Cluster Of Differentiation 4 Count Research Articles

Viral load undetectable state and predictors among children and adolescents living with HIV in South Gondar, Ethiopia, 2023: an 8-year retrospective cohort study

ObjectivesThe objective of this study is to examine the zonal-wide load undetectable state and predictors among children and adolescents living with HIV at South Gondar health institutions, 2023.DesignA retrospective cohort...

Aerobic-training effects on CD4 cell count and health related quality of life of people living with human immunodeficiency virus

This study compared the effects of 12 weeks of aerobic training against baseline data of People Living with Human Immunodeficiency Virus (PLWH) Cluster of Differentiation 4 (CD4) cell count, and Health-Related Quality of life (HRQoL) (Physical-health Component Summary (PCS) and Mental-health Component Summary (MCS)). A within-subject quasi-experimental multimethod design was used. There was purposive sampling of participants on Highly Active Antiretroviral Therapy (HAART) under Botswana Network of People Living with HIV/AIDS (BONEPWA). The 28 participants (23 females and 5 males) who met the inclusion criteria were of age 18 to 45. After 6 weeks, one female dropped out of the study. Participants were subjected to 12 weeks of aerobic training, three times a week for 60 minutes per session. The significant differences between CD4 cell count and the HRQoL variables at baseline and week 12 of the participants were compared using the paired t-test. All analysis was done using Statistical Package for the Social Sciences (SPSS) version 24.0 software. The alpha value was set at p0.05) improvements in CD4 count and PCS measures after intervention. PLWH can be advised to engage in regular aerobic training 3 times a week for 60 minutes especially when on HAART. The research is relatively preliminary; therefore, there could be some replication of the study by other researchers.

CD4 Count and Central Nervous System Infection among HIV/AIDS Patients in an Indonesian Presidential Hospital from 2020 to 2022

Highlights:1. There were insufficient data on the correlation between CD4 count and central nervous system infection as well as the risk magnitude of the infection for HIV/AIDS patients in Indonesia.2. This study revealed a significant correlation between CD4 count and the incidence of central nervous system infection in HIV/AIDS patients, showing an increased risk with a low CD4 count.3. The findings suggest that CD4 count is a vital parameter in determining therapy and evaluating the presence of opportunistic infections in HIV/AIDS patients. Abstract People living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), referred to as PLWHA, have a high rate of mortality and morbidity due to opportunistic central nervous system infections. The infections are attributed to the immune deficiency caused by HIV exposure to the immune system's cluster of differentiation 4 (CD4) cells. This allows the central nervous system, the most vital body system, to acquire an opportunistic infection. The purpose of this study was to determine the existence and magnitude of a risk by examining the correlation between CD4 count and the incidence of central nervous system infection among HIV/AIDS patients. This analytical cross-sectional study utilized a simple random sampling technique on the population of HIV/AIDS patients, which consisted of 80 medical records from January 2020 to December 2022. This study was conducted at Gatot Soebroto Presidential Hospital, also known as Gatot Soebroto Central Army Hospital, in Jakarta, Indonesia. The data analysis was performed using Fisher's exact test (p<0.05) and the prevalence odds ratio (POR). The results showed that 16.3% of the patients suffered a central nervous system infection, which consisted of cerebral toxoplasmosis (76.9%) and brain abscess (23.1%). The bivariate analysis suggested a significant correlation between CD4 count and the incidence of central nervous system infection, with an 11.5-fold increased risk for HIV/AIDS patients who had a CD4 count of <200 cells/mm3 (p=0.000; OR=11.5; 95% CI=2.9–43.8). This study concludes that CD4 count is correlated with the incidence of central nervous system infection, indicating a higher risk for HIV/AIDS patients with a low CD4 count.

Clinical profile of central nervous system space-occupying lesions and their association with CD4 counts in patients with HIV: A prospective observational study.

