screened and those who reported untested household members (index cases) were offered home- or facility-based HIV testing and counselling (HTC) of their household by a community health worker (CHW). HIV-infected household members identified were enrolled in a follow-up programme offering home and facility-based follow-up by CHWs. Of the 1567 patients enrolled in HIV services, 1030 (65.7%) were screened and 461 (44.8%) identified as index cases; 93.5% consented to HIV testing of their households and of those, 279 (64.7%) reported an untested child or young person. CHWs tested 711 children and young persons, newly diagnosed 28 HIV-infected persons (yield 4.0%; 95% CI: 2.7-5.6), and identified an additional two HIV-infected persons not enrolled in care. Of the 30 HIV-infected persons identified, 23 (76.6%) were linked to HIV services; 18 of the 20 eligible for ART (90.0%) were initiated. Median time (IQR) from identification to enrolment into HIV services was 4 days (1-8) and from identification to ART start was 6 days (1-8). Almost half of HIV-infected patients enrolled in treatment services had untested household members, many of whom were children and young persons. Index case finding, coupled with home-based testing and tracked follow-up, is acceptable, feasible and facilitates the identification and timely linkage to care of HIV-infected children and young persons. © 2017 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

  18. Why did the scale-up of HIV treatment work? A case example from Malawi.

    Science.gov (United States)

    Harries, Anthony D; Makombe, Simon D; Libamba, Edwin; Schouten, Erik J

    2011-08-01

    The national scale-up of antiretroviral therapy (ART) in Malawi is based on a public health approach, with principles and practices borrowed from the successful DOTS (directly observed treatment short course-the system used to successfully deliver antituberculosis treatment to people in some of the poorest countries of the world) tuberculosis control framework. During the first 6 years, the number of patients registered on treatment increased from 3000 to >350,000 in both the public and private sectors. The most important reasons for this success have been strong international and national leadership combined with adequate funds, a standardized approach to ART with practical guidelines, an approved national scale-up plan with clear, time-bound milestones; investment in an intensive program of training and accreditation of ART sites, quarterly supervision and monitoring of ART and operational research, rational drug forecasting and no stock-outs of drugs during the first few years, and involvement of the private sector. The looming challenges of human resources, guaranteed financial support, better but also more expensive ART regimens, use of electronic medical records to monitor response to therapy, and attention to HIV prevention need to be met head-on and solved if the momentum of the earlier years is to be maintained.

  19. Influenza A H5N1 and HIV co-infection: case report

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    Simmons Cameron

    2010-06-01

    Full Text Available Abstract Background The role of adaptive immunity in severe influenza is poorly understood. The occurrence of influenza A/H5N1 in a patient with HIV provided a rare opportunity to investigate this. Case Presentation A 30-year-old male was admitted on day 4 of influenza-like-illness with tachycardia, tachypnea, hypoxemia and bilateral pulmonary infiltrates. Influenza A/H5N1 and HIV tests were positive and the patient was treated with Oseltamivir and broad-spectrum antibiotics. Initially his condition improved coinciding with virus clearance by day 6. He clinically deteriorated as of day 10 with fever recrudescence and increasing neutrophil counts and died on day 16. His admission CD4 count was 100/μl and decreased until virus was cleared. CD8 T cells shifted to a CD27+CD28- phenotype. Plasma chemokine and cytokine levels were similar to those found previously in fatal H5N1. Conclusions The course of H5N1 infection was not notably different from other cases. Virus was cleared despite profound CD4 T cell depletion and aberrant CD8 T cell activation but this may have increased susceptibility to a fatal secondary infection.

  20. Acute toxicity of second generation HIV protease-inhibitors in combination with radiotherapy: a retrospective case series

    International Nuclear Information System (INIS)

    See, Alfred P; Zeng, Jing; Tran, Phuoc T; Lim, Michael

    2011-01-01

    There is little data on the safety of combining radiation therapy and human immunodeficiency virus (HIV) protease inhibitors to treat cancers in HIV-positive patients. We describe acute toxicities observed in a series of HIV-positive patients receiving modern radiation treatments, and compare patients receiving HIV protease inhibitors (PI) with patients not receiving HIV PIs. By reviewing the clinical records beginning January 1, 2009 from the radiation oncology department, we identified 29 HIV-positive patients who received radiation therapy to 34 body sites. Baseline information, treatment regimen, and toxicities were documented by review of medical records: patient age, histology and source of the primary tumor, HIV medication regimen, pre-radiation CD4 count, systemic chemotherapy, radiation therapy dose and fractionation, irradiated body region, toxicities, and duration of follow-up. Patients were grouped according to whether they received concurrent HIV PIs and compared using Pearson's chi-square test. At baseline, the patients in the two groups were similar with the exception of HIV medication regimens, CD4 count and presence of AIDS-defining malignancy. Patients taking concurrent PIs were more likely to be taking other HIV medications (p = 0.001) and have CD4 count >500 (p = 0.006). Patients taking PIs were borderline less likely to have an AIDS-defining malignancy (p = 0.06). After radiation treatment, 100 acute toxicities were observed and were equally common in both groups (64 [median 3 per patient, IQR 1-7] with PIs; 36 [median 3 per patient, IQR 2-3] without PIs). The observed toxicities were also equally severe in the two groups (Grades I, II, III respectively: 30, 30, 4 with PIs; 23, 13, 0 without PIs: p = 0.38). There were two cases that were stopped early, one in each group; these were not attributable to toxicity. In this study of recent radiotherapy in HIV-positive patients taking second generation PIs, no difference in toxicities was

  1. Acute HIV infection (AHI) in a specialized clinical setting: case-finding, description of virological, epidemiological and clinical characteristics.

    Science.gov (United States)

    Ammassari, Adriana; Abbate, Isabella; Orchi, Nicoletta; Pinnetti, Carmela; Rozera, Gabriella; Libertone, Raffaella; Pierro, Paola; Martini, Federico; Puro, Vincenzo; Girardi, Enrico; Antinori, Andrea; Capobianchi, Maria Rosaria

    2014-01-01

    Diagnosis of HIV infection during early stages is mandatory to catch up with the challenge of limiting HIV viral replication and reservoirs formation, as well as decreasing HIV transmissions by immediate cART initiation. Aims were to describe (a) virological characteristics of AHI identified, (b) epidemiological and clinical factors associated with being diagnosed with AHI. Cross-sectional, retrospective study. All individuals diagnosed with AHI according to Fiebig's staging between Jan 2013 and Mar 2014 at the INMI "L. Spallanzani" were included. Serum samples reactive to a fourth generation HIV-1/2 assay (Architect HIV Ag/Ab Combo, Abbott) were retested with another fourth generation assay (VIDAS DUO HIV Ultra, Biomérieux) and underwent confirmation with HIV-1 WB (New Lav I Bio-Rad) and/or with Geenius confirmatory assay (Bio-Rad). WHO criteria (two env products reactivity) were used to establish positivity of confirmatory assays. In case of clinically suspected AHI, HIV-1 RNA (Real time, Abbott) and p24 assay (VIDAS HIV P24 Bio-Rad) were also performed. Avidity test was carried out, on confirmed positive samples lacking p31 reactivity, to discriminate between recent (true Fiebig V phase) and late infections; to avoid possible misclassifications, clinical data were also used. Demographic, epidemiological, clinical and laboratory data are routinely, and anonymously recorded in the SENDIH and SIREA studies. During the study period, we observed 483 newly HIV diagnosed individuals, of whom 40 were identified as AHI (8.3%). Fiebig classification showed: 7 stage II/III, 13 stage IV, 20 stage V. Demographic, epidemiological, and clinical characteristics of patients are shown in the Table. Overall, the study population had a median S/Co ratio at fourth generation EIA (Architect) of 49.50 (IQR, 23.54-98.05): values were significantly lower in Fiebig II-IV than in Fiebig V (38.68 [IQR, 20.08-54.84] vs 75.72 [IQR, 42.66-249.80], p=0.01). Overall, median HIV-1 RNA was 5

  2. Revealed willingness-to-pay versus standard cost-effectiveness thresholds: Evidence from the South African HIV Investment Case.

    Directory of Open Access Journals (Sweden)

    Gesine Meyer-Rath

    Full Text Available The use of cost-effectiveness thresholds based on a country's income per capita has been criticized for not being relevant to decision making, in particular in middle-income countries such as South Africa. The recent South African HIV Investment Case produced an alternative cost-effectiveness threshold for HIV prevention and treatment interventions based on estimates of life years saved and the country's committed HIV budget.We analysed the optimal mix of HIV interventions over a baseline of the current HIV programme under the committed HIV budget for 2016-2018. We calculated the incremental cost-effectiveness ratio (ICER as cost per life-year saved (LYS of 16 HIV prevention and treatment interventions over 20 years (2016-2035. We iteratively evaluated the most cost effective option (defined by an intervention and its coverage over a rolling baseline to which the more cost effective options had already been added, thereby allowing for diminishing marginal returns to interventions. We constrained the list of interventions to those whose combined cost was affordable under the current HIV budget. Costs are presented from the government perspective, unadjusted for inflation and undiscounted, in 2016 USD.The current HIV budget of about $1.6 billion per year was sufficient to pay for the expansion of condom availability, medical male circumcision, universal treatment, and infant testing at 6 weeks to maximum coverage levels, while also implementing a social and behavior change mass media campaign with a message geared at increasing testing uptake and reducing the number of sexual partners. The combined ICER of this package of services was $547/ LYS. The ICER of the next intervention that was above the affordability threshold was $872/LYS.The results of the South African HIV Investment Case point to an HIV cost-effectiveness threshold based on affordability under the current budget of $547-872 per life year saved, a small fraction of the country's GDP

  3. Can risk assessment predict suicide in secondary mental healthcare? Findings from the South London and Maudsley NHS Foundation Trust Biomedical Research Centre (SLaM BRC) Case Register.

    Science.gov (United States)

    Lopez-Morinigo, Javier-David; Fernandes, Andrea C; Shetty, Hitesh; Ayesa-Arriola, Rosa; Bari, Ashraful; Stewart, Robert; Dutta, Rina

    2018-06-02

    The predictive value of suicide risk assessment in secondary mental healthcare remains unclear. This study aimed to investigate the extent to which clinical risk assessment ratings can predict suicide among people receiving secondary mental healthcare. Retrospective inception cohort study (n = 13,758) from the South London and Maudsley NHS Foundation Trust (SLaM) (London, UK) linked with national mortality data (n = 81 suicides). Cox regression models assessed survival from the last suicide risk assessment and ROC curves evaluated the performance of risk assessment total scores. Hopelessness (RR = 2.24, 95% CI 1.05-4.80, p = 0.037) and having a significant loss (RR = 1.91, 95% CI 1.03-3.55, p = 0.041) were significantly associated with suicide in the multivariable Cox regression models. However, screening statistics for the best cut-off point (4-5) of the risk assessment total score were: sensitivity 0.65 (95% CI 0.54-0.76), specificity 0.62 (95% CI 0.62-0.63), positive predictive value 0.01 (95% CI 0.01-0.01) and negative predictive value 0.99 (95% CI 0.99-1.00). Although suicide was linked with hopelessness and having a significant loss, risk assessment performed poorly to predict such an uncommon outcome in a large case register of patients receiving secondary mental healthcare.

  4. HIV/AIDS case management tasks and activities: the results of a functional analysis study.

    Science.gov (United States)

    Grube, B; Chernesky, R H

    2001-01-01

    Functional analysis, a variation of the time study technique, was used to examine how HIV/AIDS case managers in the tri-county region of New York State spend their time-the actual tasks and activities they choose to perform relative to the total universe of activities and tasks subsumed in the general category of case management. The picture developed was of a system operating primarily in a crisis mode, spending relatively brief amounts of time completing a range of activities and providing an extensive scope of services for or on behalf of clients. The bulk of the work was client centered, not administrative, and involved providing disease management and essential services (e.g., family and mental health). The implications of these findings are discussed, with particular attention paid to the potential influence of client profiles and worker demographics.

  5. Lyme neuroborreliosis in HIV-1 positive men successfully treated with oral doxycycline: a case series and literature review

    OpenAIRE

    Gisslén Magnus; Säll Christer; Bremell Daniel; Hagberg Lars

    2011-01-01

    Abstract Introduction Lyme neuroborreliosis is the most common bacterial central nervous system infection in the temperate parts of the northern hemisphere. Even though human immunodeficiency virus (HIV) -1 infection is common in Lyme borreliosis endemic areas, only five cases of co-infection have previously been published. Four of these cases presented with typical Lyme neuroborreliosis symptoms such as meningoradiculitis and facial palsy, while a fifth case had more severe symptoms of encep...

  6. Evaluation of Cellular Phenotypes Implicated in Immunopathogenesis and Monitoring Immune Reconstitution Inflammatory Syndrome in HIV/Leprosy Cases

    Science.gov (United States)

    Giacoia-Gripp, Carmem Beatriz Wagner; Sales, Anna Maria; Nery, José Augusto da Costa; Santos-Oliveira, Joanna Reis; de Oliveira, Ariane Leite; Sarno, Euzenir Nunes; Morgado, Mariza Gonçalves

    2011-01-01

    Background It is now evident that HAART-associated immunological improvement often leads to a variety of new clinical manifestations, collectively termed immune reconstitution inflammatory syndrome, or IRIS. This phenomenon has already been described in cases of HIV coinfection with Mycobacterium leprae, most of them belonging to the tuberculoid spectrum of leprosy disease, as observed in leprosy reversal reaction (RR). However, the events related to the pathogenesis of this association need to be clarified. This study investigated the immunological profile of HIV/leprosy patients, with special attention to the cellular activation status, to better understand the mechanisms related to IRIS/RR immunopathogenesis, identifying any potential biomarkers for IRIS/RR intercurrence. Methods/Principal Findings Eighty-five individuals were assessed in this study: HIV/leprosy and HIV-monoinfected patients, grouped according to HIV-viral load levels, leprosy patients without HIV coinfection, and healthy controls. Phenotypes were evaluated by flow cytometry for T cell subsets and immune differentiation/activation markers. As expected, absolute counts of the CD4+ and CD8+ T cells from the HIV-infected individuals changed in relation to those of the leprosy patients and controls. However, there were no significant differences among the groups, whether in the expression of cellular differentiation phenotypes or cellular activation, as reflected by the expression of CD38 and HLA-DR. Six HIV/leprosy patients identified as IRIS/RR were analyzed during IRIS/RR episodes and after prednisone treatment. These patients presented high cellular activation levels regarding the expression of CD38 in CD8+ cells T during IRIS/RR (median: 77,15%), dropping significantly (pleprosy individuals at risk for IRIS/RR. So, a comparative investigation to leprosy patients at RR should be conducted. PMID:22205964

  7. Cerebro-meningeal infections in HIV-infected patients: a study of 116 cases in Libreville, Gabon.

    Science.gov (United States)

    Ondounda, Magloire; Ilozue, Chinenye; Magne, Caroline

    2016-06-01

    Cerebro-meningeal pathology is common in human immunodeficiency virus (HIV) infection and the aetiology is often difficult to ascertain with certainty. To describe the major suspected and identified causes of meningeal or encephalitic syndromes in HIV infection in Libreville, Gabon. A descriptive study using clinical records of patients hospitalised in the Department of Medicine in the Military Hospital of Libreville (Gabon) between January 2006 and May 2010. Clinical features were evaluated using multivariable logistic regression to evaluate association with the outcome of a clinical improvement or death. The most frequent neurological symptoms were reduced level of consciousness (54.3%), headache (55.2%), motor deficit (38.7%), and convulsions (36.2%). Cerebral toxoplasmosis represented 64.7% of diagnoses, followed by cryptococcal neuromeningitis in 12.9% of cases. Tuberculoma was diagnosed in 4 cases and lymphoma in 2 cases. In 9.5% of cases, no aetiology was determined. Toxoplasmosis treatment led to clinical improvement in 69.3% of cases with suspected cerebral toxoplasmosis. Overall mortality was 39.7%. The diagnosis of neurological conditions in HIV positive patients is difficult, particularly in a low-resource setting. A trial of treatment for toxoplasmosis should be initiated first line with all signs of neurological pathology in a patient infected with HIV.

  8. The impact of flooding on people living with HIV: a case study from the Ohangwena Region, Namibia

    Directory of Open Access Journals (Sweden)

    Carmen Anthonj

    2015-03-01

    the HIV and Flooding Framework are not specific to Ohangwena and can be transferred to any flood-affected region that has a high HIV prevalence and relies mainly on subsistence agriculture. They serve as a model case for analysing vulnerabilities related to health and health service provision under disaster conditions. The impact will vary according to the physical, geographical, climatological, social, and behavioural characteristics of the region and the people affected. In the Ohangwena region, a disaster risk management mechanism is already in place which addresses people with HIV during flooding. However, preparedness could be improved further by applying the HIV and Flooding Framework.

  9. The impact of flooding on people living with HIV: a case study from the Ohangwena Region, Namibia.

    Science.gov (United States)

    Anthonj, Carmen; Nkongolo, Odon T; Schmitz, Peter; Hango, Johannes N; Kistemann, Thomas

    2015-01-01

    can be transferred to any flood-affected region that has a high HIV prevalence and relies mainly on subsistence agriculture. They serve as a model case for analysing vulnerabilities related to health and health service provision under disaster conditions. The impact will vary according to the physical, geographical, climatological, social, and behavioural characteristics of the region and the people affected. In the Ohangwena region, a disaster risk management mechanism is already in place which addresses people with HIV during flooding. However, preparedness could be improved further by applying the HIV and Flooding Framework.

  10. 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.

  11. HTLV-1 and HIV-1 co-infection: A case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Carmen Isache

    2016-01-01

    HTLV and HIV share the same routes of transmission and the same tropism for T-lymphocytes. Co-infection occurs probably more frequently than we are aware, since testing for HTLV is not routinely performed in outpatient HIV clinics.

  12. Arthroplasty register for Germany

    Directory of Open Access Journals (Sweden)

    Hagen, Anja

    2009-10-01

    Full Text Available Scientific background: The annual number of joint replacement operations in Germany is high. The introduction of an arthroplasty register promises an important contribution to the improvement of the quality of patient’s care. Research questions: The presented report addresses the questions on organization and functioning, benefits and cost-benefits as well as on legal, ethical and social aspects of the arthroplasty registers. Methods: A systematic literature search was conducted in September 2008 in the medical databases MEDLINE, EMBASE etc. and was complemented with a hand search. Documents describing arthroplasty registers and/or their relevance as well as papers on legal, ethical and social aspects of such registers were included in the evaluation. The most important information was extracted and analysed. Results: Data concerning 30 arthroplasty registers in 19 countries as well as one international arthroplasty register were identified. Most of the arthroplasty registers are maintained by national orthopedic societies, others by health authorities or by their cooperation. Mostly, registries are financially supported by governments and rarely by other sources.The participation of the orthopedists in the data collection process of the arthroplasty registry is voluntary in most countries. The consent of the patients is usually required. The unique patient identification is ensured in nearly all registers.Each data set consists of patient and clinic identification numbers, data on diagnosis, the performed intervention, the operation date and implanted prostheses. The use of clinical scores, patient-reported questionnaires and radiological documentation is rare. Methods for data documentation and transfer are paper form, electronic entry as well as scanning of the data using bar codes. The data are mostly being checked for their completeness and validity. Most registers offer results of the data evaluation to the treating orthopedists and

  13. Undue inducement, or unfair exclusion: considering a case study of pregnancy in an HIV prevention trial.

    Science.gov (United States)

    Haire, Bridget G; Folayan, Morenike Oluwatoyin

    2017-12-01

    In their recent paper'Undue inducement: a case study in CAPRISA 008', Mngadi et al conclude that a participant in an HIV prevention study who deliberately concealed her pregnancy was not 'unduly induced' to participate by the offer of an experimental product. This paper argues that while the authors' conclusion is sound, the framing of this case study is consistent with the preoccupation in research ethics with the concept of undue inducement, coupled with a highly risk-averse attitude to pregnancy (regardless of whether those risks may be willingly assumed by pregnant women themselves). We suggest that the critical research ethics question raised by Mngadi et al 's case study is not 'undue inducement', but the exclusion of pregnant women from research studies where the risks are acceptable to the potential participant, and benefits likely. We also suggest that current regulatory paradigms regarding pregnancy are both overly paternalistic and value the fetus over the mother. In order to ensure timely provision of new HIV prevention agents, we argue that there is a need for expeditious testing of proven effective agents in pregnancy, with due consideration given to situations where preliminary efficacy data exist but fall short of licensure standards. This requires a paradigm shift from researchers, funders, regulators and ethical review bodies towards practices that critically examine the legitimacy of the exclusion of pregnant women on a study-by-study basis. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  14. Ethical Dilemma and Management of Infertility in HIV Seropositive Discordant Couples: A Case Study in Nigeria.

    Science.gov (United States)

    Umeora, Ouj; Chukwuneke, Fn

    2013-01-01

    The traditional African society places an invaluable premium on procreation and, in some communities, a woman's place in her matrimony is only confirmed on positive reproductive outcome. Infertility is rife in Nigeria, and HIV/acquired immunodeficiency syndrome (AIDS) infection is a global pandemic, which has led to a drop in life expectancy across the world. In Nigeria, a number of cultural norms relating to gender roles and power dynamics constitute a serious barrier to issues of sexuality and infertility. Couples are concerned about their infertility diagnostic test being disclosed to each other, especially before marriage. This concern is understandable, especially in an environment that lacks the modern concepts and attitude toward sexual matters. This is complicated by the advent of HIV/AIDS infection and the societal mind-set that look at seropostive individuals as transgressors. At present, sexual and reproductive health rights are currently not in place because ethical issues are not given prominence by many physicians in Nigeria. A case of an infertile and seropostive discordant couple, which raised a lot of medical and ethical concerns, is presented here to awaken the consciousness of Nigerian physicians and stimulate discussions on the ethical matters such as this in clinical practice.

  15. Creating "communicative spaces": a case of NGO community organizing for HIV/AIDS prevention.

    Science.gov (United States)

    de Souza, Rebecca

    2009-12-01

    This study uses the case study method to investigate the processes used by a local nongovernmental organization called the Society for People's Action for Development to organize sex workers in the slums of Bangalore, India, for HIV/AIDS prevention. The nongovernmental organization-facilitated HIV/AIDS program is based on the new paradigm of community organizing that encourages community participation and capacity building. Grounded in the culture-centered approach, this study documents the processes used to organize the women, while highlighting the role of communication in these processes. The study identifies 4 primary processes used to mobilize the community, namely collectivization, community awareness and sensitization, capacity building, and providing legal education and support. Each of these processes highlights the importance of attending to the economic, social, and political realities that shape the health of women. The common thread linking these processes together is the notion of "voice." More specifically, each process serves as a catalyst to produce discursive practices that enable women to provide support to each other, increase awareness in the community about the problems that they face, build self-reliance through financial skills training and communication training, and defend their legal rights. In addition, the study suggests that the primary role of nongovernmental organizations should be the creation of "communicative spaces," which are discursive and material spaces within marginalized communities and mainstream society where cultural participants can identify problems (oftentimes beyond the realm of health), manage solutions to those problems, and advocate for health and social change.

  16. Stigma and self-esteem: A case of HIV-positive sex-workers.

    Science.gov (United States)

    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

  17. Risk Factors for DOTS Treatment Default Among New HIV-TB Coinfected Patients in Nalgonda (Dist.) Telangana (State): A Case Control Study.

    Science.gov (United States)

    Reddy Satti, Siva Balaji; Kondagunta, Nagaraj

    2016-01-01

    The therapeutic regimens as recommended by the Revised National TB Control Programme (RNTCP) have been shown to be highly effective for both preventing and treating tuberculosis, but poor adherence to medication is a major barrier to its global control. The study was conducted to assess the influence of patient related factors for DOTS Treatment Default among HIV-TB Co-infected cases. This was a case control study conducted in Nalgond, Telangana. All new HIV-TB coinfected and DOTS-defaulted patients registered under RNTCP for the period from January 2010 to December 2012 were selected. Of the 154 patients, 23 had died and 11 could not be traced, and these were excluded. Thus the total number of available cases were 120 for those age- and sex-matched controls (HIV-TB coinfected patients and those who had completed the DOTS regimen successfully) were selected. The mean age was 36.5 ± 9 years; the majority (23.3%) of patients defaulted during the second month of treatment. Significant risk factors associated with defaulting included unskilled occupation [adjusted odds ratio (AOR: 3.56; 95% confidence interval (CI): 1.1-11.56], lower middle class socioeconomic status (AOR: 17.16; 95% CI: 3.93-74.82), small family size (AOR: 21.3; 95% CI: 6.4-70.91), marital disharmony (AOR: 6.78; 95% CI: 1.93-23.76), not being satisfied with the conduct of health personnel (AOR: 7.38; 95% CI: 2.32-23.39), smoking (AOR: 8.5; 95% CI: 2.31-31.21), and side effects of drugs (AOR: 4.18; 95% CI: 1.35-12.9). Unskilled occupation, marital disharmony, small family size, lower middle class socioeconomic status, not being satisfied with the conduct of health personnel, smoking, and drug side effects were significantly associated with defaulting. Information on the pattern of tuberculosis (TB), the outcome of anti-tuberculosis treatment (ATT), and the factors associated with it will help in planning interventions to improve adherence to DOTS treatment.

  18. Interprofessional Obstetric Ultrasound Education: Successful Development of Online Learning Modules; Case-Based Seminars; and Skills Labs for Registered and Advanced Practice Nurses, Midwives, Physicians, and Trainees.

    Science.gov (United States)

    Shaw-Battista, Jenna; Young-Lin, Nichole; Bearman, Sage; Dau, Kim; Vargas, Juan

    2015-01-01

    Ultrasound is an important aid in the clinical diagnosis and management of normal and complicated pregnancy and childbirth. The technology is widely applied to maternity care in the United States, where comprehensive standard ultrasound examinations are routine. Targeted scans are common and used for an increasing number of clinical indications due to emerging research and a greater availability of equipment with better image resolution at lower cost. These factors contribute to an increased demand for obstetric ultrasound education among students and providers of maternity care, despite a paucity of data to inform education program design and evaluation. To meet this demand, from 2012 to 2015 the University of California, San Francisco nurse-midwifery education program developed and implemented an interprofessional obstetric ultrasound course focused on clinical applications commonly managed by maternity care providers from different professions and disciplines. The course included matriculating students in nursing and medicine, as well as licensed practitioners such as registered and advanced practice nurses, midwives, and physicians and residents in obstetrics and gynecology and family medicine. After completing 10 online modules with a pre- and posttest of knowledge and interprofessional competencies related to teamwork and communication, trainees attended a case-based seminar and hands-on skills practicum with pregnant volunteers. The course aimed to establish a foundation for further supervised clinical training prior to independent practice of obstetric ultrasound. Course development was informed by professional guidelines and clinical and education research literature. This article describes the foundations, with a review of the challenges and solutions encountered in obstetric ultrasound education development and implementation. Our experience will inform educators who wish to facilitate obstetric ultrasound competency development among new and experienced

  19. Death of a Close Relative and the Risk of Suicide in Sweden-A Large Scale Register-Based Case-Crossover Study.

    Directory of Open Access Journals (Sweden)

    Hanna Mogensen

    Full Text Available Bereavement is thought to be a risk factor for suicide but the association has not been thoroughly investigated according to specific sensitive time periods and risk groups using a self-matched design. We aimed to 1 determine the risk of suicide within the first year after death of a close relative, 2 investigate if and how the risk changes within this time window and 3 determine if sex, age, and type of relationship, affect this association.A self-matched, case-crossover study was performed by linking Swedish registers. In total, 31 059 individuals with suicide between 1990 and 2011 were included. Different periods within the year prior to the suicide were compared with corresponding periods one year earlier in the same individual's life. Conditional logistic regression was used to calculate odds ratios (OR and 95% confidence intervals (CI for suicide after death of a close relative.Increased ORs of suicide were seen during the first month, OR 1·77 (95% CI 1·35-2·34, and the first half-year, 1·27 (1·13-1·43. An even higher OR was found within the first week, 3·43 (1·89-6·22. Patterns were similar for women and men and across age groups. Death of a partner or child but not death of a sibling or parent was associated with a significantly increased suicide risk. The strongest association was seen after death of a partner in individuals aged 45 and older.These findings provide knowledge of sensitive time periods and at-risk groups in the early period of bereavement. Due to the use of a self-matched study design, methodological challenges of unmeasured residual confounding could be overcome.

  20. Life expectancy at birth for people with serious mental illness and other major disorders from a secondary mental health care case register in London.

    Directory of Open Access Journals (Sweden)

    Chin-Kuo Chang

    Full Text Available Despite improving healthcare, the gap in mortality between people with serious mental illness (SMI and general population persists, especially for younger age groups. The electronic database from a large and comprehensive secondary mental healthcare provider in London was utilized to assess the impact of SMI diagnoses on life expectancy at birth.People who were diagnosed with SMI (schizophrenia, schizoaffective disorder, bipolar disorder, substance use disorder, and depressive episode/disorder before the end of 2009 and under active review by the South London and Maudsley NHS Foundation Trust (SLAM in southeast London during 2007-09 comprised the sample, retrieved by the SLAM Case Register Interactive Search (CRIS system. We estimated life expectancy at birth for people with SMI and each diagnosis, from national mortality returns between 2007-09, using a life table method.A total of 31,719 eligible people, aged 15 years or older, with SMI were analyzed. Among them, 1,370 died during 2007-09. Compared to national figures, all disorders were associated with substantially lower life expectancy: 8.0 to 14.6 life years lost for men and 9.8 to 17.5 life years lost for women. Highest reductions were found for men with schizophrenia (14.6 years lost and women with schizoaffective disorders (17.5 years lost.The impact of serious mental illness on life expectancy is marked and generally higher than similarly calculated impacts of well-recognised adverse exposures such as smoking, diabetes and obesity. Strategies to identify and prevent causes of premature death are urgently required.

  1. Human-resources strategies for managing HIV/AIDS: the case of the ...

    African Journals Online (AJOL)

    Previous work has focused on HIV prevalence among forestry workers and the impact of HIV/AIDS on the sustainability of forest resources. Following a review of work examining the impacts of HIV/AIDS on the South African economy, this article presents original qualitative research examining the responses of company ...

  2. The Danish Pathology Register

    DEFF Research Database (Denmark)

    Bjerregaard, Beth; Larsen, Ole B

    2011-01-01

    The National Board of Health, Denmark in 1997 published guidelines for reporting of pathology data and the Danish Pathology Register (DPR) was established.......The National Board of Health, Denmark in 1997 published guidelines for reporting of pathology data and the Danish Pathology Register (DPR) was established....

  3. Registered Nurse (Associate Degree).

    Science.gov (United States)

    Ohio State Univ., Columbus. Center on Education and Training for Employment.

    This document, which is designed for use in developing a tech prep competency profile for the occupation of registered nurse (with an associate degree), lists technical competencies and competency builders for 19 units pertinent to the health technologies cluster in general and 5 units specific to the occupation of registered nurse. The following…

  4. The Danish Adoption Register

    DEFF Research Database (Denmark)

    Petersen, Liselotte; Sørensen, Thorkild I A

    2011-01-01

    The Danish Adoption Register was established in 1963-1964 to explore the genetic and environmental contribution to familial aggregation of schizophrenia.......The Danish Adoption Register was established in 1963-1964 to explore the genetic and environmental contribution to familial aggregation of schizophrenia....

  5. Josephson shift registers

    International Nuclear Information System (INIS)

    Przybysz, J.X.

    1989-01-01

    This paper gives a review of Josephson shift register circuits that were designed, fabricated, or tested, with emphasis on work in the 1980s. Operating speed is most important, since it often limits system performance. Older designs used square-wave clocks, but most modern designs use offset sine waves, with either two or three phases. Operating margins and gate bias uniformity are key concerns. The fastest measured Josephson shift register operated at 2.3 GHz, which compares well with a GaAs shift register that consumes 250 times more power. The difficulties of high-speed testing have prevented many Josephson shift registers from being operated at their highest speeds. Computer simulations suggest that 30-GHz operation is possible with current Nb/Al 2 O 3 /Nb technology. Junctions with critical current densities near 10 kA/cm 2 would make 100-GHz shift registers feasible

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

    Directory of Open Access Journals (Sweden)

    Partha Muliawan

    2016-01-01

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

  7. Validation of a Cerebral Palsy Register

    DEFF Research Database (Denmark)

    Topp, Monica; Langhoff-Roos, Jens; Uldall, P.

    1997-01-01

    OBJECTIVES: To analyse completeness and validity of data in the Cerebral Palsy Register in Denmark, 1979-1982. METHODS: Completeness has been assessed by comparing data from The Danish National Patient Register (DNPR) with the cases included in the Cerebral Palsy Register (CPR). Agreement between......, but gestational age was subject to a systematic error, and urinary infections in pregnancy (kappa = 0.43) and placental abruption (kappa = 0.52) were seriously under-reported in the CPR. CONCLUSIONS: Completeness of the Cerebral Palsy Register in Denmark, 1979-1982, has been assessed to maximal 85%, emphasizing...

  8. Puerperal brain cryptococcoma in an HIV-negative woman successfully treated with fluconazole: a case report

    Directory of Open Access Journals (Sweden)

    José Edward Hagan

    2014-04-01

    Full Text Available Cryptococcus spp. cerebral abscesses are uncommon in immunocompetent subjects. The recommended induction treatment is the administration of amphotericin B plus flucytosine combined with resection for lesions ≥3cm. In this paper, we describe an HIV-negative woman diagnosed with a large cryptococcoma in the immediate postpartum period. The lesion was not resected, and due to amphotericin B intolerance, she received an extended course of fluconazole monotherapy. There was no disease recurrence during the 4 years of follow-up. The abrupt onset of her symptoms following delivery suggests that she developed a postpartum immune reconstitution syndrome. This case also demonstrates that in specific situations fluconazole monotherapy can be attempted in immunocompetent patients with cryptococcoma.

  9. Knowledge, attitude, and preventive practice survey regarding AIDS comparing registered to freelance commercial sex workers in Iloilo City, Philippines.

    Science.gov (United States)

    Liu, T I; So, R

    1996-12-01

    A survey of female commercial sex workers (CSW) in Iloilo City, Philipines, was conducted in October and November 1995 to determine the level of knowledge, attitudes, and preventive practices regarding HIV/AIDS to guide future education programs. CSWs in the Philippines were categorized as registered or freelance. Registered CSWs included "hospitality girls" from licensed bars, night clubs, and massage parlors who have registered with the local social hygiene clinic (SHC). Freelance CSWs are not registered. 110 registered and 46 freelance CSWs were surveyed. We compared demographic data, scores from a basic knowledge test, and preventive practices between registered and freelance CSWs. Demographic data indicate that registered CSWs often originate from provinces outside of the Visayan Islands (25%) and most have never been married (93%). Freelance CSWs included more married (11%) and separated (11%) women from nearby cities. Knowledge test scores of registered and freelance CSWs were not significantly different. 90-96% of CSWs correctly answered questions regarding modes of transmission. However, 25% still believed it is possible to contract AIDS from using a public restroom. Registered and freelance CSWs believed their risks for AIDS to be equally great. However, 38% of freelance CSWs admit to never or almost never using condoms compared to 15% of registered CSWs. Licensed establishments and a support staff at the social hygiene clinic may provide a relatively structured working environment, giving registered CSWs security and confidence to insist on condom use. In most cases, condom use seems to depend on male customer compliance, and CSWs, especially freelancers, cannot afford to insist on condom use. The CSWs indicated that they learned most about AIDS through health personnel and television.

  10. Genotypic characterisation of human papillomavirus infections among persons living with HIV infection; a case-control study in Kumasi, Ghana.

    Science.gov (United States)

    Yar, Denis Dekugmen; Salifu, Samson Pandam; Darko, Samuel Nkansah; Annan, Augustina Angelina; Gyimah, Akosua Adumea; Buabeng, Kwame Ohene; Owusu-Dabo, Ellis

    2016-02-01

    The objective of this study is to describe the burden of human papillomavirus (HPV) infection among women living with HIV and non-infected women in Ghana. A case-control study was conducted involving 107 women living with HIV aged between 18 and 59 years (cases) and 100 non-HIV-infected apparently healthy women (controls) who were recruited from the Kumasi South Hospital, from July to December, 2014. Cervicovaginal swabs were taken from study participants to characterise 28 high- and low-risk HPV genotypes using a multiplex real-time PCR. The overall mean age for the participants was 40.10 ± 9.76 years. The prevalence of high-risk (hr)-HPV genotypes was significantly higher among the cases than the controls (77.4% vs. 41.6%, P < 0.0001). Overall, HPV 58 and 54 were the most predominant high-risk (18.8%) and low-risk (15.0%) genotypes detected. The two most common hr-HPV genotype isolates were 58 (18.8%) and 35 (15.9%) with 58 being the most prevalent among age group 35-44 years compared with hr-HPV 16, 18, 35 and 45, found predominantly among 18-34 age group. Significant variations exist in HPV genotypes among HIV-infected and uninfected women. © 2015 John Wiley & Sons Ltd.

  11. Tenofovir Disoproxil Fumarate Fails to Prevent HIV Acquisition or the Establishment of a Viral Reservoir: Two Case Reports.

    Science.gov (United States)

    Fox, Julie; Brady, Michael; Alexander, Hannah; Davies, Olubanke; Robinson, Nicola; Pace, Mathew; Else, Laura; Cason, John; Khoo, Saye; Back, David; Fidler, Sarah; Frater, John

    2016-03-01

    The use of antiretrovirals as pre-exposure prophylaxis (PrEP) is highly efficacious in HIV prevention. The World Health Organization recently recommended Truvada(®) (Gilead Sciences, Inc.) or tenofovir disoproxil fumarate (TDF) for high-risk individuals, with limited data for single-agent TDF PrEP in men who have sex with men (MSM). We report two cases of TDF PrEP failure in MSM who had received long-term TDF for hepatitis B infection and had therapeutic levels of drug immediately after HIV acquisition. Rapid antiretroviral intensification at diagnosis of acute HIV infection failed to limit immune dysfunction or prevent the establishment of a viral reservoir.

  12. Control and non-progression of HIV-1 infection in sub-Saharan Africa: A case and review

    Directory of Open Access Journals (Sweden)

    P Patel

    2012-08-01

    Full Text Available Elite and viraemic controllers represent unique subsets of HIV-infected patients who may also be long-term non-progressors (LTNPs. LNTPs constitute an estimated 1 - 15% of the total HIV-positive population in the USA and Europe, but less is known about their epidemiology in sub-Saharan Africa. Though the exact mechanisms for long-term non-progression appear to be numerous and are still under investigation, research on elite controllers may hold the key to new therapeutics and vaccine development. The clinical management of such patients can be challenging, as there are no standard guidelines for treatment, particularly in resource-limited settings. We describe the case of an HIV-infected Botswanan man who is likely an elite or viraemic controller.

  13. Decreased HIV diversity after allogeneic stem cell transplantation of an HIV-1 infected patient: a case report

    Directory of Open Access Journals (Sweden)

    Thielen Alexander

    2010-03-01

    Full Text Available Abstract The human immunodeficiency virus type 1 (HIV-1 coreceptor use and viral evolution were analyzed in blood samples from an HIV-1 infected patient undergoing allogeneic stem cell transplantation (SCT. Coreceptor use was predicted in silico from sequence data obtained from the third variable loop region of the viral envelope gene with two software tools. Viral diversity and evolution was evaluated on the same samples by Bayesian inference and maximum likelihood methods. In addition, phenotypic analysis was done by comparison of viral growth in peripheral blood mononuclear cells and in a CCR5 (R5-deficient T-cell line which was controlled by a reporter assay confirming viral tropism. In silico coreceptor predictions did not match experimental determinations that showed a consistent R5 tropism. Anti-HIV directed antibodies could be detected before and after the SCT. These preexisting antibodies did not prevent viral rebound after the interruption of antiretroviral therapy during the SCT. Eventually, transplantation and readministration of anti-retroviral drugs lead to sustained increase in CD4 counts and decreased viral load to undetectable levels. Unexpectedly, viral diversity decreased after successful SCT. Our data evidence that only R5-tropic virus was found in the patient before and after transplantation. Therefore, blocking CCR5 receptor during stem cell transplantation might have had beneficial effects and this might apply to more patients undergoing allogeneic stem cell transplantation. Furthermore, we revealed a scenario of HIV-1 dynamic different from the commonly described ones. Analysis of viral evolution shows the decrease of viral diversity even during episodes with bursts in viral load.

  14. A new analytical framework of 'continuum of prevention and care' to maximize HIV case detection and retention in care in Vietnam

    Directory of Open Access Journals (Sweden)

    Fujita Masami

    2012-12-01

    Full Text Available Abstract Background The global initiative ‘Treatment 2.0’ calls for expanding the evidence base of optimal HIV service delivery models to maximize HIV case detection and retention in care. However limited systematic assessment has been conducted in countries with concentrated HIV epidemic. We aimed to assess HIV service availability and service connectedness in Vietnam. Methods We developed a new analytical framework of the continuum of prevention and care (COPC. Using the framework, we examined HIV service delivery in Vietnam. Specifically, we analyzed HIV service availability including geographical distribution and decentralization and service connectedness across multiple services and dimensions. We then identified system-related strengths and constraints in improving HIV case detection and retention in care. This was accomplished by reviewing related published and unpublished documents including existing service delivery data. Results Identified strengths included: decentralized HIV outpatient clinics that offer comprehensive care at the district level particularly in high HIV burden provinces; functional chronic care management for antiretroviral treatment (ART with the involvement of people living with HIV and the links to community- and home-based care; HIV testing and counseling integrated into tuberculosis and antenatal care services in districts supported by donor-funded projects, and extensive peer outreach networks that reduce barriers for the most-at-risk populations to access services. Constraints included: fragmented local coordination mechanisms for HIV-related health services; lack of systems to monitor the expansion of HIV outpatient clinics that offer comprehensive care; underdevelopment of pre-ART care; insufficient linkage from HIV testing and counseling to pre-ART care; inadequate access to HIV-related services in districts not supported by donor-funded projects particularly in middle and low burden provinces and in

  15. Mesa en cuello por Mycobacterium tuberculosis en un paciente infectado por HIV A case of cervical mass due to mycobacterium tuberculosis in an HIV infected patient

    Directory of Open Access Journals (Sweden)

    Mónica Soto

    1995-02-01

    Full Text Available Se presenta el caso de un paciente de sexo masculino con diagnóstico de infección por HIV quien presentó una masa en cuello de 7 x 10 cm, dolorosa, de consistencia dura, adherida, no pulsátil, con edema de la piel adyacente y sin otros signos asociados. La evolución fue de 6 meses. Los estudios de la masa y el esputo dieron como resultado el aislamiento de M. tuberculosis, lo que permitió un adecuado enfoque terapéutico y por consiguiente una respuesta clínica satisfactoria

    We report on the case of an HIV-infected male with Mycobacterium tuberculosis infection, manifested as both pulmonary involvement and a cervical mass; lung infection was proven by culture; pathological study of the mass revealed both chronic granulomatous infection and acidfast bacilli. Response to treatment was favorable
    and rapid. We suggest that every fluid and tissue obtained from HIV-positive patients be routinely stained and cultured for mycobacteria.

  16. Mucocutaneous manifestations of HIV infection: a retrospective analysis of 145 cases in a Chinese population in Malaysia.

    Science.gov (United States)

    Jing, W; Ismail, R

    1999-06-01

    Mucocutaneous lesions directly related to human immunodeficiency virus (HIV) infection usually present as initial manifestations of immune deficiency. The most common mucocutaneous lesions are Kaposi's sarcoma, histoplasmosis, oro-esophageal candidiasis, oral hairy leukoplakia, and, in Asia, Penicillium marneffei infection. Non-HIV-related skin lesions, such as psoriasis, seborrheic dermatitis, and nodular prurigo, may be the initial presentation among HIV infected patients attending outpatient clinics. A retrospective analysis was performed on 145 HIV-positive Malaysians of Chinese descent from two centers at the University Hospital Kuala Lumpur (UHKL) and the General Hospital Kuala Lumpur (GHKL) from March 1997 to February 1998. Demographic data and clinical data were analyzed. The analysis showed that 104 out of 145 patients had mucocutaneous disorders (71.7%). In the study, there were 100 men (96.2%) and four women (3.8%). The majority of patients were in the age group 20-50 years. The patients who presented with mucocutaneous disease also had low CD4+ T-lymphocyte counts and most had acquired immunodeficiency syndrome (AIDS) defining illness. The number of cases with generalized hyperpigmentation was very high in the group (35.9%), followed by nodular prurigo (29.7%) and xerosis (27.6%). Seborrheic dermatitis was seen in 20.7% of cases, with psoriasis in 8.3%. The most common infections were oral candidiasis (35.9%), tinea corporis and onychomycosis (9.7%), and herpes infection (5.5%); however, mucocutaneous manifestations of Kaposi's sarcoma were rare. The results suggest that mucocutaneous findings are useful clinical predictors of HIV infection or signs of the presence of advanced HIV infection.

  17. Infective endocarditis not related to intravenous drug abuse in HIV-1-infected patients: report of eight cases and review of the literature.

    Science.gov (United States)

    Losa, J E; Miro, J M; Del Rio, A; Moreno-Camacho, A; Garcia, F; Claramonte, X; Marco, F; Mestres, C A; Azqueta, M; Gatell, J M

    2003-01-01

    To add to the limited information on infective endocarditis (IE) not related to intravenous drug abuse (IVDA) in HIV-1-infected patients. We have reviewed the characteristics of eight cases of IE in non-IVDA HIV-1 infected patients diagnosed in our institution between 1979 and 1999 as well as cases in the literature. All our patients were male, and the mean age was 44 years (range 29-64). HIV-1 risk factors were: homosexuality in five, heterosexuality in two, and the use of blood products in one. HIV stage C was found in six cases, and the median (range) CD4 cell count was 22/microL (4-274 cells/microL). IE was caused by Enterococcus faecalis in three cases, staphylococci in two cases, and Salmonella enteritidis, viridans group streptococci and Coxiella burnetii in one case each. Three patients acquired IE while in the hospital. All IE cases involved a native valve, and underlying valve disease was found in three patients. The aortic valve was the most frequently affected (five cases). Two patients underwent surgery, with a good outcome, and one patient died. Fourteen cases of IE not related to IVDA in HIV-1-infected patients were found in the literature review. The most common causative agents were Salmonella spp. and fungi (four cases each). Two patients had prosthetic valve IE, and the mitral valve was the most frequently affected (10 cases). The remaining clinical characteristics and the outcome were similar to those in the present series. IE not related to IVDA is rare in HIV-1-infected patients. In more than half of the cases, IE develops in patients with advanced HIV-1 disease. A wide etiologic range is found, reflecting different clinical and environmental conditions. None of the patients who underwent surgery died, and the overall mortality rate was not higher than in non-HIV-1-infected patients with IE.