Neurological manifestations are one of the major concerns for patients with human immunodeficiency virus (HIV). The secondary spectrum includes space-occupying lesions (SOL), including tuberculoma, cryptococcosis, candidiasis, toxoplasmosis, primary central nervous system lymphoma (PCNSL), and progressive multifocal leukoencephalopathy (PML). To assess the neurological manifestations, disease outcome, and their associations with cluster of differentiation 4 (CD4) counts in patients with HIV. This single-center, prospective, observational study was performed in the Department of General Medicine of a tertiary care institute, over a period of 2 years (January 2017 to December 2018). The study included 150 known or newly diagnosed HIV patients with CNS SOL. The physical examination, laboratory investigations, and imaging were conducted on every patient, and the findings were noted. The patients mainly presented with hemiparesis (52%), had involvement of the frontal region (38.7%), and were diagnosed with tuberculoma (29.3%). Other diagnoses were toxoplasmosis (22.7%), PML (17.3%), PCNSL (15.3%), brain abscess (10%), and neurocysticercosis (5.3%). Of 150 patients, 136 (90.7%) were survivors, while 14 (9.3%) were non-survivors. The mean CD4 count was significantly less in patients with toxoplasmosis (P < 0.0001) and PCNSL (P = 0.02), and significantly higher in patients with tuberculoma (P < 0.0001) and brain abscess (P = 0.0009) relative to other causes of SOL. Moreover, the mean CD4 count was not significantly associated with survivors and non-survivors (P = 0.28). In patients with HIV, CD4 count was significantly low in toxoplasmosis and PCNSL, and high in tuberculoma and brain abscess.

PERBANDINGAN CD4 HIV –TB PARU SEBELUM DAN SESUDAH ARV DAN OAT

Background: Human Immunodeficiency Virus (HIV) is a viral infectious disease that attacks the immune system or white blood cells (lymphocytes). HIV, which belongs to the Retroviridae family, is lymphatic, which can damage the specific immune system, namely T-helper lymphocytes or Cluster of Differentiation 4 (CD4). The CD4 count is normal when it is 500–1400 cells/mm3, which is usually the determinant of whether a patient is infected with HIV or not. Objective: This study aims to assess the comparison of CD4 counts in HIV-TB patients before and after ARV and OAT treatment at Dr. Pirngadi Medan City. Methods: Observational analysis research with a cross-sectional design was conducted at RSUD Dr. Pirngadi Medan City in September 2022. The sample for this study was 20 patient records from the medical records of RSUD Dr. Pirngadi, Medan City. The data were analyzed using an unpaired t-test. Results: The results of the study showed that the most HIV-TB pulmonary patients at RSUD Dr. Pirngadi Medan City were aged 36-45 years (50.0%). The majority of male patients (90.0%) and the domicile of most patients in Medan City are in the Medan Tembung sub-district (15.0%). The results of the unpaired t-test obtained a p-value of 0.022, meaning that there was a significant difference between the CD4 count before and after ARV and OAT treatment in HIV-TB patients at RSUD Dr. Pirngadi Medan City. Conclusion: There were significant differences in CD4 counts before and after ARV and OAT treatment in HIV patients with pulmonary TB co-infection at Dr. Pirngadi, Medan City. Keywords: HIV, HIV-TB pulmonary, CD4

Advancement of HIV and Co-infections: A Prospective Observational Study

Aim: To assess the incidence of comorbidities and opportunistic infections (OIs) in advanced HIV. Design: This is a prospective observational study conducted on people living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) (PLHA) with a laboratory-confirmed cluster of differentiation-4 (CD4) counts &lt;100/mm 3 . Recruitment of 102 PLHA patients was performed with no filtering criteria based on the duration of diagnosis, antiretroviral therapy (ART) naive, or ART failure. Data collection was initiated post-clearance by the Institutional Ethics Committee. Methods: The study was conducted at the tertiary care center. The prevalence of underlying comorbidities and the incidence of multiple OIs were assessed in 102 HIV patients with CD4 &lt;100/mm 3 . A detailed clinical examination was carried out, and all relevant investigations were digitally recorded. Results: The mean age of the participants among the 102 PLHA with a CD4 count of 100/mm 3 was 41.4 + 11.2 years, and their mean CD4 count was 62.3 + 20.5/mm 3 at the time of recruitment. A total of 62 (60.8%) patients were ART-naive. The two most prevalent comorbidities in the research population were anemia and renal failure. Fungal infections (66.6%) in the study cohort varied from the most frequent oral thrush (42.1%) to disseminated histoplasmosis (7.8%). Tuberculosis was the second most prevalent opportunistic illness (36.2%). Syphilis cases were prevalent (8.8%) among sexually transmitted illnesses linked to HIV, with most of the cases being latent syphilis; 3.9% of the patients were coinfected with chronic hepatitis B and HIV, and only one possessed chronic hepatitis C. Conclusion: Comorbidities and OIs are major public health concerns in Indian healthcare settings. Our findings show that the prevalence of comorbidities and OIs is high. Furthermore, late diagnosis with HIV, a CD4 count &lt;100/mm 3 , and poor adherence indicate an increased incidence and decreased survival time among PLHA with underlying comorbidities and OIs . Early care-seeking and the beginning of ART, as well as ongoing monitoring of patients to ensure they take their medication on schedule, are critical to reducing OIs and improving general health. Further research is highly recommended to gain deeper insights.

Effect of Dolutegravir regimen against other regimens on some hematological parameters, CD4 count and viral load of people living with HIV infection in South Eastern Nigeria.

Appropriate usage of highly active antiretroviral therapy (HAART) suppresses human immunodeficiency virus (HIV) replication. One of such HAART is dolutegravir (DTG) containing regimen which Nigeria included in her national protocol, as the preferred first-line option, with particularly fixed dose combination of tenofovir/lamivudine/dolutegravir (TLD) in 2018. To access the impact of this regimen as against other regimens on some hematological parameters as well as cluster of differentiation 4 (CD4) count and viral load on people living with HIV infection. The study site is a health facility center supported by President Emergency Plan for acquired immunodeficiency syndrome (AIDS) Relief where people living with HIV infection (PLWHIV) visit for their routine management in Abakaliki, Ebonyi State. A hundred and twenty-two (122) subjects participated, 58 PLWHIV and 64 control subjects. CD4 + count by partec cyflow auto analyzer, while the Viral load assay was by Roche COBAS Ampriplep/COBAS TaqMan molecular systems. Full blood count determination was by Sysmex XE-2100 hematology auto analyzer, while the detection of antibody to HAART was by Petz and direct Coombs tests. Mean values of hemoglobin (Hb), Total white cell count, Lymphocytes, Monocytes and CD4 + counts of people living with HIV infection (PLWHIV) were significantly (P = .0001) lower than the control subjects. The Hb level of PLWHIV on Efavirenz combination (TDF/3TC/EFV) are comparable 123 ± 32g/l with those on Ritonavir combination (TDF/3TC/LPV/R) 136 ± 16g/l and Dolutegravir (TLD)134 ± 20.0g/l (P = .307). On the other hand, total white cell count (4.55 ± 1.99 × 109/L) of those on Efavirenz combination (TDF/3TC/EFV) and Dolutegravir (TLD) (4.53 ± 1.31 × 109/L) were significantly higher than those on Ritonavir combination (TDF/3TC/LPV/R) (4.09 ± 1.15 × 109/L). The Viral Load of PLWHIV on Dolutegravir (TLD) was significantly lower 171.57 ± 4.56 copies/mL than those on Efavirenz combination (TDF/3TC/EFV) (86,395.91 ± 27,476.57copies/mL) and Ritonavir combination (TDF/3TC/LPV/R) (81,188.83 ± 13,393.47 copies/mL), respectively. Some hematological parameters (such as Hb, total white cell counts and CD4 + count) were lower in people living with HIV than values seen in control group. The 3 regimens used in the management of HIV infection in the locality revealed comparable Packed cell volume and Hemoglobin levels. Total white cell count of those on Efavirenz and DTG is comparable with higher values than those on Ritonavir.