  18. Non-Hodgkin's lymphoma of the mandible in HIV patient - A Rare Case Report

    Directory of Open Access Journals (Sweden)

    Mahesh Neerupakam

    2018-01-01

    Full Text Available Non-Hodgkin's lymphoma (NHL is a lymphatic system tumor originating from either B or T lymphocytes and shows a high malignant potential. In HIV-seropositive patients, NHL of head and neck is mainly found in Waldeyer's ring, oral mucosa, salivary glands, paranasal sinuses, and laryngeal tissue. Primary NHL rarely affects the bone. When the lesion affects the bones of the jaws, it is rare in the mandible when compared to the maxilla. In the reported cases, only 0.6% are found in the mandible. NHL of the mandible can be difficult to diagnose, and so the prime aim of the present case report is to establish appropriate diagnosis of one of such kinds. Clinically, they may imitate a dental infection with symptoms of pain and discomfort. A delay in diagnosis may lead to a poor prognosis. Herewith, we present a case of NHL on the lower-right mandible in a 40-year-old male. A correlation of clinical findings, radiological examination, and histopathological examination enabled us in early diagnosis and differentiating it from other similar conditions, thus aiding in initiation of prompt treatment.

  19. Federal Register in XML

    Data.gov (United States)

    National Archives and Records Administration — The Federal Register is the official daily publication for rules, proposed rules, and notices of Federal agencies and organizations, as well as executive orders and...

  20. The Danish Adoption Register.

    Science.gov (United States)

    Petersen, Liselotte; Sørensen, Thorkild I A

    2011-07-01

    The Danish Adoption Register was established in 1963-1964 to explore the genetic and environmental contribution to familial aggregation of schizophrenia. The register encompass information on all 14,425 non-familial adoptions of Danish children legally granted in Denmark 1924-1947. It includes name and date of birth of each adoptee and his or her biological and adoptive parents, date of transfer to adoptive parents and date of formal adoption. The linkage to biological and adoptive parents is close to complete, even biological fathers are registered for 91.4% of the adoptees. Adoption registers are a unique source allowing disentangling of genetic and familial environmental influences on traits, risk of diseases, and mortality.

  1. Islamic perspectives on HIV/AIDS and antiretroviral treatment: the case of Nigeria.

    Science.gov (United States)

    Balogun, Amusa Saheed

    2010-12-01

    Some religious reactions to the HIV epidemic in Africa unwittingly contributed to the expansion of the epidemic in its early years. This was because many religious people regarded the emergence of HIV and AIDS as divine punishment for man's sins as a result of people's sexual promiscuity. Some also opposed public promotion of the use of condoms for HIV prevention. However, religious bodies have made positive contributions to HIV/AIDS responses in many African countries in recent times. Though Christian bodies are taking the lead in faith-based responses to HIV and AIDS in Africa, Islamic bodies have also been major partners in HIV/AIDS interventions in several countries. Against this background, this article examines some Islamic perceptions of HIV and AIDS, and especially the impact of antiretroviral treatment (ART) for people living with HIV in Africa, with particular emphasis on Nigeria. In spite of the emergence of antiretroviral (ARV) drugs in Africa, Islam still emphasises the prevention of new infections and care for people living with HIV or AIDS. The article discusses basic issues associated with ARVs, such as health, sickness, life-prolongation and death, from an Islamic viewpoint, as well as some Islamic measures to prevent HIV-risk-taking behaviours in an era of ARVs. It also looks at the nature and extent of Islamic involvement in the national HIV/AIDS response in Nigeria. The paper concludes that while Islam sees HIV and AIDS and other diseases as 'tests' from Allah, the religion is not opposed to ART. Thus, efforts need to be intensified by Islamic bodies and Muslim leaders in Nigeria for an improved response to HIV and AIDS in the country.

  2. Molecular Electronic Shift Registers

    Science.gov (United States)

    Beratan, David N.; Onuchic, Jose N.

    1990-01-01

    Molecular-scale shift registers eventually constructed as parts of high-density integrated memory circuits. In principle, variety of organic molecules makes possible large number of different configurations and modes of operation for such shift-register devices. Several classes of devices and implementations in some specific types of molecules proposed. All based on transfer of electrons or holes along chains of repeating molecular units.

  3. IT Risk register

    OpenAIRE

    Kohout, Karel

    2011-01-01

    The theoretical part of the thesis analyzes several selected methodologies and best-practices related to information technology risks management, with focus on documents and guidance developed by ISACA. It builds a set of ideas and basic requirements for effective model of an IT risk register. Strong emphasis is placed on mapping CobiT 4.1 based Risk IT to COBIT 5. The practical part describes implementation of an exploratory web-based IT risk register in Python programming language utilizing...

  4. Risk analysis. HIV / AIDS country profile: Senegal.

    Science.gov (United States)

    1996-12-01

    Since the first acquired immunodeficiency syndrome (AIDS) case was confirmed in 1986, Senegal has conducted an aggressive prevention campaign. Senegal's National AIDS Committee has noted the contributions of poverty and migration to the spread of AIDS. By June 1994, 1297 AIDS cases had been reported and an estimated 500,000 people (1.4% of the population) were infected with human immunodeficiency virus (HIV)-1 and 2. The highest rate of HIV infection (14%) exists among commercial sex workers. At present, HIV/AIDS cases are concentrated in Dakar, Kaolack, the Matam region, and Ziguinchor; however, the growing importance of inter-regional trading is expected to spread HIV to the smaller towns and rural areas. Also salient is the recent devaluation by 50% of the CFA franc, which has reduced the public sector workforce and led many poor urban residents into commercial sex work. CFA devaluation has made Senegal attractive to tourists and business visitors--another factor responsible for growth of the legalized commercial sex industry. Although sex workers are instructed in condom use and tested annually for HIV, only 850 of the 2000 registered sex workers have reported for check-ups, and the majority of prostitutes are unregistered. Senegal's AIDS Plan for 1994-98 focuses on care of AIDS patients, pressures placed on family structures by HIV, and AIDS-related erosions in the status of women. Each health service region has its own local plan for AIDS/HIV and sexually transmitted diseases, supervised by a regional committee. Public education has involved outreach to religious leaders, promotion of affordable condoms, and distribution of over 75,000 leaflets to key target populations. About US $16 million of the $25,688,875-budget HIV/AIDS program for 1994-98 was pledged by external donors.

  5. Using risk-tracing snowball approach to increase HIV case detection among high-risk populations in Cambodia: an intervention study.

    Science.gov (United States)

    Chhim, Srean; Macom, John; Pav, Chettana; Nim, Nirada; Yun, Phearun; Seng, Sopheap; Chhim, Kolab; Tuot, Sovannary; Yi, Siyan

    2017-10-18

    Early HIV diagnosis and initiation onto antiretroviral therapy may prevent ongoing spread of HIV. Risk Tracing Snowball Approach (RTSA) has been shown to be effective in detecting new HIV cases in other settings. The main objective of this study is to evaluate the effectiveness of RTSA in increasing the rate of newly identified HIV cases among high-risk populations. Our second objective was to evaluate the effectiveness of RTSA, as compared to the walk-in group, in increasing the number of HIV tests and early case detection. This study was conducted from April 1 to September 30, 2016 at two NGO clinics in Phnom Penh, Cambodia. Respondent driven sampling method was adapted to develop RTSA to reach high-risk populations, including key populations and the general population who have social connections with key populations. Bivariate and multivariate logistic regression analyses were conducted. During the implementation period, 721 clients walked in for HIV testing (walk-in group), and all were invited to be seeds. Of the invited clients, 36.6% agreed to serve as seeds. Throughout the implementation, 6195 coupons were distributed to seeds or recruiters, and resulted in 1572 clients visiting the two clinics with coupons (RTSA group), for a coupon return rate of 25.3%. The rate of newly identified HIV cases among the RTSA group was significantly lower compared to that in walk-in group. However, the highest number of newly identified HIV cases was found during the implementation period, compared to both pre- and post-implementation period. Although statistically not significant, the mean CD4 count of newly identified HIV cases detected through RTSA was almost 200 cells/mm3 higher than that in the walk-in group. Although the rate of newly identified HIV cases among the RTSA group was lower than that in the walk-in group, the inclusion of RTSA in addition to the traditional walk-in method boosted new HIV case detection in the two participating clinics. A higher mean CD4

  6. Young People's Risk of Suicide Attempts after Contact with a Psychiatric Department--A Nested Case-Control Design Using Danish Register Data

    Science.gov (United States)

    Christiansen, Erik; Larsen, Kim Juul

    2012-01-01

    Background: There seems to be an increased risk of children and adolescents committing or attempting suicide after contact with a psychiatric department. Children and adolescents living in families with low socio-economic status (SES) might have an especially increased suicide attempt risk. Methods: A complete extraction of Danish register data…

  7. Evaluation of cellular phenotypes implicated in immunopathogenesis and monitoring immune reconstitution inflammatory syndrome in HIV/leprosy cases.

    Science.gov (United States)

    Giacoia-Gripp, Carmem Beatriz Wagner; Sales, Anna Maria; Nery, José Augusto da Costa; Santos-Oliveira, Joanna Reis; de Oliveira, Ariane Leite; Sarno, Euzenir Nunes; Morgado, Mariza Gonçalves

    2011-01-01

    It is now evident that HAART-associated immunological improvement often leads to a variety of new clinical manifestations, collectively termed immune reconstitution inflammatory syndrome, or IRIS. This phenomenon has already been described in cases of HIV coinfection with Mycobacterium leprae, most of them belonging to the tuberculoid spectrum of leprosy disease, as observed in leprosy reversal reaction (RR). However, the events related to the pathogenesis of this association need to be clarified. This study investigated the immunological profile of HIV/leprosy patients, with special attention to the cellular activation status, to better understand the mechanisms related to IRIS/RR immunopathogenesis, identifying any potential biomarkers for IRIS/RR intercurrence. Eighty-five individuals were assessed in this study: HIV/leprosy and HIV-monoinfected patients, grouped according to HIV-viral load levels, leprosy patients without HIV coinfection, and healthy controls. Phenotypes were evaluated by flow cytometry for T cell subsets and immune differentiation/activation markers. As expected, absolute counts of the CD4+ and CD8+ T cells from the HIV-infected individuals changed in relation to those of the leprosy patients and controls. However, there were no significant differences among the groups, whether in the expression of cellular differentiation phenotypes or cellular activation, as reflected by the expression of CD38 and HLA-DR. Six HIV/leprosy patients identified as IRIS/RR were analyzed during IRIS/RR episodes and after prednisone treatment. These patients presented high cellular activation levels regarding the expression of CD38 in CD8+ cells T during IRIS/RR (median: 77,15%), dropping significantly (p<0,05) during post-IRIS/RR moments (median: 29,7%). Furthermore, an increase of cellular activation seems to occur prior to IRIS/RR. These data suggest CD38 expression in CD8+ T cells interesting tool identifying HIV/leprosy individuals at risk for IRIS/RR. So, a

  8. Evaluation of cellular phenotypes implicated in immunopathogenesis and monitoring immune reconstitution inflammatory syndrome in HIV/leprosy cases.

    Directory of Open Access Journals (Sweden)

    Carmem Beatriz Wagner Giacoia-Gripp

    Full Text Available BACKGROUND: It is now evident that HAART-associated immunological improvement often leads to a variety of new clinical manifestations, collectively termed immune reconstitution inflammatory syndrome, or IRIS. This phenomenon has already been described in cases of HIV coinfection with Mycobacterium leprae, most of them belonging to the tuberculoid spectrum of leprosy disease, as observed in leprosy reversal reaction (RR. However, the events related to the pathogenesis of this association need to be clarified. This study investigated the immunological profile of HIV/leprosy patients, with special attention to the cellular activation status, to better understand the mechanisms related to IRIS/RR immunopathogenesis, identifying any potential biomarkers for IRIS/RR intercurrence. METHODS/PRINCIPAL FINDINGS: Eighty-five individuals were assessed in this study: HIV/leprosy and HIV-monoinfected patients, grouped according to HIV-viral load levels, leprosy patients without HIV coinfection, and healthy controls. Phenotypes were evaluated by flow cytometry for T cell subsets and immune differentiation/activation markers. As expected, absolute counts of the CD4+ and CD8+ T cells from the HIV-infected individuals changed in relation to those of the leprosy patients and controls. However, there were no significant differences among the groups, whether in the expression of cellular differentiation phenotypes or cellular activation, as reflected by the expression of CD38 and HLA-DR. Six HIV/leprosy patients identified as IRIS/RR were analyzed during IRIS/RR episodes and after prednisone treatment. These patients presented high cellular activation levels regarding the expression of CD38 in CD8+ cells T during IRIS/RR (median: 77,15%, dropping significantly (p<0,05 during post-IRIS/RR moments (median: 29,7%. Furthermore, an increase of cellular activation seems to occur prior to IRIS/RR. CONCLUSION/SIGNIFICANCE: These data suggest CD38 expression in CD8+ T cells

  9. Performance of Clinical Screening Algorithms for Tuberculosis Intensified Case Finding among People Living with HIV in Western Kenya.

    Directory of Open Access Journals (Sweden)

    Surbhi Modi

    Full Text Available To assess the performance of symptom-based screening for tuberculosis (TB, alone and with chest radiography among people living with HIV (PLHIV, including pregnant women, in Western Kenya.Prospective cohort study.PLHIV from 15 randomly-selected HIV clinics were screened with three clinical algorithms [World Health Organization (WHO, Ministry of Health (MOH, and "Improving Diagnosis of TB in HIV-infected persons" (ID-TB/HIV study], underwent chest radiography (unless pregnant, and provided two or more sputum specimens for smear microscopy, liquid culture, and Xpert MTB/RIF. Performance of clinical screening was compared to laboratory results, controlling for the complex design of the survey.Overall, 738 (85.6% of 862 PLHIV enrolled were included in the analysis. Estimated TB prevalence was 11.2% (95% CI, 9.9-12.7. Sensitivity of the three screening algorithms was similar [WHO, 74.1% (95% CI, 64.1-82.2; MOH, 77.5% (95% CI, 68.6-84.5; and ID-TB/HIV, 72.5% (95% CI, 60.9-81.7]. Sensitivity of the WHO algorithm was significantly lower among HIV-infected pregnant women [28.2% (95% CI, 14.9-46.7] compared to non-pregnant women [78.3% (95% CI, 67.3-86.4] and men [77.2% (95% CI, 68.3-84.2]. Chest radiography increased WHO algorithm sensitivity and negative predictive value to 90.9% (95% CI, 86.4-93.9 and 96.1% (95% CI, 94.4-97.3, respectively, among asymptomatic men and non-pregnant women.Clinical screening missed approximately 25% of laboratory-confirmed TB cases among all PLHIV and more than 70% among HIV-infected pregnant women. National HIV programs should evaluate the feasibility of laboratory-based screening for TB, such as a single Xpert MTB/RIF test for all PLHIV, especially pregnant women, at enrollment in HIV services.

  10. Adult meningitis in a setting of high HIV and TB prevalence: findings from 4961 suspected cases

    Directory of Open Access Journals (Sweden)

    Meintjes Graeme

    2010-03-01

    Full Text Available Abstract Background The presentation and causes of adult meningitis in South Africa have changed substantially as a result of HIV. Knowledge of aetiology and laboratory findings in patients presenting with meningitis are important in guiding management. We performed a retrospective study to determine these findings in a setting of high HIV and TB prevalence in Cape Town. Methods Patients undergoing lumbar punctures between 1st January 2006 and 31st December 2008 at a public sector referral hospital were studied. Cases were classified by microbiological diagnosis, or in the absence of definitive microbiology as 1 normal CSF (neutrophils ≤ 1 × 106/L, lymphocytes ≤ 5 × 106/L, protein ≤ 0.5 g/dL, glucose ≥1.5 mmol/L, 2 minor abnormalities (neutrophils 2-5, lymphocytes 6-20, protein 0.51-1.0, glucose 1.0-1.49 or 3 markedly abnormal (neutrophils>5, lymphocytes>20, protein>1.0, glucose Results 5578 LPs were performed on 4549 patients, representing 4961 clinical episodes. Of these, 2293 had normal CSF and 931 had minor abnormalities and no aetiology identified. Of the remaining 1737, microbiological diagnoses were obtained in 820 (47%. Cryptococcus accounted for 63% (514 of microbiological diagnoses, TB for 28% (227, bacterial meningitis for 8% (68. Of the remaining 917 who had marked abnormalities, the majority (59% had a sterile lymphocytic CSF. Of note 16% (81 patients with confirmed Cryptococcus, 5% (12 with TB and 4% (3 with bacterial meningitis had normal CSF cell-counts and biochemistry. Conclusions Cryptococcal and tuberculous meningitis are now the commonest causes of adult meningitis in this setting. TB meningitis is probably underdiagnosed by laboratory investigation, as evidence by the large numbers presenting with sterile lymphocytic markedly abnormal CSFs.

  11. Tubuloreticular Inclusions in the Absence of Systemic Lupus Erythematosus and HIV Infection: A Report of Three Pediatric Cases

    Directory of Open Access Journals (Sweden)

    Ayah Elmaghrabi

    2017-06-01

    Full Text Available Tubuloreticular inclusions (TRIs are subcellular structures located within the cisternae of endoplasmic reticulum. Formation of TRIs has been linked to the exposure of excess interferon (IFN, either from endogenous or exogenous sources. In renal disease, TRIs have been most commonly associated with systemic lupus erythematosus (SLE, and human immunodeficiency virus-associated nephropathy (HIVAN. Case reports of patients with renal biopsies showing TRIs without underlying SLE or HIV are infrequent in adults, and to our knowledge none have been reported in children. We report 3 pediatric cases in which the renal biopsy showed TRIs on electron microscopy without underlying SLE or HIV infection. The first patient presented at 2 years of age with nephrotic syndrome and renal failure. His renal biopsy revealed focal segmental glomerulosclerosis and TRIs. The second patient presented at 6 months of age with infantile nephrotic syndrome, and his renal biopsy revealed membranous glomerulopathy and TRIs. The last patient presented at 4 years of age with acute kidney injury of unclear etiology leading to chronic kidney disease. Her biopsy revealed acute and chronic tubulointerstitial nephritis with TRIs. Despite extensive evaluation in all 3 patients, including testing for HIV infection and SLE, we could not identify an underlying etiology to explain the presence of TRIs. In conclusion, renal biopsy with TRIs in the absence of underling SLE and HIV remains obscure. We propose a possible role for excess IFN triggered by an abnormal immune response to common viral infections in the formation of TRIs and renal injury.

  12. Sporotrichosis in HIV-infected patients: report of 21 cases of endemic sporotrichosis in Rio de Janeiro, Brazil.

    Science.gov (United States)

    Freitas, Dayvison Francis Saraiva; de Siqueira Hoagland, Brenda; do Valle, Antonio Carlos Francesconi; Fraga, Beatriz Barros; de Barros, Mônica Bastos; de Oliveira Schubach, Armando; de Almeida-Paes, Rodrigo; Cuzzi, Tullia; Rosalino, Cláudia Maria Valete; Zancopé-Oliveira, Rosely Maria; Gutierrez-Galhardo, Maria Clara

    2012-02-01

    Sporotrichosis is endemic in Rio de Janeiro, Brazil, and cases have been reported to be associated with HIV. This article describes the clinical manifestations and evolution of sporotrichosis in HIV-positive patients and constitutes the largest case series reported to date. There were 21 HIV-positive patients with sporotrichosis diagnosed by the recovery of the etiologic agent from 1999-2009. Sixteen patients (76.2%) were men and five (23.8%) were women, with a mean age of 41.2 years. Seven of these individuals were previously unaware of their HIV infection. Mean CD4 count was 346.4 cells/μl. The most frequent clinical presentations of sporotrichosis in these patients were the lymphocutaneous and disseminated form (seven patients each, 33.3%), followed by the widespread cutaneous form in five (23.8%), and fixed form in the remaining two (9.5%). In patients with the disseminated forms, clinical manifestations involved the skin in six, mucosa (nasal, oral, or conjunctival) in four, bone in two, and meninges in two. Eleven (52.4%) patients received itraconazole and eight (38.1%) amphotericin B contributing to an overall cure rate of 81%. Spontaneous cure was observed in one patient. The clinical forms of sporotrichosis varied according to the patients' immune status. The results demonstrate the importance of sporotrichosis as an opportunistic infection associated with AIDS in countries where the mycosis occurs.

  13. [Analysis of HIV antibody positive cases in Peking University Hospital of Stomatology during 9 years].

    Science.gov (United States)

    Ding, Jian-fen; Qiu, Juan; Shen, Shu-ming

    2016-02-01

    To investigate the prevalence and characteristics of HIV patients found in Peking University Hospital of Stomatology during 9 years, and provide management strategy for early diagnosis and control of HIV in Stomatology Hospital. A retrospective study of the HIV positive patients diagnosed by HIV antibody screening was carried out. The related information about these patients found in Peking University School of Stomatology during 2005-2013 was obtained from China Disease Control Information System. 68,562 patients accepted HIV antibody screening in Peking University Hospital of Stomatology during 2005-2013. Thirty one patients were found HIV antibody positive. The ratio of HIV antibody positive was about 0.045%, which was composed of 25 males and 6 females. 61.29% patients aged between 20-40 years, and their career was mainly commercial service with a education level of junior high school. The proportion of sexual route of transmission was about 74.91%, and 34.78% of them were male homosexuality. Most of the patients with HIV antibody positive were found in the out-patient clinic, especially in the department of oral mucosal diseases, accounting for 70.97%. HIV antibody positive rate in Peking University School of Stomatology was slightly lower than that in general hospitals. Medical staff should increase their awareness of AIDS prevention and control, for higher HIV risk departments, such as oral mucosal diseases and periodontal disease, efforts should be made to increase HIV screening, expand the scope of screening, and promote provider-initiated HIV testing and counseling.

  14. Association between HIV status and depressive symptoms among children and adolescents in the Southern Highlands Zone, Tanzania: A case-control study.

    Science.gov (United States)

    Lwidiko, Abraham; Kibusi, Stephen Matthew; Nyundo, Azan; Mpondo, Bonaventura C T

    2018-01-01

    Children and adolescents continue to have HIV/AIDS in southern Saharan Africa. Scaling up of HIV services has significantly improved access to ARV and consequently improved on morbidity and mortality related to HIV/AIDS including opportunistic infection. Despite the above efforts, non-communicable conditions including mental disorders such as depression have been observed to contribute to the burden of disabilities about which little is documented. This study, therefore, aimed to determine the magnitude of depressive symptoms and the associated factors among HIV-infected children and adolescents. The study was a matched case-control design involving 300 cases of HIV-infected children matched by age and sex against 600 uninfected controls. Systematic sampling technique was used to select the cases while multistage sampling technique was employed to identify villages/ streets purposive and sampling technique was employed to obtain participants from households. The overall prevalence of depressive symptoms among the cohort of 900 participants was found to be 12.9%, with 27% of HIV-infected and 5.8% of HIV-uninfected children and adolescents screened positive for depressive symptoms. Multiple logistic regression revealed that being HIV-infected (AOR 1.96(1.11-3.45)), residing in a rural setting (AOR 0.61(0.39-0.96)) and history of childhood deprivation (AOR 4.76 (2.79-8.13)) were significantly associated with depressive symptoms. HIV infected adolescents are more affected by depression compared to non-infected counterparts. Childhood deprivation was significantly associated with presence of depressive symptoms. Integration of mental health evaluation and treatment into the HIV care provided for adolescents can be beneficial. More studies to delineate factors associated with depressed adolescents with HIV may add value to the body of knowledge and overall improvement of care.

  15. The Case for Adolescent HIV Vaccination in South Africa: A Cost-Effectiveness Analysis.

    Science.gov (United States)

    Moodley, Nishila; Gray, Glenda; Bertram, Melanie

    2016-01-01

    Despite comprising 0.7% of the world population, South Africa is home to 18% of the global human immunodeficiency virus (HIV) prevalence. Unyielding HIV subepidemics among adolescents threaten national attempts to curtail the disease burden. Should an HIV vaccine become available, establishing its point of entry into the health system becomes a priority. This study assesses the impact of school-based HIV vaccination and explores how variations in vaccine characteristics affect cost-effectiveness. The cost per quality adjusted life year (QALY) gained associated with school-based adolescent HIV vaccination services was assessed using Markov modeling that simulated annual cycles based on national costing data. The estimation was based on a life expectancy of 70 years and employs the health care provider perspective. The simultaneous implementation of HIV vaccination services with current HIV management programs would be cost-effective, even at relatively higher vaccine cost. At base vaccine cost of US$ 12, the incremental cost effectiveness ratio (ICER) was US$ 43 per QALY gained, with improved ICER values yielded at lower vaccine costs. The ICER was sensitive to duration of vaccine mediated protection and variations in vaccine efficacy. Data from this work demonstrate that vaccines offering longer duration of protection and at lower cost would result in improved ICER values. School-based HIV vaccine services of adolescents, in addition to current HIV prevention and treatment health services delivered, would be cost-effective.

  16. Integrated response toward HIV: a health promotion case study from China.

    Science.gov (United States)

    Jiang, Zhen; Wang, Debin; Yang, Sen; Duan, Mingyue; Bu, Pengbin; Green, Andrew; Zhang, Xuejun

    2011-06-01

    Integrated HIV response refers to a formalized, collaborative process among organizations in communities with HIV at-risk populations. It is a both comprehensive and flexible scheme, which may include community-based environment promotion, skill coalition, fund linkage, human resource collaboration and service system jointly for both HIV prevention and control. It enables decisions and actions responds over time. In 1997, the Chinese government developed a 10-year HIV project supported by World Bank Loan (H9-HIV/AIDS/STIs). It was the first integrated STI/HIV intervention project in China and provides a unique opportunity to explore the long-term comprehensive STI/HIV intervention in a low-middle income country setting. Significant outcomes were identified as development and promotion of the national strategic plan and its ongoing implementation; positive knowledge, behavioral and STI/HIV prevalence rate change; and valuable experiences for managing integrated HIV/STI intervention projects. Essential factors for the success of the project and the key tasks for the next step were identified and included well-designed intervention in rural and low economic regions, unified program evaluation framework and real-time information collection and assessment.

  17. A case-control study of syphilis among men who have sex with men in New York City: association With HIV infection.

    Science.gov (United States)

    Paz-Bailey, Gabriela; Meyers, Andrea; Blank, Susan; Brown, James; Rubin, Steve; Braxton, Jim; Zaidi, Akbar; Schafzin, Josh; Weigl, Susan; Markowitz, Laurie E

    2004-10-01

    The objective of this study was to determine factors associated with syphilis among men who report sex with other men in New York City. DESIGN, SETTING AND STUDY SUBJECTS: We conducted a case-control study among 88 men who reported sex with men in the previous year, 18 to 55 years old and diagnosed with primary or secondary syphilis during 2001; and 176 control subjects frequently matched by age and type of health provider. HIV prevalence among syphilis cases was 48% compared with 15% among control subjects (P model were HIV infection (odds ratio [OR], 7.3; 95% confidence interval [CI], 3.5-15.4), income >$30,000 per year (OR, 2.7; CI, 1.4-5.2), and barebacking (OR, 2.6; CI, 1.4-4.8). The median time since HIV diagnosis for HIV-positive was 6 years for cases and 7 years for control subjects (P = 0.70). Among HIV-infected participants, syphilis cases were more likely than control subjects to report being on antiretroviral therapy (69% vs. 44%, P = 0.05) and to report having undetectable viral load (58% vs. 24%, P = 0.02). HIV infection was strongly associated with syphilis in this study. High-risk behavior reported by both cases and control subjects indicates the potential for increased HIV transmission.

  18. Chest radiology in HIV-positive patients with tuberculosis - analysis of 104 cases

    International Nuclear Information System (INIS)

    Camara, C.S.; Moraes, A.P.P. de; Silva, W.A.E.; Camisao, C.C.; Basilio de Oliveira, C.A.; Kisckinhevski, W.; Santos, A.A.S. dos

    1990-01-01

    Radiological examinations from 104 patients HIV-positive with tuberculosis were revised at HUGG/Uni-Rio, during the period from June/86 to June/89. From these, 91.4% were male patients, the predominant risk group was homosexual. Among the women, the most affected group was the intravenous drug consumer. The general age group mostly presented was the one from 20 to 39 years. The main tuberculosis confirmation came from the BAAR research in the sputum (57.6%); the necropsy contributed with 13.5% of the patients. The extrathoracic manifestations occurred in 27% of the cases. The most common radiological patterns were interstitial infiltrate 71.2%, bilateral in 48% of the cases, in the alveolar patterns 63.5%, mostly upper lobes, frequently they were simultaneous. Other important findings were: mediastinal lymphatic involvement, pleural effusion, cavity and X-ray without particularities with pulmonary tuberculosis. A comparison study was performed based on literature data and it was observed atypical patterns for the secondary tuberculosis. (author)

  19. Enrolling HIV-positive adolescents in mental health research: A case study reflecting on legal and ethical complexities

    Directory of Open Access Journals (Sweden)

    Nataly Woollett

    2017-08-01

    Full Text Available Background. Adolescents living with HIV are an emerging group in the global HIV/AIDS epidemic. Mental health in this population affects HIV care, treatment, consequential morbidity and secondary transmission. There is a paucity of research regarding these youth in South Africa (SA, partly because section 71 of the National Health Act of 2003 (NHA requires parental or guardian’s consent. Objective. To explore legal and ethical issues related to conducting adolescent mental health research in SA. Methods. After obtaining a High Court order permitting research on minors aged <18 years without prior parental or guardian’s consent, we used qualitative and quantitative methods to interview adolescents in five clinics serving HIV-positive adolescents in Johannesburg. Results. Our study enrolled 343 participants; 74% were orphaned and did not have legal guardians, 27% were symptomatic for depression, anxiety or post-traumatic stress disorder, 24% were suicidal, and almost 90% did not feel that they belonged in the family with which they lived. Without court intervention, most of the participants could not have participated in this research because parental consent was impossible to obtain. This case study argues for exceptions to the parental consent requirement, which excludes orphaned and vulnerable children and youth from research. Conclusions. Recommendations are made to promote ethical integrity in conducting mental health research with adolescents. A balance is needed between protecting adolescents from exploitation and permitting access to benefits of research. Requiring parental consent for all research does not necessarily give effect to policy. For the vast majority of SA HIV-positive adolescents, parental consent is not possible. Section 71 of the NHA ought to be amended to facilitate valuable and necessary research concerning HIV-positive orphan children and adolescents.

  20. An Acquired Factor VIII Inhibitor in a Patient with HIV and HCV: A Case Presentation and Literature Review

    Directory of Open Access Journals (Sweden)

    S. B. Zeichner

    2013-01-01

    Full Text Available Introduction. Despite its low incidence, acquired factor VIII inhibitor is the most common autoantibody affecting the clotting cascade. The exact mechanism of acquisition remains unclear, but postpartum patients, those with autoimmune conditions or malignancies, and those with exposure to particular drugs appear most susceptible. There have been several case reports describing acquired FVIII inhibitors in patients receiving interferon alpha for HCV treatment and in patients being treated for HIV. To our knowledge, this is the first case of a patient with HCV and HIV who was not actively receiving treatment for either condition. Case Presentation. A 57-year-old Caucasian male with a history of HIV and HCV was admitted to our hospital for a several day history of progressively worsening right thigh bruising and generalized weakness. CTA of the abdominal arteries revealed large bilateral retroperitoneal hematomas. Laboratory studies revealed the presence of a high titer FVIII inhibitor. Conclusion. Our case of a very rare condition highlights the importance of recognizing and understanding the diagnosis of acquired FVIII inhibitor. Laboratory research and clinical data on the role of newer agents are needed in order to better characterize disease pathogenesis, disease associations, genetic markers, and optimal disease management.

  1. Configuring the users of new HIV-prevention technologies: the case of HIV pre-exposure prophylaxis.

    Science.gov (United States)

    Holt, Martin

    2015-01-01

    HIV pre-exposure prophylaxis (PrEP) is a prevention technology that involves prescribing antiretroviral drugs to HIV-negative people to protect them from infection. This paper considers how the development of the technology has necessitated the parallel configuration of its users, and how this process has affected the perception and uptake of the technology. In designing a technology, potential users are typically defined, enabled and constrained, partly to create a target population (or market) for the technology, but also to reassure people that it can be used safely and effectively. This process may or may not be helpful for the uptake and use of the technology. Published research on PrEP indicates that while the technology was under trial, the primary focus was on the 'at-risk' subject in need of PrEP, with little or no consideration of the other qualities necessary for successful use. Post-trial accounts of PrEP have begun to outline desirable qualities of successful PrEP use, such as caution, compliance and being organised. It appears that the PrEP user was only partially configured during the technology's development, and the initial focus on risk has done little to counter fears of the technology, which may partially account for its slow uptake.

  2. Gastric adenocarcinoma in a patient with X-linked agammaglobulinemia and HIV: Case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Joud Hajjar

    2016-09-01

    Full Text Available X-linked agammaglobulinemia (XLA is an X-linked inherited disease usually caused by a germline mutation in the BTK gene leading to Bruton’s tyrosine kinase deficiency, which results in the impaired development of B-lymphocytes and a subsequent lack of immunoglobulin production. Patients with XLA have an increased susceptibility to bacterial and viral infections, and multiple case reports have been published regarding an association between XLA and gastrointestinal (GI malignancy. Here, we describe a case of a 25-year-old man with XLA and HIV, who developed gastric adenocarcinoma. Previously reported cases of XLA and GI malignancy are also reviewed and summarized.

  3. Association of Pulmonary Tuberculosis and HIV in the Mexican Institute of Social Security, 2006-2014.

    Directory of Open Access Journals (Sweden)

    David Alejandro Cabrera-Gaytán

    Full Text Available Tuberculosis and HIV remain a public health problem in developed countries. The objective of this study was to analyze the incidence trends of pulmonary TB and HIV comorbidity and treatment outcomes according to HIV during the period 2006 to 2014 in the Mexican Institute of Social Security.Analyzed data from this registry including pulmonary tuberculosis patients aged 15 years and older who had been diagnosed during the years 2006 to 2014 in the Mexican Institute of Social Security. The outcomes that we use were incidents rate, failure to treatment and death. Regression models were used to quantify associations between pulmonary tuberculosis and HIV mortality.During the study period, 31,352 patients were registered with pulmonary tuberculosis. The incidence rate observed during 2014 was 11.6 case of PTB per 100,000. The incidence rate for PTB and HIV was 0.345 per 100,000. The PTB incidence rate decreased by 0.07%, differences found in the PTB incidence rate by sex since in women decreased by 5.52% and in man increase by 3.62%. The pulmonary TB with HIV incidence rate decreased by 16.3% during the study period (In women increase 4.81% and in man decrease 21.6%. Analysis of PTB associated with HIV by age groups revealed that the highest incidence rates were observed for the 30 to 44 years old group. Meanwhile, the highest incidence rates of PTB without HIV occurred among the 60 and more years old individuals. We did not find statistically significant differences between treatment failure and PTB patients with HIV and without HIV. The treatment failure was associated with sex and the region of the patient. We found a strong association between HIV and the probability of dying during treatment. Our data suggested that patients suffering from both conditions (PTB and HIV have no difference in the probability of failure of treatment contrary to other reports. Hypotheses to this is adherence to tuberculosis treatment with people living with HIV

  4. Association of Pulmonary Tuberculosis and HIV in the Mexican Institute of Social Security, 2006-2014.

    Science.gov (United States)

    Cabrera-Gaytán, David Alejandro; Niebla-Fuentes, María Del Rosario; Padilla-Velázquez, Rosario; Valle-Alvarado, Gabriel; Arriaga-Nieto, Lumumba; Rojas-Mendoza, Teresita; Rosado-Quiab, Ulises; Grajales-Muñiz, Concepción; Vallejos-Parás, Alfonso

    2016-01-01

    Tuberculosis and HIV remain a public health problem in developed countries. The objective of this study was to analyze the incidence trends of pulmonary TB and HIV comorbidity and treatment outcomes according to HIV during the period 2006 to 2014 in the Mexican Institute of Social Security. Analyzed data from this registry including pulmonary tuberculosis patients aged 15 years and older who had been diagnosed during the years 2006 to 2014 in the Mexican Institute of Social Security. The outcomes that we use were incidents rate, failure to treatment and death. Regression models were used to quantify associations between pulmonary tuberculosis and HIV mortality. During the study period, 31,352 patients were registered with pulmonary tuberculosis. The incidence rate observed during 2014 was 11.6 case of PTB per 100,000. The incidence rate for PTB and HIV was 0.345 per 100,000. The PTB incidence rate decreased by 0.07%, differences found in the PTB incidence rate by sex since in women decreased by 5.52% and in man increase by 3.62%. The pulmonary TB with HIV incidence rate decreased by 16.3% during the study period (In women increase 4.81% and in man decrease 21.6%). Analysis of PTB associated with HIV by age groups revealed that the highest incidence rates were observed for the 30 to 44 years old group. Meanwhile, the highest incidence rates of PTB without HIV occurred among the 60 and more years old individuals. We did not find statistically significant differences between treatment failure and PTB patients with HIV and without HIV. The treatment failure was associated with sex and the region of the patient. We found a strong association between HIV and the probability of dying during treatment. Our data suggested that patients suffering from both conditions (PTB and HIV) have no difference in the probability of failure of treatment contrary to other reports. Hypotheses to this is adherence to tuberculosis treatment with people living with HIV/AIDS, detection of PTB

  5. Immune reconstitution inflammatory syndrome in HIV and sporotrichosis coinfection: report of two cases and review of the literature

    Directory of Open Access Journals (Sweden)

    Marcelo Rosandiski Lyra

    2014-12-01

    Full Text Available We report 2 cases of patients with immune reconstitution inflammatory syndrome (IRIS associated with cutaneous disseminated sporotrichosis and human immunodeficiency virus (HIV coinfection. The patients received specific treatment for sporotrichosis. However, after 4 and 5 weeks from the beginning of antiretroviral therapy, both patients experienced clinical exacerbation of skin lesions despite increased T CD4+ cells (T cells cluster of differentiation 4 positive count and decreased viral load. Despite this exacerbation, subsequent mycological examination after systemic corticosteroid administration did not reveal fungal growth. Accordingly, they were diagnosed with IRIS. However, the sudden withdrawal of the corticosteroids resulted in the recurrence of IRIS symptoms. No serious adverse effects could be attributed to prednisone. We recommend corticosteroid treatment for mild-to-moderate cases of IRIS in sporotrichosis and HIV coinfection with close follow-up.

  6. Immune reconstitution inflammatory syndrome in HIV and sporotrichosis coinfection: report of two cases and review of the literature.

    Science.gov (United States)

    Lyra, Marcelo Rosandiski; Nascimento, Maria Letícia Fernandes Oliveira; Varon, Andréa Gina; Pimentel, Maria Inês Fernandes; Antonio, Liliane de Fátima; Saheki, Maurício Naoto; Bedoya-Pacheco, Sandro Javier; Valle, Antonio Carlos Francesconi do

    2014-01-01

    We report 2 cases of patients with immune reconstitution inflammatory syndrome (IRIS) associated with cutaneous disseminated sporotrichosis and human immunodeficiency virus (HIV) coinfection. The patients received specific treatment for sporotrichosis. However, after 4 and 5 weeks from the beginning of antiretroviral therapy, both patients experienced clinical exacerbation of skin lesions despite increased T CD4+ cells (T cells cluster of differentiation 4 positive) count and decreased viral load. Despite this exacerbation, subsequent mycological examination after systemic corticosteroid administration did not reveal fungal growth. Accordingly, they were diagnosed with IRIS. However, the sudden withdrawal of the corticosteroids resulted in the recurrence of IRIS symptoms. No serious adverse effects could be attributed to prednisone. We recommend corticosteroid treatment for mild-to-moderate cases of IRIS in sporotrichosis and HIV coinfection with close follow-up.

  7. Changes in indinavir exposure over time : a case study in six HIV-1-infected children

    NARCIS (Netherlands)

    Fraaij, PLA; Bergshoeff, AS; van Rossum, AMC; Hartwig, NG; Burger, DM; de Groot, R

    2003-01-01

    Objective: To study changes in indinavir exposure over time in HIV-1-infected children. Materials and methods: Protease inhibitor (PI)-naive HIV-1-infected children were treated with indinavir, zidovudine and lamivudine. Steady-state plasma pharmacokinetic (PK) sampling was carried out as standard

  8. Gender Issues in STIs/HIV/AIDS Prevention and Control: The Case ...

    African Journals Online (AJOL)

    Commercial sex workers are the second target group benefiting from special programmes designed to address their particular needs in STIs/HIV/AIDS prevention and control. By targeting male workers and commercial sex workers, the agencies have failed to address married women's issues in STIs/HIV/AIDS prevention ...

  9. Students Talk about Their HIV/AIDS Education Courses: A Case of Addis Ababa, Ethiopia

    Science.gov (United States)

    Sambe, Mariam M.

    2015-01-01

    The objective of this research was to explore how Ethiopian high school students experienced the HIV/AIDS education programs offered in their schools. The project also examined gender differences in the way HIV/AIDS education was perceived and the implications for the instructional design of the programs. A total of 15 high school students (eight…

  10. HIV/AIDS prisoners: a case study on quality of life in Roumieh ...

    African Journals Online (AJOL)

    Prisons often lack the basic health services required by HIV/AIDS patients. As with many other chronic illnesses, the treatment of HIV is expensive in terms of medication, hygiene, testing and staff training. Strategies to combat the disease have been thoroughly developed, particularly in Europe (WHO/UNAIDS, 2006).

  11. Case Report:False-negative HIV-1 polymerase chain reaction in a ...

    African Journals Online (AJOL)

    Polymerase chain reaction (PCR) testing is the gold standard for determining the HIV status in children <18 months of age. However, when clinical manifestations are not consistent with laboratory results, additional investigation is required. We report a 15-month-old HIV-exposed boy referred to our hospital after he had ...

  12. Chronic genital ulcer disease with subsequent development of methicillin-resistant Staphylococcus aureus (MRSA urethritis and bacteraemia in an HIV-seropositive person – a case observation

    Directory of Open Access Journals (Sweden)

    Christine Katusiime

    2012-03-01

    Full Text Available HIV-seropositive persons are at increased risk of methicillin-resistant Staphylococcus aureus (MRSA. Genital ulcerative disease and sexually transmitted infection with subsequent MRSA infection in HIV-seropositive persons have been documented only once. We report a case of a 44-year-old man who presented to the Infectious Diseases Institute, Kampala, Uganda, with chronic genital ulcer disease and who subsequently developed MRSA urethritis and bacteraemia. This case also demonstrates that persistent genital ulcer disease in HIV-seropositive persons may be as a result of concurrent MRSA infection.

  13. Retroviral rebound syndrome after treatment discontinuation in a 15 year old girl with HIV attracted through mother-to-child transmission: case report

    OpenAIRE

    Gisslén Magnus; Friman Vanda

    2007-01-01

    Abstract A case of a 15 year old girl with retroviral rebound syndrome after discontinuation of highly active antiretroviral treatment (HAART) due to side effects is presented. The patient was transmitted with HIV at birth by her mother. She had recovered from severe AIDS after HAART was initiated five years earlier. This is the first case reported in the literature of retroviral rebound syndrome in a vertically transmitted HIV-infected patient.

  14. Task shifting of HIV/AIDS case management to Community Health Service Centers in urban China: a qualitative policy analysis.

    Science.gov (United States)

    Ma, Fuchang; Lv, Fan; Xu, Peng; Zhang, Dapeng; Meng, Sining; Ju, Lahong; Jiang, Huihui; Ma, Liping; Sun, Jiangping; Wu, Zunyou

    2015-07-02

    The growing number of people living with HIV/AIDS (PLWHA) in China points to an increased need for case management services of HIV/AIDS. This study sought to explore the challenges and enablers in shifting the HIV/AIDS case management services from Centers for Disease Control and Prevention (CDCs) to Community Health Service Centers (CHSCs) in urban China. A qualitative method based on the Health Policy Triangle (HPT) framework was employed to gain in-depth insights into four elements of the task shifting strategy. This included a review on published literature and health policy documents, 15 focus group discussions (FGDs) and 30 in-depth interviews (IDIs) with four types of key actors from three cities in China. A total of 78 studies and 17 policy files at the national, municipal and local levels were obtained and reviewed comprehensively. Three semi-structured interview guides were used to explore key actors' views on shifting the HIV/AIDS case management services to CHSCs. It is necessary and feasible for CHSCs to engage in case management services for PLWHA in local communities. The increasing number of PLWHA and shortage of qualified health professionals in CDCs made shifting case management services downwards to CHSCs an urgent agenda. CHSCs' wide distribution, technical capacity, accessibility and current practice enabled them to carry out case management services for PLWHA. However our findings indicated several challenges in this task shifting process. Those challenges included lack of specific policy and stable financial support for CHSCs, inadequate manpower, relatively low capacity for health service delivery, lack of coordination among sectors, PLWHA's fear for discrimination and privacy disclosure in local communities, which may compromise the effectiveness and sustainability of those services. Shifting the HIV/AIDS case management services from CDCs to CHSCs is a new approach to cope with the rising number of PLWHA in China, but it should be

  15. Pulmonary cystic disease in HIV positive individuals in the Democratic Republic of Congo: three case reports

    Directory of Open Access Journals (Sweden)

    Callens Steven FJ

    2007-09-01

    Full Text Available Abstract Pulmonary emphysema and bronchiectasis in HIV seropositive patients has been described in the presence of injection drug use, malnutrition, repeated opportunistic infections, such as Pneumocytis jirovici pneumonia and Mycobacterium tuberculosis infection, and has been linked to the presence of HIV virus in lung tissue. Given the high burden of pulmonary infections and malnutrition among people living with HIV in resource poor settings, these individuals may be at increased risk of developing pulmonary emphysema, potentially reducing the long term benefit of antiretroviral therapy (ART if initiated late in the course of HIV infection. In this report, we describe three HIV-infected individuals (one woman and two children presenting with extensive pulmonary cystic disease.