The Effect of Antiretroviral Therapy (ART) Duration on CD4 Counts in Human Immunodeficiency Virus (HIV) Patients in dr. Doris Sylvanus Regional Hospital

Human Immunodeficiency Virus (HIV) attacks white blood cells, thereby reducing the immunity of infected patients. It attacks Cluster of Differentiation 4 (CD4) lymphocyte cells which have a role in the immune system. It has killed 36.3 million people worldwide. There were reported 222 cases in Central Kalimantan Province in 2019. The therapy given to suppress HIV is antiretroviral (ARV) which gradually recover CD4 cells of the patients. This study aims to determine the effect of duration of the antiretroviral therapy (ART) duration on CD4 counts in patients with HIV at the VCT (Voluntary, Counselling, and Test) Polyclinic, dr. Doris Sylvanus Hospital during 2019-2020. It is a descriptive retrospective study, extracting data from patients medical record data. Following total sampling and selected based on inclusion and exclusion criteria i.e. aged ≥18 years and diagnosed with HIV during 2019-2020, with complete CD4 count records prior and after ART, there were 45 patients included. The results showed that CD4 counts increased in patients with fixed dose combination (FDC) Tenofovir, lamivudine and efavirenz, with average value of 190.36± 220.92 cells/mm3 prior ART, became 259.93± 203.74 cells/mm3 at 12 month ART, and 310.82± 22.,53 cells/mm3 at 24 month ART (p = 0.000). Thus, the longer ART duration the higher CD4 counts and recover the normal range.

Neurocognitive Disorders in HIV-positive Patients.

(1) To know the prevalence of HAND in HIV-infected patients of a multi-ethnic population. (2) To describe various types of neurocognitive impairment among patients of HAND and study the factors affecting HAND. This study was a cross-sectional descriptive study conducted on 250 HIV-positive patients in outpatient department (OPD) of a tertiary care center in Mumbai, conducted over a period of 12 months. Patients with HIV-1 attending the OPD and having a minimal formal education of 4 years were included. Patients with concomitant delirium, any known central nervous system (CNS) disorder, any psychiatric disorder, and pregnant females were excluded. Outcome measures-the test batteries used were (1) International HIV Dementia Scale (IHDS) and (2) Addenbrookes cognitive examination-revised (ACE-R) scale. Of 250 subjects studied, 55.6% (139) were males and 44.4 % (111) were females. The mean age of study population was 39.42 years. The mean years of education were 8.32 years. The mean duration of infection (diagnosis of HIV-positive state) was 64.49 months and the mean duration of HAART intake in our patients was 52.30 months. The mean cluster of differentiation 4 (CD4) counts of our subjects were 527.13 per cumm [standard deviation (SD) of 234.13]. The mean nadir CD4 counts were 224.35 per cumm (SD of 115.09). Using the ACE-R scale, the prevalence of HAND was 71.60%, of which 37.20% had an asymptomatic neurological impairment, 29.60% had mild cognitive dysfunction, and 4.80% had HAD. Memory, verbal fluency and visuospatial abilities were the most affected domains on the ACE-R and memory recall and psychomotor speed were affected more on the IHDS. The prevalence of HAND was more with increasing age (p = 0.020), lesser education (p &lt; 0.00) and lesser nadir CD4 counts (p &lt; 0.00). However, it was not affected by the duration of the disease and the current CD4 counts (p &gt; 0.05). Human immunodeficiency viruses (HIV) associated neurocognitive disorders HAND is common in HIV-positive patients, most of whom are asymptomatic. Older patients with less education and severe disease, having lower nadir counts are at the highest risk of HAND. Memory, verbal fluency, and visuospatial abilities were the most commonly affected domains.

Counseling Therapy with Hatha Yoga on Adherence Level, Nutritional Status, and Quality of Life Among HIV-Infected Adolescents: A Randomized Controlled Trial

Introduction: HIV infection and AIDS are associated with numerous challenges, and infected people experience extreme despair, fear, anxiety, and depression. However, counseling therapy and yoga techniques may help ease stress-related illness, produce internal strength through relaxation, and enhance immunity. Objective: This study aimed to evaluate the effectiveness of counseling therapy and Hatha yoga on the adherence level, nutritional status, and quality of life (QOL) of HIV-infected adolescents. Materials and Methods: A randomized controlled trial study was conducted. Through the simple random method, 388 (195 in the experimental and 193 in the control group) HIVinfected adolescents were selected. The data of HIV-infected adolescents and caregivers were collected from four main Antiretroviral Therapy clinics in Chennai, India, through Standardized Antiretroviral Therapy adherence, QOL, and a structured nutritional assessment questionnaire. Motivational counseling was given to the experimental group, and the researcher demonstrated selected asanas. The data were collected from both groups at 0, 3, and 6 months intervals. The descriptive statistics of mean, standard deviation, and inferential statistics of the student independent t test and Chi-square test were used to determine the effectiveness of interventional variables in both groups. Results: The Mean±SD age of the experimental group of adolescents was 13.6±2.2 years, and that of the control group was 13.8±2.4 years. There is an improvement range in the experimental vs the control group for the components of adherence level (13.4% vs 4.9%) and QOL (15.1% vs 0.9%) at a significance of P=0.001 with a 95% confidence interval. Also, the nutritional gain score was significantly increased to 9.3% vs 1.5% (P=0.05). Regarding CD4 (cluster of differentiation 4) count, the baseline mean score was 664.86 vs 669.72, whereas, in the sixth month, it significantly increased to 840.35 vs 703.35 (P=0.001). Conclusion: Motivational counseling and behavior modification of yoga efficiently improved health status and well-being among HIV-infected adolescents in the experimental group compared to the control group.