  16. Ocular involvement in an HIV-infected patient: not always an infectious disease. An interesting case without apparent cause.

    Science.gov (United States)

    Mozzo, Elena; Donà, Daniele; Zannin, Maria Elisabetta; Giaquinto, Carlo; Rampon, Osvalda

    2016-10-01

    We describe the case of a young girl with vertically-transmitted HIV infection who presented with chronic ocular inflammation characterized by several relapses and remissions. Good viral and immunological status made infective or neoplastic causes unlikely; the diagnosis was challenging and finally spontaneous remission was observed after several months. Clinical and histopathological findings made idiopathic orbital inflammatory syndrome the most probable diagnosis for our patient. © The Author(s) 2016.

  17. Impact of HIV/AIDS to the tourism sector human resources: Case of selected hotels in Harare

    Directory of Open Access Journals (Sweden)

    Zengeni, D.M.F.

    2013-12-01

    Full Text Available The study investigated the impacts of HIV/AIDS on human resources in the tourism sector in Zimbabwe’s capital city, Harare. Harare Hotels were used as a case study establishing how HIV/AIDS affects the workforce in the tourism sector and the consequent effects on service delivery. Visitors’ inflows into Zimbabwe have declined since the year 2000. To understand the reasons and related aspects, data was collected by way of questionnaires which were administered to 9 human resources managers and 9 marketing managers from hotels in Harare during the period of 2008 and 2009. These questionnaires were individually distributed and collected which resulted in 100% return rate. Human resources managers were used because they are involved directly with the social welfare of employees and marketing managers were used because they work in customer care and analyse service delivery. The findings of the study were that HIV/AIDS impact negatively to the hotel sector through deaths of skilled members. This was said to consequently leading to the reduction in service delivery and inconsistence in service delivery. Besides losing skilled members through death it was also discovered that the hotels were now moving HIV/AIDS effected victims to the back of the house to minimise their contact with guests. It was also discovered that hotels were using lot of funds to implement mitigation measures.

  18. Risk Factor Associated with Negative Spouse HIV Seroconversion among Sero-Different Couples: A Nested Case-Control Retrospective Survey Study in 30 Counties in Rural China.

    Directory of Open Access Journals (Sweden)

    Houlin Tang

    Full Text Available Antiretroviral therapy (ART and condom use have been proven to reduce the risk of sexual transmission of human immunodeficiency virus (HIV among HIV sero-different couples, but its full implementation remains a challenge. This study aims to assess HIV seroconversion rate of HIV-negative spouse and its associated risk factors among HIV sero-different couples in rural China.An open cohort of HIV sero-different couples enrolled in 30 counties in China between October 1, 2010, and September 30, 2012, and followed-up to December 31, 2012, was constructed retrospectively. A nested case-control study of risk factors of HIV seroconversion among sero-different couples was conducted in April and May of 2013, based on the open cohort. Sero-different couples with the HIV-negative spouse seroconverting at least 3 months after the previous negative diagnosis during cohort observation period were labeled as "case couples". The "control couples" were selected randomly from the same cohort that did not have the HIV-negative spouse seroconversion during the same period. The "case couples" and "control couples" were matched on gender, age, and region of residence. Sexual behaviors among HIV sero-different couples before and after the index spouses notifying their HIV infection status to their HIV-negative spouses were collected via face-to-face interview. Univariate and multivariate logistic regression models were used to assess factors associated with HIV seroconversion among HIV sero-different couples.Of 4481 HIV sero-different couples, a total of 53 seroconversions were observed within 5218 person-years of follow-up. The incidence rate was 1.02 (95%CI: 0.76-1.33 per 100 person-years. Forty "case couples" confirmed HIV-negative spouse seroconversions infected via marital sexual transmission, were matched to 80 "control couples". Of the 120 couples, 81(67.5% were receiving ART, and 70 (58.3% reported consistently used condoms during intercourse after the index

  19. Risk Factor Associated with Negative Spouse HIV Seroconversion among Sero-Different Couples: A Nested Case-Control Retrospective Survey Study in 30 Counties in Rural China.

    Science.gov (United States)

    Tang, Houlin; Wu, Zunyou; Mao, Yurong; Cepeda, Javier; Morano, Jamie

    2016-01-01

    Antiretroviral therapy (ART) and condom use have been proven to reduce the risk of sexual transmission of human immunodeficiency virus (HIV) among HIV sero-different couples, but its full implementation remains a challenge. This study aims to assess HIV seroconversion rate of HIV-negative spouse and its associated risk factors among HIV sero-different couples in rural China. An open cohort of HIV sero-different couples enrolled in 30 counties in China between October 1, 2010, and September 30, 2012, and followed-up to December 31, 2012, was constructed retrospectively. A nested case-control study of risk factors of HIV seroconversion among sero-different couples was conducted in April and May of 2013, based on the open cohort. Sero-different couples with the HIV-negative spouse seroconverting at least 3 months after the previous negative diagnosis during cohort observation period were labeled as "case couples". The "control couples" were selected randomly from the same cohort that did not have the HIV-negative spouse seroconversion during the same period. The "case couples" and "control couples" were matched on gender, age, and region of residence. Sexual behaviors among HIV sero-different couples before and after the index spouses notifying their HIV infection status to their HIV-negative spouses were collected via face-to-face interview. Univariate and multivariate logistic regression models were used to assess factors associated with HIV seroconversion among HIV sero-different couples. Of 4481 HIV sero-different couples, a total of 53 seroconversions were observed within 5218 person-years of follow-up. The incidence rate was 1.02 (95%CI: 0.76-1.33) per 100 person-years. Forty "case couples" confirmed HIV-negative spouse seroconversions infected via marital sexual transmission, were matched to 80 "control couples". Of the 120 couples, 81(67.5%) were receiving ART, and 70 (58.3%) reported consistently used condoms during intercourse after the index spouse was

  20. Factors associated with late Human Immunodeficiency Virus (HIV) diagnosis among peoples living with it, Northwest Ethiopia: hospital based unmatched case-control study.

    Science.gov (United States)

    Aniley, Abebayehu Bitew; Ayele, Tadesse Awoke; Zeleke, Ejigu Gebeye; Kassa, Assefa Andargie

    2016-10-12

    Early HIV diagnosis and access to treatment is one of the most effective ways to prevent its further spread and to protect the health of those living with the virus. However, delay in diagnosis is the major risk factor for uptake of and response to antiretroviral therapy. Institution-based unmatched case-control study design was used in the study. The study was conducted in Debre-Markos and Finote-Selam Hospitals, Northwest Ethiopia. Cases were people living with HIV who had CD4 count study as World Health Organization recommended. A total of 392 respondents (196 cases and 196 controls) were recruited and selected systematically. The data were collected by trained nurses using chart review and interviewer administered structured questionnaire. Binary Logistic Regression Model was used to identify the factors associated with late HIV diagnosis. About 95.9 % of study participants provided complete response. Having no understanding, compared to having understanding, about HIV/AIDS (AOR = 1.7, 95 %CI = 1.08-2.79) and ART (AOR = 2.1, 95 %CI: 1.25-3.72), being tested as a result of symptoms/ illness, compared to being tested for risk exposure (inverted AOR =2.5, 95 %CI: 1.64-4.76), and acquiring HIV through sexual contact, compared to acquiring it through other modes (AOR = 2.5, 95 %CI = 1.52-4.76) were positively and independently associated with late HIV diagnosis. Unlike perceived HIV stigma, having no understanding about HIV and ART, being tested for presence of symptoms/illness, and acquiring HIV through sexual contact were independent and significant factors for late HIV diagnosis.

  1. Lymphogranuloma venereum among patients presenting at the HIV/STI clinic in Antwerp, Belgium : a case series.

    Science.gov (United States)

    Apers, Ludwig; Florence, Eric; Crucitti, Tania; Anwar, Nabila

    2017-01-01

    Objective of this study was to describe the patient characteristics and clinical presentation of laboratory confirmed lymphogranuloma venereum (LGV) cases, diagnosed at the Institute of Tropical Medicine (ITM), Antwerp, Belgium. Demographic and biomedical characteristics of all patients with chlamydia-positive sample results were retrieved for the years 2013 and 2014. Samples were obtained from both symptomatic and asymptomatic patients who consulted at the HIV/STI clinic. Fifty four patients with laboratory confirmed LGV were detected among 3885 nucleic acid amplification tests (NAATs) performed for the detection of chlamydia during the two years under review. Fifty three were men and equally fifty three had sex with men only (MSM). HIV (87%) and HCV (31.5%) were common concomitant infections, whilst anal gonorrhoea and syphilis were detected at the moment of the LGV diagnosis among 19 (35.2%) and 6 (11.0%) cases respectively. All cases were symptomatic, except one. The most frequent symptoms that were recorded could be categorised as proctitis (in 40 patients (74%)). Lymphadenopathy, anal and genital ulcers were signs that were present in 7 (13.0%), 4 (7.4%) and 2 patients (3.7%) respectively. LGV remains an important sexually transmitted disease among MSM. In this retrospective study, the far majority of LGV was detected amongst symptomatic persons. HCV, HIV, anal gonorrhoea and syphilis were associated co-infections. Proctitis in a high risk patient should alert the clinician for the possibility of an STI. © Acta Gastro-Enterologica Belgica.

  2. Hello! Are You Registered?

    Science.gov (United States)

    Institute for Political/Legal Education, Sewell, NJ.

    Organizational procedures and appropriate forms for high school students to conduct a community survey of non-registered voters are provided. Duties for student coordinator, field staff, and clerical staff are described and a flow chart depicts the relationship of personnel to one another and to the community. Students are instructed to notify…

  3. EU Transparency Register

    NARCIS (Netherlands)

    Mańko, R.; Thiel, M.; Bauer, E.

    2014-01-01

    Widespread lobbying in the EU institutions has led to criticism regarding the transparency and accountability of the EU's decision-making process. In response to these concerns, the Parliament set up its transparency register in 1995, followed by the Commission in 2008. The two institutions merged

  4. The Danish heart register

    DEFF Research Database (Denmark)

    Abildstrøm, Steen Z; Madsen, Mette

    2011-01-01

    Introduction: The Danish Heart Register (DHR) is a clinical database of invasive procedures within cardiology. Content: All providers of these procedures have been obliged to report to DHR since 2000. DHR is used to monitor the activity and quality of the procedures and serves as a data source...

  5. Register for Suicide Attempts

    DEFF Research Database (Denmark)

    Christiansen, Erik; Jensen, Børge Frank

    2004-01-01

    The Register for Suicide Attempts (RSA) is a product of the WHO research project "WHO/Euro Multicentre Study on Parasuicide", which, among other things, had the purpose of collecting data on suicide attempts from 13 European countries. Data is collected in order to calculate trends and identify...

  6. Dideoxynucleoside HIV reverse transcriptase inhibitors and drug-related hepatotoxicity: a case report

    Directory of Open Access Journals (Sweden)

    Lapadula Giuseppe

    2007-05-01

    Full Text Available Abstract This report regards the case of a 43 year-old HIV-positive woman who developed an episode of serious transaminase elevation during stavudine-including antiretroviral therapy. Diagnostic assessment ruled out hepatitis virus co-infection, alcohol abuse besides other possible causes of liver damage. No signs of lactic acidosis were present. Liver biopsy showed portal inflammatory infiltrate, spotty necrosis, vacuoles of macro- and micro-vesicular steatosis, acidophil and foamy hepatocytes degeneration with organelles clumping, poorly formed Mallory bodies and neutrophil granulocytes attraction (satellitosis. A dramatic improvement in liver function tests occurred when stavudine was discontinued and a new antiretroviral regimen with different nucleoside reverse transcriptase inhibitors was used. The importance of considering hepatotoxicity as an adverse event of HAART including stavudine, even in absence of other signs of mitochondrial toxicity should therefore be underlined. Liver biopsy may provide further important information regarding patients with severe transaminase elevation, for a better understanding of the etiology of liver damage.

  7. Clinical manifestations and treatment outcomes of syphilitic uveitis in HIV-negative patients in China: A retrospective case study.

    Science.gov (United States)

    Zhu, Jiang; Jiang, Yuan; Shi, Yewen; Zheng, Bo; Xu, Zhiguo; Jia, Wei

    2017-10-01

    Syphilitic chorioretinitis should be included in differential diagnosis of any form of ocular inflammation. A significantly higher proportion of human immunodeficiency virus (HIV)-positive patients with ocular syphilis as compared to HIV-negative cases have been reported in published studies. However, the clinical signs and symptoms are more insidious in HIV-negative patients who are easily misdiagnosed. We report a series of cases of ocular syphilis and describe the clinical manifestations and treatment outcomes of syphilitic chorioretinitis in HIV-negative patients in China.This was a retrospective case series study. The clinical records of patients with syphilis chorioretinitis were reviewed. Demographic information and findings of fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA), and spectral domain optical coherence tomography (SD-OCT) were analyzed. All patients received the standard treatment. Ophthalmology examination and laboratory evaluation were repeated every 3 months. All changes were recorded. The treatment was considered successful if the patients had no inflammation in both eyes and rapid plasma reagin titer was negative after therapy.The study examined 41 eyes of 28 HIV-negative patients. The main complaints were blurry vision, floaters, and visual field defect. Twenty-seven eyes presented with panuveitis, and all had posterior involvement, including uveitis, vasculitis, chorioretinitis, and optic neuritis. The most common manifestations were uveitis and retinal vasculitis. Disc hyperfluorescence and persistent dark spots were the most common findings on FFA and ICGA. The ill-defined inner segment/outer segment junction was the most frequent manifestation on SD-OCT. Patients were diagnosed with syphilitic uveitis based on positive serological tests. Best-corrected visual acuity (BCVA) was improved in 34 eyes after treatment. Eleven patients were misdiagnosed before serological tests were performed. The delay in treatment

  8. Related or not? Development of spontaneous Creutzfeldt-Jakob disease in a patient with chronic, well-controlled HIV: A case report and review of the literature.

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    Babi, M-Alain; Kraft, Bryan D; Sengupta, Sweta; Peterson, Haley; Orgel, Ryan; Wegermann, Zachary; Lugogo, Njira L; Luedke, Matthew W

    2016-01-01

    We report a novel case of a rare disease: spontaneous Creutzfeldt-Jakob disease in a patient with well-controlled HIV. We explore the relationship between spontaneous Creutzfeldt-Jakob disease and HIV. A 66-year-old man with long-standing, well-controlled HIV infection presented with 3 months of progressive, subacute neurocognitive decline. His symptoms included conceptual apraxia, apathy, memory impairment, and gait disturbance, and were initially attributed to depressive "pseudo-dementia." Unfortunately, the patient's symptoms rapidly progressed and he ultimately succumbed to his illness. Autopsy confirmed the clinical diagnosis of spontaneous Creutzfeldt-Jakob disease. This case highlights spontaneous Creutzfeldt-Jakob disease as a rare terminal illness in the setting of well-controlled chronic HIV. To our knowledge, this is the first report of a patient with chronic and previously well-controlled HIV infection dying from a prion disease. Despite the very different epidemiology and pathophysiology of HIV and spontaneous Creutzfeldt-Jakob disease, this case does raise questions of whether certain host genetic factors could predispose to both conditions, albeit currently, there is no clear causal link between HIV and spontaneous Creutzfeldt-Jakob disease.

  9. ETHICS OF MANDATORY PREMARITAL HIV TESTING IN AFRICA: THE CASE OF GOMA, DEMOCRATIC REPUBLIC OF CONGO

    Science.gov (United States)

    RENNIE, STUART; MUPENDA, BAVON

    2015-01-01

    Despite decades of prevention efforts, millions of persons worldwide continue to become infected by the human immunodeficiency virus (HIV) every year. This urgent problem of global epidemic control has recently lead to significant changes in HIV testing policies. Provider-initiated approaches to HIV testing have been embraced by the Centers for Disease Control and Prevention and the World Health Organization, such as those that routinely inform persons that they will be tested for HIV unless they explicitly refuse (‘opt out’). While these policies appear to increase uptake of testing, they raise a number of ethical concerns that have been debated in journals and at international AIDS conferences. However, one special form of ‘provider-initiated’ testing is being practiced and promoted in various parts of the world, and has advocates within international health agencies, but has received little attention in the bioethical literature: mandatory premarital HIV testing. This article analyses some of the key ethical issues related to mandatory premarital HIV testing in resource-poor settings with generalized HIV epidemics. We will first briefly mention some mandatory HIV premarital testing proposals, policies and practices worldwide, and offer a number of conceptual and factual distinctions to help distinguish different types of mandatory testing policies. Using premarital testing in Goma (Democratic Republic of Congo) as a point of departure, we will use influential public health ethics principles to evaluate different forms of mandatory testing. We conclude by making concrete recommendations concerning the place of mandatory premarital testing in the struggle against HIV/AIDS. PMID:19143089

  10. TB-HIV co-infection among pregnant women in Karnataka, South India: A case series.

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    Suresh, Shastri; Sharath, Burugina N; Anita, Shet; Lalitha, Ravindra; Prasad, Tripathy J; Rewari, Bharat B

    2016-01-01

    Tuberculosis (TB) is a significant contributor to mortality in HIV-infected patients. Concurrent TB infection is also a significant contributing factor to maternal mortality in human immunodeficiency virus (HIV)-infected pregnant women. Studies addressing the outcomes of TB and HIV co-infection among pregnant women are generally infrequent. Although limited, the records maintained by the Revised National Tuberculosis Control Programme (RNTCP) and the National AIDS Control Programme (NACP) in Karnataka State, Southern India provide information about the numbers of pregnant women who are co-infected with TB and HIV and their pregnancy outcomes. We reviewed the data and conducted this study to understand how TB-HIV co-infection influences the outcomes of pregnancy in this setting. We sought to determine the incidence and treatment and delivery outcomes of TB-HIV co-infected pregnant women in programmatic settings in Karnataka State in southern India. The study participants were all the HIV-infected pregnant women who were screened for tuberculosis under the NACP from 2008 to 2012. For the purposes of this study, the program staff in the field gathered the data regarding on treatment and delivery outcomes of pregnant women. A total of seventeen pregnant women with TB-HIV co-infection were identified among 3,165,729 pregnant women (for an incidence of 5.4 per million pregnancies). The median age of these pregnant women was 24 years, and majority were primiparous women with WHO HIV stage III disease and were on a stavudine-based ART regimen. The maternal mortality rates were 18% before delivery and 24% after delivery. The abortion rate was 24%, and the neonatal mortality rate was 10%. The anti-tuberculosis treatment and anti-retroviral treatment outcome mortality rates were 30% and 53%, respectively. Although the incidence of TB among the HIV-infected pregnant women was marginally less than that among the non-HIV-infected women, the delivery outcomes were relatively

  11. Tracking Global Fund HIV/AIDS resources used for sexual and reproductive health service integration: case study from Ethiopia.

    Science.gov (United States)

    Mookherji, Sangeeta; Ski, Samantha; Huntington, Dale

    2015-05-27

    The Global Fund to Fight AIDS, Tuberculosis & Malaria (GF) strives for high value for money, encouraging countries to integrate synergistic services and systems strengthening to maximize investments. The GF needs to show how, and how much, its grants support more than just HIV/AIDS, TB and malaria. Sexual and Reproductive Health (SRH) has been part of HIV/AIDS grants since 2007. Previous studies showed the GF PBF system does not allow resource tracking for SRH integration within HIV/AIDS grants. We present findings from a resource tracking case study using primary data collected at country level. Ethiopia was the study site. We reviewed data from four HIV/AIDS grants from January 2009-June 2011 and categorized SDAs and activities as directly, indirectly, or not related to SRH integration. Data included: GF PBF data; financial, performance, in-depth interview and facility observation data from Ethiopia. All HIV/AIDS grants in Ethiopia support SRH integration activities (12-100%). Using activities within SDAs, expenditures directly supporting SRH integration increased from 25% to 66% for the largest HIV/AIDS grant, and from 21% to 34% for the smaller PMTCT-focused grant. Using SDAs to categorize expenditures underestimated direct investments in SRH integration; activity-based categorization is more accurate. The important finding is that primary data collection could not resolve the limitations in using GF GPR data for resource tracking. The remedy is to require existing activity-based budgets and expenditure reports as part of PBF reporting requirements, and make them available in the grant portfolio database. The GF should do this quickly, as it is a serious shortfall in the GF guiding principle of transparency. Showing high value for money is important for maximizing impact and replenishments. The Global Fund should routinely track HIV/AIDs grant expenditures to disease control, service integration, and overall health systems strengthening. The current PBF system

  12. De novo anaplastic Kaposi sarcoma in a HIV-negative man: A case report and review of the literature

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    Slim Charfi

    2017-07-01

    Full Text Available Anaplastic Kaposi sarcoma is a rare variant of Kaposi’s and is typically associated with an agressive clinical course. We report a case of a 67-year-old HIV negative man, presented with multiple, pink nodules on the left ankle and a keratotic lesion of the right heel. Initial histopathological exam concluded to an undifferentiated sarcoma. A second biopsy was performed and concluded to an anaplastic Kaposi sarcoma. Immunohistochemical study was positive for HHV8. Treatment consisted on a tumor excision of all lesions. Our case and the review of the literature highlight the benefit of the non conservative surgical treatment for this aggressive form of Kaposi sarcoma.

  13. Converging risk factors but no association between HIV infection and multidrug-resistant tuberculosis in Kazakhstan.

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    van den Hof, S; Tursynbayeva, A; Abildaev, T; Adenov, M; Pak, S; Bekembayeva, G; Ismailov, S

    2013-04-01

    Kazakhstan is a country with a low HIV/AIDS (human immunodeficiency virus/acquired immune-deficiency syndrome) burden, but a high prevalence of multidrug-resistant tuberculosis (MDR-TB). We describe the epidemiology of multidrug resistance and HIV among TB patients, using the 2007-2011 national electronic TB register. HIV test results were available for 97.2% of TB patients. HIV prevalence among TB patients increased from 0.6% in 2007 to 1.5% in 2011. Overall, 41.6% of patients had a positive smear at diagnosis, 38.6% a positive culture and 51.7% either a positive smear or culture. Drug susceptibility testing (DST) results were available for 92.7% of culture-positive cases. Socio-economic factors independently associated with both HIV and MDR-TB were urban residency, drug use, homelessness and a history of incarceration. In adjusted analysis, HIV positivity was not associated with MDR-TB (OR 1.0, 95%CI 0.86-1.2). Overall, among TB patients with DST and HIV test results available, 65.0% were positive for neither HIV nor MDR-TB, 33.5% only for MDR-TB, 0.9% only for HIV and 0.6% for both HIV and MDR-TB. Among injection drug users, 12.5% were positive for HIV and MDR-TB. We showed increasing HIV prevalence among TB patients in Kazakhstan. HIV was not an independent risk factor for MDR-TB, but risk factors were largely overlapping and we did identify subgroups at particular risk of HIV-MDR-TB co-infection, notably drug users. Enhanced efforts are necessary to provide care to these socially vulnerable populations.

  14. Electronic vending machines for dispensing rapid HIV self-testing kits: a case study.

    Science.gov (United States)

    Young, Sean D; Klausner, Jeffrey; Fynn, Risa; Bolan, Robert

    2014-02-01

    This short report evaluates the feasibility of using electronic vending machines for dispensing oral, fluid, rapid HIV self-testing kits in Los Angeles County. Feasibility criteria that needed to be addressed were defined as: (1) ability to find a manufacturer who would allow dispensing of HIV testing kits and could fit them to the dimensions of a vending machine, (2) ability to identify and address potential initial obstacles, trade-offs in choosing a machine location, and (3) ability to gain community approval for implementing this approach in a community setting. To address these issues, we contracted a vending machine company who could supply a customized, Internet-enabled machine that could dispense HIV kits and partnered with a local health center available to host the machine onsite and provide counseling to participants, if needed. Vending machines appear to be feasible technologies that can be used to distribute HIV testing kits.

  15. HIV/AIDS and access to water: A case study of home-based care in Ngamiland, Botswana

    Science.gov (United States)

    Ngwenya, B. N.; Kgathi, D. L.

    This case study investigates access to potable water in HIV/AIDS related home-based care households in five rural communities in Ngamiland, Botswana. Primary data collected from five villages consisted of two parts. The first survey collected household data on demographic and rural livelihood features and impacts of HIV/AIDS. A total of 129 households were selected using a two-stage stratified random sampling method. In the second survey, a total of 39 family primary and community care givers of continuously ill, bed-ridden or non-bed-ridden HIV/AIDS patients were interviewed. A detailed questionnaire, with closed and open-ended questions, was used to collect household data. In addition to using the questionnaire, data were also collected through participant observation, informal interviews and secondary sources. The study revealed that there are several sources of water for communities in Ngamiland such as off-plot, outdoor (communal) and on-plot outdoor and/or indoor (private) water connections, as well as other sources such as bowsed water, well-points, boreholes and open perennial/ephemeral water from river channels and pans. There was a serious problem of unreliable water supply caused by, among other things, the breakdown of diesel-powered water pumps, high frequency of HIV/AIDS related absenteeism, and the failure of timely delivery of diesel fuel. Some villages experienced chronic supply disruptions while others experienced seasonal or occasional water shortages. Strategies for coping with unreliability of water supply included economizing on water, reserve storage, buying water, and collection from river/dug wells or other alternative sources such as rain harvesting tanks in government institutions. The unreliability of water supply resulted in an increase in the use of water of poor quality and other practices of poor hygiene as well as a high opportunity cost of water collection. In such instances, bathing of patients was cut from twice daily to once or

  16. Chylous ascites and chylothorax due to constrictive pericarditis in a patient infected with HIV: a case report

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    Summachiwakij Sarawut

    2012-06-01

    Full Text Available Abstract Introduction Chylothorax and chylous ascites are uncommon and usually associated with trauma or neoplasms. To the best of our knowledge, constrictive pericarditis leading to chylothorax and chylous ascites in a person infected with HIV has never previously been described. Case presentation A 39-year-old Thai man was referred to our institute with progressive dyspnea, edema and abdominal distension. His medical history included HIV infection and pulmonary tuberculosis that was complicated by tuberculous pericarditis and cardiac tamponade. Upon further investigation, we found constrictive pericarditis, chylothorax and chylous ascites. A pericardiectomy was performed which resulted in gradual resolution of the ascites and chylous effusion. Conclusions Although constrictive pericarditis is an exceptionally rare cause of chylothorax and chylous ascites, it should nonetheless be considered in the differential diagnosis as a potentially reversible cause.

  17. How funding structures for HIV/AIDS research shape outputs and utilization: a Swiss case study.

    Science.gov (United States)

    Frey, Kathrin; Kübler, Daniel

    2011-09-27

    Research policy in the field of HIV has changed substantially in recent decades in Switzerland. Until 2004, social science research on HIV/AIDS was funded by specialized funding agencies. After 2004, funding of such research was "normalized" and integrated into the Swiss National Science Foundation as the main funding agency for scientific research in Switzerland. This paper offers a longitudinal analysis of the relationship between the changing nature of funding structures on the one hand and the production and communication of policy-relevant scientific knowledge in the field of HIV on the other hand. The analysis relies on an inventory of all social sciences research projects on HIV in Switzerland that were funded between 1987 and 2010, including topics covered and disciplines involved, as well as financial data. In addition, in-depth interviews were conducted with 18 stakeholders. The analysis highlights that the pre-2004 funding policy ensured good coverage of important social science research themes. Specific incentives and explicit promotion of social science research related to HIV gave rise to a multidisciplinary, integrative and health-oriented approach. The abolition of a specific funding policy in 2004 was paralleled by a drastic reduction in the number of social science research projects submitted for funding, and a decline of public money dedicated to such research. Although the public administration in charge of HIV policy still acknowledges the relevance of findings from social sciences for the development of prevention, treatment and care, HIV-related social science research does not flourish under current funding conditions. The Swiss experience sheds light on the difficulties of sustaining social science research and multidisciplinary approaches related to HIV without specialized funding agencies. Future funding policy might not necessarily require specialized agencies, but should better take into account research dynamics and motivations in the

  18. Joint modeling of correlated binary outcomes: The case of contraceptive use and HIV knowledge in Bangladesh.

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    Di Fang

    Full Text Available Recent advances in statistical methods enable the study of correlation among outcomes through joint modeling, thereby addressing spillover effects. By joint modeling, we refer to simultaneously analyzing two or more different response variables emanating from the same individual. Using the 2011 Bangladesh Demographic and Health Survey, we jointly address spillover effects between contraceptive use (CUC and knowledge of HIV and other sexually transmitted diseases. Jointly modeling these two outcomes is appropriate because certain types of contraceptive use contribute to the prevention of HIV and STDs and the knowledge and awareness of HIV and STDs typically lead to protection during sexual intercourse. In particular, we compared the differences as they pertained to the interpretive advantage of modeling the spillover effects of joint modeling HIV and CUC as opposed to addressing them separately. We also identified risk factors that determine contraceptive use and knowledge of HIV and STDs among women in Bangladesh. We found that by jointly modeling the correlation between HIV knowledge and contraceptive use, the importance of education decreased. The HIV prevention program had a spillover effect on CUC: what seemed to be impacted by education can be partially contributed to one's exposure to HIV knowledge. The joint model revealed a less significant impact of covariates as opposed to both separate models and standard models. Additionally, we found a spillover effect that would have otherwise been undiscovered if we did not jointly model. These findings further suggested that the simultaneous impact of correlated outcomes can be adequately addressed for the commonality between different responses and deflate, which is otherwise overestimated when examined separately.

  19. Understanding the urban-rural disparity in HIV and poverty nexus: the case of Kenya.

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    Magadi, Monica A

    2017-09-01

    The relationship between HIV and poverty is complex and recent studies reveal an urban-rural divide that is not well understood. This paper examines the urban-rural disparity in the relationship between poverty and HIV infection in Kenya, with particular reference to possible explanations relating to social cohesion/capital and other moderating factors. Multilevel logistic regression models are applied to nationally-representative samples of 13 094 men and women of reproductive age from recent Kenya Demographic and Health Surveys. The results confirm a disproportionate higher risk of HIV infection among the urban poor, despite a general negative association between poverty and HIV infection among rural residents. Estimates of intra-community correlations suggest lower social cohesion in urban than rural communities. This, combined with marked socio-economic inequalities in urban areas is likely to result in the urban poor being particularly vulnerable. The results further reveal interesting cultural variations and trends. In particular, recent declines in HIV prevalence among urban residents in Kenya have been predominantly confined to those of higher socio-economic status. With current rapid urbanization patterns and increasing urban poverty, these trends have important implications for the future of the HIV epidemic in Kenya and similar settings across the sub-Saharan Africa region. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  20. [Situation and reasons for missed follow-up services among newly reported HIV/AIDS cases transmitted by homosexual behavior in China, 2008-2015].

    Science.gov (United States)

    Xu, J; Han, J; Tang, H L; Li, J; Zang, C P; Mao, Y R

    2018-04-10

    Objective: To determine the prevalence and relative factors on those who missed the follow-up service among newly reported HIV/AIDS cases that were infected by homosexual behavior. Methods: Data were extracted from both HIV/AIDS case-reporting and follow-up cards on HIV/AIDS in the Comprehensive Response Information Management System, between December 2008 and December 2015. Data was analyzed, using the generalized estimating equations (GEE) to explore the relative factors of influence. Results: Among the newly reported HIV infection among MSM, the proportion of those who missed the follow-up services was 5.06% (6 037/119 358), and decreased dramatically, from 37.57% (1 261/3 356) to 0.84% (267/31 935) (trend χ (2)=103.43, P discovered MSM HIV cases declined dramatically. Among the MSM HIV cases, those having the following characteristics as: younger than 50-year old, with less school education, with unspecified occupation or unemployment, working in commercial service, being student, having history of incarceration, recruited from special investigation, and floating population were prone to miss the follow-up program, suggesting that the follow-up service should be targeting on these patients.

  1. KSHV/HHV-8 associated lymph node based lymphomas in HIV seronegative subjects. Case report and review of the literature

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    Quyen Nguyen, MD

    2016-12-01

    Full Text Available Extracavitary primary effusion lymphoma (ExPEL is a rare, high-grade lymphoproliferative disorder that displays immunoblastic, plasmablastic, or anaplastic morphology. It usually lacks expression of B-cell and T-cell markers, but often expresses the plasma cell markers CD138 and MUM1, and the activation marker CD30, along with EMA. ExPEL, similar to classic PEL occurring as lymphomatous effusions in serous body cavities without an associated tumor mass, is consistently associated with human herpes virus-8 (HHV8 infection, while a majority of cases also exhibits Epstein–Barr virus (EBV co-infection. Clinically, it is characterized by an almost exclusive male predominance (98% male, HIV-positivity (96% of patients are HIV+, acute presentation with B symptoms, and unfavorable overall survival (40% of patients die within 2 months. We report an asymptomatic HIV-negative female patient with incidentally found splenomegaly and extensive PET FDG-avid retroperitoneal, pelvic, and mediastinal lymphadenopathy. A core biopsy of her right pelvic lymph node showed aggregates of atypical cells with anaplastic features. Immunohistochemistry revealed that the neoplastic cells were positive for CD45, CD20, CD30, MUM1, CD138, EMA, CD3, HHV-8 and EBER. The diagnosis of ExPEL was established. Against medical advice and given the absence of significant symptoms, the patient refused to start treatment. Four months after the diagnosis, the patient remains asymptomatic, and follow-up CT scan demonstrates stability of her lymphadenopathy. We present here a case of ExPEL in which the patient's presentation defies the clinical norms, illustrating that ExPEL should also be included in the differential diagnosis of lymphomas occurring in asymptomatic HIV-negative patients.

  2. A case of lupus-like glomerulonephritis in an HIV patient with nephrotic range proteinuria, purpura, and elevated IgA level.

    Science.gov (United States)

    Yang, Jihyun; Seo, Min Young; Kim, Ki Tae; Lee, Jun Yong; Kim, Sun-Chul; Kim, Myung-Gyu; Jo, Sang-Kyung; Cho, Won-Yong; Kim, Hyoung-Kyu; Won, Nam Hee; Cha, Ran-Hui; Cho, Eunjung

    2014-01-01

    Human immunodeficiency virus (HIV) infection is growing medical concern worldwide. There are many types of glomerulonephritis which are associated with HIV infection. We report a case of a 53-year-old Korean man with an HIV infection, who was developed nephritic range proteinuria and purpura with elevated IgA level rasing a possibility of Henoch-Schölein Purpura (H-S purpura). However, renal biopsy showed "lupus-like feature" glomerulonephritis without clinical or serologic evidence of systemic lupus erythematosus. Although baseline renal function was maintained without further need for maintenance dialysis following anti-retroviral therapy (ART) and steroid, patient died from uncontrolled gastrointestinal bleeding.

  3. Chancre of the eyelid as manifestation of primary syphilis, and precocious chorioretinitis and uveitis in an HIV-infected patient: a case report

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    Cillino Salvatore

    2012-09-01

    Full Text Available Abstract Background Ocular syphilis is often difficult to diagnose because of the wide variation in clinical features. HIV co-infection may further complicate the picture. Case presentation Herein the authors report an unusual primary syphilitic ocular lesion in a 45-year-old Italian HIV-infected bisexual man who presented with a unilateral eyelid lesion. Associated precocious signs and symptoms in the posterior segment of both eyes, bilateral chorioretinitis and uveitis, are described. Intravenous penicillin and steroid treatment produced a rapid improvement in clinical status and complete resolution. Conclusions Careful questioning about sexual behavior is crucial for unmasking unusual features of ocular syphilis in HIV-infected subjects.

  4. [Kidney transplantation in HIV positive patients: two case reports from Hospital de Clínicas de Porto Alegre initial experience].

    Science.gov (United States)

    Spuldaro, Fábio; Ribeiro, Adriana Reginato; Vicari, Alessandra Rosa; Denicol, Nancy Tamara; Dini, Leonardo Infantini; dos Santos, Emanuel Burck; Pegas, Karla Laís; Gonçalves, Luiz Felipe Santos; Manfro, Roberto Ceratti

    2012-01-01

    Recently kidney transplantation has become an accepted treatment modality for the treatment of HIV infected patients with end-stage renal diseases. For such treatment it is required stability of clinical and laboratory parameters related to HIV infection and the use of highly active antiretroviral therapy. In this report we present the first two cases in Brazil of patients with HIV infection transplanted with organs from deceased donors performed successfully in our institution. The interactions between immunosuppressive and antiretroviral drugs, the co-infections, cardiovascular risk profile and the high incidence of acute rejection remain the major problems to be dealt with in these patients.

  5. HIV Antibody Test

    Science.gov (United States)

    ... 65 in the case of the USPSTF) and pregnant women be screened for HIV at least once. The CDC and American College ... to make sure she is not infected with HIV before getting pregnant may opt to get tested (see Pregnancy: HIV .) ...

  6. A Comparative study of Personality as a common pathway in HIV Sero-positive and Alcohol dependent cases on Five Factor Model

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    Kalpana Srivastava

    2016-01-01

    Full Text Available Aim: The aim of this study was to identify the personality traits of alcohol and human immunodeficiency virus (HIV-positive patients and to compare them with normal controls. Materials and Methods: This cross-sectional study included 100 consecutive patients with alcohol dependence and HIV each and a control group of 100 normal cases without any physical or psychiatric illness. A score of 2 or less on the General Health Questionnaire was taken as cutoff, and the participants were included in the study with written informed consent. All participants were assessed with the NEO personality inventory revised and sensation-seeking scale (SSS. Results: There were significant differences among the study group on all the five factors, i.e., neuroticism (N, extraversion (E, conscientiousness (C, openness to experience (O, and agreeableness (A. On factor “N,” HIV and alcohol group scored significantly more as compared to normal group. Odds ratio revealed high neuroticism to be a risk factor in alcohol-dependent and HIV cases (P < 0.05. The normal group scored significantly higher on factor “E” as compared to HIV and alcohol cases. High scores on factor “E” and “C” have a protective. Odds ratio found low score of factor “C” as a risk factor; however, “O” did not emerge as a risk factor. The logistic regression revealed that high scores on “N” and “E” and low “A” score had a significant association with alcohol dependence (P < 0.05. Among HIV cases, high score on “N” and “E” and low “C” score emerged significant. Alcohol cases scored significantly more on boredom susceptibility (BS on SSS as compared to HIV and normal controls. On disinhibition (DIS, HIV cases and alcohol cases scored significantly higher as compared to normal group (P < 0.05. Conclusion: High “N” scores on NEO personality inventory are significantly associated with alcohol dependence and HIV while high scores on “E” and “C” have a

  7. Beneficial effects of physical activity in an HIV-infected woman with lipodystrophy: a case report

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    de Oliveira Leandro

    2011-09-01

    Full Text Available Abstract Introduction Lipodystrophy is common in patients infected with human immunodeficiency virus receiving highly active antiretroviral therapy, and presents with morphologic changes and metabolic alterations that are associated with depressive behavior and reduced quality of life. We examined the effects of exercise training on morphological changes, lipid profile and quality of life in a woman with human immunodeficiency virus presenting with lipodystrophy. Case presentation A 31-year-old Latin-American Caucasian woman infected with human immunodeficiency virus participated in a 12-week progressive resistance exercise training program with an aerobic component. Her weight, height, skinfold thickness, body circumferences, femur and humerus diameter, blood lipid profile, maximal oxygen uptake volume, exercise duration, strength and quality of life were assessed pre-exercise and post-exercise training. After 12 weeks, she exhibited reductions in her total subcutaneous fat (18.5%, central subcutaneous fat (21.0%, peripheral subcutaneous fat (10.7%, waist circumference (WC (4.5%, triglycerides (9.9%, total cholesterol (12.0% and low-density lipoprotein cholesterol (8.6%. She had increased body mass (4.6%, body mass index (4.37%, humerus and femur diameter (3.0% and 2.3%, respectively, high-density lipoprotein cholesterol (16.7%, maximal oxygen uptake volume (33.3%, exercise duration (37.5% and strength (65.5%. Quality of life measures improved mainly for psychological and physical measures, independence and social relationships. Conclusions These findings suggest that supervised progressive resistance exercise training is a safe and effective treatment for evolving morphologic and metabolic disorders in adults infected with HIV receiving highly active antiretroviral therapy, and improves their quality of life.

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

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    Bianca Barone

    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.

  9. A case-control study of HIV infection and cancer in the era of antiretroviral therapy in Rwanda.

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    Mpunga, Tharcisse; Znaor, Ariana; Uwizeye, F Regis; Uwase, Aline; Munyanshongore, Cyprien; Franceschi, Silvia; Clifford, Gary M

    2018-04-16

    The aim of this study was to assess the association between HIV infection and cancer risk in Rwanda approximately a decade after the introduction of antiretroviral therapy (cART). All persons seeking cancer care at Butaro Cancer Center of Excellence (BCCOE) in Rwanda from 2012 to 2016 were routinely screened for HIV, prior to being confirmed with or without cancer (cases and controls, respectively). Cases were coded according to ICD-O-3 and converted to ICD10. Associations between individual cancer types and HIV were estimated using adjusted unconditional logistic regression. 2,656 cases and 1,196 controls differed by gender (80.3% vs. 70.8% female), age (mean 45.5 vs. 37.7 years), place of residence and proportion of diagnoses made by histopathology (87.5% vs. 67.4%). After adjustment for these variables, HIV was significantly associated with Kaposi Sarcoma (n = 60; OR = 110.3, 95%CI 46.8-259.6), non-Hodgkin lymphoma (NHL) (n = 265; OR = 2.5, 1.4-4.6), Hodgkin lymphoma (HL) (n = 76; OR = 5.2, 2.3-11.6) and cancers of the cervix (n = 560; OR = 5.9, 3.8-9.2), vulva (n = 23; OR = 17.8, 6.3-50.1), penis (n = 29; OR = 8.3, 2.5-27.4) and eye (n = 17; OR = 4.7, 1.0-25.0). Associations varied by NHL/HL subtype, with that for NHL being limited to DLBCL (n = 56; OR = 6.6, 3.1-14.1), particularly plasmablastic lymphoma (n = 6, OR = 106, 12.1-921). No significant associations were seen with other commonly diagnosed cancers, including female breast cancer (n = 559), head and neck (n = 116) and colorectal cancer (n = 106). In conclusion, in the era of cART in Rwanda, HIV is associated with increased risk of a range of infection-related cancers, and accounts for an important fraction of cancers presenting to a referral hospital. © 2018 International Agency for Research on Cancer (IARC/WHO); licensed by UICC.

  10. Regulation of oxidative stress in response to acute aerobic and resistance exercise in HIV-infected subjects: a case-control study.

    Science.gov (United States)

    Deresz, L F; Sprinz, E; Kramer, A S; Cunha, G; de Oliveira, A R; Sporleder, H; de Freitas, D R J; Lazzarotto, A R; Dall'Ago, P

    2010-11-01

    Human immunodeficiency virus (HIV)-infected subjects have increased levels of oxidative stress which could impair immunological function and therefore contribute to the progression of AIDS. These characteristics are usually evaluated at rest and responses to exercise have yet to be evaluated. The aim of the present study was to assess the effect of a bout of aerobic exercise followed by resistance exercises on antioxidant system in HIV-infected and non-HIV subjects. There were included 14 cases (HIV-positive) and 14 controls (HIV-negative). The exercise protocol consisted of a single session of 20 minutes on a cycloergometer followed by a set of six resistance exercises. The activity of glutathione S-transferase (GST) and catalase were measured in plasma samples, total glutathione (TGSH) and thiobarbituric acid reactive substances (TBARS) were measured in erythrocytes. T CD4+ cells, T CD8+, viral load, complete blood count, and white blood count were also assessed. All measurements were performed at three times: baseline, after aerobic exercise, and after resistance exercises. At baseline, the HIV group had lower GST activity than controls, but after the exercise session GST values were similar in both groups. Compared to the control group TGSH was significantly lower in the HIV group at baseline, after aerobic and resistance exercises. The control group presented higher TBARS values after aerobic exercise compared to the HIV group. The neutrophil count was lower in the HIV group after aerobic and resistance exercises. These data indicate that HIV-infected subjects had lower antioxidant activity at rest. Physical exercise stimulated the enzymatic activity similarly in both groups.

  11. Malnutrition is associated with HIV infection in children less than 5 years in Bobo-Dioulasso City, Burkina Faso: A case-control study.

    Science.gov (United States)

    Poda, Ghislain Gnimbar; Hsu, Chien-Yeh; Chao, Jane C-J

    2017-05-01

    Pediatric human immunodeficiency virus (HIV) infection and malnutrition are still 2 major health issues in sub-Saharan Africa including Burkina Faso where few studies have been conducted on child malnutrition and HIV infection. This study assessed the effects of antiretroviral therapy (ART) in HIV infection and also compared the prevalence of malnutrition in terms of an inadequate diet, underweight, stunting, and wasting among HIV-infected and uninfected children less than 5 years in Bobo-Dioulasso city, Burkina Faso.This was a case-control study matching for age and sex in 164 HIV-infected and 164 HIV-uninfected children. The sociodemographic characteristics of mothers and children, household food security, drinking water source, child feeding and care practices, and child anthropometric data such as body weight, height, and mid-upper arm circumference were collected.The prevalence of food insecurity and inadequate diet was 58% and 92% of children less than 5 years of age, respectively. The prevalence of underweight, stunting, and wasting was 77% versus 35%, 65% versus 61%, and 63% versus 26% in HIV-infected and uninfected children less than 5 years of age, respectively. Out of 164 HIV-infected children, 59% were on ART initiation during data collection and the median of CD4 cell counts was 1078 cells/μL. HIV-infected children on ART had greater CD4 cell counts (P = .04) and higher weight-for-age Z (P = .01) and weight-for-height Z scores (P = .03) than those without ART. HIV infection was a risk factor for those who had inadequate dietary intake [adjusted odds ratio (AOR) = 2.17, 95% confidence interval (CI) 1.17-3.62, P = .04]. In addition, HIV-infected children were more likely of being underweight (AOR = 10.24, 95% CI 4.34-24.17, P children less than 5 years of age.High prevalence of malnutrition was observed in HIV-infected children compared with HIV-uninfected children. Except for ART, nutritional assessment and support should be

  12. Register-based studies of cardiovascular disease

    DEFF Research Database (Denmark)

    Abildstrøm, Steen Z; Torp-Pedersen, Christian; Madsen, Mette

    2011-01-01

    Introduction: The use of the unique personal identification number in the Nordic database systems enables the researchers to link the registers at the individual level. The registers can be used for both defining specific patient populations and to identify later events during follow-up. This rev...... the hospitalisation rate and treatment of cardiovascular disease. The risk of unmeasured factors affecting the results calls for cautious interpretation of the results.......-up. This review gives three examples within cardiovascular epidemiology to illustrate the use of the national administrative registers available to all researchers upon request. Research topics: The hospitalisation rate of acute myocardial infarction (AMI) was expected to be increased and case-fatality rate......-based treatment increased significantly over time and adherence to treatment was high. Finally, use of specific nonsteroidal antiinflammatory drugs by healthy subjects was associated with a dose-dependent increase in cardiovascular risk. CONCLUSION: The nationwide registers have proven very useful in monitoring...

  13. Temporal analysis of reported cases of tuberculosis and of tuberculosis-HIV co-infection in Brazil between 2002 and 2012

    Directory of Open Access Journals (Sweden)

    Renato Simões Gaspar

    Full Text Available ABSTRACT Objective: To investigate the reported cases of tuberculosis and of tuberculosis-HIV co-infection in Brazil between 2002 and 2012. Methods: This was an observational study based on secondary time series data collected from the Brazilian Case Registry Database for the 2002-2012 period. The incidence of tuberculosis was stratified by gender, age group, geographical region, and outcome, as was that of tuberculosis-HIV co-infection. Results: Nationally, the incidence of tuberculosis declined by 18%, whereas that of tuberculosis-HIV co-infection increased by 3.8%. There was an overall decrease in the incidence of tuberculosis, despite a significant increase in that of tuberculosis-HIV co-infection in women. The incidence of tuberculosis decreased only in the 0- to 9-year age bracket, remaining stable or increasing in the other age groups. The incidence of tuberculosis-HIV co-infection increased by 209% in the ≥ 60-year age bracket. The incidence of tuberculosis decreased in all geographical regions except the south, whereas that of tuberculosis-HIV co-infection increased by over 150% in the north and northeast. Regarding the outcomes, patients with tuberculosis-HIV co-infection, in comparison with patients infected with tuberculosis only, had a 48% lower chance of cure, a 50% greater risk of treatment nonadherence, and a 94% greater risk of death from tuberculosis. Conclusions: Our study shows that tuberculosis continues to be a relevant public health issue in Brazil, because the goals for the control and cure of the disease have yet to be achieved. In addition, the sharp increase in the incidence of tuberculosis-HIV co-infection in women, in the elderly, and in the northern/northeastern region reveals that the population of HIV-infected individuals is rapidly becoming more female, older, and more impoverished.

  14. Protecting young women from HIV/AIDS: the case against child and adolescent marriage.

    Science.gov (United States)

    Clark, Shelley; Bruce, Judith; Dude, Annie

    2006-06-01

    In most developing countries, the majority of sexually active female adolescents are married. Although married adolescents are often assumed to be at low risk for HIV infection, little is known about the actual HIV risks these adolescents face or about ways to minimize these risks. Demographic and Health Survey data from 29 countries in Africa and Latin America were used to examine the frequency of factors that may increase HIV risk in married women aged 15-19. Several behavioral and social factors may increase the vulnerability of married female adolescents to HIV infection. First, these young women engage in frequent unprotected sex: In most countries, more than 80% of adolescents who had had unprotected sex during the previous week were married. Second, women who marry young tend to have much older husbands (mean age difference, 5-14 years) and, in polygamous societies, are frequently junior wives, factors that may increase the probability that their husbands are infected and weaken their bargaining power within the marriage. Third, married adolescents have relatively little access to educational and media sources of information about HIV. Finally, the most common AIDS prevention strategies (abstinence, condom use) are not realistic options for many married adolescents. New policies and interventions, tailored to the sexual and behavioral profiles of women in each country, are needed to address the vulnerabilities of adolescent wives. In some countries, delaying age at marriage may be an important strategy; in others, making intercourse within marriage safer may be more valuable.

  15. Register / Andri Ksenofontov

    Index Scriptorium Estoniae

    Ksenofontov, Andri, 1962-

    2007-01-01

    Näitused: Eesti Kujundusgraafikute Liidu aastanäitus "Register 2007" Kunstihoone galeriis, Signe Kivi "Võimuvaibad ja vaimukleidid" Arhitektuuri- ja Disainigaleriis, "Kehaturg / Sex market" (Dagmar Kase, Eveli Variku tööd) Tallinna Kunstihoones, Andrei Maksimjuki "Surematu klassika" Ühispanga galeriis, Katrin Veegeni "Varsti" A-galeriis, Eda Lõhmuse "Ülespoole" ja Rein Kelpmani "Grosso modo" ArtDepoo Galeriis, Jaan Elkeni "Valge valgus" Galeriis 008, Paul Rodgersi "Transplants" Hobusepea galeriis, Masayo Ave "Haptic Interface Design" Arhitektuuri- ja Disainigaleriis ja workshop Eesti Kunstiakadeemias

  16. Registered Replication Report

    DEFF Research Database (Denmark)

    Bouwmeester, S.; Verkoeijen, P. P.J.L.; Aczel, B.

    2017-01-01

    and colleagues. The results of studies using time pressure have been mixed, with some replication attempts observing similar patterns (e.g., Rand et al., 2014) and others observing null effects (e.g., Tinghög et al., 2013; Verkoeijen & Bouwmeester, 2014). This Registered Replication Report (RRR) assessed...... the size and variability of the effect of time pressure on cooperative decisions by combining 21 separate, preregistered replications of the critical conditions from Study 7 of the original article (Rand et al., 2012). The primary planned analysis used data from all participants who were randomly assigned...

  17. The Danish Education Registers

    DEFF Research Database (Denmark)

    Jensen, Vibeke Myrup; Rasmussen, Astrid Würtz

    to adults continuing education and training stem from administrative education reports. Therefore, for cohorts born 1945-1990, 97 percent of the Danish population has a valid education identifier. For the immigrant population born in the same cohorts the coverage is 85-90 percent. Despite a higher level......Collection of systematic information on education is a long established practice in Denmark. Since 1910, the Danish Ministry of Education's annual reports collects information about individual-level test scores in e.g. compulsory schooling. Today, several registers from compulsory schooling...

  18. The Danish Education Registers

    DEFF Research Database (Denmark)

    Jensen, Vibeke Myrup; Würtz Rasmussen, Astrid

    to adults continuing education and training stem from administrative education reports. Therefore, for cohorts born 1945-1990, 97 percent of the Danish population has a valid education identifier. For the immigrant population born in the same cohorts the coverage is 85-90 percent. Despite a higher level......Collection of systematic information on education is a long established practice in Denmark. Since 1910, the Danish Ministry of Education’s annual reports collects information about individual-level test scores in e.g. compulsory schooling. Today, several registers from compulsory schooling...

  19. The Danish Education Registers

    DEFF Research Database (Denmark)

    Jensen, Vibeke Myrup; Rasmussen, Astrid Würtz

    2011-01-01

    Collection of systematic information on education is a long established practice in Denmark. Since 1910, the Danish Ministry of Education’s annual reports collects information about individual-level test scores in e.g. compulsory schooling. Today, several registers from compulsory schooling...... to adults continuing education and training stem from administrative education reports. Therefore, for cohorts born 1945-1990, 97 percent of the Danish population has a valid education identifier. For the immigrant population born in the same cohorts the coverage is 85-90 percent. Despite a higher level...

  20. Factors Associated with Delayed Enrollment in HIV Medical Care among HIV-Positive Individuals in Odessa Region, Ukraine.

    Science.gov (United States)

    Neduzhko, Oleksandr; Postnov, Oleksandr; Perehinets, Ihor; DeHovitz, Jack; Joseph, Michael; Odegaard, David; Kaplan, Robert; Kiriazova, Tetiana

    In Ukraine, about one-third of identified HIV-positive individuals are not connected to care. We conducted a cross-sectional survey (n = 200) among patients registered at Odessa AIDS centers in October to December 2011. Factors associated with delayed enrollment in HIV care (>3 months since positive HIV test) were evaluated using logistic regression. Among study participants (mean age 35 ± 8.2 years, 47.5% female, 42.5% reported history of injecting drugs), 55% delayed HIV care enrollment. Odds of delayed enrollment were higher for those with lower educational attainment (adjusted odds ratio [aOR]: 2.65, 95% confidence interval [CI]: 1.04-6.76), not feeling ill (aOR: 2.98, 95% CI: 1.50-5.93), or not having time to go to the AIDS center (aOR: 3.89, 95% CI: 1.39-10.89); injection drug use was not associated with delayed enrollment. Programs linking HIV-positive individuals to specialized care should address enrollment barriers and include education on HIV care benefits and case management for direct linkage to care. HIV testing and treatment should be coupled to ensure a continuum of care.

  1. Síndrome de Parsonage-Turner: relato de caso em paciente HIV soropositivo Parsonage-Turner Syndrome: case report of a HIV seropositive patient

    Directory of Open Access Journals (Sweden)

    Saulo Gomes de Oliveira

    2010-01-01

    Full Text Available A síndrome de Parsonage-Turner é uma doença rara que acomete a musculatura da cintura escapular levando à hipotrofia muscular e grande déficit motor. A etiologia é indeterminada; acredita-se que existam fatores infecciosos e autoimunes envolvidos. O diagnóstico é de exceção, e os principais diagnósticos diferenciais são hérnias discais cervicais, lesões do manguito rotador e doenças reumáticas. Na investigação diagnóstica realizamos exames laboratoriais, radiografias e ressonância magnética dos ombros e da coluna cervical com destaque para a eletroneuromiografia auxiliando no diagnóstico definitivo. Por se tratar de uma doença raramente associada à soropositividade do vírus HIV e pela importância do diagnóstico precoce para o melhor tratamento destes pacientes é que relatamos este caso.The Parsonage-Turner Syndrome is a rare disease that affects the muscles of the scapular girdle, leading to muscular atrophy and a large motor deficit. The etiology is unknown, but it is believed that infectious and autoimmune factors are involved. The diagnosis is made by exclusion, and the main differential diagnoses are cervical disc hernias, rotator cuff injuries and rheumatic diseases. During diagnostic research, we conducted laboratory tests, radiographs and MRI of the shoulder and cervical spine, with particular reference to electroneuromyography to help generate a definitive diagnosis. This case report is presented because it shows a disease that is rarely associated with HIV seropositivity and the importance of early diagnosis for better treatment of these patients.

  2. PREDNISONE THERAPY SAFETY FOR TREATMENT OF PATIENTS WITH MIX OF TUBERCULOSIS AND HIV-INFECTION

    Directory of Open Access Journals (Sweden)

    G. V. Maksimov

    2013-01-01

    Full Text Available Abstract. The study of prednisone safety for treatment of TB mixed with HIV-infection has been conducted. Two groups of patients were compared. The first group was consisted of 88 patients who were treated by prednisone and standard tuberculosis therapy, the second group of patients presented by 45 patients received only tuberculosis medicines. It was demonstrated that in case of prednisone using (1st group the number of CD4 limphocytes increased, intoxication symptoms disappeared fast and recovery process accelerated. Increasing of cases with unfavorable course of TB and HIV-infection in patients of first group was not registered in compare with the second group. Thus, using of prednisone therapy to treat TB mixed with HIV-infection was safe, not lead to unfavorable course of TB or HIV-infection. Such kind of treatment especially important for patients with exudative reactions.

  3. Epidemiological profile of naive HIV-1/AIDS patients in Istanbul: the largest case series from Turkey.

    Science.gov (United States)

    Yemisen, Mucahit; Aydın, Ozlem Altuntas; Gunduz, Alper; Ozgunes, Nail; Mete, Bilgul; Ceylan, Bahadir; Karaosmanoglu, Hayat Kumbasar; Yildiz, Dilek; Sargin, Fatma; Ozaras, Resat; Tabak, Fehmi

    2014-01-01

    The aim of the study was to report the epidemiological profile of HIV-1 positive patients from, Istanbul, Turkey, which has one of the lowest HIV-1/AIDS prevalences in Europe. The patients were followed by ACTHIV-IST group which was established by the Infectious Diseases Departments of five teaching hospitals (three university hospitals and two public hospitals) in Istanbul, Turkey. The HIV-1 positive patients were added to the standard patient files in all of the centers; these files were then transferred to the ACTHIV-IST database in the Internet. A total of 829 naiv-untreated HIV-1 positive patients were chosen from the database. The number of male patients was 700 (84.4%) and the mean age of the patients was 37 years (range, 17-79). In our study group 348 (42%) of the patients were married and 318 (38.7%) of the patients were single. The probable route of transmission was heterosexual intercourse in 437 (52.7%) patients and homosexual intercourse in 256 (30.9%) patients. In 519 (62.6%) patients the diagnose was made due to a screening test and in 241 (29.1%) patients, the diagnose was made due to an HIV-related/non-related disease. The mean CD4+ T cell number in 788 of the patients was 357.8/mm(3) (±271.1), and the median viral load in 698 of the patients was 100,000 copies/mL (20-9,790,000). In Turkey, the number of HIV-1 positive patients is still low and to diagnose with a screening test is the most common way of diagnostic route.

  4. HIV Case Management Support Service Is Associated with Improved CD4 Counts of Patients Receiving Care at the Antiretroviral Clinic of Pantang Hospital, Ghana

    Directory of Open Access Journals (Sweden)

    Bismark Sarfo

    2017-01-01

    Full Text Available Background. Factors associated with individual patient-level management of HIV have received minimal attention in sub-Saharan Africa. This study determined the association between support services and cluster of differentiation 4 (CD4 counts among HIV patients attending ART clinic in Ghana. Methodology. This was a cross-sectional study involving adults with HIV recruited between 1 August 2014 and 31 January 2015. Data on support services were obtained through a closed-ended personal interview while the CD4 counts data were collected from their medical records. Data were entered into EpiData and analyzed using Stata software. Results. Of the 201 patients who participated in the study, 67% (129/191 received case management support service. Counseling about how to prevent the spread of HIV (crude odds ratio (cOR (95% confidence interval (CI (2.79 (1.17–6.68, mental health services (0.2 (0.04–1.00, and case management support service (2.80 (1.34–5.82 was associated with improved CD4 counts of 350 cells/mm3 or more. After adjusting for counseling about how to prevent the spread of HIV and mental health services, case management support service was significantly associated with CD4 counts of 350 cells/mm3 or more (aOR = 2.36 (CI = 1.01–5.49. Conclusion. Case management support service for HIV patients receiving ART improves their CD4 counts above 350 cells/mm3. Incorporating HIV case management services in ART regimen should be a priority in sub-Saharan Africa.

  5. Occupational HIV Infection in a Research Laboratory With Unknown Mode of Transmission: A Case Report.

    Science.gov (United States)

    Soria, Alessandro; Alteri, Claudia; Scarlatti, Gabriella; Bertoli, Ada; Tolazzi, Monica; Balestra, Emanuela; Bellocchi, Maria Concetta; Continenza, Fabio; Carioti, Luca; Biasin, Mara; Trabattoni, Daria; Bandera, Alessandra; Ceccherini-Silberstein, Francesca; Perno, Carlo Federico; Gori, Andrea

    2017-03-15

    A laboratory worker was infected with human immunodeficiency virus (HIV) type 1 in a biosafety level 2 containment facility, without any apparent breach. Through full-genome sequencing and phylogenetic analyses, we could identify the source of infection in a replication-competent clone that unknowingly contaminated a safe experiment. Mode of transmission remains unclear. Caution is warranted when handling HIV-derived constructs. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

  6. Hearing abilities and analysis in an oralized hearing-impaired child with HIV: a case study

    OpenAIRE

    Bastos, Francine Nolasco; Fleig, Raquel; Nascimento, Iramar Baptistella do

    2009-01-01

    TEMA: habilidades auditivas em criança portadora de Vírus da Imunodeficiência Humana (HIV). PROCEDIMENTOS: se a perda de audição não for detectada precocemente, assim como a sua etiologia, a criança terá muitos prejuízos no desenvolvimento da linguagem. Um fator que vem aumentando os índices de deficiência auditiva é a grande dose de medicamentos que os portadores de Vírus da Imunodeficiência Humana (HIV) devem ingerir para o controle da doença. Durante o processo de desenvolvimento da audiçã...

  7. Universal Verification Methodology Based Register Test Automation Flow.

    Science.gov (United States)

    Woo, Jae Hun; Cho, Yong Kwan; Park, Sun Kyu

    2016-05-01

    In today's SoC design, the number of registers has been increased along with complexity of hardware blocks. Register validation is a time-consuming and error-pron task. Therefore, we need an efficient way to perform verification with less effort in shorter time. In this work, we suggest register test automation flow based UVM (Universal Verification Methodology). UVM provides a standard methodology, called a register model, to facilitate stimulus generation and functional checking of registers. However, it is not easy for designers to create register models for their functional blocks or integrate models in test-bench environment because it requires knowledge of SystemVerilog and UVM libraries. For the creation of register models, many commercial tools support a register model generation from register specification described in IP-XACT, but it is time-consuming to describe register specification in IP-XACT format. For easy creation of register model, we propose spreadsheet-based register template which is translated to IP-XACT description, from which register models can be easily generated using commercial tools. On the other hand, we also automate all the steps involved integrating test-bench and generating test-cases, so that designers may use register model without detailed knowledge of UVM or SystemVerilog. This automation flow involves generating and connecting test-bench components (e.g., driver, checker, bus adaptor, etc.) and writing test sequence for each type of register test-case. With the proposed flow, designers can save considerable amount of time to verify functionality of registers.

  8. A comparison of registered and unregistered female sex workers in Tijuana, Mexico.

    Science.gov (United States)

    Sirotin, Nicole; Strathdee, Steffanie A; Lozada, Remedios; Nguyen, Lucie; Gallardo, Manuel; Vera, Alicia; Patterson, Thomas L

    2010-01-01

    Sex work is regulated in Tijuana, Mexico, but only half of the city's female sex workers (FSWs) are registered with the municipal health department, which requires regular screening for sexually transmitted infections (STIs) and human immunodeficiency virus (HIV). We examined correlates of registration to determine if it confers measurable health benefits. From 2004 to 2006, we interviewed FSWs in Tijuana > or = 18 years of age who reported recent unprotected sex with at least one client and were not knowingly HIV-positive, and tested them for HIV, syphilis, gonorrhea, and chlamydia. Logistic regression identified factors associated with registration. Of 410 FSWs, 44% were registered, 69% had been tested for HIV, 6% were HIV-positive, and 44% tested positive for any STI. Compared with unregistered FSWs, registered FSWs were more likely to have had HIV testing (86% vs. 56%, p $30 per transaction without a condom (AOR = 2.41), whereas working on the street (AOR = 0.34), injecting cocaine (AOR = 0.06), snorting or smoking methamphetamine (AOR = 0.27), and being born in the Mexican state of Baja California (AOR = 0.35) were inversely associated with registration. Registered FSWs were more likely than unregistered FSWs to have had HIV testing and to engage in less drug use, but did not have significantly lower HIV or STI prevalence after adjusting for confounders. Current regulation of FSWs in Tijuana should be further examined to enhance the potential public health benefits of registration.

  9. Community-acquired pneumonia due to Staphylococcus cohnii in an HIV-infected patient: case report and review.

    Science.gov (United States)

    Mastroianni, A; Coronado, O; Nanetti, A; Manfredi, R; Chiodo, F

    1995-10-01

    Coagulase-negative staphylococci recently have been implicated as a cause of serious infections in immunocompromised individuals. An unusual case of community-acquired pneumonia due to Staphylococcus cohnii in an HIV-infected drug user is described. Results of a study conducted to examine the prevalence of infection due to Staphylococcus cohnii strains and their antibiotic-sensitivity patterns show a low frequency but a high morbidity. These results and a brief review of the literature emphasize the importance of these organisms and other staphylococcal species as emerging opportunistic pathogens in patients with AIDS.

  10. The use of HIV post-exposure prophylaxis in forensic medicine following incidents of sexual violence in Hamburg, Germany: a retrospective study.

    Science.gov (United States)

    Ebert, Julia; Sperhake, Jan Peter; Degen, Olaf; Schröder, Ann Sophie

    2018-05-18

    In Hamburg, Germany, the initiation of HIV post-exposure prophylaxis (HIV PEP) in cases of sexual violence is often carried out by forensic medical specialists (FMS) using the city's unique Hamburg Model. FMS-provided three-day HIV PEP starter packs include a combination of raltegravir and emtricitabine/tenofovir. This study aimed to investigate the practice of offering HIV PEP, reasons for discontinuing treatment, patient compliance, and whether or not potential perpetrators were tested for HIV. We conducted a retrospective study of forensic clinical examinations carried out by the Hamburg Department of Legal Medicine following incidents of sexual violence from 2009 to 2016. One thousand two hundred eighteen incidents of sexual violence were reviewed. In 18% of these cases, HIV PEP was initially prescribed by the FMS. HIV PEP indication depended on the examination occurring within 24 h after the incident, no/unknown condom use, the occurrence of ejaculation, the presence of any injury, and the perpetrator being from population at high risk for HIV. Half of the HIV PEP recipients returned for a reevaluation of the HIV PEP indication by an infectious disease specialist, and just 16% completed the full month of treatment. Only 131 potential perpetrators were tested for HIV, with one found to be HIV positive. No HIV seroconversion was registered among the study sample. Provision of HIV PEP by an FMS after sexual assault ensures appropriate and prompt care for victims. However, patient compliance and completion rates are low. HIV testing of perpetrators must be carried out much more rigorously.

  11. Comorbidades entre dependência química, distimia, HIV e HCV: relato de caso Comorbidity between addiction, dysthymia, HIV and HCV: case report

    Directory of Open Access Journals (Sweden)

    Vanessa Fabiane Machado Gomes Marsden

    2009-01-01

    , contribute to mental status deterioration and the treatment for such conditions can cause fluctuations on mood. CASE REPORT: A 40 years old patient with comorbidity between chemical dependence (heroin and alcohol and dysthymia, complicated by relapses, IV drug use and serological status positive to HIV-1 and HCV. CONCLUSION: Addiction patients with psychiatric and infectious comorbidity are challenging to diagnose, treat and define therapeutical approaches to the different conditions. Proper clinical investigation and approach leads to benefits in health quality and potential financial benefits.

  12. The Relationship between Scientific Knowledge and Behaviour: An HIV/AIDS Case

    Science.gov (United States)

    Mnguni, Lindelani; Abrie, Mia; Ebersohn, Liesel

    2016-01-01

    Debates on the role of scientific knowledge to affect behaviour are continuing. The theory of planned behaviour suggests that behaviour is influenced by attitudes, subjective norms and perceived behavioural control and not by knowledge. However, a large body of knowledge argues that increased HIV/AIDS-related knowledge leads to the adoption of…

  13. Case of disclosure of HIV status helps to clarify privacy law in Ontario.

    Science.gov (United States)

    Lang, Renée

    2008-07-01

    A judge in the Ontario Superior Court of Justice has dismissed a breach of privacy suit on the basis that the plaintiff failed to prove that the disclosure of his HIV status had caused him harm. The judgment set out guidelines for how future claims of breach of privacy should be addressed.

  14. HIV testing in community based research: a case study of female ...

    African Journals Online (AJOL)

    Female genital schistosomiasis prevalence found was 10.3%, Trichomonas vaginalis, 2.1%, Candida albicans, 9.6%, Gardnerella vaginalis, 11.8% and HIV 6.6%. The study also showed that, the location of Voluntary Counseling and Testing (VCT) services in rural communities in the Volta Basin were unavailable. The use ...

  15. 'Race' and HIV vulnerability in a transnational context: the case of Chinese immigrants to Canada.

    Science.gov (United States)

    Zhou, Yanqiu Rachel

    2017-06-01

    Although immigrants' sustained connections with their homelands are well documented, so far we know little about how 'race' - in particular, conceptions of race back home - influences the HIV vulnerability of racialised immigrants to Western countries. Drawing on data from a multi-sited, qualitative study of Chinese immigrants to Canada, this paper presents a contextualised understanding of the impacts of race on HIV risk faced by these individuals in a transnational context. Data were collected from four study sites in Canada and China as part of a study investigating the relationship between HIV risk and transnationalism. Although race appears to have bearing on their risk perceptions and sexual practices, immigrants' understandings of race are not necessarily consistent with dominant discourses of race in Canada, but are also mediated by their racial habitus developed in China. Findings reveal the complex power dynamics - not just power asymmetries but also power fluidity - around race from a transnational perspective and thus challenge the assumed dichotomy of dominance and subordination underpinning traditional explanations of the relationship between race and HIV risk. In the context of transnationalism, researchers should go beyond a nation-bound concept of society (i.e. the host society) and take into account the simultaneous influence of both host and home countries on immigrant health.

  16. Vasculopathy in HIV-infected children – a case series | Demopoulos ...

    African Journals Online (AJOL)

    We report on 6 HIV-infected South African children who presented with vasculopathy involving medium and large vessels. Four patients presented with a stroke, one with heart failure and one with gangrene. Five patients had aneurysms and one patient had an occlusion. The arteries of the circle of Willis and the aorta and ...

  17. Social capital and the decline in HIV transmission – A case study in ...

    African Journals Online (AJOL)

    provided social and economic support to members by providing loans. Their strict rules of conduct helped to create new norms, values and trust, important for HIV prevention. Members of different networks ultimately became role models for healthy protective behaviour. Formal organisations also worked together with social ...

  18. Preparing Teachers to Deliver Gender-Focused Sexuality/HIV Education: A Case Study from Nigeria

    Science.gov (United States)

    Wood, Susan Y.; Rogow, Deborah; Stines, Frederica

    2015-01-01

    Evidence shows that a focus on gender and power in sexuality/HIV education increases the likelihood of achieving positive sexual health outcomes, and international agencies have called for a shift to a gender-focused approach. However, questions remain about the implementation of such programmes, including how best to prepare teachers to deliver…

  19. Enrolling HIV-positive adolescents in mental health research: A case ...

    African Journals Online (AJOL)

    HIV-positive adolescents in low- and middle-income countries ... orphaned and did not have legal guardians, 27% were symptomatic for depression, ... N Woollett,1 MA (Psychology, Art Therapy); J Peter,2 SC, BCom, LLB, LLM; .... lifetime physical abuse, 35.5% for lifetime emotional abuse and 9% .... Author contributions.

  20. Soft tissue non-Hodgkin lymphoma of shoulder in a HIV patient: a report of a case and review of the literature

    Directory of Open Access Journals (Sweden)

    Larocca Luigi Maria

    2008-10-01

    Full Text Available Abstract Background The risk of developing lymphoma is greatly increased in HIV infection. Musculoskeletal manifestations of the human immunodeficiency virus (HIV are common and are sometimes the initial presentation of the disease. Muscle, bone, and joints are involved by septic arthritis, myopathies and neoplasms. HIV-related neoplastic processes that affect the musculoskeletal system include Kaposi's sarcoma and non-Hodgkin's lymphoma, the latter being mainly localized at lower extremities, spine and skull. Case presentation The Authors report a case of a 34 year-old lady. In December 2003 the patient noted a painless mass on her right shoulder whose size increased progressively. In March 2004 she was diagnosed HIV positive and contemporary got pregnant. The patient decided to continue her pregnancy and to not undergo any diagnostic procedure and treatment. At the end of August she underwent a surgical ablation of the lesion that revealed a lesion of 7 cm × 7 cm × 3,3 cm. The histology showed B-cells expressing CD20, PAX-5, CD10, BCL-6 and MUM-1 with 70% Ki67 positive nuclei. The lesion was also negative for EBV infection and showed a monoclonal rearrangement of IgH chain and a polyclonal pattern for TCR gamma and beta. A final diagnosis of diffuse large B-cell lymphoma was made. The patient underwent postoperative chemotherapy. At four-years follow up the patient is symptom free and no local nor systemic recurrence of pathology has been noted on MRI control. HIV infection is still under control. Conclusion In this report, we present a case of diffuse large B-cell lymphoma localized in the soft tissue of the shoulder in a HIV infected patient. Authors want to underline this case for the rare position, the big size and the association with HIV infection.

  1. Estimating unbiased economies of scale of HIV prevention projects: a case study of Avahan.

    Science.gov (United States)

    Lépine, Aurélia; Vassall, Anna; Chandrashekar, Sudha; Blanc, Elodie; Le Nestour, Alexis

    2015-04-01

    Governments and donors are investing considerable resources on HIV prevention in order to scale up these services rapidly. Given the current economic climate, providers of HIV prevention services increasingly need to demonstrate that these investments offer good 'value for money'. One of the primary routes to achieve efficiency is to take advantage of economies of scale (a reduction in the average cost of a health service as provision scales-up), yet empirical evidence on economies of scale is scarce. Methodologically, the estimation of economies of scale is hampered by several statistical issues preventing causal inference and thus making the estimation of economies of scale complex. In order to estimate unbiased economies of scale when scaling up HIV prevention services, we apply our analysis to one of the few HIV prevention programmes globally delivered at a large scale: the Indian Avahan initiative. We costed the project by collecting data from the 138 Avahan NGOs and the supporting partners in the first four years of its scale-up, between 2004 and 2007. We develop a parsimonious empirical model and apply a system Generalized Method of Moments (GMM) and fixed-effects Instrumental Variable (IV) estimators to estimate unbiased economies of scale. At the programme level, we find that, after controlling for the endogeneity of scale, the scale-up of Avahan has generated high economies of scale. Our findings suggest that average cost reductions per person reached are achievable when scaling-up HIV prevention in low and middle income countries. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. [Clinico-epidemiological characteristics of HIV-positive immigrants: study of 371 cases].

    Science.gov (United States)

    Llenas-García, Jara; Rubio, Rafael; Hernando, Asunción; Fiorante, Silvana; Maseda, Diego; Matarranz, Mariano; Costa, José Ramón; Alonso, Beatriz; Pulido, Federico

    2012-10-01

    The number of HIV-positive immigrants have increased in Spain in the last few years, and now represent a significant proportion of the epidemic. Our objective is to describe the clinico-epidemiological characteristics of HIV-positive immigrants seen in a specialist unit in Madrid. Retrospective study. Every patient born in a country other than Spain and attended an HIV Unit in Madrid between 1992 and 2009 was included. Of the 371 patients included, 53.1% were Latin Americans, 24.5% Sub-Saharan Africans, and 22.4% others), and 60% were males. Immigrants represented 0.3% of new patients in 1992 and rose to 49.2% in 2009. The principal reason for HIV testing had been pregnancy/delivery among women (32.7%) and having a category-B disease among men (17.4%). Sexual transmission accounted for 92% of patients. Tuberculosis was the principal AIDS-diagnosing illness. Respectively 90%, 7.7%, 60%, 26.7%, 96% and 95% of patients had an IgG for HAV, HCV, Toxoplasma, Treponema, CMV and VZV. VHB-Ags+: 5.4%; PPD+: 17%. At least one syphilis episode was recorded in 62% of the men who have sex with men (MSM). Prevalence of HLA-B5701 was 6%, 0.9% and 3.8% in Caucasians, Amerindians and Afro-Americans, respectively. Immigrants represent a significant proportion of new HIV-positive patients. It is a very heterogeneous group according to their clinical and epidemiological characteristics. Copyright © 2011 Elsevier España, S.L. All rights reserved.

  3. Evolution of hepatitis B serological markers in HIV coinfected patients: a case study

    Directory of Open Access Journals (Sweden)

    Ana Luiza de Castro Conde Toscano

    Full Text Available ABSTRACT OBJECTIVE To describe the evolution of serological markers among HIV and hepatitis B coinfected patients, with emphasis on evaluating the reactivation or seroreversion of these markers. METHODS The study population consisted of patients met in an AIDS Outpatient Clinic in São Paulo State, Brazil. We included in the analysis all HIV-infected and who underwent at least two positive hepatitis B surface antigen serological testing during clinical follow up, with tests taken six months apart. Patients were tested with commercial kits available for hepatitis B serological markers by microparticle enzyme immunoassay. Clinical variables were collected: age, sex, CD4+ T-cell count, HIV viral load, alanine aminotransferase level, exposure to antiretroviral drugs including lamivudine and/or tenofovir. RESULTS Among 2,242 HIV positive patients, we identified 105 (4.7% patients with chronic hepatitis B. Follow up time for these patients varied from six months to 20.5 years. All patients underwent antiretroviral therapy during follow-up. Among patients with chronic hepatitis B, 58% were hepatitis B “e” antigen positive at the first assessment. Clearance of hepatitis B surface antigen occurred in 15% (16/105 of patients with chronic hepatitis B, and 50% (8/16 of these patients presented subsequent reactivation or seroreversion of hepatitis B surface antigen. Among hepatitis B “e” antigen positive patients, 57% (35/61 presented clearance of this serologic marker. During clinical follow up, 28.5% (10/35 of those who initially cleared hepatitis B “e” antigen presented seroreversion or reactivation of this marker. CONCLUSIONS Among HIV coinfected patients under antiretroviral therapy, changes of HBV serological markers were frequently observed. These results suggest that frequent monitoring of these serum markers should be recommended.

  4. Towards a Science of Community Stakeholder Engagement in Biomedical HIV Prevention Trials: An Embedded Four-Country Case Study.

    Science.gov (United States)

    Newman, Peter A; Rubincam, Clara; Slack, Catherine; Essack, Zaynab; Chakrapani, Venkatesan; Chuang, Deng-Min; Tepjan, Suchon; Shunmugam, Murali; Roungprakhon, Surachet; Logie, Carmen; Koen, Jennifer; Lindegger, Graham

    2015-01-01

    Broad international guidelines and studies in the context of individual clinical trials highlight the centrality of community stakeholder engagement in conducting ethically rigorous HIV prevention trials. We explored and identified challenges and facilitators for community stakeholder engagement in biomedical HIV prevention trials in diverse global settings. Our aim was to assess and deepen the empirical foundation for priorities included in the GPP guidelines and to highlight challenges in implementation that may merit further attention in subsequent GPP iterations. From 2008-2012 we conducted an embedded, multiple case study centered in Thailand, India, South Africa and Canada. We conducted in-depth interviews and focus groups with respondents from different trial-related subsystems: civil society organization representatives, community advocates, service providers, clinical trialists/researchers, former trial participants, and key HIV risk populations. Interviews/focus groups were recorded, and coded using thematic content analysis. After intra-case analyses, we conducted cross-case analysis to contrast and synthesize themes and sub-themes across cases. Lastly, we applied the case study findings to explore and assess UNAIDS/AVAC GPP guidelines and the GPP Blueprint for Stakeholder Engagement. Across settings, we identified three cross-cutting themes as essential to community stakeholder engagement: trial literacy, including lexicon challenges and misconceptions that imperil sound communication; mistrust due to historical exploitation; and participatory processes: engaging early; considering the breadth of "community"; and, developing appropriate stakeholder roles. Site-specific challenges arose in resource-limited settings and settings where trials were halted. This multiple case study revealed common themes underlying community stakeholder engagement across four country settings that largely mirror GPP goals and the GPP Blueprint, as well as highlighting

  5. Towards a Science of Community Stakeholder Engagement in Biomedical HIV Prevention Trials: An Embedded Four-Country Case Study

    Science.gov (United States)

    Newman, Peter A.; Rubincam, Clara; Slack, Catherine; Essack, Zaynab; Chakrapani, Venkatesan; Chuang, Deng-Min; Tepjan, Suchon; Shunmugam, Murali; Roungprakhon, Surachet; Logie, Carmen; Koen, Jennifer; Lindegger, Graham

    2015-01-01

    Objectives Broad international guidelines and studies in the context of individual clinical trials highlight the centrality of community stakeholder engagement in conducting ethically rigorous HIV prevention trials. We explored and identified challenges and facilitators for community stakeholder engagement in biomedical HIV prevention trials in diverse global settings. Our aim was to assess and deepen the empirical foundation for priorities included in the GPP guidelines and to highlight challenges in implementation that may merit further attention in subsequent GPP iterations. Methods From 2008–2012 we conducted an embedded, multiple case study centered in Thailand, India, South Africa and Canada. We conducted in-depth interviews and focus groups with respondents from different trial-related subsystems: civil society organization representatives, community advocates, service providers, clinical trialists/researchers, former trial participants, and key HIV risk populations. Interviews/focus groups were recorded, and coded using thematic content analysis. After intra-case analyses, we conducted cross-case analysis to contrast and synthesize themes and sub-themes across cases. Lastly, we applied the case study findings to explore and assess UNAIDS/AVAC GPP guidelines and the GPP Blueprint for Stakeholder Engagement. Results Across settings, we identified three cross-cutting themes as essential to community stakeholder engagement: trial literacy, including lexicon challenges and misconceptions that imperil sound communication; mistrust due to historical exploitation; and participatory processes: engaging early; considering the breadth of “community”; and, developing appropriate stakeholder roles. Site-specific challenges arose in resource-limited settings and settings where trials were halted. Conclusions This multiple case study revealed common themes underlying community stakeholder engagement across four country settings that largely mirror GPP goals and the

  6. Towards a Science of Community Stakeholder Engagement in Biomedical HIV Prevention Trials: An Embedded Four-Country Case Study.

    Directory of Open Access Journals (Sweden)

    Peter A Newman

    Full Text Available Broad international guidelines and studies in the context of individual clinical trials highlight the centrality of community stakeholder engagement in conducting ethically rigorous HIV prevention trials. We explored and identified challenges and facilitators for community stakeholder engagement in biomedical HIV prevention trials in diverse global settings. Our aim was to assess and deepen the empirical foundation for priorities included in the GPP guidelines and to highlight challenges in implementation that may merit further attention in subsequent GPP iterations.From 2008-2012 we conducted an embedded, multiple case study centered in Thailand, India, South Africa and Canada. We conducted in-depth interviews and focus groups with respondents from different trial-related subsystems: civil society organization representatives, community advocates, service providers, clinical trialists/researchers, former trial participants, and key HIV risk populations. Interviews/focus groups were recorded, and coded using thematic content analysis. After intra-case analyses, we conducted cross-case analysis to contrast and synthesize themes and sub-themes across cases. Lastly, we applied the case study findings to explore and assess UNAIDS/AVAC GPP guidelines and the GPP Blueprint for Stakeholder Engagement.Across settings, we identified three cross-cutting themes as essential to community stakeholder engagement: trial literacy, including lexicon challenges and misconceptions that imperil sound communication; mistrust due to historical exploitation; and participatory processes: engaging early; considering the breadth of "community"; and, developing appropriate stakeholder roles. Site-specific challenges arose in resource-limited settings and settings where trials were halted.This multiple case study revealed common themes underlying community stakeholder engagement across four country settings that largely mirror GPP goals and the GPP Blueprint, as well as

  7. Correlation of mental illness and HIV/AIDS infection

    Directory of Open Access Journals (Sweden)

    Anousheh Safarcherati

    2016-01-01

    Full Text Available HIV/AIDS is among the leading causes of morbidity and mortality in world. There are more than 35 million people living with HIV/AIDS in the world. Although the annual incidence of HIV infection is decreasing globally, HIV prevalence is rising due to development of more effective treatment and higher survival. Iran suffers from concentrated HIV epidemics among injecting and non-injecting drug users. There are more than 27 thousand registered cases of HIV infection and it is estimated that there are above seventy eight thousand cases in the country. Regarding the burden of disease, it is projected that HIV/AIDS will have the highest growth during the next 10 years. The outcome of this epidemics will be determined by human behavior. HIV, psychiatric disorders and substance use disorders are closely correlated and are accompanied by similar risk factors. They also share common consequences such as stigma and discrimination. Correlation of psychiatric disorders, as one of the most influential determinants of our behavior, and HIV/AIDS infection is reviewed in this narrative article. Psychiatric disorders are associated with greater risk of HIV acquisition. Substance use disorders, both injecting and non-injecting, as well as severe mental illnesses put the individual at higher risk of acquiring HIV infection. Impaired judgment, diminished inhibition and control over behaviors, lack of insight and poor self-care have been proposed as the underlying mechanisms. On the other hand, HIV infection may put the individual at greater risk of developing a mental illness. Coping with a chronic and life-threatening illness, fear of stigma and discrimination, CNS invasion of the virus as well as the adverse neuropsychiatric side effects of anti-retroviral medications may all contribute to establishment of a psychiatric disorder. Although there exists a bi-directional correlation between mental health problems and HIV/AIDS infection, this reciprocity goes beyond

  8. Factors associated with late Human Immunodeficiency Virus (HIV diagnosis among peoples living with it, Northwest Ethiopia: hospital based unmatched case-control study

    Directory of Open Access Journals (Sweden)

    Abebayehu Bitew Aniley

    2016-10-01

    Full Text Available Abstract Background Early HIV diagnosis and access to treatment is one of the most effective ways to prevent its further spread and to protect the health of those living with the virus. However, delay in diagnosis is the major risk factor for uptake of and response to antiretroviral therapy. Methods Institution-based unmatched case-control study design was used in the study. The study was conducted in Debre-Markos and Finote-Selam Hospitals, Northwest Ethiopia. Cases were people living with HIV who had CD4 count <350cells/mm3 or WHO clinical stage III and IV regardless of the CD4 count at first presentation and controls were those who had CD4 count ≥350cells/mm3 or WHO clinical stage I and II. If both criteria were available, the CD4 count was used in the study as World Health Organization recommended. A total of 392 respondents (196 cases and 196 controls were recruited and selected systematically. The data were collected by trained nurses using chart review and interviewer administered structured questionnaire. Binary Logistic Regression Model was used to identify the factors associated with late HIV diagnosis. Results About 95.9 % of study participants provided complete response. Having no understanding, compared to having understanding, about HIV/AIDS (AOR = 1.7, 95 %CI = 1.08–2.79 and ART (AOR = 2.1, 95 %CI: 1.25–3.72, being tested as a result of symptoms/ illness, compared to being tested for risk exposure (inverted AOR =2.5, 95 %CI: 1.64–4.76, and acquiring HIV through sexual contact, compared to acquiring it through other modes (AOR = 2.5, 95 %CI = 1.52–4.76 were positively and independently associated with late HIV diagnosis. Conclusions Unlike perceived HIV stigma, having no understanding about HIV and ART, being tested for presence of symptoms/illness, and acquiring HIV through sexual contact were independent and significant factors for late HIV diagnosis.

  9. 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.

  10. Controle de polidrâmnio recorrente em gestante portadora do HIV-1: relato de caso Recurrent polyhydramnios management in an HIV-1 infected pregnant woman: a case report

    Directory of Open Access Journals (Sweden)

    Geraldo Duarte

    2004-04-01

    Full Text Available A redução da transmissão vertical (TV do vírus da imunodeficiência humana tipo 1 (HIV-1 utilizando a profilaxia com a zidovudina (AZT representa significativo avanço na assistência pré-natal e obstétrica destas pacientes. Condutas obstétricas invasivas são contra-indicadas em gestantes portadoras do HIV-1, em face do risco de aumento da taxa de TV deste vírus. Os autores relatam um caso de polidrâmnio recorrente em gestante portadora do HIV-1, que exigiu drenagem por amniocentese. Foram realizadas quatro punções ao longo da gestação, na 23ª, 26ª, 27ª e 29ª semanas, todas guiadas por ultra-sonografia, drenando, respectivamente, 1.800, 1.450, 1.700 e 1.960 mL de líquido amniótico claro em cada punção. Com 30 semanas e 5 dias de gestação a paciente apresentou trabalho de parto pré-termo, evoluindo para parto vaginal de recém-nato (RN pesando 1.690 g e medindo 43 cm. O RN evoluiu com diagnóstico de nefropatia perdedora de sódio, tendo três aferições de reação em cadeia de polimerase para HIV-1 negativas. Os autores ilustram uma opção no manejo de situações que envolvam gestantes portadoras do HIV-1 que necessitem de procedimentos obstétricos invasivos, utilizando AZT endovenoso (2 mg/kg previamente ao procedimento, medida que apresentou excelente resultado no caso descrito, evitando a infecção perinatal pelo HIV-1.The reduction of mother-to-child transmission (MTCT of the HIV-1 using zidovudine (ZDV represents a cornerstone in the prenatal and obstetrical care to these patients. The invasive fetal and obstetric procedures are proscribed in HIV-1 infected pregnant patients, to avoid the increased risk of MTCT of this virus. The authors present a case of an HIV-1 infected woman with recurrent polyhydramnios. Four ultrasound-guided amniotic punctures were performed in the 23rd, 26th, 27th and 29th weeks of gestation, each one draining the respective volumes of 1,800, 1,450, 1,700 and 1,960 ml of clear amniotic

  11. Relation among Stakeholders in HIV/AIDS Response Case Study: Palu Municipality

    Directory of Open Access Journals (Sweden)

    Mustika Sari

    2017-06-01

    research results show that the increasing trend of HIV/AIDS found in the Palu Municipality is due to the poorly established relation among stakeholders, be it key stakeholders, primary stakeholders, or secondary stakeholders. In addition to the poor relationship established among stakeholders being observable through a number of negative characteristics seen in their interactional and relational paterns, it was also found that the said relation was influenced by each of the stakeholders’ power and interests.

  12. Outcomes of Expectant Management in HIV-Infected Pregnancy with Preterm Premature Rupture of Membranes at Less Than 34-Week Gestation: A Case Series

    Directory of Open Access Journals (Sweden)

    Nalat Sompagdee, M.D.