Study of quality of life and depression in people living with HIV/AIDS in India.

The aim of this study was to assess the quality of life (QOL) and the severity of depression in people living with HIV/AIDS (PLWHA) and investigate its correlates. This was a cross-sectional study on 700 PLWHA in India. World Health Organization QOL HIV (WHOQOL HIV-BREF) and Patient Health Questionnaire-9 (PHQ-9) were used to assess QOL and depression in PLWHA, respectively. The study population was divided into five groups on the basis of Cluster of Differentiation 4 (CD4) count as follows: Group A [< 50 cells/μL], Group B [50-199 cells/μL], Group C [200-349 cells/μL], Group D [350-499 cells/μL], and Group E [>500 cells/μL]. The lowest mean scores were noted under Group A [< 50 cells/μL] in physical and psychological domains and the highest mean scores were noted under Group E [> 500 cells/μL] in physical and environment domains. PHQ9 scores negatively correlated with QOL domains and the correlation was statistically significant (p < 0.001) with the highest negative correlation was found in relation to the psychological domain (r = -0.739). The PHQ9 score in those who do not have opportunistic illnesses (7.23 ± 6.14) was lower in comparison to those who had opportunistic illnesses (9.81 ± 6.40) and the difference was statistically significant (p < 0.001). We observed that there was almost a chronological increase in the individual QOL domain score and a decrease in the PHQ9 score with an increase in CD4 count. Our result supports the implementation of routine screening for depression in antiretroviral therapy centers and multidisciplinary interventions to improve outcomes among depressed PLWHA.

Seemingly Unrelated Regression Analysis of the Cost and Health-Related Quality of Life Outcomes of the REVAMP Randomized Clinical Trial

ObjectiveThis study aimed to evaluate the 9-month cost and health-related quality of life (HRQOL) outcomes of resistance versus viral load testing strategies to manage virological failure in low-middle income countries. MethodsWe analyzed secondary outcomes from the REVAMP clinical trial: a pragmatic, open label, parallel-arm randomized trial investigating resistance versus viral load testing for individuals failing first-line treatment in South Africa and Uganda. We collected resource data, valued according to local cost data and used the 3-level version of EQ-5D to measure HRQOL at baseline and 9 months. We applied seemingly unrelated regression equations to account for the correlation between cost and HRQOL. We conducted intention-to-treat analyses with multiple imputation using chained equations for missing data and performed sensitivity analyses using complete cases. ResultsFor South Africa, resistance testing and opportunistic infections were associated with statistically significantly higher total costs, and virological suppression was associated with lower total cost. Higher baseline utility, higher cluster of differentiation 4 (CD4) count, and virological suppression were associated with better HRQOL. For Uganda, resistance testing and switching to second-line treatment were associated with higher total cost, and higher CD4 was associated with lower total cost. Higher baseline utility, higher CD4 count, and virological suppression were associated with better HRQOL. Sensitivity analyses of the complete-case analysis confirmed the overall results. ConclusionResistance testing showed no cost or HRQOL advantage in South Africa or Uganda over the 9-month REVAMP clinical trial.

Prospective evaluation of radiographic manifestations of tuberculosis in relationship with CD4 count in patients with HIV/AIDS.