    2018-01-01

    Full Text Available Objective: To present outcomes of expectant management (EM in HIV-infected pregnancy with preterm premature rupture of membranes (PPROM at less than 34-week gestation. Case presentation: During January 2008-December 2015, there were 513 HIV-infected pregnant women giving birth at Siriraj Hospital, Thailand. Ten of them presented with PPROM at GA <34 weeks and six women received EM. The deliveries took place at GA 28 2/7 - 33 5/7 weeks. The longest interval of ROM was 15 days and the highest on-admission viral load was 633,000 copies/mL. Three of them had antepartum highly active antiretroviral therapy (HAART for at least four weeks prior to the delivery. Mode of delivery included 3 vaginal deliveries and 3 caesarean sections. All infants’ HIV molecular tests were negative at birth. The longest follow-up interval was 12 months and HIV vertical transmission remained negative. Conclusion: Expectant management in HIV-infected women with PPROM at GA <34 weeks may be sensible because complications of prematurity outweigh the risk of vertical HIV transmission.

  13. A case-control study of non-AIDS-defining cancers in a prospective cohort of HIV-infected patients.

    Science.gov (United States)

    Rodríguez Arrondo, Francisco; von Wichmann, Miguel Ángel; Camino, Xabier; Goenaga, Miguel Ángel; Ibarguren, Maialen; Azcune, Harkaitz; Bustinduy, María Jesús; Ferrero, Oscar; Muñoz, Josefa; Ibarra, Sofía; Aguirrebengoa, Koldo; Goicoetxea, Josune; Bereciartua, Elena; Montejo, Miguel; García, M Asunción; Martínez, Eduardo; Portu, Joseba; Metola, Luis; Silvariño, Rafael; Sarasqueta, Cristina; Arrizabalaga, Julio; Iribarren, Jose Antonio

    2018-04-23

    We present a case-control study of non-AIDS-defining cancers (NADCs) in a cohort of HIV-infected patients where we value the incidence, survival and prognostic factors of mortality. All NADCs diagnosis conducted from 2007 to 2011 in 7 hospitals were collected prospectively, with a subsequent follow up until December 2013. A control group of 221 HIV patients without a diagnosis of cancer was randomly selected. Two hundred and twenty-one NADCs were diagnosed in an initial cohort of 7,067 HIV-infected patients. The most common were: hepatocellular carcinoma 20.5%, lung 18.7%, head and neck 11.9% and anal 10.5%. The incidence rate of NADCs development was 7.84/1,000 people-year. In addition to aging and smoking, time on ART (OR 1.11; 95% CI 1.05-1.17) and PI use (OR 1.72; 95% CI 1.0-2.96) increased the risk of developing a NADC. During follow-up 53.42% died, with a median survival time of 199.5 days. In the analysis of the prognostic factors of mortality the low values of CD4 at tumour diagnosis (OR 0.99; 95% CI 0.99-1.0; P=.033), and the previous diagnosis of AIDS (OR 2.06; 95% CI 1.08-3.92) were associated with higher mortality. Predictors of NADCs in our cohort were age, smoking, CD4 lymphocytes and time on ART. Mortality is high, with NADC risk factors being low CD4 count and previous diagnosis of AIDS. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  14. Primary Effusion Lymphoma without an Effusion: A Rare Case of Solid Extracavitary Variant of Primary Effusion Lymphoma in an HIV-Positive Patient

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    Hamza Hashmi

    2018-01-01

    Full Text Available Primary effusion lymphoma (PEL is a unique form of non-Hodgkin lymphoma, usually seen in severely immunocompromised, HIV-positive patients. PEL is related to human herpesvirus-8 (HHV-8 infection, and it usually presents as a lymphomatous body cavity effusion in the absence of a solid tumor mass. There have been very few case reports of HIV-positive patients with HHV-8-positive solid tissue lymphomas not associated with an effusion (a solid variant of PEL. In the absence of effusion, establishing an accurate diagnosis can be challenging, and a careful review of morphology, immunophenotype, and presence of HHV-8 is necessary to differentiate from other subtypes of non-Hodgkin lymphoma. Treatment involves intensive chemotherapy, and prognosis is usually poor. We present a rare case of a PEL variant in an HIV-positive patient who presented with extensive lymphadenopathy without any associated effusions.

  15. HIV 1065_IN.indd

    African Journals Online (AJOL)

    disease. is case highlights the diagnostic value of lymph node excision biopsy in HIV-infected patients. S Afr J HIV .... illustrated that life expectancy in multicentric ... Schulte KM, Talat N. Castleman's disease: A two compartment model of HHV.

  16. Situational analysis of communication of HIV and AIDS information to persons with visual impairment: a case of Kang'onga Production Centre in Ndola, Zambia.

    Science.gov (United States)

    Chintende, Grace Nsangwe; Sitali, Doreen; Michelo, Charles; Mweemba, Oliver

    2017-04-04

    Despite the increases in health promotion and educational programs on HIV and AIDS, lack of information and communication on HIV and AIDS for the visually impaired persons continues. The underlying factors that create the information and communication gaps have not been fully explored in Zambia. It is therefore important that, this situational analysis on HIV and AIDS information dissemination to persons with visual impairments at Kang'onga Production Centre in Ndola was conducted. The study commenced in December 2014 to May 2015. A qualitative case study design was employed. The study used two focus group discussions with males and females. Each group comprised twelve participants. Eight in-depth interviews involving the visually impaired persons and five key informants working with visually impaired persons were conducted. Data was analysed thematically using NVIVO 8 software. Ethical clearance was sought from Excellency in Research Ethics and Science. Reference Number 2014-May-030. It was established that most visually impaired people lacked knowledge on the cause, transmission and treatment of HIV and AIDS resulting in misconceptions. It was revealed that health promoters and people working with the visually impaired did not have specific HIV and AIDS information programs in Zambia. Further, it was discovered that the media, information education communication and health education were channels through which the visually impaired accessed HIV and AIDS information. Discrimination, stigma, lack of employment opportunities, funding and poverty were among the many challenges identified which the visually impaired persons faced in accessing HIV and AIDS information. Integration of the visually impaired in HIV and AIDS programs would increase funding for economic empowerment and health promotions in order to improve communication on HIV and AIDS information. The study showed that, the visually impaired persons in Zambia are not catered for in the dissemination of HIV

  17. Portable shift register

    International Nuclear Information System (INIS)

    Halbig, J.K.; Bourret, S.C.; Hansen, W.J.; Hicks, D.V.; Klosterbuer, S.F.; Krick, M.S.

    1994-01-01

    An electronics package for a small, battery-operated, self-contained, neutron coincidence counter based on a portable shift-register (PSR) has been developed. The counter was developed for applications not adequately addressed by commercial packages, including in-plant measurements to demonstrate compliance with regulations (domestic and international), in-plant process control, and in-field measurements (environmental monitoring or safeguards). Our package's features, which address these applications, include the following: Small size for portability and ease of installation;battery or mains operation; a built-in battery to power the unit and a typical detector such as a small sample counter, for over 6 h if power lines are bad or noisy, if there is a temporary absence of power, or if portability is desired; complete support, including bias, for standard neutron detectors; a powerful communications package to easily facilitate robust external control over a serial port; and a C-library to simplify creating external control programs in computers or other controllers. Whereas the PSR specifically addresses the applications mentioned above, it also performs all the measurements made by previous electronics packages for neutron coincidence counters developed at Los Alamos and commercialized. The PSR electronics package, exclusive of carrying handle, is 8 by 10 by 20 cm; it contains the circuit boards, battery, and bias supply and weighs less than 2 kg. This instrument package is the second in an emerging family of portable measurement instruments being developed; the first was the Miniature and Modular Multichannel Analyzer (M 3 CA). The PSR makes extensive use of hardware and software developed for the M 3 CA; like the M 3 CA, it is intended primarily for use with an external controller interfaced over a serial channel

  18. Neurotuberculosis immune reconstitution inflammatory syndrome in the setting of HIV infection: A case report and review of literature

    Directory of Open Access Journals (Sweden)

    Deepasree Jaganmohan

    2016-01-01

    Full Text Available Immune reconstitution inflammatory syndrome (IRIS is an exaggerated immune response which can occur with various coinfections in human immunodeficiency virus (HIV infected patients, of which the most commonly implicated in central nervous system (CNS-IRIS are progressive multifocal leukoencephalopathy (PML, cryptococcosis, and tuberculosis (TB. TB-IRIS is a known complication of pulmonary TB or TB lymphadenitis coinfection in HIV infected patients who are on antituberculosis treatment (ATT after the initiation of antiretroviral therapy (ART. However, development of IRIS in extrapulmonary TB such as CNS TB is very rare. Our case is that of an isolated CNS-TB-IRIS, presenting as increase in the size and perilesional edema of the ring enhancing lesions in the brain, which was observed in two sequential magnetic resonance imaging done over a period of 2 months in a retropositive patient who presented with clinical deterioration after commencement of ART. As prompt diagnosis was made and specific management aimed at IRIS was started without delay, the patient improved symptomatically.

  19. Integration of TB-HIV services at an ANC facility in Frances Baard District, Northern Cape, South Africa.

    Science.gov (United States)

    Peters, J A; Heunis, C; Kigozi, G; Osoba, T; van der Walt, M

    2015-03-21

    Integrated tuberculosis-human immunodeficiency virus (TB-HIV) service delivery as part of maternal health services, including antenatal care (ANC), is widely recommended. This study assessed the implementation of collaborative TB-HIV service delivery at a hospital-based ANC service unit. A record review of a random sample of 308 pregnant women attending the ANC service between April 2011 and February 2012 was conducted. Data were extracted from registers and patient case notes. Outcomes included the proportion of women who underwent HIV counselling and testing (HCT), CD4 count testing, antiretroviral treatment (ART), cotrimoxazole preventive treatment (CPT), TB screening and isoniazid preventive treatment (IPT). Analysis measured variations in patient characteristics associated with service delivery. All women underwent HCT; 80% of those who tested HIV-positive were screened for TB. Most (85.9%) of the HIV-positive women received a CD4 count. However, only 12.9% of eligible women received ART prophylaxis onsite, only 35.7% were referred for initiation of ART, only 42.3% commenced IPT and none received CPT or further investigations for TB. HIV-negative women had 2.6 higher odds (95%CI 1.3-5.3) of receiving TB screening than their HIV-positive counterparts. Although the identification of HIV-positive women and TB suspects was adequate, implementation of other TB-HIV collaborative activities was sub-optimal.

  20. Acquisition of wild-type HIV-1 infection in a patient on pre-exposure prophylaxis with high intracellular concentrations of tenofovir diphosphate: a case report.

    NARCIS (Netherlands)

    Hoornenborg, Elske; Prins, Maria; Achterbergh, Roel C A; Woittiez, Lycke R; Cornelissen, Marion; Jurriaans, Suzanne; Kootstra, Neeltje A; Anderson, Peter L; Reiss, Peter; de Vries, Henry J C; Prins, Jan M; de Bree, Godelieve J

    2017-01-01

    Pre-exposure prophylaxis (PrEP) with emtricitabine and tenofovir disoproxil fumarate is highly effective against acquisition of HIV infection, and only two cases of infection with a multidrug-resistant virus have been reported under adequate long-term adherence, as evidenced by tenofovir diphosphate

  1. THE MAIN DIRECTIONS OF ART IN HIV-INFECTED CITIZENS OF THE LEBANESE REPUBLIC

    Directory of Open Access Journals (Sweden)

    Zh. V. Mironenkova

    2017-01-01

    Full Text Available The purpose of the study is the morbidity analysis of HIV infection and procuring of antiretroviral medicines in the Arab countries on the example of the Lebanese Republic. Materials and methods: The research was carried out for the period from 2010 to 2016. The objects were the State Register of Medicines, statistical reporting materials of the Center for AIDS Prevention and Control of the Lebanese Republic. Results. The article analyzes the dynamics of the morbidity of citizens of the Lebanese Republic with HIV infection. The following is shown: the growth rate of the number of newly detected cases of HIV infection relative to the previous period; the number of cases identified by age group, sex, type of sexual orientation, method of infection. The characteristic of the system of procuring HIV-positive citizens with antiretroviral medicines is given. The holders of marketing authorization of these drugs in Russia are indicated. The possibilities of conducting the most cost-effective antiretroviral therapy are shown. Conclusion. There are opportunities in the Lebanese Republic for effective antiretroviral therapy. The availability of HIV treatment is provided through the use of predominantly generic versions of medicines, which reduces the number of new HIV infections and deaths from HIV / AIDS.

  2. Case study: An ethics case study of HIV prevention research on Facebook: the Just/Us study.

    Science.gov (United States)

    Bull, Sheana S; Breslin, Lindsey T; Wright, Erin E; Black, Sandra R; Levine, Deborah; Santelli, John S

    2011-01-01

    To consider issues related to research with youth on social networking sites online. Description of the data collection process from 1,588 participants in a randomized controlled trial testing the efficacy of HIV prevention education delivered on Facebook. Using respondent-driven sampling, staff-recruited participants are encouraged to recruit up to three friends to enroll in the study. Researchers should (a) consider whether an online social networking site is an appropriate place to implement a research study; (b) offer opportunities to review informed consent documents at multiple times and in multiple locations throughout the study; and (c) collect data outside the social networking site and store it behind secure firewalls to ensure it will not be accessible to any person on the social networking site. Online social networks are growing in popularity. Conducting research on social media sites requires deliberate attention to consent, confidentiality, and security.

  3. Case series of fertility treatment in HIV-discordant couples (male positive, female negative: the Ontario experience.

    Directory of Open Access Journals (Sweden)

    Trent Newmeyer

    Full Text Available The success of combination antiretroviral therapies for the treatment of human immunodeficiency virus (HIV has resulted in prolonged life expectancy (over 40 years from diagnosis and an improved quality of life for people living with HIV. The risk of vertical HIV transmission during pregnancy has been reduced to less than 1%. As a result of these breakthroughs and as many of these individuals are of reproductive age, fertility issues are becoming increasingly important for this population. One population in which conception planning and reduction of horizontal HIV transmission warrants further research is HIV-discordant couples where the male partner is HIV-positive and the female partner is HIV-negative. Sperm washing is a technique carried out in a fertility clinic that separates HIV from the seminal fluid. Although sperm washing followed by intrauterine insemination significantly reduces the risk of horizontal HIV transmission, there has been limited access to the procedure in North America. Furthermore, little is known about the conception decision-making experiences of HIV-discordant couples who might benefit from sperm washing. Chart reviews and semi-structured interviews were completed with 12 HIV-discordant couples in Ontario, Canada. Couples were recruited through HIV clinics and one fertility clinic that offered sperm washing. Participants identified a number of factors that affected their decision-making around pregnancy planning. Access to sperm washing and other fertility services was an issue (cost, travel and few clinics. Participants identified a lack of information on the procedure (availability, safety. Sources of support (social networks, healthcare providers were unevenly distributed, especially among those who did not disclose their HIV status to friends and family. Finally, the stigmatisation of HIV continues to have a negative affect on HIV-discordant couples and their intentions to conceive. Access to sperm washing and

  4. The Danish Hip Arthroplasty Register

    DEFF Research Database (Denmark)

    Gundtoft, Per Hviid; Varnum, Claus; Pedersen, Alma Becic

    2016-01-01

    AIM OF DATABASE: The aim of the Danish Hip Arthroplasty Register (DHR) is to continuously monitor and improve the quality of treatment of primary and revision total hip arthroplasty (THA) in Denmark. STUDY POPULATION: The DHR is a Danish nationwide arthroplasty register established in January 1995...

  5. Associations between Burkitt lymphoma among children in Malawi and infection with HIV, EBV and malaria: results from a case-control study.

    Directory of Open Access Journals (Sweden)

    Nora Mutalima

    Full Text Available BACKGROUND: Burkitt lymphoma, a childhood cancer common in parts of sub-Saharan Africa, has been associated with Epstein Barr Virus (EBV and malaria, but its association with human immunodeficiency virus (HIV is not clear. METHODOLOGY/PRINCIPAL FINDINGS: We conducted a case-control study of Burkitt lymphoma among children (aged < or = 15 years admitted to the pediatric oncology unit in Blantyre, Malawi between July 2005 and July 2006. Cases were 148 children diagnosed with Burkitt lymphoma and controls were 104 children admitted with non-malignant conditions or cancers other than hematological malignancies and Kaposi sarcoma. Interviews were conducted and serological samples tested for antibodies against HIV, EBV and malaria. Odds ratios for Burkitt lymphoma were estimated using unconditional logistic regression adjusting for sex, age, and residential district. Cases had a mean age of 7.1 years and 60% were male. Cases were more likely than controls to be HIV positive (Odds ratio (OR = 12.4, 95% Confidence Interval (CI 1.3 to 116.2, p = 0.03. ORs for Burkitt lymphoma increased with increasing antibody titers against EBV (p = 0.001 and malaria (p = 0.01. Among HIV negative participants, cases were thirteen times more likely than controls to have raised levels of both EBV and malaria antibodies (OR = 13.2; 95% CI 3.8 to 46.6; p = 0.001. Reported use of mosquito nets was associated with a lower risk of Burkitt lymphoma (OR = 0.2, 95% CI, 0.03 to 0.9, p = 0.04. CONCLUSIONS: Our findings support prior evidence that EBV and malaria act jointly in the pathogenesis of Burkitt lymphoma, suggesting that malaria prevention may decrease the risk of Burkitt lymphoma. HIV may also play a role in the etiology of this childhood tumor.

  6. Prevention of mother-to-child transmission of HIV: the Georgian experience.

    Science.gov (United States)

    Tsertsvadze, Tengiz; Kakabadze, Tea; Shermadini, Ketevan; Abutidze, Akaki; Karchava, Marika; Chkhartishvili, Nikoloz; Badridze, Nino; Bokhua, Zaza; Asatiani, Tengiz

    2008-09-01

    The objective of this paper is to review experience in prevention of mother-to-child transmission (PMTCT) of HIV in Georgia. PMTCT is one of the strategic priorities in Georgia. The first case of HIV infection in pregnant women was reported in 1999. Starting 2005 the National Programme on PMTCT became operational. One hundred sixteen HIV voluntary counselling and testing (VCT) centers operate throughout the country at antenatal clinics. According to the National PMTCT protocol, all first time attending pregnant women are offered Voluntary Counselling and Testing (VCT). Testing on HIV/AIDS is based on identification of HIV antibodies by screening method and all positive results are referred to the Infectious Diseases, AIDS and Clinical Immunology Research Center (IDACIRC) for the further investigation (confirmation by Western Blot assay) and further management. Data collection was made retrospectively, using information from IDACIRC National HIV/AIDS Data Base, VRF for the period 1999-2007. Prevalence of HIV among pregnant women availing VCT services in 2006 was 0.03%. As of December, 2007 total 69 pregnancies of 64 women were registered at the IDACIRC. Fifty eight women (90.6%) acquired infection through heterosexual contact. None of the HIV positive women reported intravenous injection of illicit drugs. The majority of the HIV infected pregnant women had one sexual partner (90.6%). Of children delivered by 51 positive partners 41(80%) were infected through injecting drugs intravenously and 10 (20%) persons through heterosexual contacts. Throughout the period 1999-2007 14 pregnant women received PMTCT services only partially. In 2 cases children were HIV-infected. In 12 pregnancies women received AZT in about the 28th week of pregnancy. No case of HIV transmission to child was recorded in this group. In 32 cases pregnant women received full prophylaxis therapy and all children were negative for HIV infection. Among 6 pregnant women admitted at IDACIRC later than

  7. Exploring the effects of task shifting for HIV through a systems thinking lens: the case of Burkina Faso.

    Science.gov (United States)

    Yaya Bocoum, Fadima; Kouanda, Seni; Kouyaté, Bocar; Hounton, Sennen; Adam, Taghreed

    2013-10-22

    While the impact of task shifting on quality of care and clinical outcomes has been demonstrated in several studies, evidence on its impact on the health system as a whole is limited. This study has two main objectives. The first is to conceptualize the wider range of effects of task shifting through a systems thinking lens. The second is to explore these effects using task shifting for HIV in Burkina Faso as a case study. We used a case study approach, using qualitative research methods. Data sources included document reviews, reviews of available data and records, as well as interviews with key informants and health workers. In addition to the traditional measures of impact of task shifting on health outcomes, our study identified 20 possible effects of the strategy on the system as a whole. Moreover, our analysis highlighted the importance of differentiating between two types of health systems effects. The first are effects inherent to the task shifting strategy itself, such as job satisfaction or better access to health services. The second are effects due to health system barriers, for example the unavailability of medicines and supplies, generating a series of effects on the various components of the health system, e.g., staff frustration.Among the health systems effects that we found are positive, mostly unintended, effects and synergies such as increased health workers' sense of responsibility and worthiness, increased satisfaction due to using the newly acquired skills in other non-HIV tasks, as well as improved patient-provider relationships. Among the negative unintended effects are staff frustration due to lack of medicines and supplies or lack of the necessary infrastructure to be able to perform the new tasks. Our analysis highlights the importance of adopting a systems thinking approach in designing, implementing and evaluating health policies to mitigate some of the design issues or system bottle-necks that may impede their successful implementation

  8. Case Series of HIV Infection-Associated Arteriopathy: Diagnosis, Management, and Outcome Over a 5-Year period at Maharaj Nakorn Chiang Mai Hospital, Chiang Mai University.

    Science.gov (United States)

    Orrapin, Saritphat; Reanpang, Termpong; Orrapin, Saranat; Arwon, Supapong; Kattipathanapong, Thanate; Lekwanavijit, Suree; Rerkasem, Kittipan

    2015-09-01

    Patients infected with human immunodeficiency virus (HIV) can present with 4 pathology types: drug-induced vasospasm (ergotism), arterial limb ischemia, critical limb ischemia, and aneurysm. Although these problems are common vascular problems, they result in increased morbidity and mortality in HIV-infected patients, especially aneurysm. Patients with these problems tend to be diagnosed with difficulty because of atypical symptoms and signs. Because of lack of data in treatment outcome literature, our report explores and provides information on HIV infection-related arteriopathy. There were 17 patients in our 5-year review. There was no death in patients except the aneurysm type. The survival of aneurysm patients was significantly lower than from other pathologies (P = .003). Our case series showed good short-term outcome, and patients were not at risk for less beneficial surgical procedures. © The Author(s) 2015.

  9. HIV/AIDS status disclosure increases support, behavioural change and, HIV prevention in the long term: a case for an Urban Clinic, Kampala, Uganda.

    Science.gov (United States)

    Atuyambe, Lynn Muhimbuura; Ssegujja, Eric; Ssali, Sarah; Tumwine, Christopher; Nekesa, Nicolate; Nannungi, Annette; Ryan, Gery; Wagner, Glenn

    2014-06-21

    Disclosure of HIV status supports risk reduction and facilitates access to prevention and care services, but can be inhibited by the fear of negative repercussions. We explored the short and long-term outcomes of disclosure among clients attending an urban HIV clinic in Uganda. Qualitative semi-structured interviews were administered to a purposeful sample of 40 adult HIV clients that was stratified by gender. The information elicited included their lived experiences and outcomes of disclosure in the short and long term. A text data management software (ATLAS.ti) was used for data analysis. Codes were exported to MS Excel and pivot tables, and code counts made to generate statistical data. Of the 134 short-term responses elicited during the interview regarding disclosure events, most responses were supportive including encouragement, advice and support regarding HIV care and treatment. The results show on-disclosing to spouse, there was more trust, and use of condoms for HIV prevention. Only one third were negative responses, like emotional shock and feeling of distress. The negative reactions to the spouses included rejection, shock and distress in the short term. Even then, none of these events led to drastic change such as divorce. Other responses reflected HIV prevention and call for behavioural change and advice to change sexual behaviour, recipient seeking HIV testing or care. Women reported more responses of encouragement compared to men. Men reported more preventive behaviour compared to women. Of the 137 long-term outcomes elicited during disclosure, three quarters were positive followed by behavioral change and prevention, and then negative responses. Men reported increased care and support when they disclosed to fellow men compared to when women disclosed to women. There was better or not change in relationship when women disclosed to women than when women disclosed to men. There is overwhelming support to individuals that disclose their HIV status

  10. Legionella pneumophila infection presenting as headache, confusion and dysarthria in a human immunodeficiency virus-1 (HIV-1 positive patient: case report

    Directory of Open Access Journals (Sweden)

    Robbins Nathaniel M

    2012-09-01

    Full Text Available Abstract Background Legionella pneumophila is a common cause of community-acquired pneumonia. Central nervous system dysfunction is common, and diagnosis in the absence of pulmonary symptoms can be challenging. Here we describe an atypical clinical presentation of Legionella infection in a patient with HIV who was found to have an unusual neuroradiologic lesion that further served to obscure the diagnosis. This is the first such description in a patient with Legionellosis and HIV coinfection. Case presentation A 43 year-old HIV positive man presented to our hospital with dysarthria, fevers, headache, and altered mental status. Initial work-up revealed pneumonia and a lesion of the splenium of the corpus callosum on magnetic resonance imaging. He was subsequently diagnosed with Legionella pneumonia and treated with complete symptom resolution. Conclusions Neurologic abnormalities are frequent in Legionellosis, but the diagnosis may be difficult in the absence of overt respiratory symptoms and in the presence of HIV coinfection. A high index of suspicion and early initiation of empiric antibiotics is imperative since early treatment may help prevent long-term sequelae. Neuroimaging abnormalities, though rare, can help the physician narrow down the diagnosis and avoid unnecessary invasive testing. Future studies should aim to elucidate the as yet unknown role of neuroimaging in the diagnoses and prognostication of Legionellosis, as well as the interaction between Legionella infection and HIV.

  11. Are students kidding with health research ethics? The case of HIV/AIDS research in Cameroon

    Directory of Open Access Journals (Sweden)

    Munung Nchangwi

    2012-06-01

    Full Text Available Abstract Background Universities in Cameroon are playing an active part in HIV/AIDS research and much of this research is carried out by students, usually for the purpose of a dissertation/thesis. Student theses/dissertations present research findings in a much more comprehensive manner and have been described as the stepping-stone of a budding scientist’s potential in becoming an independent researcher. It is therefore important to verify how students handle issues of research ethics. Method Theses/dissertations on HIV/AIDS that described research studies involving the use of human research participants were screened to verify if research ethics approval and informed consent were obtained and documented. The contents of the consent forms were also qualitatively analyzed. Results Of 174 theses/dissertations on HIV, ethics approval was documented in 17 (9.77% and informed consent in 77 (47.83%. Research ethics approval was first mentioned at all in 2002 and highly reported in the year 2007. Evidence of ethics approval was found for the first time in 2005 and informed consent first observed and evidenced in 1997. Ethics approval was mostly reported by students studying for an MD (14.01% and was not reported in any Bachelors’ degree dissertation. Informed consent was also highly reported in MD theses (64.58% followed by undergraduate theses (31.58%. Voluntary participation and potential benefits of the study were some of the common aspects dealt with in most of the consent forms. The right to discontinue participation in the study and management of residual samples were scarcely ever mentioned. Conclusions Overall, and given the current state of the art of research ethics around the world, student-scientists in Cameroon would seem to be merely kidding with research ethics. It is thus essential that training in health research ethics (HRE be incorporated in the curriculum of universities in Cameroon in order that the next generation of

  12. The impact of human immunodeficiency virus (HIV) service scale-up on mechanisms of accountability in Zambian primary health centres: a case-based health systems analysis.

    Science.gov (United States)

    Topp, Stephanie M; Black, Jim; Morrow, Martha; Chipukuma, Julien M; Van Damme, Wim

    2015-02-18

    Questions about the impact of large donor-funded HIV interventions on low- and middle-income countries' health systems have been the subject of a number of expert commentaries, but comparatively few empirical research studies. Aimed at addressing a particular evidence gap vis-à-vis the influence of HIV service scale-up on micro-level health systems, this article examines the impact of HIV scale-up on mechanisms of accountability in Zambian primary health facilities. Guided by the Mechanisms of Effect framework and Brinkerhoff's work on accountability, we conducted an in-depth multi-case study to examine how HIV services influenced mechanisms of administrative and social accountability in four Zambian primary health centres. Sites were selected for established (over 3 yrs) antiretroviral therapy (ART) services and urban, peri-urban and rural characteristics. Case data included provider interviews (60); patient interviews (180); direct observation of facility operations (2 wks/centre) and key informant interviews (14). Resource-intensive investment in HIV services contributed to some early gains in administrative answerability within the four ART departments, helping to establish the material capabilities necessary to deliver and monitor service delivery. Simultaneous investment in external supervision and professional development helped to promote transparency around individual and team performance and also strengthened positive work norms in the ART departments. In the wider health centres, however, mechanisms of administrative accountability remained weak, hindered by poor data collection and under capacitated leadership. Substantive gains in social accountability were also elusive as HIV scale-up did little to address deeply rooted information and power asymmetries in the wider facilities. Short terms gains in primary-level service accountability may arise from investment in health system hardware. However, sustained improvements in service quality and

  13. Acute adverse effects of radiation therapy on HIV-positive patients in Japan. Study of 31 cases at Tokyo Metropolitan Komagome Hospital

    International Nuclear Information System (INIS)

    Kaminuma, Takuya; Karasawa, Katsuyuki; Hanyu, Nahoko

    2010-01-01

    Recently, the number of human immunodeficiency virus (HIV)-positive patients has increased in Japan. HIV-positive patients are at a higher risk of cancer than the general population. This paper retrospectively reports the acute adverse effects of radiation therapy on HIV-positive patients who were treated at Tokyo Metropolitan Cancer and Infectious diseases Center Komagome Hospital (TMCICK). Thirty-one cases involving 24 HIV-positive cancer patients who were treated at TMCICK from January 1997 to March 2009 were included in this study. All acute adverse effects of radiation therapy were examined during, and one month after, the last radiation therapy session. Acute adverse effects were classified according to the site of radiation therapy treatment and analyzed using the Common Terminology Criteria for Adverse Events (CTCAE) version 3.0. Grade 3 acute adverse effects were seen in 17% of cases, and Grade 2 toxicities were found in 23% of patients. Damage to the skin and mucosa, including stomatitis or diarrhea, tended to occur after low-dose radiation therapy; however, no severe acute adverse effects were seen in other organs, such as the brain, lung, and bone. Acute adverse effects tended to occur earlier in HIV-positive patients and became severe more frequently than in the general population. In particular, disorders of the mucosa, such as those of the oral cavity, pharynx, and intestine, tended to occur rapidly. It was shown that radiation therapy is safe when treatment is performed carefully and that it is a very useful treatment for cancer in HIV-positive patients. (author)

  14. HIV Status Discordance: Associated Factors Among HIV Positive ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    infection for a partner of a person with HIV is about 10%, with higher annual transmission rates ... We recommend the tracking of both men and women as index cases in other to reduce HIV .... HIV status was accepted as known only if backed.

  15. Developing clinical strength-of-evidence approach to define HIV-associated malignancies for cancer registration in Kenya.

    Directory of Open Access Journals (Sweden)

    Anne Korir

    Full Text Available Sub-Saharan Africa cancer registries are beset by an increasing cancer burden further exacerbated by the AIDS epidemic where there are limited capabilities for cancer-AIDS match co-registration. We undertook a pilot study based on a "strength-of-evidence" approach using clinical data that is abstracted at the time of cancer registration for purposes of linking cancer diagnosis to AIDS diagnosis.The standard Nairobi Cancer Registry form was modified for registrars to abstract the following clinical data from medical records regarding HIV infection/AIDS in a hierarchal approach at time of cancer registration from highest-to-lowest strength-of-evidence: 1 documentation of positive HIV serology; 2 antiretroviral drug prescription; 3 CD4+ lymphocyte count; and 4 WHO HIV clinical stage or immune suppression syndrome (ISS, which is Kenyan terminology for AIDS. Between August 1 and October 31, 2011 a total of 1,200 cancer cases were registered. Of these, 171 cases (14.3% met clinical strength-of-evidence criteria for association with HIV infection/AIDS; 69% (118 cases were tumor types with known HIV association - Kaposi's sarcoma, cervical cancer, non-Hodgkin's and Hodgkin's lymphoma, and conjunctiva carcinoma and 31% (53 were consistent with non-AIDS defining cancers. Verifiable positive HIV serology was identified in 47 (27% cases for an absolute seroprevalence rate of 4% among the cancer registered cases with an upper boundary of 14% among those meeting at least one of strength-of-evidence criteria.This pilot demonstration of a hierarchal, clinical strength-of-evidence approach for cancer-AIDS registration in Kenya establishes feasibility, is readily adaptable, pragmatic, and does not require additional resources for critically under staffed cancer registries. Cancer is an emerging public health challenge, and African nations need to develop well designed population-based studies in order to better define the impact and spectrum of malignant disease

  16. Developing clinical strength-of-evidence approach to define HIV-associated malignancies for cancer registration in Kenya.

    Science.gov (United States)

    Korir, Anne; Mauti, Nathan; Moats, Pamela; Gurka, Matthew J; Mutuma, Geoffrey; Metheny, Christine; Mwamba, Peter M; Oyiro, Peter O; Fisher, Melanie; Ayers, Leona W; Rochford, Rosemary; Mwanda, Walter O; Remick, Scot C

    2014-01-01

    Sub-Saharan Africa cancer registries are beset by an increasing cancer burden further exacerbated by the AIDS epidemic where there are limited capabilities for cancer-AIDS match co-registration. We undertook a pilot study based on a "strength-of-evidence" approach using clinical data that is abstracted at the time of cancer registration for purposes of linking cancer diagnosis to AIDS diagnosis. The standard Nairobi Cancer Registry form was modified for registrars to abstract the following clinical data from medical records regarding HIV infection/AIDS in a hierarchal approach at time of cancer registration from highest-to-lowest strength-of-evidence: 1) documentation of positive HIV serology; 2) antiretroviral drug prescription; 3) CD4+ lymphocyte count; and 4) WHO HIV clinical stage or immune suppression syndrome (ISS), which is Kenyan terminology for AIDS. Between August 1 and October 31, 2011 a total of 1,200 cancer cases were registered. Of these, 171 cases (14.3%) met clinical strength-of-evidence criteria for association with HIV infection/AIDS; 69% (118 cases were tumor types with known HIV association - Kaposi's sarcoma, cervical cancer, non-Hodgkin's and Hodgkin's lymphoma, and conjunctiva carcinoma) and 31% (53) were consistent with non-AIDS defining cancers. Verifiable positive HIV serology was identified in 47 (27%) cases for an absolute seroprevalence rate of 4% among the cancer registered cases with an upper boundary of 14% among those meeting at least one of strength-of-evidence criteria. This pilot demonstration of a hierarchal, clinical strength-of-evidence approach for cancer-AIDS registration in Kenya establishes feasibility, is readily adaptable, pragmatic, and does not require additional resources for critically under staffed cancer registries. Cancer is an emerging public health challenge, and African nations need to develop well designed population-based studies in order to better define the impact and spectrum of malignant disease in the

  17. Perception of taste in HIV-positive individuals in treatment antiretroviral: results of a case-control study.

    Science.gov (United States)

    Henn, Indiara Welter; da Silva, Ruann Oswaldo Carvalho; Chaiben, Cassiano Lima; Fernandes, Ângela; Naval Machado, Maria Ângela; de Lima, Antonio Adilson Soares

    2017-01-01

    The aim of this study was to evaluate the perception of taste in HIV-infected patients. One hundred males and females (11 to 60 years old) were divided into two groups (50 patients infected by HIV and 50 controls) and evaluated for gustatory function. The results revealed that the mean score in the evaluation of taste was significantly lower in individuals with HIV when compared to controls for both sides of the tongue (p < 0.05). Patients with HIV infection had difficulty recognizing the bitter taste, followed by salty and sweet. When each side of the tongue was evaluated separately and compared, the Wilcoxon test showed that there was no significant difference on the tongue of individuals with HIV. The prevalence of hypogeusia was 20% in individuals with this disease. Individuals with HIV infection may have a deficit in taste that can affect your general and oral health. © 2016 Special Care Dentistry Association and Wiley Periodicals, Inc.

  18. Registering Researchers in Authority Files

    NARCIS (Netherlands)

    Altman, M.; Conlon, M.; Cristan, A.L.; Dawson, L.; Dunham, J.; Hickey, T.; Hook, D.; Horstmann, W.; MacEwan, A.; Schreur, P.; Smart, L.; Smith-Yoshimura, K.; Wacker, M.; Woutersen, S.

    2014-01-01

    Registering researchers in some type of authority file or identifier system has become more compelling as both institutions and researchers recognize the need to compile their scholarly output. The report presents functional requirements and recommendations for six stakeholders: researchers,

  19. Numbers, systems, people: how interactions influence integration. Insights from case studies of HIV and reproductive health services delivery in Kenya.

    Science.gov (United States)

    Mayhew, Susannah H; Sweeney, Sedona; Warren, Charlotte E; Collumbien, Martine; Ndwiga, Charity; Mutemwa, Richard; Lut, Irina; Colombini, Manuela; Vassall, Anna

    2017-11-01

    Drawing on rich data from the Integra evaluation of integrated HIV and reproductive-health services, we explored the interaction of systems hardware and software factors to explain why some facilities were able to implement and sustain integrated service delivery while others were not. This article draws on detailed mixed-methods data for four case-study facilities offering reproductive-health and HIV services between 2009 and 2013 in Kenya: (i) time-series client flow, tracking service uptake for 8841 clients; (ii) structured questionnaires with 24 providers; (iii) in-depth interviews with 17 providers; (iv) workload and facility data using a periodic activity review and cost-instruments; and (v) contextual data on external activities related to integration in study sites. Overall, our findings suggested that although structural factors like stock-outs, distribution of staffing and workload, rotation of staff can affect how integrated care is provided, all these factors can be influenced by staff themselves: both frontline and management. Facilities where staff displayed agency of decision making, worked as a team to share workload and had management that supported this, showed better integration delivery and staff were able to overcome some structural deficiencies to enable integrated care. Poor-performing facilities had good structural integration, but staff were unable to utilize this because they were poorly organized, unsupported or teams were dysfunctional. Conscientious objection and moralistic attitudes were also barriers.Integra has demonstrated that structural integration is not sufficient for integrated service delivery. Rather, our case studies show that in some cases excellent leadership and peer-teamwork enabled facilities to perform well despite resource shortages. The ability to provide support for staff to work flexibly to deliver integrated services and build resilient health systems to meet changing needs is particularly relevant as health

  20. Psychogenic "HIV infection"

    NARCIS (Netherlands)

    Sno, H. N.; Storosum, J. G.; Wortel, C. H.

    1991-01-01

    The case of a man who falsely represented himself as being HIV positive is reported. In less than one year he was admitted twice with symptoms suggestive of HIV infection. The diagnoses malingering and factitious disorder were consecutively made. Early recognition of Factitious Disorder is essential

  1. Occupational risk factors for testicular cancer: a registry-based case-control study in Rhineland Palatinate – Germany [Berufliche Risikofaktoren für Hodenkrebs: eine Register-basierte Fall-Kontroll-Studie in Rheinland-Pfalz – Deutschland

    Directory of Open Access Journals (Sweden)

    Yousif, Lamyaa

    2013-11-01

    Full Text Available [english] Objectives: Testicular cancer affects mainly men below the age of 50. An association with occupation and social status has been suggested but risk factors are not well understood. A registry-based case-control study focusing on occupation was performed in Germany.Methods: All 348 testicular cancer cases with available gainful occupational information registered between 2000 and 2005; as well as uitable controls (from a pool of other cancers were drawn from the Cancer Registry of Rhineland-Palatinate. Unconditional logistic regression was used to compute odds ratios (OR and associated onfidence intervals (CI.Results: Slightly elevated OR were observed for technicians and related professionals (OR 1.62, 95% CI 1.00–2.63 and for clerical support workers (OR 1.71, 95% CI 1.14–2.56. This increase was highest in the age group 20–50 for technicians (OR 2.02, 95% CI 1.23–3.33 and clerks (OR 2.00, 95% CI 1.30–3.09, respectively. An association with testicular cancer was observed for no other occupation.Conclusion: An increased risk of testicular cancer was observed for technicians and related professionals and clerical support workers. This could be related to socioeconomic status or sedentary life style, two factors that were identified in previous studies. While the feasibility of a purely registry-based study was shown, missing occupational data and the choice of cancer controls represent challenges to the validity of this approach.[german] Ziele: Hodenkrebs betrifft vor allem junge Männer im Alter von unter 50 Jahren. Ein Zusammenhang zwischen erhöhtem Auftreten von Hodenkrebs und Beruf bzw. sozialem Status wurde untersucht (in Betracht gezogen, aber die Risikofaktoren sind bislang noch nicht umfassend erforscht. Eine Register-basierte Fall-Kontroll-Studie zur Untersuchung eines Zusammenhangs von beruflicher Erwerbstätigkeit und Hodenkrebs wurde in Deutschland durchgeführt.Methoden: 348 Hodenkrebsfälle mit den verf

  2. T-cell subset alterations and lymphocyte responsiveness to mitogens and antigen during severe primary infection with HIV: a case series of seven consecutive HIV seroconverters

    DEFF Research Database (Denmark)

    Pedersen, C; Dickmeiss, E; Gaub, J

    1990-01-01

    Seven consecutive patients who presented with a severe acute mononucleosis-like illness associated with HIV seroconversion were evaluated by T-cell subset enumerations and measurements of lymphocyte transformation responses to mitogens and antigen during both their primary illness and a 1-year...

  3. Awareness and understanding of HIV non-disclosure case law among people living with HIV who use illicit drugs in a Canadian setting.

    Science.gov (United States)

    Patterson, Sophie; Kaida, Angela; Ogilvie, Gina; Hogg, Robert; Nicholson, Valerie; Dobrer, Sabina; Kerr, Thomas; Shoveller, Jean; Montaner, Julio; Milloy, M-J

    2017-05-01

    In 2012, the Supreme Court of Canada (SCC) ruled that people living with HIV (PLWH) could face criminal charges if they did not disclose their serostatus before sex posing a "realistic possibility" of HIV transmission. Condom-protected vaginal sex with a low (i.e., self-reported awareness of the 2012 SCC ruling, drawn from cross-sectional survey data. Participants aware of the ruling were asked how similar their understanding was to a provided definition. Sources of information from which participants learned about the ruling were determined. Multivariable logistic regression identified factors independently associated with ruling awareness. Among 249 participants (39% female), median age was 50 (IQR: 44-55) and 80% had a suppressed HIV VL (disclosure and the law were lacking in healthcare settings. Advancing education about HIV disclosure and the law is a key priority. The role of healthcare providers in delivering information and support to PLWH in this legal climate should be further explored. Copyright © 2017. Published by Elsevier B.V.

  4. Relating timed and register automata

    Directory of Open Access Journals (Sweden)

    Diego Figueira

    2010-11-01

    Full Text Available Timed automata and register automata are well-known models of computation over timed and data words respectively. The former has clocks that allow to test the lapse of time between two events, whilst the latter includes registers that can store data values for later comparison. Although these two models behave in appearance differently, several decision problems have the same (undecidability and complexity results for both models. As a prominent example, emptiness is decidable for alternating automata with one clock or register, both with non-primitive recursive complexity. This is not by chance. This work confirms that there is indeed a tight relationship between the two models. We show that a run of a timed automaton can be simulated by a register automaton, and conversely that a run of a register automaton can be simulated by a timed automaton. Our results allow to transfer complexity and decidability results back and forth between these two kinds of models. We justify the usefulness of these reductions by obtaining new results on register automata.

  5. Involuntary sterilization among HIV-positive Garifuna women from Honduras seeking asylum in the United States: Two case reports.

    Science.gov (United States)

    Atkinson, Holly G; Ottenheimer, Deborah

    2018-05-01

    Voluntary sterilization is one of the most widely used forms of contraception by women worldwide; however, involuntary sterilization is considered a violation of multiple human rights and grounds for asylum in the United States. Women have been disproportionately affected by this practice. We report two cases of involuntary sterilization in HIV-positive Garifuna women from Honduras who sought asylum in America and were medically evaluated at the request of their attorneys. Key lessons can be drawn from these cases with regard to the importance of medical evaluations in establishing persecution. These include the need for a detailed account of the events surrounding sterilization, radiologic proof of tubal blockage if at all possible, and confirmation of significant and enduring mental distress as a result of the involuntary sterilization. Immigration attorneys and medical evaluators need to be attuned to the possibility of a history of involuntary sterilization among at risk women seeking asylum in the United States. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  6. The usefulness of traditional birth attendants to women living with HIV in resource-poor settings: the case of Mfuwe, Zambia.

    Science.gov (United States)

    Muzyamba, Choolwe; Groot, Wim; Tomini, Sonila M; Pavlova, Milena

    2017-01-01

    Although there is increased attention on the role of trained traditional birth attendants (TBAs) in maternal care, most of the research has mainly focused on providing evidence of the relevance of trained TBAs to women in general without a specific focus on women who are HIV positive, despite them being most vulnerable. Therefore, the aim of this study is to fill this gap by assessing the relevance of trained TBAs to women living with HIV in resource-poor settings by using Zambia as a case study. Our data collection consisted of two focus group discussions, one involving HIV-positive women utilizing trained TBAs and the other with women not utilizing TBAs. Additionally, in-depth interviews were conducted with trained TBAs and health workers. Thematic analysis was used to analyze the data. In general, women living with HIV positively characterized the services of TBAs. In the face of an inefficient health system, trained TBAs were seen to be useful in providing efficient, cheap and quality care, counseling, and referral and logistical support, including treatment adherence support. In Zambia, trained TBAs and professional care are not mutually exclusive but complementary. There is no doubt that HIV-positive women need professionals to handle complications and offer antiretroviral treatment to ensure prevention of mother to child transmission (PMTCT). However, additional "soft" services offered by trained TBAs are equally important in the promotion of maternal health care among HIV-positive women. Thus, it seems there is more to gain by systematically allowing trained TBAs to work alongside professionals in a well-coordinated and complementary manner.

  7. Tuberculosis screening in patients with HIV

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  8. Optimal antiretroviral therapy adherence as evaluated by CASE index score tool is associated with virological suppression in HIV-infected adults in Dakar, Senegal.

    Science.gov (United States)

    Byabene, A K; Fortes-Déguénonvo, L; Niang, K; Manga, M N; Bulabula, A N H; Nachega, J B; Seydi, M

    2017-06-01

    To determine the prevalence and factors associated with optimal antiretroviral therapy (ART) adherence and virological failure (VLF) among HIV-infected adults enrolled in the national ART programme at the teaching hospital of Fann, Dakar, Senegal. Cross-sectional study from 1 September 2013 to 30 January 2014. (1) optimal ART adherence by the Center for Adherence Support Evaluation (CASE) Index Score (>10) and (2) VLF (HIV RNA > 1000 copies/ml). Diagnostic accuracy of CASE Index Score assessed using sensitivity (Se), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV) and corresponding 95% confidence intervals (CIs). Multivariate logistic regression analysis was performed to identify independent factors associated with optimal adherence and VLF. Of 98 HIV-infected patients on ART, 68% were female. The median (IQR) age was 42 (20-50) years. A total of 57 of 98 (60%) were on ART more than 3 years, and majority (88%) were on NNRTI-based first-line ART regimen. A total of 79 of 98 (80%) patients reported optimal ART adherence, and only five of 84 (5.9%) had documented VLF. Patients with VLF were significantly more likely to have suboptimal ART adherence (17.7% vs. 2.9%; P = 0.02). CASE Index Score showed the best trade-off in Se (78.9%, 95% CI: 54.4-93.9%), Sp (20.0%, 95% CI: 11.1-31.7), PPV (22.4, 95% CI: 13.1-34.2%) and NPV (76.5%, 95% CI: 50.1-93.2), when used VLF threshold of HIV RNA >50 copies/ml. Factors independently associated with VLF were CASE Index Score CASE Index Score was independently associated with virological outcomes, supporting usefulness of this low-cost ART adherence monitoring tool in this setting. © 2017 John Wiley & Sons Ltd.

  9. [Problem issues related to HIV/AIDS in Eastern European and Central Asian countries].

    Science.gov (United States)

    Onishchenko, G G

    2007-01-01

    HIV has been spreading over the territories of our countries for 18 years, and it is still possible to resist the epidemic in a unique and efficient way. In June 2001, the UNO General Assembly Special Session was devoted to the problem of HIV/AIDS in full. Its Declaration of Commitment on HIV/AIDS (Resolution S-26/2) defines main directions of this work both in world-wide, regional, and international scopes. It should be stressed that first of all the Declaration emphasizes the necessity to improve management and coordination of efforts at the global, regional, and national levels, which is of special importance to Eastern Europe and Central Asia, where a new phase of HIV infection epidemic has begun and the spread of the virus grows and very soon may gain uncontrollable character. As for the countries of our region, here the epidemic process has been developing mostly through sexual way of transmission for 8 years since 1987, when the first case of HIV infection was revealed. More than 350000 HIV-infected people, including more than 15,000 children, have been registered in Russian Federation. More than 9000 people have died. The proportion of childbearing age women constantly grows, and the number of children born to mothers with AIDS has now exceeded 15,000. To realize the component "Prevention of HIV infection, B and C hepatitis, and revealing and treatment of HIV patients" of the priority national health project, 3.1 billion rubles are allocated for the prophylaxis of and fight against HIV and AIDS. The measures that are planned to take will allow for principle changes in the present situation with medical aid providence of contemporary antiretroviral medicines. Russian Orthodox Church with its parishes, monasteries etc. carries out numerous projects of primary HIV prophylaxis among children and young people in different regions; these projects are directed towards forming moral values.

  10. HIV-1 virological remission lasting more than 12 years after interruption of early antiretroviral therapy in a perinatally infected teenager enrolled in the French ANRS EPF-CO10 paediatric cohort: a case report.

    Science.gov (United States)

    Frange, Pierre; Faye, Albert; Avettand-Fenoël, Véronique; Bellaton, Erianna; Descamps, Diane; Angin, Mathieu; David, Annie; Caillat-Zucman, Sophie; Peytavin, Gilles; Dollfus, Catherine; Le Chenadec, Jerome; Warszawski, Josiane; Rouzioux, Christine; Sáez-Cirión, Asier

    2016-01-01

    Durable HIV-1 remission after interruption of combined antiretroviral therapy (ART) has been reported in some adults who started treatment during primary infection; however, whether long-term remission in vertically infected children is possible was unknown. We report a case of a young adult perinatally infected with HIV-1 with viral remission despite long-term treatment interruption. The patient was identified in the ANRS EPF-CO10 paediatric cohort among 100 children infected with HIV perinatally who started ART before 6 months of age. HIV RNA viral load and CD4 cell counts were monitored from birth. Ultrasensitive HIV RNA, peripheral blood mononuclear cell (PBMC)-associated HIV DNA, HIV-specific T-cell responses (ie, production of cytokines and capacity to suppress HIV infection), reactivation of the CD4 cell reservoir (measured by p24 ELISA and HIV RNA in supernatants upon phytohaemagglutinin activation of purified CD4 cells), and plasma concentrations of antiretroviral drugs were assessed after 10 years of documented control off therapy. The infant was born in 1996 to a woman with uncontrolled HIV-1 viraemia and received zidovudine-based prophylaxis for 6 weeks. HIV RNA and DNA were not detected 3 days and 14 days after birth. HIV DNA was detected at 4 weeks of age. HIV RNA reached 2·17× 10(6) copies per mL at 3 months of age and ART was started. HIV RNA was undetectable 1 month later. ART was discontinued by the family at some point between 5·8 and 6·8 years of age. HIV RNA was undetectable at 6·8 years of age and ART was not resumed. HIV RNA has remained below 50 copies per mL and CD4 cell counts stable through to 18·6 years of age. After 11·5 years of control off treatment, HIV RNA was below 4 copies per mL and HIV DNA was 2·2 log10 copies per 10(6) PBMCs. The HLA genotype showed homozygosity at several loci (A*2301-, B*1503/4101, C*0210/0802, DRB1*1101-, and DQB1*0602-). HIV-specific CD8 T-cell responses and T-cell activation were weak. Findings

  11. A Controlled Study of Tuberculosis Diagnosis in HIV-Infected and Uninfected Children in Peru

    Science.gov (United States)

    Oberhelman, Richard A.; Soto-Castellares, Giselle; Gilman, Robert H.; Castillo, Maria E.; Kolevic, Lenka; Delpino, Trinidad; Saito, Mayuko; Salazar-Lindo, Eduardo; Negron, Eduardo; Montenegro, Sonia; Laguna-Torres, V. Alberto; Maurtua-Neumann, Paola; Datta, Sumona; Evans, Carlton A.

    2015-01-01

    Background Diagnosing tuberculosis in children is challenging because specimens are difficult to obtain and contain low tuberculosis concentrations, especially with HIV-coinfection. Few studies included well-controls so test specificities are poorly defined. We studied tuberculosis diagnosis in 525 children with and without HIV-infection. Methods and Findings ‘Cases’ were children with suspected pulmonary tuberculosis (n = 209 HIV-negative; n = 81 HIV-positive) and asymptomatic ‘well-control’ children (n = 200 HIV-negative; n = 35 HIV-positive). Specimens (n = 2422) were gastric aspirates, nasopharyngeal aspirates and stools analyzed by a total of 9688 tests. All specimens were tested with an in-house hemi-nested IS6110 PCR that took 0.2) for HIV-positive versus HIV-negative cases. All specimens were also tested with auramine acid-fast microscopy, microscopic-observation drug-susceptibility (MODS) liquid culture, and Lowenstein-Jensen solid culture that took ≤6 weeks and had 100% specificity (all 2112 tests on 704 specimens from 235 well-controls were negative). Microscopy-positivity was rare (0.21%, 5/2422 specimens) and all microscopy-positive specimens were culture-positive. Culture-positivity was less frequent (P≤0.01) in HIV-infection: 1.2% (1/81) HIV-positive cases versus 11% (22/209) HIV-negative cases; caused by 0.42% (2/481) versus 4.7% (58/1235) of their specimens, respectively. Conclusions In HIV-positive children with suspected tuberculosis, diagnostic yield was so low that 1458 microscopy and culture tests were done per case confirmed and even in children with culture-proven tuberculosis most tests and specimens were false-negative; whereas PCR was so prone to false-positives that PCR-positivity was as likely in specimens from well-controls as suspected-tuberculosis cases. This demonstrates the importance of control participants in diagnostic test evaluation and that even extensive laboratory testing only rarely contributed to the care of

  12. Globalisation, transport and HIV | Andrews | Southern African ...

    African Journals Online (AJOL)

    Southern African Journal of HIV Medicine. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 5, No 4 (2004) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Download this PDF file. The PDF file you selected ...

  13. Dominance of HIV-1 subtype CRF01_AE in sexually acquired cases leads to a new epidemic in Yunnan province of China.

    Directory of Open Access Journals (Sweden)

    Yong Zhang

    2006-11-01

    Full Text Available Dating back to the first epidemic among injection drug users in 1989, the Yunnan province has had the highest number of human immunodeficiency virus type 1 (HIV-1 infections in China. However, the molecular epidemiology of HIV-1 in Yunnan has not been fully characterized.Using immunoassays, we identified 103,015 accumulated cases of HIV-1 infections in Yunnan between 1989 and 2004. We studied 321 patients representing Yunnan's 16 prefectures from four risk groups, 11 ethnic populations, and ten occupations. We identified three major circulating subtypes: C/CRF07_BC/CRF08_BC (53%, CRF01_AE (40.5%, and B (6.5% by analyzing the sequence of p17, which is part of the gag gene. For patients with known risk factors, 90.9% of injection drug users had C/CRF07_BC/CRF08_BC viruses, whereas 85.4% of CRF01_AE infections were acquired through sexual transmission. No distinct segregation of CRF01_AE viruses was found among the Dai ethnic group. Geographically, C/CRF07_BC/CRF08_BC was found throughout the province, while CRF01_AE was largely confined to the prefectures bordering Myanmar. Furthermore, C/CRF07_BC/CRF08_BC viruses were found to consist of a group of viruses, including C, CRF08_BC, CRF07_BC, and new BC recombinants, based on the characterization of their reverse transcriptase genes.This is the first report of a province-wide HIV-1 molecular epidemiological study in Yunnan. While C/CRF07_BC/CRF08_BC and CRF01_AE are codominant, the discovery of many sexually transmitted CRF01_AE cases is new and suggests that this subtype may lead to a new epidemic in the general Chinese population. We discuss implications of our results for understanding the evolution of the HIV-1 pandemic and for vaccine development.

  14. Testing the Technology Acceptance Model: HIV case managers' intention to use a continuity of care record with context-specific links.

    Science.gov (United States)

    Schnall, Rebecca; Bakken, Suzanne

    2011-09-01

    To assess the applicability of the Technology Acceptance Model (TAM) constructs in explaining HIV case managers' behavioural intention to use a continuity of care record (CCR) with context-specific links designed to meet their information needs. Data were collected from 94 case managers who provide care to persons living with HIV (PLWH) using an online survey comprising three components: (1) demographic information: age, gender, ethnicity, race, Internet usage and computer experience; (2) mock-up of CCR with context-specific links; and items related to TAM constructs. Data analysis included: principal components factor analysis (PCA), assessment of internal consistency reliability and univariate and multivariate analysis. PCA extracted three factors (Perceived Ease of Use, Perceived Usefulness and Perceived Barriers to Use), explained variance = 84.9%, Cronbach's ά = 0.69-0.91. In a linear regression model, Perceived Ease of Use, Perceived Usefulness and Perceived Barriers to Use explained 43.6% (p Technology assessed.

  15. Hepatocellular Carcinoma Metastasis to the Orbit in a Coinfected HIV+ HBV+ Patient Previously Treated with Orthotopic Liver Transplantation: A Case Report

    Directory of Open Access Journals (Sweden)

    S. Guerriero

    2011-01-01

    Full Text Available Hepatocellular carcinoma rarely metastasizes to the orbit. We report a 45-year-old male, HBV+, HIV+, with a past history of a liver transplant for ELSD (end-stage liver disease with hepatocellular carcinoma and recurrent HCC, who presented with proptosis and diplopia of the left eye. CT scans of the head revealed a large, irregular mass in the left orbit causing superior and lateral destruction of the orbital bone. Biopsy specimens of the orbital tumor showed features of metastatic foci of hepatocellular carcinoma. Only 16 other cases of HCC metastasis to the orbit have been described in literature, and this is the first case in a previously transplanted HIV+, HBV+ patient.

  16. Features associated with underlying HIV infection in severe acute ...

    African Journals Online (AJOL)

    NRUs) in Malawi with severe acute malnutrition (SAM) are infected with HIV. There are many similarities in the clinical presentation of SAM and HIV. It is important to identify HIV infected children, in order to improve case management.

  17. The Provision of a Health Promoting Environment for HIV/AIDS Education: The Case of Namibian Senior Secondary Schools

    Science.gov (United States)

    Campbell, Bob; Lubben, Fred

    2003-01-01

    HIV/AIDS programmes in schools ultimately intend to decrease high risk sexual behaviour. One factor facilitating this outcome is a strong health promoting environment in the school. This paper reports a study surveying the health promoting environments supporting HIV/AIDS education in Namibian senior secondary schools. It develops a…

  18. HIV infection and its association with an excess risk of clinical fractures : a nationwide case-control study

    NARCIS (Netherlands)

    Prieto-Alhambra, Daniel; Güerri-Fernández, Robert; De Vries, Frank; Lalmohamed, Arief; Bazelier, Marloes; Starup-Linde, Jakob; Diez-Perez, Adolfo; Cooper, Cyrus; Vestergaard, Peter

    2014-01-01

    BACKGROUND: Different studies have reported an association between HIV infection, antiretroviral therapies, and impaired bone metabolism, but data on their impact on fracture risk are scarce. We studied the association between a clinical diagnosis of HIV infection and fracture risk. METHODS: We

  19. HIV infection and its association with an excess risk of clinical fractures: A nationwide case-control study

    NARCIS (Netherlands)

    Prieto-Alhambra, Daniel; Güerri-Fernández, Robert; De Vries, Frank|info:eu-repo/dai/nl/303546670; Lalmohamed, Arief|info:eu-repo/dai/nl/357580680; Bazelier, Marloes|info:eu-repo/dai/nl/341589802; Starup-Linde, Jakob; Diez-Perez, Adolfo; Cooper, Cyrus; Vestergaard, Peter

    2014-01-01

    BACKGROUND: Different studies have reported an association between HIV infection, antiretroviral therapies, and impaired bone metabolism, but data on their impact on fracture risk are scarce. We studied the association between a clinical diagnosis of HIV infection and fracture risk. METHODS: We

  20. Maternal welfare, morbidity and mortality 6-15 years after a pregnancy complicated by alcohol and substance abuse: a register-based case-control follow-up study of 524 women.

    Science.gov (United States)

    Kahila, Hanna; Gissler, Mika; Sarkola, Taisto; Autti-Rämö, Ilona; Halmesmäki, Erja

    2010-10-01

    A register-based retrospective case-control study to investigate the long-term morbidity, mortality, and welfare among women with alcohol and/or substance misuse identified during pregnancy. Cohort of 524 women followed-up ante- and perinatally 1992-2001 at special out-patient clinics of maternity hospitals in the capital area of Finland. The control group of 1792 women with no evidence of alcohol or substance misuse was matched for maternal age, parity, date of birth and hospital of index delivery. Both groups were followed-up until end of 2007. 7.9% (42/524) of the cases and 0.2% (4/1792) of the controls had died by the end of the median follow-up of 9 years (OR 38, 95% CI 14-108). The cases displayed significant morbidity requiring in-patient care in the areas of mental disorders (AOR 8.8, 95% CI 6.5-11.9), viral (AOR 23.5, 95% CI 8.8-62.7) and bacterial (AOR 6.1, 95% CI 3.5-10.4) infections, skin diseases (AOR 3.9, 95% CI 2.0-7.8) and injury and poisoning (AOR 4.2, 95% CI 3.1-5.6). The cases displayed more out-patient visits (OR 2.7, 95% CI 2.7-2.8). Their mean length of hospital stay was longer compared to controls (10.3 vs. 4.4 days, p<0.001). The risk of pension granted due to a disorder, disease or disability (OR 8.8, 95% CI 6.0-13.0) and the risk for minimum unemployment benefit were higher compared to controls (OR 2.1, 95% CI 1.8-2.5). These women display significant long-term morbidity, mortality and loss of productivity after delivery. The results emphasize the importance of adequate postnatal follow-up and treatment for misuse. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  1. Temporal analysis of reported cases of tuberculosis and of tuberculosis-HIV co-infection in Brazil between 2002 and 2012.

    Science.gov (United States)

    Gaspar, Renato Simões; Nunes, Natália; Nunes, Marina; Rodrigues, Vandilson Pinheiro

    2016-01-01

    To investigate the reported cases of tuberculosis and of tuberculosis-HIV co-infection in Brazil between 2002 and 2012. This was an observational study based on secondary time series data collected from the Brazilian Case Registry Database for the 2002-2012 period. The incidence of tuberculosis was stratified by gender, age group, geographical region, and outcome, as was that of tuberculosis-HIV co-infection. Nationally, the incidence of tuberculosis declined by 18%, whereas that of tuberculosis-HIV co-infection increased by 3.8%. There was an overall decrease in the incidence of tuberculosis, despite a significant increase in that of tuberculosis-HIV co-infection in women. The incidence of tuberculosis decreased only in the 0- to 9-year age bracket, remaining stable or increasing in the other age groups. The incidence of tuberculosis-HIV co-infection increased by 209% in the ≥ 60-year age bracket. The incidence of tuberculosis decreased in all geographical regions except the south, whereas that of tuberculosis-HIV co-infection increased by over 150% in the north and northeast. Regarding the outcomes, patients with tuberculosis-HIV co-infection, in comparison with patients infected with tuberculosis only, had a 48% lower chance of cure, a 50% greater risk of treatment nonadherence, and a 94% greater risk of death from tuberculosis. Our study shows that tuberculosis continues to be a relevant public health issue in Brazil, because the goals for the control and cure of the disease have yet to be achieved. In addition, the sharp increase in the incidence of tuberculosis-HIV co-infection in women, in the elderly, and in the northern/northeastern region reveals that the population of HIV-infected individuals is rapidly becoming more female, older, and more impoverished. Investigar os casos notificados de tuberculose e de sua coinfecção com o HIV na população brasileira no período entre 2002 e 2012. Realizou-se um estudo observacional de série temporal, no qual

  2. HIV Testing

    Science.gov (United States)

    ... Abroad Treatment Basic Statistics Get Tested Find an HIV testing site near you. Enter ZIP code or city Follow HIV/AIDS CDC HIV CDC HIV/AIDS See RSS | ... All Collapse All Should I get tested for HIV? CDC recommends that everyone between the ages of ...

  3. Use Contexts and Usage Patterns of Interactive Case Simulation Tools by HIV Healthcare Providers in a Statewide Online Clinical Education Program.

    Science.gov (United States)

    Wang, Dongwen

    2017-01-01

    We analyzed four interactive case simulation tools (ICSTs) from a statewide online clinical education program. Results have shown that ICSTs are increasingly used by HIV healthcare providers. Smart phone has become the primary usage platform for specific ICSTs. Usage patterns depend on particular ICST modules, usage stages, and use contexts. Future design of ICSTs should consider these usage patterns for more effective dissemination of clinical evidence to healthcare providers.

  4. Increasing Number and Proportion of Adverse Obstetrical Outcomes among Women Living with HIV in the Ottawa Area: A 20-Year Clinical Case Series

    Directory of Open Access Journals (Sweden)

    Sarah Buchan

    2016-01-01

    Full Text Available Background. The prevalence and associated risks with adverse obstetrical outcomes among women living with HIV are not well measured. The objective of this study was to longitudinally investigate the prevalence and correlates of adverse obstetrical outcomes among women with HIV. Methods. This 20-year (1990–2010 clinical case series assessed the prevalence of adverse obstetrical outcomes among pregnant women with HIV receiving care at The Ottawa Hospital (TOH. General estimating equation modeling was used to identify factors independently associated with adverse obstetrical outcomes, while controlling for year of childbirth clustering. Results. At TOH, there were 127 deliveries among 94 women (1990–2010: 22 preterm births, 9 births with low birth weight, 12 births small for gestational age, and 4 stillbirths. Per year, the odds of adverse obstetrical outcomes increased by 15% (OR: 1.15, 95% CI: 1.03–1.30. Psychiatric illness (AOR: 2.64, 95% CI: 1.12–6.24, teen pregnancy (AOR: 3.35, 95% CI: 1.04–1.46, and recent immigrant status (AOR: 7.24, 95% CI: 1.30–40.28 were the strongest correlates of adverse obstetrical outcomes. Conclusions. The increasing number and proportion of adverse obstetrical outcomes among pregnant women with HIV over the past 20 years highlight the need for social supports and maternal and child health interventions, especially among adolescents, new immigrants, and those with a history of mental illness.

  5. Administrative integration of vertical HIV monitoring and evaluation into health systems: a case study from South Africa.

    Science.gov (United States)

    Kawonga, Mary; Fonn, Sharon; Blaauw, Duane

    2013-01-24

    In light of an increasing global focus on health system strengthening and integration of vertical programmes within health systems, methods and tools are required to examine whether general health service managers exercise administrative authority over vertical programmes. To measure the extent to which general health service (horizontal) managers, exercise authority over the HIV programme's monitoring and evaluation (M&E) function, and to explore factors that may influence this exercise of authority. This cross-sectional survey involved interviews with 51 managers. We drew ideas from the concept of 'exercised decision-space' - traditionally used to measure local level managers' exercise of authority over health system functions following decentralisation. Our main outcome measure was the degree of exercised authority - classified as 'low', 'medium' or 'high' - over four M&E domains (HIV data collection, collation, analysis, and use). We applied ordinal logistic regression to assess whether actor type (horizontal or vertical) was predictive of a higher degree of exercised authority, independent of management capacity (training and experience), and M&E knowledge. Relative to vertical managers, horizontal managers had lower HIV M&E knowledge, were more likely to exercise a higher degree of authority over HIV data collation (OR 7.26; CI: 1.9, 27.4), and less likely to do so over HIV data use (OR 0.19; CI: 0.05, 0.84). A higher HIV M&E knowledge score was predictive of a higher exercised authority over HIV data use (OR 1.22; CI: 0.99, 1.49). There was no association between management capacity and degree of authority. This study demonstrates a HIV M&E model that is neither fully vertical nor integrated. The HIV M&E is characterised by horizontal managers producing HIV information while vertical managers use it. This may undermine policies to strengthen integrated health system planning and management under the leadership of horizontal managers.

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  8. Validity of dementia diagnoses in the danish hospital registers

    DEFF Research Database (Denmark)

    Phung, T.K.T.; Andersen, B.B.; Phung, T.K.T.

    2007-01-01

    Background:The validity of dementia diagnoses in the Danish nationwide hospital registers was evaluated to determine the value of these registers in epidemiological research about dementia. Methods: Two hundred patients were randomly selected from 4,682 patients registered for the first time...... with a dementia diagnosis in the last 6 months of 2003. The patients' medical journals were reviewed to evaluate if they fulfilled ICD-10 and/or DSM-IV criteria for dementia and specific dementia subtypes. The patients who were still alive in 2006 were invited to an interview. Results: One hundred and ninety......-seven journals were available for review and 51 patients were interviewed. A registered diagnosis of dementia was found to be correct in 169 (85.8%) cases. Regarding dementia subtypes, the degree of agreement between the registers and the results of the validating process was low with a kappa of 0.36 (95% CI 0...

  9. The Danish Medical Birth Register

    DEFF Research Database (Denmark)

    Bliddal, Mette; Broe, Anne; Pottegård, Anton

    2018-01-01

    The Danish Medical Birth Register was established in 1973. It is a key component of the Danish health information system. The register enables monitoring of the health of pregnant women and their offspring, it provides data for quality assessment of the perinatal care in Denmark, and it is used...... on all births in Denmark and comprises primarily of data from the Danish National Patient Registry supplemented with forms on home deliveries and stillbirths. It contains information on maternal age provided by the Civil Registration System. Information on pre-pregnancy body mass index and smoking...

  10. Danish registers on aspects of reproduction

    DEFF Research Database (Denmark)

    Blenstrup, Lene Tølbøll; Knudsen, Lisbeth B.

    2011-01-01

    Introduction: The establishing of three Danish population based registers, namely the Fertility Database, the Register of Legally Induced Abortions and the In Vitro Fertilisation register aimed at providing data for surveying of reproductive outcome. Content: The registers include information...... on births, abortions and assisted reproduction as well as selected characteristics of the women (and men) involved. Validity and Coverage: Both the validity and coverage of each register is considered of high quality. Conclusions: These registers provide, both individually and in combination, unique...

  11. Factors associated with male involvement in the prevention of mother to child transmission of HIV, Midlands Province, Zimbabwe, 2015 - a case control study

    Directory of Open Access Journals (Sweden)

    Annamercy Makoni

    2016-04-01

    Full Text Available Abstract Background Uptake of and adherence to the prevention of mother to child transmission of HIV (PMTCT interventions are a challenge to most women if there is no male partner involvement. Organizations which include the National AIDS Council and the Zimbabwe AIDS Prevention Project- University of Zimbabwe have been working towards mobilizing men for couple HIV testing and counseling (HTC in antenatal care (ANC. In 2013, Midlands province had 19 % males who were tested together with their partners in ANC, an increase by 9 % from 2011. However, this improvement was still far below the national target, hence this study was conducted to determine the associated factors. Methods A1:1 unmatched case control study was conducted. A case was a man who did not receive HIV testing and counseling together with his pregnant wife in ANC in Midlands province from January to June 2015. A control was a man who received HIV testing and counseling together with his pregnant wife in ANC in Midlands province from January to June 2015. Simple random sampling was used to select 112 cases and 112 controls. Epi Info statistical software was used to analyze data. Written informed consent was obtained from each study participant. Results Independent factors that predicted male involvement in PMTCT were: having been previously tested as a couple (aOR 0.22, 95 % CI = 0.12, 0.41 and having time to visit the clinic (aOR 0.41, 95 % CI = 0.21, 0.80. Being afraid of knowing one’s HIV status (aOR 2.22, 95 % CI = 1.04, 4.76 was independently associated with low male involvement in PMTCT. Conclusion Multiple factors were found to be associated with male involvement in PMTCT. Routine PMTCT educational campaigns in places where men gather, community based couple HTC and accommodating the working class during weekends are essential in fostering male involvement in PMTCT thereby reducing HIV transmission to the baby.

  12. Human-resources strategies for managing HIV/AIDS: the case of the South African forestry industry.

    Science.gov (United States)

    Gow, Jeff; Grant, Bligh

    2010-09-01

    Previous work has focused on HIV prevalence among forestry workers and the impact of HIV/AIDS on the sustainability of forest resources. Following a review of work examining the impacts of HIV/AIDS on the South African economy, this article presents original qualitative research examining the responses of company management to the HIV epidemic across a range of enterprises in the South African forestry industry, including large companies, contractors and cooperatives. At the level of the enterprise, management occupies a critical nexus, at which the intersecting requirements of complex government legislation, the wellbeing of workers and the demands of the business must be met. The research demonstrates that large forestry companies tend to provide only a small fraction of their workforces with HIV/AIDS education, prevention or treatment services, as they have essentially outsourced the requirement through the use of labour-supply contractors who, by and large, provide workers with scant HIV/AIDS-related programmes or benefits. Moreover, the extent to which the different types of forestry enterprises incorporate the management of HIV/AIDS in the workforce with the management of the business is highly variable, and in most instances falls short of legislative requirements that have been in place for over a decade. The implications of this for the forestry industry in South Africa are acute.

  13. Dynamic of CSF and serum biomarkers in HIV-1 subtype C encephalitis with CNS genetic compartmentalization-case study.

    Science.gov (United States)

    de Almeida, Sergio M; Rotta, Indianara; Ribeiro, Clea E; Oliveira, Michelli F; Chaillon, Antoine; de Pereira, Ana Paula; Cunha, Ana Paula; Zonta, Marise; Bents, Joao França; Raboni, Sonia M; Smith, Davey; Letendre, Scott; Ellis, Ronald J

    2017-06-01

    Despite the effective suppression of viremia with antiretroviral therapy, HIV can still replicate in the central nervous system (CNS). This was a longitudinal study of the cerebrospinal fluid (CSF) and serum dynamics of several biomarkers related to inflammation, the blood-brain barrier, neuronal injury, and IgG intrathecal synthesis in serial samples of CSF and serum from a patient infected with HIV-1 subtype C with CNS compartmentalization.The phylogenetic analyses of plasma and CSF samples in an acute phase using next-generation sequencing and F-statistics analysis of C2-V3 haplotypes revealed distinct compartmentalized CSF viruses in paired CSF and peripheral blood mononuclear cell samples. The CSF biomarker analysis in this patient showed that symptomatic CSF escape is accompanied by CNS inflammation, high levels of cell and humoral immune biomarkers, CNS barrier dysfunction, and an increase in neuronal injury biomarkers with demyelization. Independent and isolated HIV replication can occur in the CNS, even in HIV-1 subtype C, leading to compartmentalization and development of quasispecies distinct from the peripheral plasma. These immunological aspects of the HIV CNS escape have not been described previously. To our knowledge, this is the first report of CNS HIV escape and compartmentalization in HIV-1 subtype C.

  14. Clinical and laboratory profile of patients with TB/HIV coinfection: A case series of 50 patients

    Directory of Open Access Journals (Sweden)

    Anand K Patel

    2011-01-01

    Full Text Available Background: Tuberculosis (TB is said to be one of the commonest opportunistic infection in patients with HIV/AIDS. Objective: To study the clinical and laboratory profile of patients with HIV/TB coinfection. Materials and Methods: Fifty adult TB patients having confirmed HIV seropositivity were included in randomized manner. A detailed history and thorough physical examination was done. Laboratory and radiological investigations were carried out as appropriately warranted. Results: Most of the patients were farm workers (30% followed by manual laborers (22% and transport drivers (16%. Heterosexual route was found in 86% of patients. Cough was present in 94% while fever and weight loss in 86% and 78% of patients, respectively. Out of 50 patients, 40% had only pulmonary TB (PTB, 46% had pulmonary and extra-pulmonary TB (EPTB, 10% had only EPTB and 4% had multisystemic EPTB. Mediastinal lymphadenopathy was present in 34% while pleural effusion and extra-thoracic lymph nodes was present in 20% and 18% of patients, respectively. Positive smear for acid-fast bacilli (AFB was found in 25.58% while positive Mantoux test was found in 32.14% of patients. Conclusion: HIV/TB coinfection is more common in sexually active age group and commonest mode of HIV infection is heterosexual transfer. Sputum smear AFB and Mantoux test positivity is low in TB patients having HIV. Disseminated TB is common in HIV. Mediastinal lymphadenopathy is common site among extra-pulmonary tuberculosis.

  15. Attitudes and practices on HIV preventions among students of higher education institutions in Ethiopia: the case of Addis Ababa University.

    Science.gov (United States)

    Regassa, Nigatu; Kedir, Seman

    2011-06-01

    The main objective of this cross-sectional study is to assess higher education students' attitudes, their practice on preventive measures against HIV/AIDS; and examined factors affecting attitude and practice of the students related to HIV/AIDS prevention. The 606 study participants were drawn from Addis Ababa University, which is the oldest and biggest public university in Ethiopia, through multistage sampling. Data were collected using survey quantitative (questionnaire) and qualitative (FGDs), and subsequently, analysis of the data was made through the use of descriptive statistics (Frequency and logistic regression model). The findings of the study revealed that 207 (34.2%) of respondents were sexually active during the survey. Of these, 144 (23.8%) of them had sexual intercourse with their partner or someone in the last 6 months. The mean and median age at first sex debut was computed as 17.8 and 18.0 years respectively. About 489 (80.7%) did not perceive being at risk of contracting HIV/AIDS. But 65.5% of the respondent had favorable attitude on HIV prevention. 359 (59.2%) of the respondents had experienced at least one of the three HIV prevention practice. Of which, more than half (52.4%) adopted abstinence as top preventive measure. The result also showed that out of the total respondents 47.2% had been tested for HIV/AIDS and more than 80% have willingness to take VCT service for HIV/AIDS. As to the multivariate analysis result; sex, previous residence, religious participation, pornographic viewing, currently alcohol intake, chewing khat and cigarette smoking were found to be determinant of AAU students' attitude on HIV prevention. Similarly, age, having pocket money, pornographic film show and currently khat chewing were determinants of practices on HIV prevention. Finally, based on the findings, the study has forwarded some workable recommendations.

  16. Case Studies of Mental Health in General practice(28)---HIV and Mood Disturbance

    Institute of Scientific and Technical Information of China (English)

    Fiona Judd; Leon Piterman; Grant Blashki; Hui Yang

    2014-01-01

    The Journal presents the Column of Case Studies of Mental Health in General Practice;with aca-demic support from Australian eXperts in general practice,psychology and psychiatry from Monash University and the University of Mel-bourne. The Columnˊs purpose is to respond to the increasing need for the development of mental health services in China. Through study and analysis of mental health cases,we hope to improve understanding of mental illnesses in Chinese primary health settings,and to build capaci-ty amongst community health professionals in managing mental illnesses and psychological problems in general practice. A patient - centred whole - person approach in general practice is the best way to maintain and improve the physical and mental health of residents. Our hope is that these case studies will lead the new wave of general practice and mental health service development both in practice and research. A num-ber of Australian eXperts from the disciplines of general practice,mental health and psychiatry will contribute to the Column. Professor Blash-ki,Professor Judd and Professor Piterman are authors of the teXt General Practice Psychiatry;the Chinese version of the book to be published in 2014. The Journal cases are helping to prepare for the translation and publication of a Chinese version of the book in China. We believe Chi-nese mental health in primary health care will reach new heights under this international cooperation.

  17. Widowhood in the era of HIV/AIDS: A case study of Slaya District ...

    African Journals Online (AJOL)

    2007-08-02

    Aug 2, 2007 ... were drunk by the widow, guardian, his wife and children to protect them from any bad omen due to .... hired a mentally impaired man to cleanse me so that they could be free to re-marry in case their spouses died (FGD with .... driving forces for cleansing rites.This belief is deep- seated among the Luo such ...

  18. Treatment of Recurrent Hepatocellular Carcinoma with Sorafenib in a HIV/HCV Co-Infected patient in HAART: A Case Report

    Directory of Open Access Journals (Sweden)

    De Nardo Pasquale

    2012-06-01

    Full Text Available Abstract Background Liver disease is the second cause of death among HIV patients receiving highly active antiretroviral therapy (HAART in Europe. HIV patients have a high prevalence of chronic HBV (6–10% and HCV (33% co-infection, and accelerated progression of viral hepatitis. Furthermore, the long duration of both HIV and HCV diseases in the HAART era increases the risk of hepatocellular carcinoma. Findings We report the case of a 49 year -old HIV/HCV co-infected male patient who developed hepatocellular carcinoma. The patient underwent a partial hepatectomy, and a few months later was treated with transcatheter arterial chemoembolisation due to hepatocarcinoma recurrence. Two months later, advanced hepatocellular carcinoma was diagnosed and sorafenib therapy was initiated. The patient achieved partial response of the main lesions, complete regression of the smallest lesions and did not experience clinical progression during the 20-month follow-up period. During therapy with sorafenib, the patient was treated with HAART with good viral and immunological responses. We used the therapeutic drug monitoring to assess antiretroviral concentrations during co-administration of sorafenib. Fosamprenavir Ctrough was found under the minimum level recommended by international guidelines. No grade 3 or 4 toxicities were observed. At month 20 of treatment, new liver lesions with portal vein thrombosis were diagnosed. After 28 months of sorafenib therapy, the patient deceased for severe liver insufficiency. Conclusions Sorafenib monotherapy demonstrated a marked delay in HCC disease progression in an HIV/HCV co-infected patient. Fosamprenavir Ctrough was found under the minimum level recommended by international guidelines, suggesting a possible interaction.

  19. The Pediatric Cataract Register (PECARE)

    DEFF Research Database (Denmark)

    Haargaard, Birgitte; Nyström, Alf; Rosensvärd, Annika

    2015-01-01

    examination with a pencil light at age 5 weeks, whereas newborn red reflex examination using a handheld ophthalmoscope is routine protocol in Swedish maternity wards. Data regarding age of referral were derived from the Pediatric Cataract Register (PECARE). All children operated on before 1 year of age...

  20. Are Local Registers the Solution?

    NARCIS (Netherlands)

    Baldwin, R.; English, C.; Lemmen, C.H.J.; Rose, I.; Smith, A.; Solovov, A.; Sullivan, T.

    2018-01-01

    This paper explores the possibility of using local registers to manage and update land rights. Secure land rights are largely taken for granted in the developed world. Yet for many people in developing nations, clear and enforceable land rights are not a reality. In the developed world, land rights

  1. Encephalitis in primary HIV infection

    DEFF Research Database (Denmark)

    Helleberg, M; Kirk, O

    2013-01-01

    We report a case of primary HIV encephalitis, which initially presented as acute psychosis. Magnetic resonance imaging of the brain was suggestive of vasculitis and multiple infarctions, whereas a brain biopsy after six weeks of symptoms showed HIV encephalitis with microglial nodules, but no signs...... of vasculitis. We review previous reported cases and radiological findings in HIV encephalitis and discuss the role of antiretroviral therapy and steroids in its management....

  2. Increased health care utilization and increased antiretroviral use in HIV-infected individuals with mental health disorders.

    Science.gov (United States)

    Mijch, A; Burgess, P; Judd, F; Grech, P; Komiti, A; Hoy, J; Lloyd, J H; Gibbie, T; Street, A

    2006-05-01

    The aims of the study were to describe the prevalence and associations of mental health disorder (MHD) among a cohort of HIV-infected patients attending the Victorian HIV/AIDS Service between 1984 and 2000, and to examine whether antiretroviral therapy use or mortality was influenced by MHD (defined as a record of service provision by psychiatric services on the Victorian Psychiatric Case Register). It was hypothesized that HIV-positive individuals with MHD would have poorer treatment outcomes, reduced responses to highly active antiretroviral therapy (HAART) and increased mortality compared with those without MHD. This is a retrospective cohort of 2981 individuals (73% of the Victorian population diagnosed with HIV infection) captured on an HIV database which was electronically matched with the public Victorian Psychiatric Case Register (VPCR) (accounting for 95% of public system psychiatry service provision). The prevalence, dates and recorded specifics of mental health disorders at the time of the electronic match on 1 June 2000 are described. The association with recorded MHD, gender, age, AIDS illness, HIV exposure category, duration and type of antiviral therapy, treatment era (prior to 1986, post-1987 and pre-HAART, and post-HAART) on hospitalization and mortality at 1 September 2001 was assessed. Five hundred and twenty-five individuals (17.6% of the Victorian HIV-positive population) were recorded with MHD, most frequently coded as attributable to substance dependence/abuse or affective disorder. MHD was diagnosed prior to HIV in 33% and, of those diagnosed after HIV, 93.8% were recorded more than 1 year after the HIV diagnosis. Schizophrenia was recorded in 6% of the population with MHD. Hospitalizations for both psychiatric and nonpsychiatric illness were more frequent in those with MHD (relative risk 5.4; 95% confidence interval 3.7, 8.2). The total number of antiretrovirals used (median 6.4 agents vs 5.5 agents) was greater in those with MHD. When

  3. Using water and sanitation as an entry point to fight poverty and respond to HIV/AIDS: The case of Isulabasha Small Medium Enterprise

    Science.gov (United States)

    Manase, G.; Nkuna, Z.; Ngorima, E.

    South Africa is faced by a number of challenges that include low water and sanitation coverage in rural and peri-urban areas, high unemployment and increasing inequality between the rich and the poor as indicated by a Gini coefficient of 0.77; the second highest inequality in the world after Brazil. The situation is compounded by high HIV prevalence with South Africa having the largest HIV infection in the world. This case study demonstrates how water and sanitation is used as an entry point to address these major challenges and to empower communities. The project has two main components: the Small Medium Enterprise (SME) that trades in water and sanitation facilities and a community garden that ensures food security and nutrition for people living with HIV/AIDS. Income generated through these activities is ploughed back into the community through construction of sanitation facilities, maintenance of water pipes and paying school fees for orphans. In addition to creating employment, the project has also empowered the community to mobilise and address other challenges such as gender, child abuse and crime. The case study identifies weaknesses with projects designed solely to provide domestic drinking water and sanitation and calls for an integrated approach that uses water and sanitation as an entry point to unlock opportunities and empower the targeted communities.

  4. Data-protection standards and confidentiality of HIV/AIDS status in the workplace - a South African case study.

    Science.gov (United States)

    Muskat-Gorska, Zuzanna

    2008-11-01

    The article contextualises an emerging new regime for information privacy in South Africa (i.e. the draft Protection of Personal Information Bill). Subsequently, it discusses the possibility of successful implementation of international data-protection standards in an environment where there is an urgent need to balance HIV/AIDS confidentiality rights with public health requirements. Also, the article presents a preliminary assessment of the possible impact of professionalisation (and outsourcing) of workplace HIV/AIDS management on workplace data-protection practices, and it identifies some spaces for social dialogue on HIV/AIDS-data treatment in South Africa. The study methods comprise an analysis of legal documents (concerning international data-protection standards and the development of law governing data protection and HIV/AIDS confidentiality in South Africa) and interviews conducted with workplace health managers and trade union representatives, in Johannesburg, in 2007.

  5. HIV counseling and testing in a tertiary care hospital in Ganjam district, Odisha, India

    Directory of Open Access Journals (Sweden)

    M Dash

    2013-01-01

    Full Text Available Background: Human immunodeficiency virus (HIV counseling and testing (HCT conducted at integrated counseling and testing centers (ICTCs is an entry point, cost-effective intervention in preventing transmission of HIV. Objectives: To study the prevalence of HIV among ICTC attendees, sociodemographic characteristics, and risk behaviors of HIV-seropositive clients. Materials and Methods: It was hospital record-based cross-sectional study of 26,518 registered ICTC clients at a tertiary care hospital in Ganjam district, Odisha, India over a 4-year period from January 2009 to September 2012. Results: A total of 1732 (7.5% out of 22,897 who were tested for HIV were seropositive. Among HIV-seropositives, 1138 (65.7% were males, while 594 (34.3% were females. Majority (88.3% of seropositives were between the age group of 15-49 years. Client-initiated HIV testing (12.1% was more seropositive compared to provider-initiated (2.9%. Among discordant couples, majority (95.5% were male partner/husband positive and female partner/wife negative. Positives were more amongst married, less educated, low socioeconomic status, and outmigrants (P<0.0001. Risk factors included heterosexual promiscuous (89.3%, parent-to-child transmission 5.8%, unknown 3.1%, infected blood transfusion 0.8%, homosexual 0.5%, and infected needles (0.5%. Conclusions: There is need to encourage activities that promote HCT in all health facilities. This will increase the diagnosis of new HIV cases. The data generated in ICTC provide an important clue to understand the epidemiology in a particular geographic region and local planning for care and treatment of those infected with HIV and preventive strategies for those at risk especially married, young adults, and outmigrants to reduce new infections.

  6. HIV counseling and testing in a tertiary care hospital in Ganjam district, Odisha, India.

    Science.gov (United States)

    Dash, M; Padhi, S; Sahu, S; Mohanty, I; Panda, P; Parida, B; Sahoo, M K

    2013-01-01

    Human immunodeficiency virus (HIV) counseling and testing (HCT) conducted at integrated counseling and testing centers (ICTCs) is an entry point, cost-effective intervention in preventing transmission of HIV. To study the prevalence of HIV among ICTC attendees, sociodemographic characteristics, and risk behaviors of HIV-seropositive clients. It was hospital record-based cross-sectional study of 26,518 registered ICTC clients at a tertiary care hospital in Ganjam district, Odisha, India over a 4-year period from January 2009 to September 2012. A total of 1732 (7.5%) out of 22,897 who were tested for HIV were seropositive. Among HIV-seropositives, 1138 (65.7%) were males, while 594 (34.3%) were females. Majority (88.3%) of seropositives were between the age group of 15-49 years. Client-initiated HIV testing (12.1%) was more seropositive compared to provider-initiated (2.9%). Among discordant couples, majority (95.5%) were male partner/husband positive and female partner/wife negative. Positives were more amongst married, less educated, low socioeconomic status, and outmigrants (P<0.0001). Risk factors included heterosexual promiscuous (89.3%), parent-to-child transmission 5.8%, unknown 3.1%, infected blood transfusion 0.8%, homosexual 0.5%, and infected needles (0.5%). There is need to encourage activities that promote HCT in all health facilities. This will increase the diagnosis of new HIV cases. The data generated in ICTC provide an important clue to understand the epidemiology in a particular geographic region and local planning for care and treatment of those infected with HIV and preventive strategies for those at risk especially married, young adults, and outmigrants to reduce new infections.

  7. AIDS Impact special issue 2009: HIV prevention through sport: the case of the Mathare Youth Sport Association in Kenya

    OpenAIRE

    2010-01-01

    Abstract Sport has become a popular tool for HIV prevention, based on claims that it can foster life skills that are necessary to translate knowledge, attitudes and behavioural intentions into actual behaviour. Empirical evidence of the effectiveness of sport-based HIV prevention programmes is, however, sorely lacking. We therefore conducted a cross-sectional survey assessing sexual behaviour and the determinants thereof among 454 youth of the Mathare Youth Sport Association (MYSA)...