A major risk factor to develop active tuberculosis (TB) is the infection with the human immunodeficiency virus (HIV). Chest radiography is the first-line imaging modality used to rule out TB. Coinfected individuals present often with atypical imaging patterns, due to the immunosuppression caused by the virus, making diagnosis difficult. In this prospective observational study 268 TB and HIV coinfected patients were included. During a follow-up period of 24 weeks, the predominant patterns on chest radiography were analyzed and compared to the cluster of differentiation 4 (CD4) count under antiretroviral and anti-TB therapy. Patients with low CD4 counts (<200 cells//µL) showed more often lymphadenopathy (62% vs 38%;P = .08) and a miliary pattern (64% vs 36%;P = .04) but less likely cavitation (32% vs 68%;P = .008) or consolidation (47% vs 63%;P = .002) compared to individuals with higher CD4 counts. Over the follow-up period, partial response to therapy was the most frequent radiological evolution (62%), mainly accompanied by an increase of CD4 cells (92%). Patients with a decrease in CD4 count mostly presented with a worsening in radiological findings (53%). Radiographic TB manifestation correlated with the immune status of patients coinfected with HIV. Low CD4 counts often showed atypical manifestation.

Prevalence, Profile and Treatment Outcome of Tuberculosis-Human Immunodeficiency Virus Co-Infection in South Eastern Nigeria: A 3-Year Retrospective Study.

Tuberculosis (TB) and the Human Immune Deficiency Virus (HIV) represent major public health challenges and are intricately linked to each other. This is more prevalent in the sub-Saharan African region, where about 80% of this co-infection is recorded. This study aimed to review the prevalence, profile, and treatment outcome of TB-HIV co-infected patients. A hospital-based retrospective study was conducted in a tertiary center in southeast Nigeria for the period 2015-2017. Information elicited from participant's medical records included socio-demographic profile (age, sex, residential area, and occupation), Cluster of Differentiation 4 (CD4) count level at the time of diagnosis of co-infection, weight, treatment outcome, as well as the record of the number of TB patients who presented within this same period. The total number of TB/HIV co-infected patients who participated in the study during this period was 207, with a prevalence of TB/HIV co-infection of 33.9%. The highest proportion of cases was recorded among participants within the age group of 31-40, and the cases of co-infection were more common in males (58.9%) and students (27.5%). The results also showed a significant relationship between gender, occupation, residential area, and TB/HIV co-infection. Most of the co-infected participants had a CD4 count of <300 cells/mm3 and an associated poor treatment outcome of 41.1%. TB/HIV co-infection needs to be properly addressed, and screening for HIV among TB patients should be a priority. This will help in early diagnosis and subsequently improve the treatment outcome of both diseases.

Maternal and Perinatal Outcomes in Pregnancies Associated with HIV Infection: A Prospective Cohort Study

Introduction: Human Immunodeficiency Virus (HIV) has persisted as the world’s leading infectious killer disease. Globally, around 19.3 million women in the reproductive age group are suffering from HIV, and most of these women are capable of transmitting this infection to their babies. Although pregnancy does not have an adverse effect on the natural history of HIV infection in women, Acquired Immunodeficiency Syndrome (AIDS) has become a leading cause of maternal and perinatal morbidity and mortality in some areas as the epidemic progresses. Aim: To assess the impact of HIV infection on maternal health, the risk of vertical transmission, and neonatal complications. Materials and Methods: This prospective cohort study was conducted at the Department of Obstetrics and Gynaecology, RG Kar Medical College and Hospital, Kolkata, West Bengal, India between March 1, 2021, and August 31, 2022. The study population comprised all pregnant patients with a known positive HIV status or those diagnosed newly during routine antenatal screening at the antenatal Outpatient Department (OPD) and Prevention of Parent to Child Transmission of HIV (PPTCT) clinic, or attending obstetric emergency. After registering in the antenatal clinic, they underwent all routine investigations, including baseline CD4 count, husband’s HIV status, screening for other sexually transmitted diseases, and initiation of Antiretroviral Therapy (ART). Maternal and perinatal outcomes, such as maternal complications, risk of vertical transmission, gestational age at birth, and birth weight of the baby, were assessed throughout the antenatal period and up to six weeks post-delivery. Data were entered into a Microsoft Excel datasheet and analysed using Statistical Packages for Social Sciences (SPSS) version 22.0 software. Categorical data were represented in the form of frequencies and proportions. Chi-square test was used for significance testing, with a p-value &lt;0.05 considered statistically significant. Results: Out of a total of 15,087 deliveries during the study period, 55 were HIV-positive cases, with a prevalence of 0.36%. Both vaginal delivery and cesarean section showed almost similar vertical transmission rates in the newborns, i.e., 4 (14%) and 4 (17%), respectively. Opportunistic infection rates were significantly higher in mothers with lower CD4 counts (&lt;200). Mothers receiving regular ART treatment showed a lower incidence of perinatal complications, such as neonatal sepsis, perinatal asphyxia, convulsions, or perinatal death, i.e., 6 (13.63%), compared to those not on treatment, 8 (72.72%) (p-value=0.005475). Higher rates of vertical transmission were observed in patients with significantly lower Cluster of Differentiation 4 (CD4) counts, 5 (71%) versus 3 (6.8%) (p-value=0.00001). Conclusion: Pregnancy outcomes in terms of maternal risks of infection, risk of vertical transmission, preterm births, foetal deaths, and neonatal complications can be significantly improved by early diagnosis and treatment of HIV infection. Proper antenatal care, early detection, initiation of antiretroviral drugs, and patient compliance with the multidrug regimen are the mainstay of feto-maternal well-being.