  8. Impact of systematic HIV testing on case finding and retention in care at a primary care clinic in South Africa.

    Science.gov (United States)

    Clouse, Kate; Hanrahan, Colleen F; Bassett, Jean; Fox, Matthew P; Sanne, Ian; Van Rie, Annelies

    2014-12-01

    Systematic, opt-out HIV counselling and testing (HCT) may diagnose individuals at lower levels of immunodeficiency but may impact loss to follow-up (LTFU) if healthier people are less motivated to engage and remain in HIV care. We explored LTFU and patient clinical outcomes under two different HIV testing strategies. We compared patient characteristics and retention in care between adults newly diagnosed with HIV by either voluntary counselling and testing (VCT) plus targeted provider-initiated counselling and testing (PITC) or systematic HCT at a primary care clinic in Johannesburg, South Africa. One thousand one hundred and forty-four adults were newly diagnosed by VCT/PITC and 1124 by systematic HCT. Two-thirds of diagnoses were in women. Median CD4 count at HIV diagnosis (251 vs. 264 cells/μl, P = 0.19) and proportion of individuals eligible for antiretroviral therapy (ART) (67.2% vs. 66.7%, P = 0.80) did not differ by HCT strategy. Within 1 year of HIV diagnosis, half were LTFU: 50.5% under VCT/PITC and 49.6% under systematic HCT (P = 0.64). The overall hazard of LTFU was not affected by testing policy (aHR 0.98, 95%CI: 0.87-1.10). Independent of HCT strategy, males, younger adults and those ineligible for ART were at higher risk of LTFU. Implementation of systematic HCT did not increase baseline CD4 count. Overall retention in the first year after HIV diagnosis was low (37.9%), especially among those ineligible for ART, but did not differ by testing strategy. Expansion of HIV testing should coincide with effective strategies to increase retention in care, especially among those not yet eligible for ART at initial diagnosis. © 2014 John Wiley & Sons Ltd.

  9. Longitudinal associations between case management and supportive services use among black and Latina HIV-positive women in New York City.

    Science.gov (United States)

    Halkitis, Perry N; Kupprat, Sandra A; Mukherjee, Preetika Pandey

    2010-01-01

    The literature analyzing the relationship between case management and supportive service use longitudinally among African American and Latina HIV-positive women is limited. This retrospective analysis of participant case management, supportive service, and medical charts sought to examine both descriptive and relational data on use of case management and supportive services over a 2-year period from 2002 to 2005 and to analyze moderating person- level or institution-level factors. The analyzed case management, supportive service, and medical charts revealed that participants interacted with their case manager four times and received 3.6 supportive services per month. Transportation, primary healthcare/medical specialists, and support groups were the services most used, with rates ranging from 70% to 80%. Using hierarchical linear modeling (HLM), the unconditional growth models showed that case management and supportive service use patterns remained constant over the 24-month period. Additionally, the multivariate unconditional model suggests a significant positive relationship between case management and supportive services. No moderation was indicated in the association between case management and supportive service use by person-level (e.g., mental illness, substance use) and institution-level (i.e., service delivery model) factors. Participants use supportive and case management services in a similar manner based on individual need. This synergistic relationship suggests that increases in either may result in retaining women in care. Implications for service delivery point to the need for skills building training for case managers, outreach workers, or system navigators to assist with short-term goals of establishing rapport and maintaining the client relationship, as this may lead to HIV-positive women accessing services. Additionally, outreach and engagement strategies need to be developed for those who typically underuse these services.

  10. Development of a prototype continuity of care record with context-specific links to meet the information needs of case managers for persons living with HIV.

    Science.gov (United States)

    Schnall, Rebecca; Cimino, James J; Bakken, Suzanne

    2012-08-01

    (1) To develop a prototype Continuity of Care Record (CCR) with context-specific links to electronic HIV information resources; and (2) to assess case managers' perceptions regarding the usability of the prototype. We integrated context-specific links to HIV case management information resources into a prototype CCR using the Infobutton Manager and Librarian Infobutton Tailoring Environment (LITE). Case managers (N=9) completed a think-aloud protocol and the Computer System Usability Questionnaire (CSUQ) to evaluate the usability of the prototype. Verbalizations from the think-aloud protocol were summarized using thematic analysis. CSUQ data were analyzed with descriptive statistics. Although participants expressed positive comments regarding the usability of the prototype, the think-aloud protocol also identified the need for improvement in resource labels and for additional resources. On a scale ranging from 1 (strongly agree) to 7 (strongly disagree), the average CSUQ overall satisfaction was 2.25 indicating that users (n=9) were generally satisfied with the system. Mean CSUQ factor scores were: System Usefulness (M=2.13), Information Quality (M=2.46), and Interface Quality (M=2.26). Our novel application of the Infobutton Manager and LITE in the context of case management for persons living with HIV in community-based settings resulted in a prototype CCR with infobuttons that met the majority of case managers' information needs and received relatively positive usability ratings. Findings from this study inform future integration of context-specific links into CCRs and electronic health records and support their use for meeting end-users information needs. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  11. [Neuromeningeal cryptococcosis in patients infected with HIV at Agadir regional hospital, (Souss-Massa, Morocco)].

    Science.gov (United States)

    Chadli, S; Aghrouch, M; Taqarort, N; Malmoussi, M; Ouagari, Z; Moustaoui, F; Bourouache, M; Oulkheir, S

    2018-03-01

    Neuromeningeal cryptococcosis (NMC) is a severe and fatal opportunistic infection. Lethality is frequent in the absence of treatment, especially in the presence of HIV co-infection. To determine the prevalence, epidemiological, clinical, biological and therapeutic aspects as well as the evolution of NMC for patients infected with HIV. This is a retrospective study of 40 cases of neuromeningeal cryptococcosis diagnosed in HIV-infected patients. Data are collected for 7 years (from January 2010 to December 2016) in the registers of the parasitology laboratory and the infectious diseases department at the regional hospital center in Agadir. A reduction in the prevalence of neuromeningeal cryptococcosis in HIV-infected patients was noted from 2010 to 2016 (3.66% to 0.83%). The overall prevalence of NMC was 1.53%. The mean age was 37±10 years old, with 90% of patients aged less than 45 years. The main clinical symptomatology was headache (75%). The main cytochemical abnormalities of cerebrospinal fluid analysis were hyperproteinorachy (60%), hypoglycorachy (63%) and lymphocytosis (50%). The mean CD4 cell count was 47/mm 3 . Patients were initially treated with amphotericin B, relayed with fluconazole. The overall lethality was 35%. Neuromeningeal cryptococcosis is a serious opportunistic infection in patients HIV-infected, and the lethality rate remains unacceptable. Fighting NMC in HIV+ patients requires early diagnosis, increased access to antiretrovirals, rapid introduction of appropriate treatment and the prescription of effective systemic antifungals. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  12. Pregnancy outcomes in perinatally HIV-infected young women in Madrid, Spain: 2000-2015.

    Science.gov (United States)

    Prieto, Luis M; Fernández McPhee, Carolina; Rojas, Patricia; Mazariegos, Diana; Muñoz, Eloy; Mellado, Maria José; Holguín, África; Navarro, María Luisa; González-Tomé, María Isabel; Ramos, José Tomás

    2017-01-01

    An increasing number of perinatally HIV-infected women (PHIV) are reaching adulthood and becoming pregnant. Most PHIV women have been exposed to a high number of antiretroviral regimens, and they may have difficulties to achieve viral suppression. Psychosocial problems are not uncommon and could be an important barrier for treatment adherence. The effects of chronic HIV infection and long-term exposure to antiretroviral treatment of PHIV women cause concerns on the developing fetus. The aims of this study were to describe the prevention of mother-to-child transmission strategies in PHIV women and the infant outcomes in the Madrid Cohort of HIV-infected mother-infant pairs. All PHIV pregnant women registered in the Cohort that gave birth from 2000 to 2015 were included in the study. Twenty-eight pregnancies in twenty-two perinatally infected women were registered. Most women were Caucasian and heavily treatment-experienced. Nine cases (32.1%) were at high risk of HIV mother-to-child transmission. Maternal HIV-1 viral load was detectable close to delivery in four women (14.3%). The management of these cases was described, and the treatment strategies were discussed. None of the newborns acquired HIV infection. Eight infants (28.6%) were small for gestational age. This study included a large series of pregnancies among PHIV women attended according to a youth-centered care model. The challenges in the management of this population by health-care providers were described. Specific strategies to minimize perinatal transmission risks should be addressed in future collaborative studies.

  13. The Copenhagen School Health Records Register

    DEFF Research Database (Denmark)

    Baker, Jennifer L; Sørensen, Thorkild I A

    2011-01-01

    The Copenhagen School Health Records Register is an electronic register of health examination information on 372,636 children who attended school in Copenhagen, Denmark from 1936 to 2005.......The Copenhagen School Health Records Register is an electronic register of health examination information on 372,636 children who attended school in Copenhagen, Denmark from 1936 to 2005....

  14. CD3 Positive Gastric Plasmablastic Lymphoma in A HIV Negative Patient: A Case Report

    Directory of Open Access Journals (Sweden)

    Betül Bolat Küçükzeybek,

    2017-03-01

    Full Text Available Plasmablastic lymphoma is a rare and aggressive lymphoma characterized by the diffuse proliferation of large neoplastic cells resembling immunoblasts with an immunophenotype of plasma cells. A 47-year-old male was referred to our hospital with gastrointestinal bleeding, and a mass 10 cm in diameter, was detected. An endoscopic biopsy was performed subsequently. Histopathological examination of the biopsy material revealed ulcer, alterations associated with ulcer, and further presented a diffuse infiltration of atypical cells with abundant cytoplasm and pleomorphic nuclei, some with crush artifacts in lamina propria. Immunohistochemically, the tumor cells were negative for cytokeratin, CD2, CD20, and PAX5; but they were positive for CD3, MUM1, CD38 and CD138. Ki67 proliferation index was as high as 95%. The case was signed out as CD3-positive plasmablastic lymphoma with clinical, histopathological and immunohisto-chemical findings. The plasmablastic lymphoma case with an aberrant CD3 expression has been presented here, which is rarely observed in stomach.

  15. Administrative integration of vertical HIV monitoring and evaluation into health systems: a case study from South Africa

    Directory of Open Access Journals (Sweden)

    Mary Kawonga

    2013-01-01

    Full Text Available Background: In light of an increasing global focus on health system strengthening and integration of vertical programmes within health systems, methods and tools are required to examine whether general health service managers exercise administrative authority over vertical programmes. Objective: To measure the extent to which general health service (horizontal managers, exercise authority over the HIV programme's monitoring and evaluation (M&E function, and to explore factors that may influence this exercise of authority. Methods: This cross-sectional survey involved interviews with 51 managers. We drew ideas from the concept of ‘exercised decision-space’ – traditionally used to measure local level managers’ exercise of authority over health system functions following decentralisation. Our main outcome measure was the degree of exercised authority – classified as ‘low’, ‘medium’ or ‘high’ – over four M&E domains (HIV data collection, collation, analysis, and use. We applied ordinal logistic regression to assess whether actor type (horizontal or vertical was predictive of a higher degree of exercised authority, independent of management capacity (training and experience, and M&E knowledge. Results: Relative to vertical managers, horizontal managers had lower HIV M&E knowledge, were more likely to exercise a higher degree of authority over HIV data collation (OR 7.26; CI: 1.9, 27.4, and less likely to do so over HIV data use (OR 0.19; CI: 0.05, 0.84. A higher HIV M&E knowledge score was predictive of a higher exercised authority over HIV data use (OR 1.22; CI: 0.99, 1.49. There was no association between management capacity and degree of authority. Conclusions: This study demonstrates a HIV M&E model that is neither fully vertical nor integrated. The HIV M&E is characterised by horizontal managers producing HIV information while vertical managers use it. This may undermine policies to strengthen integrated health system

  16. Independent predictors of tuberculosis mortality in a high HIV prevalence setting: a retrospective cohort study.

    Science.gov (United States)

    Pepper, Dominique J; Schomaker, Michael; Wilkinson, Robert J; de Azevedo, Virginia; Maartens, Gary

    2015-01-01

    Identifying those at increased risk of death during TB treatment is a priority in resource-constrained settings. We performed this study to determine predictors of mortality during TB treatment. We performed a retrospective analysis of a TB surveillance population in a high HIV prevalence area that was recorded in ETR.net (Electronic Tuberculosis Register). Adult TB cases initiated TB treatment from 2007 through 2009 in Khayelitsha, South Africa. Cox proportional hazards models were used to identify risk factors for death (after multiple imputations for missing data). Model selection was performed using Akaike's Information Criterion to obtain the most relevant predictors of death. Of 16,209 adult TB cases, 851 (5.3 %) died during TB treatment. In all TB cases, advancing age, co-infection with HIV, a prior history of TB and the presence of both pulmonary and extra-pulmonary TB were independently associated with an increasing hazard of death. In HIV-infected TB cases, advancing age and female gender were independently associated with an increasing hazard of death. Increasing CD4 counts and antiretroviral treatment during TB treatment were protective against death. In HIV-uninfected TB cases, advancing age was independently associated with death, whereas smear-positive disease was protective. We identified several independent predictors of death during TB treatment in resource-constrained settings. Our findings inform resource-constrained settings about certain subgroups of TB patients that should be targeted to improve mortality during TB treatment.

  17. National register of research projects

    Energy Technology Data Exchange (ETDEWEB)

    1985-03-01

    This Register is intended to serve as a source of information on research which is being conducted in all fields (both natural and human sciences) in the Republic of South Africa. New research projects commenced during 1983 or 1984, and significantly changed research projects, as well as project that were completed or terminated during this period, on which information was received by the compilers before December 1984, are included, with the exception of confidential projects.

  18. VISUALIZATION OF REGISTERED SUBSURFACE ANATOMY

    DEFF Research Database (Denmark)

    2010-01-01

    A system and method for visualization of subsurface anatomy includes obtaining a first image from a first camera and a second image from a second camera or a second channel of the first camera, where the first and second images contain shared anatomical structures. The second camera and the secon....... A visual interface displays the registered visualization of the first and second images. The system and method are particularly useful for imaging during minimally invasive surgery, such as robotic surgery....

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

    DEFF Research Database (Denmark)

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

    2007-01-01

    We identified all Danish HIV patients registered with myocardial infarction (MI) when on HAART (44 patients) and compared their mortality with that of matched patients with MI and no HIV and patients with HIV and no MI. Mortality in HIV-infected MI patients was not significantly different...... to that of MI only patients in the first 90 days post-MI and thereafter was not significantly different to that of HIV patients without MI. Udgivelsesdato: 2007-Apr-23...

  20. Determinant factors associated with occurrence of tuberculosis among adult people living with HIV after antiretroviral treatment initiation in Addis Ababa, Ethiopia: a case control study.

    Directory of Open Access Journals (Sweden)

    Kelemu Tilahun Kibret

    Full Text Available INTRODUCTION: Tuberculosis (TB is a leading morbidity and mortality, and the first presenting sign in majority of people living with Human Immune deficiency Virus (PLWH. Determinants of active TB among HIV patients on anti retroviral treatment (ART are not well described in resource limited settings. The aim of this study was to assess determinant factors for the occurrence of TB among people living with HIV after ART initiation in public hospitals and health centers in Addis Ababa, Ethiopia. METHODS AND FINDINGS: A case control study was conducted from December 2011 to February 2012 in 2 public hospitals and 13 health centers in Addis Ababa. The study population consisted of 204 cases and 409 controls. Cases were adult people living with HIV who developed TB after ART initiation and controls were adult people living with HIV who did not develop TB after ART initiation. An interviewer administered structured questionnaire was used to collect information. After adjustment for potential confounders, presence of isoniazid prophylaxis (adjusted odd ratio [AOR] 0.35, 95% confidence interval [CI] 0.125, 0.69 and cotrimoxazole prophylaxis (AOR = 0.19; 95% CI: 0.06, 0.62 had protective benefit against risk of TB. In contrary, bedridden (AOR = 9.36; 95% CI: 3.39, 25.85, having World Health Organization (WHO clinical stage III/IV (AOR = 3.40; 95% CI: 1.69, 6.87 and hemoglobin level <10 mg/dl (AOR = 7.43; 95% CI; 3.04, 18.31 at enrollment to ART care were predictors for increased risk of tuberculosis in PLWH after ART initiation. CONCLUSION: Increasing coverage of isoniazid preventive therapy and cotrimoxazole preventive therapy reduced risk of TB among HIV patients who started treatment. All PLWH should be screened for TB, but for patients who have advanced disease condition (WHO clinical stage III/IV, being bedridden and having hemoglobin level <10 mg/dl intensified screening is highly recommended during treatment follow up.

  1. HIV pre-exposure prophylaxis and health and community systems in the Global South: Thailand case study.

    Science.gov (United States)

    Colby, Donn; Srithanaviboonchai, Kriengkrai; Vanichseni, Suphak; Ongwandee, Sumet; Phanuphak, Nittaya; Martin, Michael; Choopanya, Kachit; Chariyalertsak, Suwat; van Griensven, Frits

    2015-01-01

    Pre-exposure prophylaxis (PrEP) is recommended by the World Health Organization as an effective method of HIV prevention for individuals at risk for infection. In this paper, we describe the unique role that Thailand has played in the global effort to combat the HIV epidemic, including its role in proving the efficacy of PrEP, and discuss the opportunities and challenges of implementing PrEP in a middle-income country. Thailand was one of the first countries in the world to successfully reverse a generalized HIV epidemic. Despite this early success, HIV prevalence has remained high among people who inject drugs and has surged among men who have sex with men (MSM) and transgender women (TGW). Two pivotal trials that showed that the use of oral antiretroviral medication as PrEP can reduce HIV transmission were conducted partially or entirely at Thai sites. Demonstration projects of PrEP, as well as clinical trials of alternative PrEP regimens, began or will begin in 2014-2015 in Thailand and will provide additional data and experience on how to best implement PrEP for high-risk individuals in the community. Financing of drug costs, the need for routine laboratory monitoring and lack of awareness about PrEP among at-risk groups all present challenges to the wider implementation of PrEP for HIV prevention in Thailand. Although significant challenges to wider use remain, PrEP holds promise as a safe and highly effective method to be used as part of a combined HIV prevention strategy for MSM and TGW in Thailand.

  2. Solitary Kaposi's sarcoma in retromolar region of an HIV positive patient: case report Sarcoma de Kaposi em região retromolar de um paciente HIV positivo: relato de caso

    Directory of Open Access Journals (Sweden)

    Maiara de Moraes

    2012-02-01

    Full Text Available Kaposi's sarcoma is a malignant neoplasm of vascular origin. It occurs mainly among immune deficient individuals, thus it is the most common neoplasm among HIV- positive patients. Its pathogenesis is complex and has not been fully clarified. This case arouses particular interest due to its anatomic location in the retromolar region of a 39-year-old male HIV- positive patient, who presented low white blood cell count and was not undergoing antiretroviral therapy. The emergence of this lesion may be associated with highly active antiretroviral therapy (HAART discontinuation and leukopenia. Hence, the reestablishment of therapy allows a suitable therapeutic approach and contributes to prognosis and survival rates.Sarcoma de Kaposi é uma neoplasia maligna de origem vascular que ocorre principalmente em indivíduos com deficiência imunológica, sendo a neoplasia mais comum em pacientes HIV positivos. Sua patogênese é complexa e não está bem estabelecida. Este caso é de interesse pela localização anatômica em região retromolar de paciente soropositivo, que apresentou baixa contagem de células brancas do sangue e que não realizava terapia antirretroviral. O surgimento da lesão pode estar associado à interrupção da terapia antirretroviral altamente ativa (HAART e à baixa contagem leucocitária. Assim, o restabelecimento da terapia pode permitir a abordagem terapêutica e contribuir para o prognóstico e a sobrevida.

  3. HIV counselling in prisons.

    Science.gov (United States)

    Curran, L; McHugh, M; Nooney, K

    1989-01-01

    HIV presents particular problem in penal establishments: the nature of the population; conditions in prison; media attention and misinformation; the possibility of transmission within and beyond the prison population; the extra issues that apply to female prisoners. These are discussed in the context of prison policy regarding HIV and the broad strategic approach which is being adopted to manage the problem of HIV within penal institutions. Counselling has a key role in the overall strategy. Pre- and post-test counselling with prisoners is described and the particular problems presented by inmates are discussed and illustrated by reference to case histories. Developments in counselling provision for inmates are outlined.

  4. Corporate social responsibility in public health: A case-study on HIV/AIDS epidemic by Johnson & Johnson company in Africa.

    Science.gov (United States)

    Chattu, Vijay Kumar

    2015-01-01

    HIV/AIDS has claimed millions of lives in the global workforce and continues to remain a threat to many businesses. An estimated 36.5 million of working people are living with HIV; the global workforce has lost 28 million people from AIDS since the beginning of the epidemic. In the absence of access to treatment, this number could grow to 74 million by 2015. The epidemic continues to affect the working population through absenteeism, sickness and death. Corporate Social Responsibility (CSR) is an obligation that corporates have toward their employees, community and society. A review and documentation of one such CSR by Johnson & Johnson (a multinational company) for HIV/AIDS in Africa is presented here. Johnson & Johnson Company is involved in numerous projects around the world to combat the HIV/AIDS epidemic. The company is working to fight the spread of the disease and improve the quality of life for those living with the illness through various donations of its products and sponsorship of local programs. This case study also highlights different categories of CSR activities such as Cause Promotion, Cause related Marketing, Corporate Philanthropy, Corporate Social Marketing, Corporate Volunteering and Socially responsible business practices, which are discussed with specific examples from different countries in Africa. CSR of any business encompasses the economic, legal, ethical & discretionary expectation placed on the organization by society at a given point of time. CSR is therefore the obligation that corporations have toward their stakeholders and society in general which horizons beyond what is prescribed by law or union contracts. Johnson & Johnson has a proved history of being committed to caring for people and a good example of a company with a long history of citizenship and sustainability.

  5. Corporate social responsibility in public health: A case-study on HIV/AIDS epidemic by Johnson & Johnson company in Africa

    Science.gov (United States)

    Chattu, Vijay Kumar

    2015-01-01

    HIV/AIDS has claimed millions of lives in the global workforce and continues to remain a threat to many businesses. An estimated 36.5 million of working people are living with HIV; the global workforce has lost 28 million people from AIDS since the beginning of the epidemic. In the absence of access to treatment, this number could grow to 74 million by 2015. The epidemic continues to affect the working population through absenteeism, sickness and death. Corporate Social Responsibility (CSR) is an obligation that corporates have toward their employees, community and society. A review and documentation of one such CSR by Johnson & Johnson (a multinational company) for HIV/AIDS in Africa is presented here. Johnson & Johnson Company is involved in numerous projects around the world to combat the HIV/AIDS epidemic. The company is working to fight the spread of the disease and improve the quality of life for those living with the illness through various donations of its products and sponsorship of local programs. This case study also highlights different categories of CSR activities such as Cause Promotion, Cause related Marketing, Corporate Philanthropy, Corporate Social Marketing, Corporate Volunteering and Socially responsible business practices, which are discussed with specific examples from different countries in Africa. Conclusions: CSR of any business encompasses the economic, legal, ethical & discretionary expectation placed on the organization by society at a given point of time. CSR is therefore the obligation that corporations have toward their stakeholders and society in general which horizons beyond what is prescribed by law or union contracts. Johnson & Johnson has a proved history of being committed to caring for people and a good example of a company with a long history of citizenship and sustainability. PMID:25810667

  6. Registratie van SOA en HIV consulten bij GGD's en SOA-poliklinieken: Jaarverslag 2000

    NARCIS (Netherlands)

    Laar MJW van de; Haks K; Coenen AJJ; CIE

    2001-01-01

    Public health nurses at the municipal health services keep a register of patients attending the MHS or STD clinic for diagnosis and treatment of STD or request for HIV-testing. Data are collected at a national level and are only registered for an actual STD or HIV consultation with confirmed

  7. Epidemiological and Immunological Characteristics at the Time of HIV Diagnosis for HIV/AIDS Cohort Registrants Representative of HIV-Infected Populations in Korea

    OpenAIRE

    Lee, Jin-Hee; Kim, Seung Hyun; Wang, Jin-Sook; Sung, Kyoung Mi; Kim, Sung Soon; Kee, Mee-Kyung

    2012-01-01

    Objectives The Korea HIV/AIDS cohort was constructed with 18 hospitals that care for HIV-infected individuals in 2006. We compared the epidemiological and immunological characteristics of the cohort registrants with those of the HIVinfected population at the time of HIV diagnosis. Methods This study was conducted on 5717 people living with HIV/AIDS from 1985 to 2009, of which 789 individuals registered with the Korea HIV/AIDS cohort study. Individuals who had data from initial CD4+ T-cell cou...

  8. The Times, They are a-Changing: HOPE for HIV-to-HIV Organ Transplantation.

    Science.gov (United States)

    Haidar, Ghady; Singh, Nina

    2017-09-01

    HIV-infected persons who achieve undetectable viral loads on antiretroviral therapy currently have near-normal lifespans. Liver disease is a major cause of non-AIDS-related deaths, and as a result of longer survival, the prevalence of end-stage renal disease in HIV is increasing. HIV-infected persons undergoing organ transplantation generally achieve comparable patient and graft survival rates compared to their HIV-uninfected counterparts, despite a nearly threefold increased risk of acute rejection. However, the ongoing shortage of suitable organs can limit transplantation as an option, and patients with HIV have higher waitlist mortality than others. One way to solve this problem would be to expand the donor pool to include HIV-infected individuals. The results of a South Africa study involving 27 HIV-to-HIV kidney transplants showed promise, with 3- and 5-year patient and graft survival rates similar to those of their HIV-uninfected counterparts. Similarly, individual cases of HIV-to-HIV liver transplantation from the United Kingdom and Switzerland have also shown good results. In the United States, HIV-to-HIV kidney and liver transplants are currently permitted only under a research protocol. Nevertheless, areas of ambiguity exist, including streamlining organ allocation practices, optimizing HIV-infected donor and recipient selection, managing donor-derived transmission of a resistant HIV strain, determining optimal immunosuppressive and antiretroviral regimens, and elucidating the incidence of rejection in HIV-to-HIV solid organ transplant recipients.

  9. Complete self-mutilation of male genitals as a severe form of psychiatric manifestation of HIV: A case report with review of literature

    Directory of Open Access Journals (Sweden)

    Sriharsha Bokka

    2016-01-01

    Full Text Available Genital self-mutilation (GSM is a rare event that is commonly associated with psychotic disorders. However, such injuries have also been reported in nonpsychotic patients as a result of either bizarre autoerotic acts and attempts at crude sex-change operation by transsexuals or secondary complex religious beliefs and delusions regarding sexual guilt. We report a case of GSM in a human immunodeficiency virus (HIV-positive individual who not only severed his penis, scrotum, and testes completely as a result of internal conflict and frustration but also refused any further treatment toward reconstruction owing to his guilt.

  10. Women and HIV

    Science.gov (United States)

    ... Consumer Information by Audience For Women Women and HIV: Get the Facts on HIV Testing, Prevention, and Treatment Share Tweet Linkedin Pin ... How can you lower your chance of HIV? HIV Quick Facts What is HIV? HIV is the ...

  11. Children's caregiving of HIV-infected parents accessing treatment in ...

    African Journals Online (AJOL)

    Children's caregiving of HIV-infected parents accessing treatment in western Kenya: challenges and ... Log in or Register to get access to full text downloads. ... The research draws attention to the difficulties and opportunities of strengthening ...

  12. Neurological manifestations of HIV infection in Nigerians | Imam ...

    African Journals Online (AJOL)

    Log in or Register to get access to full text downloads. ... Nervous system complications commonly accompany HIV infection and are associated with significant ... In all, 89 patients (44%) were diagnosed with at least one neurological disorder.

  13. Retrivability in The Danish National Hospital Registry of HIV and hepatitis B and C coinfection diagnoses of patients managed in HIV centers 1995–2004

    Directory of Open Access Journals (Sweden)

    Sørensen Henrik T

    2008-04-01

    Full Text Available Abstract Background Hospital-based discharge registries are used increasingly for longitudinal epidemiological studies of HIV. We examined completeness of registration of HIV infections and of chronic hepatitis B (HBV and hepatitis C (HCV coinfections in the Danish National Hospital Registry (DNHR covering all Danish hospitals. Methods The Danish HIV Cohort Study (DHCS encompasses all HIV-infected patients treated in Danish HIV clinics since 1 January 1995. All 2,033 Danish patients in DHCS diagnosed with HIV-1 during the 10-year period from 1 January 1995 to 31 December 2004 were included in the current analysis. We used the DHCS as a reference to examine the completeness of HIV and of HBV and HCV coinfections recorded in DNHR. Cox regression analysis was used to estimate hazard ratios of time to diagnosis of HIV in DNHR compared to DHCS. Results Of the 2,033 HIV patients in DHCS, a total of 2,006 (99% were registered with HIV in DNHR. Of these, 1,888 (93% were registered in DNHR within one year of their first positive HIV test. A CD4 = 100,000 copies/ml and being diagnosed after 1 January 2000, were associated with earlier registration in DNHR, both in crude and adjusted analyses. Thirty (23% HIV patients registered with chronic HBV (n = 129 in DHCS and 126 (48% of HIV patients with HCV (n = 264 in DHCS were registered with these diagnoses in the DNHR. Further 17 and 8 patients were registered with HBV and HCV respectively in DNHR, but not in DHCS. The positive predictive values of being registered with HBV and HCV in DHCS were thereby estimated to 0.88 and 0.97 and in DNHR to 0.32 and 0.54. Conclusion The study demonstrates that secondary data from national hospital databases may be reliable for identification of patients diagnosed with HIV infection. However, the predictive value of co-morbidity data may be low.

  14. Quality control of portal imaging with PTW EPID QC PHANTOM registered

    International Nuclear Information System (INIS)

    Pesznyak, Csilla; Kiraly, Reka; Polgar, Istvan; Zarand, Pal; Mayer, Arpad; Fekete, Gabor; Mozes, Arpad; Kiss, Balazs

    2009-01-01

    Purpose: quality assurance (QA) and quality control (QC) of different electronic portal imaging devices (EPID) and portal images with the PTW EPID QC PHANTOM registered . Material and methods: characteristic properties of images of different file formats were measured on Siemens OptiVue500aSi registered , Siemens BeamView Plus registered , Elekta iView registered , and Varian PortalVision trademark and analyzed with the epidSoft registered 2.0 program in four radiation therapy centers. The portal images were taken with Kodak X-OMAT V registered and the Kodak Portal Localisation ReadyPack registered films and evaluated with the same program. Results: the optimal exposition both for EPIDs and portal films of different kind was determined. For double exposition, the 2+1 MU values can be recommended in the case of Siemens OptiVue500aSi registered , Elekta iView registered and Kodak Portal Localisation ReadyPack registered films, while for Siemens BeamView Plus registered , Varian PortalVision trademark and Kodak X-OMAT V registered film 7+7 MU is recommended. Conclusion: the PTW EPID QC PHANTOM registered can be used not only for amorphous silicon EPIDs but also for images taken with a video-based system or by using an ionization chamber matrix or for portal film. For analysis of QC tests, a standardized format (used at the acceptance test) should be applied, as the results are dependent on the file format used. (orig.)

  15. HIV+ deceased donor referrals: A national survey of organ procurement organizations.

    Science.gov (United States)

    Cash, Ayla; Luo, Xun; Chow, Eric K H; Bowring, Mary Grace; Shaffer, Ashton A; Doby, Brianna; Wickliffe, Corey E; Alexander, Charles; McRann, Deborah; Tobian, Aaron A R; Segev, Dorry L; Durand, Christine M

    2018-02-01

    HIV-infected (HIV+) donor organs can be transplanted into HIV+ recipients under the HIV Organ Policy Equity (HOPE) Act. Quantifying HIV+ donor referrals received by organ procurement organizations (OPOs) is critical for HOPE Act implementation. We surveyed the 58 USA OPOs regarding HIV+ referral records and newly discovered HIV+ donors. Using data from OPOs that provided exact records and CDC HIV prevalence data, we projected a national estimate of HIV+ referrals. Fifty-five (95%) OPOs reported HIV+ referrals ranging from 0 to 276 and newly discovered HIV+ cases ranging from 0 to 10 annually. Six OPOs in areas of high HIV prevalence reported more than 100 HIV+ donor referrals. Twenty-seven (47%) OPOs provided exact HIV+ referral records and 28 (51%) OPOs provided exact records of discovered HIV+ cases, totaling 1450 HIV+ referrals and 39 discovered HIV+ donors in the prior year. These OPOs represented 67% and 59% of prevalent HIV cases in the USA; thus, we estimated 2164 HIV+ referrals and 66 discovered HIV+ cases nationally per year. OPOs reported a high volume of HIV+ referrals annually, of which a subset will be medically eligible for donation. Particularly in areas of high HIV prevalence, OPOs require ongoing support to implement the HOPE Act. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. Decoherence in large NMR quantum registers

    International Nuclear Information System (INIS)

    Krojanski, Hans Georg; Suter, Dieter

    2006-01-01

    Decoherence causes the decay of the quantum information that is stored in highly correlated states during quantum computation. It is thus a limiting factor for all implementations of a quantum computer. Because a scalable quantum computer with hundreds or thousands of qubits is not available yet, experimental data about decoherence rates was restricted to small quantum registers. With solid state nuclear magnetic resonance we create highly correlated multiqubit states that serve as a model quantum register and measure their decay. By measuring the decay as a function of the system size, we determined the scaling of the decoherence rate with the number of qubits. Using the same system, we also used decoupling techniques to reduce the coupling between system and environment and thereby the decoherence rate by more than an order of magnitude, independent of the system size. For the free decay as well as for the decoupled case, we found a relatively weak scaling with system size, which could be fitted to a power law ∝K p with an exponent p≅1/2. This raises the prospect for large-scale quantum computation

  17. Epidemiology of HIV infection in Northern Pakistan

    International Nuclear Information System (INIS)

    Tariq, W.U.Z.; Malik, I.A.; Hassan, Z.U.; Hannan, A.; Ahmad, M.

    1993-01-01

    At the Armed Forces Institute of Pathology, Rawalpindi, facilities for HIV screening are available since 1987. So far, 54, 170 individuals have been tested. These included 48235 blood donors, 3369 persons proceeding abroad, 561 patients of venereal diseases, 350 Lymphoma cases, 21 deportees from the UAE, 460 clinically suspected cases of AIDS, 735 persons who were worried about HIV infection and 439 family members of HIV positive cases. A total of 30 cases were positive for anti-HIV on a strict protocol, which included screening tests followed by confirmatory tests including Western blot for HIV antibodies. The mode of HIV transmission was ascertained after a detailed history of all seropostive cases. It was found that in 24 cases the virus was acquired through sexual contact with high risk persons, which was homosexual in 3, heterosexual in 17, and bisexual in 4 cases. In 4 cases, the infection was acquired through blood transfusion, one child was infected through breast feeding, whereas only in one case the exact mode of HIV transmission was unclear. Out of 30 HIV positive cases, only three cases acquired the disease within Pakistan, 20 had acquired HIV infection during their stay in the Gulf states, while few cases had it from other countries (Saudi Arabia 1, Greece 1, France 2, S E Asia 3). (author)

  18. HIV in elderly women after travelling abroad

    DEFF Research Database (Denmark)

    Jespersen, Sanne; Thorsteinsson, Kristina; David, Kim Peter

    2016-01-01

    We report two cases of HIV infection among female travellers of older age. A Danish woman in her eighties was diagnosed with acute HIV infection after travelling to West Africa. A sexual history was not recorded before her third hospital visit. A West African woman in her seventies who had been...... living in Denmark for 40 years was diagnosed with advanced HIV after having been to West Africa for family visits. We want to emphasize that women of older age also have sex that may put them at risk of HIV, that febrile returning travellers should be tested for HIV, and that presence of HIV indicator...

  19. Creation of the uniform Chernobyl register of Russia and Belarus

    International Nuclear Information System (INIS)

    Sosnouskaya, Alena; Kotava, Aksana; Ivanov, Victor; Maksutov, Marat

    2008-01-01

    Creation of operation of uniform medical and dosimetric data banks for carrying out of collateral wide-scale radiation epidemiological researches and prediction of medical consequences of Chernobyl accident (ChA) in territory of Russia and Belarus. On the basis of medical and dosimetric data banks of the national registers of Russia and Belarus the uniform technology of collection personal of a state information of health of the population, injured from ChA . Three levels of observation are created. The first level - Bryansk area of Russia and Gomel area of Belarus, interests of research - radiation hazards of oncologic diseases of various localizations for the population living in these territories. The second level - Bryansk, Kaluga, Tula and Oryol area of Russia and Brest, Vitebsk, Gomel, Grodno, Minsk and Mogilyov area of Belarus, preferred direction of researches - thyroid cancer. The third level all territory of Russia and Belarus, area of research - medical consequences for health of the liquidators, their children and persons migrating from polluted territories. Personal uniform sub-registers are created and function on a stationary value to a basis. Is sub-registers containing information about diseases by a thyroid cancer, leukemia and breast cancer, uniform register of the liquidators and their children, uniform cancer-register of the liquidators and uniform cancer-register of the population living in territories with density of contamination on Cs 137 more than 185 kBq/m 2 . The personal information on 20440 cases of thyroid cancer, 5234 cases of a leukemia, 16679 cases of breast cancer, 252884 liquidators, 6882 cases of a cancer of various localizations among the liquidators, 35423 children of the liquidators, 11407 cases of oncologic diseases among the population living in territories with density of contamination on Cs 137 more than 185 kBq/m 2 is accumulated. (author)

  20. Understanding the susceptibility to HIV of female and male students case study of LAMS school in Benin

    NARCIS (Netherlands)

    Kissezounnon, M.S.

    2008-01-01

    This research project aims to understand the factors that influence susceptibility to HIV for female and male students in LAMS (Lycee Agricole Meidji o Sekou in Benin), in order to contribute to the reduction of the phenomenon. The results of questionnaires, group discussions and interviews show the

  1. Critical bioethics in the time of epidemic: The case of the criminalization of HIV/AIDS nondisclosure in Canada

    Directory of Open Access Journals (Sweden)

    Jennifer M. Kilty

    2017-01-01

    Full Text Available This article highlights the ethically uncertain and emotionally charged climate that governs the criminalization of HIV nondisclosure in Canada. Focusing on AIDS Service Organizations (ASO, we suggest that interlocutors perform critical work that helps people living with HIV/AIDS make sense of their rights and responsibilities. Semi-structured interviews with 62 ASO staff across Canada revealed this shifting landscape of HIV advocacy in the age of criminalizing HIV nondisclosure. Drawing on a critical bioethics approach that is informed by considering the role of emotion in decision-making, this article critiques the liberal model of the rational actor that is central to traditional discussions of bioethics and law. Our findings suggest that ASO workers have varying degrees of knowledge about the intricacies of legal duties of disclosure, which affect how they balance their own emotions and thoughts about nondisclosure with their professional duties to provide support and counselling. Ultimately, we argue that critical bioethics in the context of criminalization commands us to appreciate the inherently affective nature of the environment in which bioethical decisions are made.

  2. Caste- and ethnicity-based inequalities in HIV/AIDS-related knowledge gap: a case of Nepal.

    Science.gov (United States)

    Atteraya, Madhu; Kimm, HeeJin; Song, In Han

    2015-05-01

    Caste- and ethnicity-based inequalities are major obstacles to achieving health equity. The authors investigated whether there is any association between caste- and ethnicity-based inequalities and HIV-related knowledge within caste and ethnic populations. They used the 2011 Nepal Demographic and Health Survey, a nationally represented cross-sectional study data set. The study sample consisted of 11,273 women between 15 and 49 years of age. Univariate and logistic regression models were used to examine the relationship between caste- and ethnicity-based inequalities and HIV-related knowledge. The study sample was divided into high Hindu caste (47.9 percent), "untouchable" caste (18.4 percent), and indigenous populations (33.7 percent). Within the study sample, the high-caste population was found to have the greatest knowledge of the means by which HIV is prevented and transmitted. After controlling for socioeconomic and demographic characteristics, untouchables were the least knowledgeable. The odds ratio for incomplete knowledge about transmission among indigenous populations was 1.27 times higher than that for high Hindu castes, but there was no significant difference in knowledge of preventive measures. The findings suggest the existence of a prevailing HIV knowledge gap. This in turn suggests that appropriate steps need to be implemented to convey complete knowledge to underprivileged populations.

  3. Knowledge, attitudes and practices on HIV / AIDS in the south region of Cameroon: case of the town of Kribi.

    Science.gov (United States)

    Sanou, Sobze Martin; Fokam, Joseph Martin; Mabvouna, Biguioh Rodriguez; Guetiya, Wadoum Raoul; Sali, Ben Bechir Adogaye; Teikeu, Tessa Vivaldi Vladimir; Nafack, Sonkeng Sonia; Panà, Augusto; Colizzi, Vittorio; Russo, Gianluca

    2014-01-01

    The aim of our study was to assess knowledge, attitudes, and practices (KAP) regarding HIV/AIDS in the city of Kribi, southern region of Cameroon. In November 2012, a questionnaire composed of 20 items was administered by trained staff from the Biomedical Sciences Department of the University of Dschang to 200 students selected from four population groups: high school students, local traders, tourism personnel (staff of bars, restaurants, hotels, nightclubs), and motorcycle taxi drivers. A cluster sampling method was used to select the first three groups while motorcycle taxi drivers were selected by the method of all comers. KAP regarding HIV/AIDS was found to be fragmentary in the studied population. Only 6.5% systematically uses condoms, 59% believe that AIDS can be cured by traditional medicine and religious faith and 40.9% developed stigmatizing behaviour toward HIV infected people. Among participants there is a wide discrepancy between knowledge and social behaviours toward HIV/AIDS. Strategic and continuous awareness campaigns that are culturally and socially tailored are urgently needed.

  4. The case for addressing gender and power in sexuality and HIV education: a comprehensive review of evaluation studies.

    Science.gov (United States)

    Haberland, Nicole A

    2015-03-01

    Curriculum-based sexuality and HIV education is a mainstay of interventions to prevent STIs, HIV and unintended pregnancy among young people. Evidence links traditional gender norms, unequal power in sexual relationships and intimate partner violence with negative sexual and reproductive health outcomes. However, little attention has been paid to analyzing whether addressing gender and power in sexuality education curricula is associated with better outcomes. To explore whether the inclusion of content on gender and power matters for program efficacy, electronic and hand searches were conducted to identify rigorous sexuality and HIV education evaluations from developed and developing countries published between 1990 and 2012. Intervention and study design characteristics of the included interventions were disaggregated by whether they addressed issues of gender and power. Of the 22 interventions that met the inclusion criteria, 10 addressed gender or power, and 12 did not. The programs that addressed gender or power were five times as likely to be effective as those that did not; fully 80% of them were associated with a significantly lower rate of STIs or unintended pregnancy. In contrast, among the programs that did not address gender or power, only 17% had such an association. Addressing gender and power should be considered a key characteristic of effective sexuality and HIV education programs.

  5. Previously Unidentified Single Nucleotide Polymorphisms in HIV/AIDS Cases Associate with Clinical Parameters and Disease Progression

    Directory of Open Access Journals (Sweden)

    Vladimir V. Anokhin

    2016-01-01

    Full Text Available The genetic background of an individual plays an important role in the progression of HIV infection to AIDS. Identifying previously unknown or uncharacterized single nucleotide polymorphisms (SNPs that associate with disease progression may reveal important therapeutic targets and provide a greater understanding of disease pathogenesis. In the present study, we employed ultra-high multiplex PCR on an Ion Torrent next-generation sequencing platform to sequence 23 innate immune genes from 94 individuals with HIV/AIDS. This data was used to identify potential associations of SNPs with clinical parameters and disease progression. SNPs that associated with an increased viral load were identified in the genes for the interleukin 15 receptor (IL15RA, toll-like receptor 7 (TLR7, tripartite motif-containing protein 5 (TRIM5, and two killer-cell immunoglobulin-like receptors (KIR2DL1 and KIR2DL3. Additionally, SNPs that associated with progression from HIV infection to AIDS were identified in two 2′-5′-oligoadenylate synthetase genes (OAS2 and OAS3. In contrast, other SNPs identified in OAS2 and OAS3 genes, as well as in the TRIM5 and KIR2DS4 genes, were associated with a slower progression of disease. Taken together, our data demonstrates the utility of ultra-high multiplex PCR in identifying polymorphisms of potential clinical significance and further,identifies SNPs that may play a role in HIV pathogenesis.

  6. Clinicopathological correlates in HIV seropositive tuberculosis cases presenting with jaundice after initiating antiretroviral therapy with a structured review of the literature

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    Barr David A

    2012-10-01

    Full Text Available Abstract Background The development of jaundice after initiation of HAART in HIV-TB co-infected patients is a challenging presentation in resource constrained settings, and is often attributed to drug induced liver injury (DILI.Some investigators have described hepatic tuberculosis Immune Reconstitution Inflammatory Syndrome (TB-IRIS as a cause of liver disease in patients initiating HAART, which could also cause jaundice. Case presentations We report the clinical and histopathological features of five HIV-TB co-infected patients presenting with a syndrome of jaundice, tender hepatomegaly, bile canalicular enzyme rise and return of constitutional symptoms within 8 weeks of initiation of highly active antiretroviral therapy (HAART for advanced HIV infection at a rural clinic in KwaZulu Natal, South Africa. All five patients had been diagnosed with tuberculosis infection prior to HAART initiation and were on antituberculous medication at time of developing jaundice. There was evidence of multiple aetiologies of liver injury in all patients. However, based on clinical course and pathological findings, predominant hepatic injury was thought to be drug induced in one case and hepatic tuberculosis associated immune reconstitution inflammatory syndrome (TB-IRIS in the other four. In these later 4 patients, liver biopsy findings included necrotising and non-necrotising granulomatous inflammation in the lobules and portal tracts. The granulomas demonstrated – in addition to epithelioid histiocytes and Langhans giant cells – neutrophils, plasma cells and large numbers of lymphocytes, which are not features of a conventional untreated tuberculous response. Conclusion In this high TB prevalent, low resource setting, TB-IRIS may be an important cause of jaundice post-HAART initiation. Clinicopathological correlation is essential for optimal diagnosis. Further multi-organ based histopathological studies in the context of immune reconstitution would be

  7. The combination of phylogenetic analysis with epidemiological and serological data to track HIV-1 transmission in a sexual transmission case.