Ocular manifestations in HIV patients and its correlation with CD4 count before and after starting HAART

Background: Human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) are a global pandemic, with cases reported from practically every country. The majority of information and studies regarding ophthalmic manifestations in India reflects the pre-HAART (highly active anti-retroviral therapy) era. India may be going through an intermediate stage, where the spectrum of the ophthalmological manifestations may be changing significantly. Aims and Objectives: The aims of this study were to study the age and gender distribution in HIV patients presenting with various ocular manifestation and to correlate the cluster of differentiation 4 (CD4) count with various ocular manifestation of AIDS. Materials and Methods: Prospective cross-sectional study was conducted on 120 patients. Ocular manifestations and WHO clinical stage of HIV were noted and CD4 count was calculated. The participants were followed up for at least 6 months on monthly basis when they come to take ART tables or as required for any ophthalmic disorder presented by patient. Any manifestation during this months was included in post HAART group. CD4 count after 6 months was taken into account in post HAART group. Results: Males predominated females. The number of males in Pre HAART was 60.8% and post-HAART 59.4%. Mean CD4 count in pre-HAART was 140.63 and post-HAART was 221.93. Majority (34 patients) in pre-HAART had CD4 count between 100 and 150, while in post-HAART, majority had count more than 200 (57 patients). Conclusion: Mean CD4 count of pre-HAART group patients raised significantly. Mean CD4 count of pre-HAART group is 140.63 with SD of 63.4, while it increased in post-HAART group to 222 which is statistically highly significant.

HIV Infection Progression Monitoring System Based on CD4 Counts and Wishart Distribution.

The human immunodeficiency virus (HIV) is a viral infection that destroys the human immune system, resulting in the acquired immunodeficiency syndrome (AIDS). The management and care of patients on antiretroviral therapy (ART) consumes a large portion of the health budget of many countries. ART improves the lives of the HIV patients. However, benefiting from the treatment remains to be low due to the nonadherence, adverse events, and treatment failure associated with the transmitted drug resistance mutations (TDRMs). Extra care is therefore required in prescribing switch of ART regimens for HIV-naive patients. We propose a disease monitoring system, which depends on how the HIV-naive patients respond to the ART regimen. We model cluster of differentiation 4 (CD4) counts data measured at every 3 months in a period of 48 weeks on a cohort of 87 HIV-naive patients on ART, from Zambia. We demonstrate how to apply the Bayesian Wishart distribution to model CD4 counts, leading to an informative HIV progression monitoring system. We found a steady increase in the average of the CD4 counts (from 219 to 315) for HIV-naive patients on the ART regimen. The average was still below the expected 500 CD4 counts for a normal person. The derived precision matrix shows an increase in probability of potency of the ART regimen, which ranges from 0.1261 to 0.8678. An early detection is crucial as it allows for timely switch of regimen from first to second line or to the third line. The proposed HIV disease progression monitoring system for HIV-naive patients on ART regimen that is based on CD4 counts could enable physicians make informed decisions on the management and care of the patients.