    Directory of Open Access Journals (Sweden)

    Min Chen

    Full Text Available To investigate the linkage of HIV transmission from a man to a woman through unprotected sexual contact without disclosing his HIV-positive status.Combined with epidemiological information and serological tests, phylogenetic analysis was used to test the a priori hypothesis of HIV transmission from the man to the woman. Control subjects, infected with HIV through heterosexual intercourse, from the same location were also sampled. Phylogenetic analyses were performed using the consensus gag, pol and env sequences obtained from blood samples of the man, the woman and the local control subjects. The env quasispecies of the man, the woman, and two controls were also obtained using single genome amplification and sequencing (SGA/S to explore the paraphyletic relationship by phylogenetic analysis.Epidemiological information and serological tests indicated that the man was infected with HIV-1 earlier than the woman. Phylogenetic analyses of the consensus sequences showed a monophyletic cluster for the man and woman in all three genomic regions. Furthermore, gag sequences of the man and woman shared a unique recombination pattern from subtype B and C, which was different from those of CRF07_BC or CRF08_BC observed in the local samples. These indicated that the viral sequences from the two subjects display a high level of similarity. Further, viral quasispecies from the man exhibited a paraphyletic relationship with those from the woman in the Bayesian and maximum-likelihood (ML phylogenetic trees of the env region, which supported the transmission direction from the man to the woman.In the context of epidemiological and serological evidence, the results of phylogenetic analyses support the transmission from the man to the woman.

  8. The diagnostic performance of a single GeneXpert MTB/RIF assay in an intensified tuberculosis case finding survey among HIV-infected prisoners in Malaysia.

    Directory of Open Access Journals (Sweden)

    Haider Abdulrazzaq Abed Al-Darraji

    Full Text Available Delays in tuberculosis (TB diagnosis, particularly in prisons, is associated with detrimental outcomes. The new GeneXpert MTB/RIF assay (Xpert offers accurate and rapid diagnosis of active TB, but its performance in improving case detection in high-transmission congregate settings has yet to be evaluated. We assessed the diagnostic accuracy of a single Xpert assay in an intensified case finding survey among HIV-infected prisoners in Malaysia.HIV-infected prisoners at a single site provided two early-morning sputum specimens to be examined using fluorescence smear microscopy, BACTEC MGIT 960 liquid culture and a single Xpert. The sensitivity, specificity, negative and positive predictive values of Xpert were calculated relative to gold-standard results using MGIT 960 liquid culture. Relevant clinical and demographic data were used to examine correlates of active TB disease.The majority of enrolled subjects with complete data (N=125 were men (90.4%, age <40 years (61.6% and had injected drugs (75.2%. Median CD4 lymphocyte count was 337 cells/µL (IQR 149-492; only 19 (15.2% were receiving antiretroviral therapy. Of 15 culture-positive TB cases, single Xpert assay accurately detected only eight previously undiagnosed TB cases, resulting in a sensitivity, specificity, positive predictive value and negative predictive value of 53.3% (95% CI 30.12-75.2%, 100% (95% CI 96.6-100%, 100% (95% CI 67.56-100% and 94.0% (95% CI 88.2-97.1%, respectively. Only 1 of 15 (6.7% active TB cases was smear-positive. The prevalence (12% of undiagnosed active pulmonary TB (15 of 125 prisoners was high and associated with longer duration of drug use (AOR 1.14, 95% CI 1.03-1.26, for each year of drug use.Single Xpert assay improved TB case detection and outperformed AFB smear microscopy, but yielded low screening sensitivity. Further examination of the impact of HIV infection on the diagnostic performance of the new assay alongside other screening methods in correctional

  9. Comparative brain pathology of HIV-seronegative and HIV-infected drug addicts.

    Science.gov (United States)

    Makrigeorgi-Butera, M; Hagel, C; Laas, R; Puschel, K; Stavrou, D

    1996-01-01

    Early stages of infection with human immunodeficiency virus (HIV) were studied in HIV-seropositive drug addicts. Since heroin users are immunocompromized even in the absence of HIV infection, the aim of the present study was to compare the morphological alterations present in HIV-seronegative and HIV-seropositive drug addicts. A total of 60 cases (32 HIV-seronegative subjects, 21 HIV-seropositive patients without signs of acquired immunodeficiency syndrome (AIDS), and 7 HIV-seropositive patients with signs of AIDS) were investigated macroscopically, histologically, and immunohistochemically HIV-seronegative patients presented more frequently with acute drug intoxication, died at a significantly younger age than HIV-seropositive patients, and were found to suffer more frequently from alcohol-related changes. These results indicated that HIV-seronegative and HIV-seropositive patients differed possibly in their drug consumption and also in their general conditions of life. In accordance with previous reports activated microglia and a diffuse astrogliosis in the white matter were detected at a significantly higher frequency and found to be more severe in HIV-seropositive subjects than in HIV-seronegative addicts. A lymphocytic meningitis was present in 6 of 21 HIV-seropositive patients but in none of the HIV-seronegative patients. Perivascular infiltrates consisting of lymphocytes and macrophages were detected at similar frequencies in HIV-seronegative and HIV-seropositive patients but were significantly more severe in patients suffering from lymphocytic meningitis or purulent encephalitis. Opportunistic infections were only demonstrated in 2 AIDS cases. In 10 of the HIV-seronegative patients and in 3 of the HIV-seropositive patients CD68-and Ham56-positive multinucleated cells were detected scattered in the subarachnoidal space exclusively over the frontal cortex.

  10. Wavefunctions for topological quantum registers

    International Nuclear Information System (INIS)

    Ardonne, E.; Schoutens, K.

    2007-01-01

    We present explicit wavefunctions for quasi-hole excitations over a variety of non-abelian quantum Hall states: the Read-Rezayi states with k ≥ 3 clustering properties and a paired spin-singlet quantum Hall state. Quasi-holes over these states constitute a topological quantum register, which can be addressed by braiding quasi-holes. We obtain the braid properties by direct inspection of the quasi-hole wavefunctions. We establish that the braid properties for the paired spin-singlet state are those of 'Fibonacci anyons', and thus suitable for universal quantum computation. Our derivations in this paper rely on explicit computations in the parafermionic conformal field theories that underly these particular quantum Hall states

  11. Heterotopic pregnancy in HIV women

    OpenAIRE

    Savasi, V.; Antonazzo, P.; Personeni, C.

    2016-01-01

    Heterotopic pregnancy occurs when intrauterine and ectopic pregnancy are concomitant; overall rate rises from 1/30.000 to 1.5/1000 in assisted reproductive technology pregnancies. HIV (human immunodeficiency virus) patients are at increased risk of heterotopic pregnancies due to the greater frequency of assisted reproductive technology and pelvic inflammatory disease. We report the first case of heterotopic pregnancy in HIV woman.

  12. VERTICAL TRANSMISSION OF HIV: A STUDY PERFORMED AT THE MUNICIPALITY OF SOUTHWEST BAIANO

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    Maria Tereza Magalhães Morais

    2014-09-01

    Full Text Available The Human Immunodeficiency Virus (HIV is a Retrovirus RNA of simple filament, responsible for the Acquired Immune Deficiency Syndrome (AIDS. The virus affects the body's immunologic system destroying the defense cells, particularly the CD4 + T lymphocytes. By the infection of women of reproductive age comes another form of HIV transmission, the vertical transmission, it is a kind of contamination from mother to fetus or to newborn. Such transmission can occur during pregnancy, through birth or through breastfeeding. The research's scope was to evaluate the social and economic profile of HIV positive pregnant women among 2007- 2012, in a city located in southwestern of Bahia (Brazil country. Through data primaries gathered by analyzing records research and notification of HIV positive pregnant women living in Vitória da Conquista, Bahia, Brazil, registered in the Information System for Notifiable Diseases (SINAN could be verified records of 110 cases of pregnant women infected by HIV in the city among the researched period. Through the research, could be verified a high rate of young women with low education level and living in the urban area of city, as well a low rate of vertical transmission.

  13. Intimate partner violence and HIV infection among women: a systematic review and meta-analysis

    Science.gov (United States)

    Li, Ying; Marshall, Caitlin M; Rees, Hilary C; Nunez, Annabelle; Ezeanolue, Echezona E; Ehiri, John E

    2014-01-01

    Introduction To assess evidence of an association between intimate partner violence (IPV) and HIV infection among women. Methods Medline/PubMed, Embase, Web of Science, EBSCO, Ovid, Cochrane HIV/AIDS Group's Specialized Register and Cochrane Central Register of Controlled Trials were searched up to 20 May 2013 to identify studies that examined the association between IPV and HIV infection in women. We included studies on women aged ≥15 years, in any form of sexually intimate relationship with a male partner. Results Twenty-eight studies [(19 cross-sectional, 5 cohorts and 4 case-control studies) involving 331,468 individuals in 16 countries – the US (eight studies), South Africa (four studies), East Africa (10 studies), India (three studies), Brazil (one study) and multiple low-income countries (two studies)] were included. Results were pooled using RevMan 5.0. To moderate effect estimates, we analyzed all data using the random effects model, irrespective of heterogeneity level. Pooled results of cohort studies indicated that physical IPV [pooled RR (95% CI): 1.22 (1.01, 1.46)] and any type of IPV [pooled RR (95% CI): 1.28 (1.00, 1.64)] were significantly associated with HIV infection among women. Results of cross-sectional studies demonstrated significant associations of physical IPV with HIV infection among women [pooled OR (95% CI): 1.44 (1.10, 1.87)]. Similarly, results of cross-sectional studies indicated that combination of physical and sexual IPV [pooled OR (95% CI): 2.00 (1.24, 3.22) and any type of IPV [pooled OR (95% CI): 1.41 (1.16, 1.73)] were significantly associated with HIV infection among women. Conclusions Available evidence suggests a moderate statistically significant association between IPV and HIV infection among women. To further elucidate the strength of the association between IPV and HIV infection among women, there is a need for high-quality follow-up studies conducted in different geographical regions of the world, and among

  14. Administrative integration of vertical HIV monitoring and evaluation into health systems: a case study from South Africa

    OpenAIRE

    Kawonga, Mary; Fonn, Sharon; Blaauw, Duane

    2013-01-01

    Background: In light of an increasing global focus on health system strengthening and integration of vertical programmes within health systems, methods and tools are required to examine whether general health service managers exercise administrative authority over vertical programmes. Objective: To measure the extent to which general health service (horizontal) managers, exercise authority over the HIV programme’s monitoring and evaluation (M&E) function, and to explore factors that may i...

  15. How to Integrate HIV and Sexual and Reproductive Health Services in Namibia, the Epako Clinic Case Study

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    Tomas Zapata

    2017-07-01

    Full Text Available Introduction: During the past two decades, HIV and Sexual and Reproductive Health services in Namibia have been provided in silos, with high fragmentation. As a consequence of this, quality and efficiency of services in Primary Health Care has been compromised.  Methods: We conducted an operational research (observational pre-post study in a public health facility in Namibia. A health facility assessment was conducted before and after the integration of health services. A person-centred integrated model was implemented to integrate all health services provided at the health facility in addition to HIV and Sexual and Reproductive Health services. Comprehensive services are provided by each health worker to the same patients over time (longitudinality, on a daily basis (accessibility and with a good external referral system (coordination. Prevalence rates of time flows and productivity were done.  Results: Integrated services improved accessibility, stigma and quality of antenatal care services by improving the provider-patient communication, reducing the time that patients stay in the clinic in 16% and reducing the waiting times in 14%. In addition, nurse productivity improved 85% and the expected time in the health facility was reduced 24% without compromising the uptake of TB, HIV, outpatient, antenatal care or first visit family planning services. Given the success on many indicators resulting from integration of services, the goal of this paper was to describe “how” health services have been integrated, the “process” followed and presenting some “results” from the integrated clinic.  Conclusions: Our study shows that HIV and SRH services can be effectively integrated by following the person-centred integrated model. Based on the Namibian experience on “how” to integrate health services and the “process” to achieve it, other African countries can replicate the model to move away from the silo approach and contribute to

  16. The big imitator strikes again: a case report of neurosyphilis in a patient with newly diagnosed HIV.

    Science.gov (United States)

    de Bruijn, Sévérine; Kenyon, Chris; Léonard, Nicolas; Vlieghe, Erika

    2017-10-01

    Neurosyphilis is the result of an infection of the central nervous system caused by the spirochete Treponema pallidum. Its clinical presentation includes meningovascular syphilis, tabes dorsalis, and dementia paralytica, resulting in a wide range of symptoms such as psychosis, Parkinsonism, and depression. A 49-year-old male was admitted to a psychiatric hospital because of social withdrawal and self-neglect, indicative of a major depression. A routine HIV-test was positive and resulted in an admission to the Antwerp University Hospital. Clinical examination showed Argyll Robertson pupils, a wide-based gait, absence of vibration sense in the lower limbs, and a MMSE-score of 25/30. Blood analysis revealed a CD4+ count of 99 cells/μL and a HIV viral load of 2,13 × 10 5 copies/mL plasma. A serum TPHA (T. pallidum hemagglutination assay) titre of 1/20480 and RPR (rapid plasma reagin) titre of 1/128 were detected. TPHA and RPR titre in the cerebrospinal fluid were, respectively, 1/10240 and 1/4. A brain MRI showed diffuse cortical atrophy and lesions in the white matter compatible with HIV-encephalopathy. The diagnoses of advanced HIV-infection and late neurosyphilis were made. HAART (highly active antiretroviral therapy) and high-dose IV penicillin G were started. In all patients with new-onset dementia or untreatable psychosis, neurosyphilis should always be considered. Argyll Robertson pupils are regarded as pathognomonic of neurosyphilis. The management of neurosyphilis includes high-dose IV benzyl penicillin for 10 to 14 days. Close follow-up including a lumbar puncture after 6 months is warranted to ensure treatment recovery.

  17. Cesariana em paciente com doença de von Willebrand associada à infecção pelo HIV: relato de caso Cesárea en paciente con enfermedad de von Willebrand asociada a la infección por el HIV: relato de caso Anesthesia for cesarean section in patient with von Willebrand's disease and HIV infection: case report

    Directory of Open Access Journals (Sweden)

    Vanessa Rezende Balle

    2004-12-01

    Willebrand y HIV positiva sometida a cesárea. RELATO DEL CASO: Paciente de 24 años, portadora de anemia microcítica, enfermedad de von Willebrand y HIV, llegó a la emergencia obstétrica en inicio de trabajo de alumbramiento. No realizó prenatal. Fue indicada cesárea a fin de disminuir los riesgos de transmisión vertical en paciente con carga vírica de HIV desconocida. Presentaba hematomas por el cuerpo e historia de hematoma de pared abdominal en cesárea anterior. Los tests de coagulación estaban un poco alterados. Después de infusión de concentrado de factor VIII fue realizada anestesia general. Madre y recién nacido presentaron evolución satisfactoria. CONCLUSIONES: La evaluación de manifestaciones clínicas en pacientes con coagulopatia es fundamental en la decisión del tipo de anestesia que será indicada para cada paciente. La evaluación debe ser individualizada, considerando los riesgos y beneficios de la técnica escogida. En estas pacientes, se debe siempre restringir al máximo la indicación de interrupción de la gestación por vía alta, optándose siempre por los métodos menos invasivos. La terapia con concentrado de factor VIII es actualmente la mejor opción de tratamiento, corrigiendo la deficiencia específica y dismunuyendo los riesgos de transmisión vírica.BACKGROUND AND OBJECTIVES: Von Willebrand's disease is the most common hereditary coagulation disorder in young women. The incidence of HIV infection among women has been progressively increasing, and vertical transmission may account for 25% of cases. This report aimed at describing the case of an HIV-positive patient with von Willebrand's disease scheduled for cesarean section. CASE REPORT: Female HIV-positive patient, 24 years old, with microcytic anemia and von Willebrand's disease, admitted to the emergency room in early labor. She had no pre-natal care. Cesarean section was indicated to lower vertical transmission risks since HIV viral count was unknown. Patient had hematomas

  18. EFFECT OF HIV PREVENTION AND TREATMENT PROGRAM ON HIV AND HCV TRANSMISSION AND HIV MORTALITY AT AN INDONESIAN NARCOTIC PRISON.

    Science.gov (United States)

    Nelwan, Erni J; Indrati, Agnes K; Isa, Ahmad; Triani, Nurlita; Alam, Nisaa Nur; Herlan, Maria S; Husen, Wahid; Pohan, Herdiman T; Alisjahbana, Bachti; Meheus, Andre; Van Crevel, Reinout; van der Ven, Andre Jam

    2015-09-01

    Validated data regarding HIV-transmission in prisons in developing countries is scarce. We examined sexual and injecting drug use behavior and HIV and HCV transmission in an Indonesian narcotic prison during the implementation of an HIV prevention and treatment program during 2004-2007 when the Banceuy Narcotic Prison in Indonesia conducted an HIV transmission prevention program to provide 1) HIV education, 2) voluntary HIV testing and counseling, 3) condom supply, 4) prevention of rape and sexual violence, 5) antiretroviral treatment for HIV-positive prisoners and 6) methadone maintenance treatment. During a first survey that was conducted between 2007 and 2009, new prisoners entered Banceuy Narcotics Prison were voluntary tested for HIV and HCV-infection after written informed consent was obtained. Information regarding sexual and injecting risk behavior and physical status were also recorded at admission to the prison. Participants who tested negative for both HIV and HCV during the first survey were included in a second survey conducted during 2008-2011. During both surveys, data on mortality among HIV-seropositive patients were also recorded. All HIV-seropositive participants receive treatment for HIV. HIV/ AIDS-related deaths decreased: 43% in 2006, 18% in 2007, 9% in 2008 and 0% in 2009. No HIV and HCV seroconversion inside Banceuy Narcotic Prison were found after a median of 23 months imprisonment (maximum follow-up: 38 months). Total of 484.8 person-years observation was done. Participants reported HIV transmission risk-behavior in Banceuy Prison during the second survey was low. After implementation of HIV prevention and treatment program, no new HIV or HCV cases were detected and HIV-related mortality decreased.

  19. Clinicopathological correlates in HIV seropositive tuberculosis cases presenting with jaundice after initiating antiretroviral therapy with a structured review of the literature.

    Science.gov (United States)

    Barr, David A; Ramdial, Pravistadevi K

    2012-10-14

    The development of jaundice after initiation of HAART in HIV-TB co-infected patients is a challenging presentation in resource constrained settings, and is often attributed to drug induced liver injury (DILI).Some investigators have described hepatic tuberculosis Immune Reconstitution Inflammatory Syndrome (TB-IRIS) as a cause of liver disease in patients initiating HAART, which could also cause jaundice. We report the clinical and histopathological features of five HIV-TB co-infected patients presenting with a syndrome of jaundice, tender hepatomegaly, bile canalicular enzyme rise and return of constitutional symptoms within 8 weeks of initiation of highly active antiretroviral therapy (HAART) for advanced HIV infection at a rural clinic in KwaZulu Natal, South Africa.All five patients had been diagnosed with tuberculosis infection prior to HAART initiation and were on antituberculous medication at time of developing jaundice. There was evidence of multiple aetiologies of liver injury in all patients. However, based on clinical course and pathological findings, predominant hepatic injury was thought to be drug induced in one case and hepatic tuberculosis associated immune reconstitution inflammatory syndrome (TB-IRIS) in the other four.In these later 4 patients, liver biopsy findings included necrotising and non-necrotising granulomatous inflammation in the lobules and portal tracts. The granulomas demonstrated - in addition to epithelioid histiocytes and Langhans giant cells - neutrophils, plasma cells and large numbers of lymphocytes, which are not features of a conventional untreated tuberculous response. In this high TB prevalent, low resource setting, TB-IRIS may be an important cause of jaundice post-HAART initiation. Clinicopathological correlation is essential for optimal diagnosis. Further multi-organ based histopathological studies in the context of immune reconstitution would be useful to clinicians in low resource settings dealing with this challenging

  20. Post-exposure prophylaxis | Smith | Southern African Journal of HIV ...

    African Journals Online (AJOL)

    Southern African Journal of HIV Medicine. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 2, No 1 (2001) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. Post-exposure prophylaxis. C Smith. Abstract.

  1. Síndrome do ápice orbital associado com herpes zoster oftálmico em paciente HIV positivo: relato de caso Orbital apex syndrome and herpes zoster ophthalmicus in an HIV positive patient: case report

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    João Baptista Nigro Santiago Malta

    2004-12-01

    Full Text Available O presente relato tem como objetivo apresentar um caso raro de síndrome do ápice orbital associado com herpes zoster oftálmico de prognóstico reservado em paciente HIV positivo que procurou o pronto-socorro com quadro clínico de lesões crostosas em hemiface esquerda, dolorosa, acompanhado de baixa acuidade visual, diminuição da sensibilidade corneal e oftalmoplegia completa do olho esquerdo. A síndrome do ápice orbital é entidade rara que se caracteriza por ptose, proptose, oftalmoplegia interna e externa (acometimento do II, III, IV e VI nervos cranianos, prejuízo funcional da primeira divisão do nervo trigêmeo (nervo oftálmico e graus variados de diminuição da acuidade visual. O tratamento do herpes zoster oftálmico baseia-se no uso de antivirais sistêmicos, sendo que o prognóstico irá variar conforme o acometimento ocular.To present a rare case of orbital apex syndrome associated with herpes zoster ophthalmicus of unfavorable prognosis in an HIV positive patient, who arrived at the Emergency Room with the following clinical history: left facial crust lesions, low visual acuity, ocular pain, low corneal sensitivity and complete ophthalmoplegia of the left eye. The orbital apex syndrome is a rare disorder which is characterized by ptosis, proptosis, internal and external ophthalmoplegia (involvement of the second, third, fourth and sixth cranial nerves, damage to the first division of the trigeminal (ophthalmic nerve, and varied degrees of visual acuity loss. The treatment of herpes zoster ophthalmicus is based on the use of systemic antiviral drugs and the prognosis will depend on ocular damage.

  2. RCT of an integrated CBT-HIV intervention on depressive symptoms and HIV risk.

    Science.gov (United States)

    Tobin, Karin; Davey-Rothwell, Melissa A; Nonyane, Bareng A S; Knowlton, Amy; Wissow, Lawrence; Latkin, Carl A

    2017-01-01

    Depression and depressive symptoms mediate the association between drug use and HIV risk. Yet, there are few interventions that target depressive symptoms and HIV risk for people who use drugs (PWUD). This study was a randomized controlled trial of an integrated cognitive behavioral therapy and HIV prevention intervention to reduce depressive symptoms, injection risk behaviors and increase condom use in a sample of urban people who used heroin or cocaine in the prior 6 months. A total of 315 individuals aged 18-55, who self-reported at least one HIV drug and sex risk behavior and scored ≥16 and symptoms, but weak impact on HIV risk. This trial is registered with ClinicalTrials.gov under the title "Neighborhoods, Networks, Depression, and HIV Risk" number NCT01380613.

  3. Building a population-based diabetes register: an Italian experience.

    Science.gov (United States)

    Ballotari, Paola; Chiatamone Ranieri, Sofia; Vicentini, Massimo; Caroli, Stefania; Gardini, Andrea; Rodolfi, Rossella; Crucco, Roberto; Greci, Marina; Manicardi, Valeria; Giorgi Rossi, Paolo

    2014-01-01

    To describe the methodology used to set up the Reggio Emilia (northern Italy) Diabetes Register. The prevalence estimates on December 31st, 2009 are also provided. The Diabetes Register covers all residents in the Reggio Emilia province. The register was created by deterministic linkage of six routinely collected data sources through a definite algorithm able to ascertain cases and to distinguish type of diabetes and model of care: Hospital Discharge, Drug Dispensation, Biochemistry Laboratory, Disease-specific Exemption, Diabetes Outpatient Clinics, and Mortality databases. Using these data, we estimated crude prevalence on December 31st, 2009 by sex, age groups, and type of diabetes. There were 25,425 ascertained prevalent cases on December 31st, 2009. Drug Dispensation and Exemption databases made the greatest contribution to prevalence. Analyzing overlapping sources, more than 80% of cases were reported by at least two sources. Crude prevalence was 4.8% and 5.9% for the whole population and for people aged 18 years and over, respectively. Males accounted for 53.6%. Type 1 diabetes accounted for 3.8% of cases, while people with Type 2 diabetes were the overriding majority (91.2%), and Diabetes Outpatient Clinics treated 75.4% of people with Type 2 diabetes. The Register is able to quantify the burden of disease, the first step in planning, implementing, and monitoring appropriate interventions. All data sources contributed to completeness and/or accuracy of the Register. Although all cases are identified by deterministic record linkage, manual revision and General Practitioner involvement are still necessary when information is insufficient or conflicting. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  4. Pollutant Release and Transfer Register

    International Nuclear Information System (INIS)

    2008-01-01

    Since 1974 a number of organisations have been working closely together in this pollutant register (PRTR) project to collect and formally establish the yearly releases of pollutants to air, water and soil in the Netherlands. Results of this project serve to underpin the national environmental policy. Data is in this way also provided for the many environmental reports to international organisations such as the European Union and the United Nations, e.g. the National Inventory Report for the Kyoto Protocol. This website shows the yearly releases (emissions) of the most important pollutants in the Netherlands. You can explore the emission data through various channels, such as maps, graphs and tables. But you can also download all the details into your own database. The data shown in this website is updated 2 to 3 times a year. The current release shows emissions for 1990, 1995, 2000, 2004, 2005 and 2006 The 2006 emissions are preliminary data and not yet shown in the maps. We expect to add an extra year in August 2008 [nl

  5. Canadian consensus statement on HIV and its transmission in the context of criminal law

    Directory of Open Access Journals (Sweden)

    Mona Loutfy

    2014-01-01

    Full Text Available INTRODUCTION: A poor appreciation of the science related to HIV contributes to an overly broad use of the criminal law against individuals living with HIV in cases of HIV nondisclosure.

  6. Care seeking behaviour and various delays in tuberculosis patients registered under RNTCP in Pune city

    Directory of Open Access Journals (Sweden)

    Jayashree Sachin Gothankar

    2016-03-01

    Full Text Available Introduction: Case finding in tuberculosis is known to be influenced by factors such as patient motivation, care seeking, the degree of diagnostic suspicion by health care provider which could result in a delayed diagnosis.Objective: To determine care seeking behaviour and delay in diagnosis and treatment of new sputum positive tuberculosis patients registered under RNTCP.Material and Methods: Descriptive cross sectional study. 283 new sputum positive tuberculosis patients (≥15 years of age registered during a period of six months at two randomly selected tuberculosis unit of Pune city. Questionnaire by WHO was modified and used. Interviews were conducted in DOT centres. Statistical analysis: Frequency, mean and standard deviation, chi square test.Results: Mean age of patients was 35 (±15 years18% of patients were unemployed and 77% resided in urban slums. The commonest co morbidity in 7.4% and 3.5 % patients was HIV/ AIDS followed by diabetics respectively. Majority of the patients, for the first and second time visited a general practitioner. Median patient, health care system and total delay were 18, 22 and 47 days with mean of 24±21, 32±30 and 56±33 days respectively. Health care system delay was less (p<0.05 in patients who first visited the public health care facility than patients who first visited a private health care provider.Conclusions: General practitioners are preferred first choice of health care provider for tuberculosis patients. Mean health care system delay is more than patient delay.

  7. Comparing Measures of Late HIV Diagnosis in Washington State

    Directory of Open Access Journals (Sweden)

    Laura Saganic

    2012-01-01

    Full Text Available As more US HIV surveillance programs routinely use late HIV diagnosis to monitor and characterize HIV testing patterns, there is an increasing need to standardize how late HIV diagnosis is measured. In this study, we compared two measures of late HIV diagnosis, one based on time between HIV and AIDS, the other based on initial CD4+ results. Using data from Washington's HIV/AIDS Reporting System, we used multivariate logistic regression to identify predictors of late HIV diagnosis. We also conducted tests for trend to determine whether the proportion of cases diagnosed late has changed over time. Both measures lead us to similar conclusions about late HIV diagnosis, suggesting that being male, older, foreign-born, or heterosexual increase the likelihood of late HIV diagnosis. Our findings reaffirm the validity of a time-based definition of late HIV diagnosis, while at the same time demonstrating the potential value of a lab-based measure.

  8. 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.

  9. 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

    Directory of Open Access Journals (Sweden)

    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.

  10. Primary effusion lymphoma associated with Human Herpes Virus-8 and Epstein Barr virus in an HIV-infected woman from Kampala, Uganda: a case report

    Directory of Open Access Journals (Sweden)

    Osuwat Lawrence O

    2011-02-01

    Full Text Available Abstract Introduction Primary effusion lymphoma is a recently recognized entity of AIDS related non-Hodgkin lymphomas. Despite Africa being greatly affected by the HIV/AIDS pandemic, an extensive MEDLINE/PubMed search failed to find any report of primary effusion lymphoma in sub-Saharan Africa. To our knowledge this is the first report of primary effusion lymphoma in sub-Saharan Africa. We report the clinical, cytomorphologic and immunohistochemical findings of a patient with primary effusion lymphoma. Case presentation A 70-year-old newly diagnosed HIV-positive Ugandan African woman presented with a three-month history of cough, fever, weight loss and drenching night sweats. Three weeks prior to admission she developed right sided chest pain and difficulty in breathing. On examination she had bilateral pleural effusions. Haematoxylin and eosin stained cytologic sections of the formalin-fixed paraffin-embedded cell block made from the pleural fluid were processed in the Department of Pathology, Makerere University, College of Health Sciences, Kampala, Uganda. Immunohistochemistry was done at the Institute of Haematology and Oncology "L and A Seragnoli", Bologna University School of Medicine, Bologna, Italy, using alkaline phosphatase anti-alkaline phosphatase method. In situ hybridization was used for detection of Epstein-Barr virus. The tumor cells were CD45+, CD30+, CD38+, HHV-8 LANA-1+; but were negative for CD3-, CD20-, CD19-, and CD79a- and EBV RNA+ on in situ hybridization. CD138 and Ki-67 were not evaluable. Our patient tested HIV positive and her CD4 cell count was 127/μL. Conclusions A definitive diagnosis of primary effusion lymphoma rests on finding a proliferation of large immunoblastic, plasmacytoid and anaplastic cells; HHV-8 in the tumor cells, an immunophenotype that is CD45+, pan B-cell marker negative and lymphocyte activated marker positive. It is essential for clinicians and pathologists to have a high index of suspicion of

  11. A socio-ecological perspective of access to and acceptability of HIV/AIDS treatment and care services: a qualitative case study research

    Directory of Open Access Journals (Sweden)

    Bereket Yakob

    2016-02-01

    Full Text Available Abstract Background Access to healthcare is an essential element of health development and a fundamental human right. While access to and acceptability of healthcare are complex concepts that interact with different socio-ecological factors (individual, community, institutional and policy, it is not known how these factors affect HIV care. This study investigated the impact of socio-ecological factors on access to and acceptability of HIV/AIDS treatment and care services (HATCS in Wolaita Zone of Ethiopia. Method Qualitative case study research was conducted in six woredas (districts. Focus group discussions (FGDs were conducted with 68 participants in 11 groups (six with people using antiretroviral therapy (ART and five with general community members. Key informant interviews (KIIs were conducted with 28 people involved in HIV care, support services and health administration at different levels. Individual in-depth interviews (IDIs were conducted with eight traditional healers and seven defaulters from (ART. NVIVO 10 was used to assist qualitative content data analysis. Results A total of 111 people participated in the study, of which 51 (45.9 % were male and 60 (54.1 % were female, while 58 (53.3 % and 53 (47.7 % were urban and rural residents, respectively. The factors that affect access to and acceptability of HATCS were categorized in four socio-ecological units of analysis: client-based factors (awareness, experiences, expectations, income, employment, family, HIV disclosure and food availability; community-based factors (care and support, stigma and discrimination and traditional healing; health facility-based factors (interactions with care providers, availability of care, quality of care, distance, affordability, logistics availability, follow up and service administration; and policy and standards (healthcare financing, service standards, implementation manuals and policy documents. Conclusions A socio-ecological perspective

  12. Evolution of HIV and AIDS Programmes in an African Institution of Higher Learning: The Case of the Copperbelt University in Zambia

    OpenAIRE

    Sanjobo, Nawa; Lukwesa, Matilda; Kaziya, Charity; Tepa, Cornwell; Puta, Bernard

    2016-01-01

    Background: Universities present the foundation for socio-economic and political development. Without structures and processes to fight HIV, there is no prospect of enhancing treatment, prevention, care and support services. Copperbelt University HIV and AIDS response was initiated in 2003 with the aim of building capacity of students and employees in HIV and AIDS. Objectives: The main objective of this paper is to demonstrate how the CBU HIV response has evolved over time and provide a timel...

  13. THE TRANSFER OF THE COMPANY’S REGISTERED OFFICE

    Directory of Open Access Journals (Sweden)

    Saša Prelič

    2016-01-01

    Full Text Available In the light of the relevant case law of The Court of Justice of the EU it is emphasized that the cross-border transfer of company’s registered office (and its real seat must be permitted in accordance with the Treaty on the Functioning of the EU. Nevertheless, the Fourteenth Company law Directive should be adopted for the reasons of legal certainty and it should determine, whether the transfer of the registered office (without transfer of company’s real seat to another Member State is admissible or not. Furthermore, the authors discuss the cross-border restructuring of the company, which in addition to relocation of the registered office also includes a change of its legal form. The Court of Justice of the EU has not yet decided on such cross-border restructuring, nevertheless it should be allowed based of the freedom of establishment (cross-border formal transformation.

  14. The Prosody of Topic Transition in Interaction: Pitch Register Variations.

    Science.gov (United States)

    Riou, Marine

    2017-12-01

    In conversation, speakers can mobilize a variety of prosodic cues to signal a switch in topics. This paper uses a mixed-methods approach combining Conversation Analysis and Instrumental Prosody to investigate the prosody of topic transition in American English, and analyzes the ways in which speakers can play on register level and on register span. A cluster of three prosodic parameters was found to be predictive of transitions: a higher maximum fundamental frequency (F0), a higher median F0 (key), and an expanded register span. Relative to speakers' habitual profiles, the mobilization of such prosodic cues corresponds to a marked upgraded prosodic design. This finding is consistent with the general assumption that continuation constitutes the norm in conversation, and that departing from it, as in the case of a topic transition, requires a marked action and marked linguistic design. The disjunctive action of opening a new topic corresponds to the use of a marked prosodic cue.

  15. Registers of multiple sclerosis in Denmark

    DEFF Research Database (Denmark)

    Koch-Henriksen, N; Magyari, M; Laursen, B

    2015-01-01

    between a number of different environmental exposures in the past and the subsequent risk of MS. Some of these studies have been able to exonerate suspected risk factors. The other register, the nationwide Danish Multiple Sclerosis Treatment Register, is a follow-up register for all patients who have......There are two nationwide population-based registers for multiple sclerosis (MS) in Denmark. The oldest register is The Danish Multiple Sclerosis Registry (DMSR), which is an epidemiological register for estimation of prevalence and incidence of MS and survival, and for identifying exposures earlier...... received disease-modifying treatments since 1996. It has, in particular, contributed to the knowledge of the role of antibodies against the biological drugs used for the treatment of MS....

  16. Análise das habilidades auditivas em uma criança deficiente auditiva oralizada e portadora de HIV: estudo de caso Hearing abilities and analysis in an oralized hearing-impaired child with HIV: a case study

    Directory of Open Access Journals (Sweden)

    Francine Nolasco Bastos

    2010-08-01

    doses of drugs taken by HIV carriers in order to control the disease have been responsible for increasing hearing impairment levels. During the process of hearing development, an individual passes through acquisition of auditory skills, which occurs in different steps of the therapeutic process, as follows: detection, discrimination, introductory identification, advanced identification and comprehension. This research is a case report, which aims to describe and characterize auditory skills in a hearing-impaired child. The child was a hearing device user and attended Speech-language therapy at the clinic located in the Estácio de Sá University Campus, in Educational Audiology supervised apprenticeship. Four speech therapy sessions were filmed for data collection, with the objective of observing presence or absence of auditory skills. RESULTS: auditory detection skills, discrimination and introductory identification were found in the individual. Advanced identification and comprehension were found in development stage, thus, they were absent. CONCLUSION: the development of auditory skills is crucial to oral language acquisition by the hearing impaired.

  17. A case study of school support and the psychological, emotional and behavioural consequences of HIV and AIDS on adolescents.

    Science.gov (United States)

    Asikhia, Olubusayo Aduke; Mohangi, Kesh

    2015-01-01

    Various studies have reported a huge increase in the numbers of orphaned adolescents in Sub-Saharan Africa and its effects on their psychological, emotional and behavioural development. Yet, their needs are seldom recognised or adequately addressed in policy and programmes.This article uses a qualitative study to report the experiences of 11 orphaned adolescents (5 boys and 6 girls aged between 15 and 18 years) affected by HIV and AIDS in a secondary school (in Atteridgeville, Pretoria, South Africa) and the school support provided by them. The primary data-generation strategies were informal interviews and the Beck Youth Inventories-II (BYI-II) (adopted to measure the participants' level of emotional, behavioural and psychological problems). All interview transcriptions with the participants were thematically analysed. BYI-II data were subjected to T scores (in percentages) to know the participant's psychological, behavioural and emotional problems in order to compare it with their perceptions on the degree of support provided by the school. Result shows that participants have a high prevalence of psychological, behavioural and emotional problems and that the school support provided to them (teachers' support, the general school environment and the degree of discrimination, labelling and bullying that exists in the school) was not sufficient. The participants, however, reported a high level of support from the principal. In conclusion, we have suggested the urgent need for teachers to acquire and possess basic knowledge and skills in caring and paying attention to learners affected by HIV and AIDS and for government agencies and NGOs working with HIV-and AIDS-affected children, to focus on proposals that address the psychological, behavioural and emotional problems in such affected adolescents.

  18. Register-based studies of healthcare costs

    DEFF Research Database (Denmark)

    Kruse, Marie; Christiansen, Terkel

    2011-01-01

    Introduction: The aim of this paper is to provide an overview and a few examples of how national registers are used in analyses of healthcare costs in Denmark. Research topics: The paper focuses on health economic analyses based on register data. For the sake of simplicity, the studies are divided...... into three main categories: economic evaluations of healthcare interventions, cost-of-illness analyses, and other analyses such as assessments of healthcare productivity. Conclusion: We examined a number of studies using register-based data on healthcare costs. Use of register-based data renders...

  19. Increasing Rates of Brain Tumours in the Swedish National Inpatient Register and the Causes of Death Register

    Directory of Open Access Journals (Sweden)

    Lennart Hardell

    2015-04-01

    Full Text Available Radiofrequency emissions in the frequency range 30 kHz–300 GHz were evaluated to be Group 2B, i.e., “possibly”, carcinogenic to humans by the International Agency for Research on Cancer (IARC at WHO in May 2011. The Swedish Cancer Register has not shown increasing incidence of brain tumours in recent years and has been used to dismiss epidemiological evidence on a risk. In this study we used the Swedish National Inpatient Register (IPR and Causes of Death Register (CDR to further study the incidence comparing with the Cancer Register data for the time period 1998–2013 using joinpoint regression analysis. In the IPR we found a joinpoint in 2007 with Annual Percentage Change (APC +4.25%, 95% CI +1.98, +6.57% during 2007–2013 for tumours of unknown type in the brain or CNS. In the CDR joinpoint regression found one joinpoint in 2008 with APC during 2008–2013 +22.60%, 95% CI +9.68, +37.03%. These tumour diagnoses would be based on clinical examination, mainly CT and/or MRI, but without histopathology or cytology. No statistically significant increasing incidence was found in the Swedish Cancer Register during these years. We postulate that a large part of brain tumours of unknown type are never reported to the Cancer Register. Furthermore, the frequency of diagnosis based on autopsy has declined substantially due to a general decline of autopsies in Sweden adding further to missing cases. We conclude that the Swedish Cancer Register is not reliable to be used to dismiss results in epidemiological studies on the use of wireless phones and brain tumour risk.

  20. Incidence and risk factors of AIDS-defining cancers in a cohort of HIV-positive adults: Importance of the definition of incident cases.

    Science.gov (United States)

    Suárez-García, Inés; Jarrín, Inmaculada; Iribarren, José Antonio; López-Cortés, Luis Fernando; Lacruz-Rodrigo, José; Masiá, Mar; Gómez-Sirvent, Juan Luis; Hernández-Quero, José; Vidal, Francesc; Alejos-Ferreras, Belén; Moreno, Santiago; Del Amo, Julia

    2013-05-01

    The aim of this study was to investigate the incidence and risk factors for the development of AIDS-defining cancers (ADCs); and to investigate the effect of making different assumptions on the definition of incident cases. A multicentre cohort study was designed. Poisson regression was used to assess incidence and risk factors. To account for misclassification, incident cases were defined using lag-times of 0, 14 and 30 days after enrolment. A total of 6393 HIV-positive subjects were included in the study. The incidences of ADCs changed as the lag periods were varied from 0 to 30 days. Different risk factors emerged as the definition of incident cases was changed. For a lag time of 0, the risk of Kaposi sarcoma [KS] and non-Hodgkin lymphoma [NHL] increased at CD4 counts sex with men had a higher risk of KS. KS and NHL were not associated with viral load, gender, or hepatitis B or C. The results were similar for a lag-time of 14 and 30 days; however, hepatitis C was significantly associated with NHL. This analysis shows the importance of the definition of incident cases in cohort studies. Alternative definitions gave different incidence estimates, and may have implications for the analysis of risk factors. Copyright © 2011 Elsevier España, S.L. All rights reserved.

  1. Epilepsy in Individuals with a History of Asperger's Syndrome: A Danish Nationwide Register-Based Cohort Study

    Science.gov (United States)

    Mouridsen, Svend Erik; Rich, Bente; Isager, Torben

    2013-01-01

    We performed a nationwide, register-based retrospective follow-up study of epilepsy in all people who were born between January 1, 1980 and June 29, 2006 and registered in the Danish Psychiatric Central Register with Asperger's syndrome on February 7, 2011. All 4,180 identified cases with AS (3,431 males and 749 females) were screened through the…

  2. Provider-initiated HIV testing & counselling in incident tuberculosis cases under National TB Programme conditions at a tertiary care teaching hospital in Tirupati, south India

    Directory of Open Access Journals (Sweden)

    Alladi Mohan

    2017-01-01

    >Interpretation & conclusions: The findings of this study showed that a higher proportion of TB patients underwent HIV testing (75% compared to the national figure of 63 per cent in 2013-2014. HIV seropositivity (4.6% in TB patients who underwent HIV testing was similar to the five per cent figure observed at national level during 2013-2014. The HIV status of 25 per cent of patients with incident TB still remained unknown, suggesting a need for better integration and co-ordination for effective management of HIV-TB co-infection.

  3. Sequence- and interactome-based prediction of viral protein hotspots targeting host proteins: a case study for HIV Nef.

    Directory of Open Access Journals (Sweden)

    Mahdi Sarmady

    Full Text Available Virus proteins alter protein pathways of the host toward the synthesis of viral particles by breaking and making edges via binding to host proteins. In this study, we developed a computational approach to predict viral sequence hotspots for binding to host proteins based on sequences of viral and host proteins and literature-curated virus-host protein interactome data. We use a motif discovery algorithm repeatedly on collections of sequences of viral proteins and immediate binding partners of their host targets and choose only those motifs that are conserved on viral sequences and highly statistically enriched among binding partners of virus protein targeted host proteins. Our results match experimental data on binding sites of Nef to host proteins such as MAPK1, VAV1, LCK, HCK, HLA-A, CD4, FYN, and GNB2L1 with high statistical significance but is a poor predictor of Nef binding sites on highly flexible, hoop-like regions. Predicted hotspots recapture CD8 cell epitopes of HIV Nef highlighting their importance in modulating virus-host interactions. Host proteins potentially targeted or outcompeted by Nef appear crowding the T cell receptor, natural killer cell mediated cytotoxicity, and neurotrophin signaling pathways. Scanning of HIV Nef motifs on multiple alignments of hepatitis C protein NS5A produces results consistent with literature, indicating the potential value of the hotspot discovery in advancing our understanding of virus-host crosstalk.

  4. Kebijakan Pengendalian HIV/AIDS di Denpasar

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    Tri Rini Puji Lestari

    2013-08-01

    Full Text Available Secara nasional, Indonesia telah mengantisipasi epidemi HIV/AIDS, tetapi jumlah kasus HIV/AIDS di Provinsi Bali dari tahun ke tahun memperlihatkan peningkatan yang semakin mengkhawatirkan. Penelitian ini bertujuan untuk mengetahui perkembangan jumlah kasus dan kebijakan penanggulangan HIV/AIDS di Denpasar. Penelitian ini menggunakan metode kualitatif yang dilakukan di Denpasar pada tanggal 11-17 September 2011. Sampel penelitian ini menggunakan informan terpilih yaitu kepala bappeda, pejabat Dinas Kesehatan Kabupaten Denpasar, direktur rumah sakit, puskesmas, ketua komisi penanggulangan AIDS di kabupaten/kota dan pemerhati HIV/AIDS termasuk ODHA. Penelitian menemukan jumlah kasus HIV/AIDS di Kota Denpasar yang tertinggi dan penularan terbesarnya melalui hubungan seks. Namun, dukungan pemerintah daerah dalam upaya pencegahan dan penanggulangan HIV/AIDS terlihat belum maksimal. Padahal kebijakan penanggulangan HIV/AIDS sangat ditentukan oleh cara pandang pemerintah terhadap penyakit HIV/AIDS. Untuk itu, perlu peningkatan pemahaman tentang HIV/AIDS serta pencegahan dan penanganan semua pihak terkait sehingga penanggulangan HIV/AIDS dapat lebih efektif, efisien, dan tepat sasaran. Nationally, Indonesia anticipated HIV/AIDS epidemic, but the number of cases of HIV/AIDS in Bali province from year to year showed an increase in the increasingly alarming. This study aimed to determine the number of cases and the development of policies on HIV / AIDS in Denpasar. This research was conducted using qualitative methods in Denpasar on 11-17 September 2011. The study sample was selected using the informant is head of planning, Denpasar District health officers, the director of the hospital, health center, chairman of the commission on AIDS in the district/city and observer of HIV / AIDS, including people living with HIV. The study found the number of cases of HIV / AIDS in the city of Denpasar is the highest and greatest transmission through sexual intercourse

  5. HIV Prevention

    Centers for Disease Control (CDC) Podcasts

    2012-02-01

    Dr. Kevin Fenton, Director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, talks about steps people can take to protect their health from HIV.  Created: 2/1/2012 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP).   Date Released: 2/1/2012.