Severe immunosuppression is related to poorer immunogenicity to SARS-CoV-2 vaccines among people living with HIV

ObjectivesThe aim of this study was to assess the immunogenicity of SARS-CoV-2 available vaccines among people living with HIV (PLWH) after a complete vaccination scheme, and determine predictors of seroconversion. MethodsThis multicentre prospective cohort study included 420 PLWH who had received a standard immunization, either with mRNA or adenoviral-vectored COVID-19 vaccines. Antibody response was evaluated within 1 to 2 months after the last dose of the vaccine with a quantitative determination of antitrimeric spike protein-specific IgG antibodies and IgG neutralizing antibodies. ResultsOverall, 384 of 420 PLWH (91%) showed antibody response to vaccination. Seroconversion was observed in 308 of 326 individuals with cluster of differentiation 4 (CD4) counts ≥350 cells/mm3 (95%), 55 of 61 PLWH with 200 to 349 cells/mm3 (90%), and 21 of 33 PLWH with CD4 counts <200 cells/mm3 (64%; p < 0.001). The median log10 IgG neutralization levels were 2.4 IU/mL (Q1–Q3, 1.0–3.1) among PLWH with CD4 counts <200 cells/mm3, 3.1 IU/mL (Q1–Q3, 2.8–3.4) for the 200 to 349 cells/mm3 group, and 3.1 IU/mL (Q1–Q3, 2.7–3.4) for PLWH with CD4 counts ≥350 cells/mm3 (p = 0.016). In the multivariate analysis, CD4 counts ≥350 cells/mm3 (OR: 7.10; 95% CI, 1.91–26.46; p = 0.004) and receiving mRNA-vectored COVID-19 vaccines (OR: 8.19; 95% CI, 3.24–20.70; p ≤ 0.001) were independently associated with a higher probability of response to vaccination. DiscussionHIV-related immunosuppression impairs the antibody response to SARS-CoV-2 vaccines. Specific vaccination schemes should be urgently tailored in this setting, particularly in patients with CD4 cell counts <200 cells/μL. Adenoviral-vectored vaccines should be avoided in PLWH whenever possible.

The Body Fat Percentage Rather Than the BMI Is Associated with the CD4 Count among HIV Positive Japanese Individuals.

Maintenance of the cluster of differentiation 4 (CD4) positive lymphocyte count (CD4 count) is important for human immunodeficiency virus (HIV) positive individuals. Although a higher body mass index (BMI) is shown to be associated with a higher CD4 count, BMI itself does not reflect body composition. Therefore, we examined the association of body weight, body composition and the CD4 count, and determined the optimal ranges of CD4 count associated factors in Japanese HIV positive individuals. This cross-sectional study included 338 male patients treated with antiretroviral therapy for ≥12 months. Multiple logistic regression analysis was used to identify factors significantly associated with a CD4 count of ≥500 cells (mm3)−1. The cutoff values of factors for a CD4 ≥ 500 cells (mm3)−1 and cardiovascular disease risk were obtained by receiver operating characteristic curves. Age, body fat percentage (BF%), nadir CD4 count, duration of antiretroviral therapy (ART), years since the HIV-positive diagnosis and cholesterol intake showed significant associations with the CD4 count. The cutoff value of BF% for a CD4 ≥ 500 cells (mm3)−1 and lower cardiovascular disease risk were ≥25.1% and ≤25.5%, respectively. The BF%, but not the BMI, was associated with CD4 count. For the management of HIV positive individuals, 25% appears to be the optimal BF% when considering the balance between CD4 count management and cardiovascular disease risk.

Comparative effects of 6-weeks progressive resistance exercise and moderate intensity aerobic exercise on CD4 count and weights of people living with HIV/AIDS in Alex-Ekwueme Federal University Teaching Hospital Ebonyi State.

Introduction:The most significant clinical challenges in people living with HIV/AIDS (PLWHA) are decline in CD4+ T helper cells and abnormal weight reduction. Consequently, PLWHA who are on Anti-Retroviral Therapy (ART) or Highly Active Anti-Retroviral Therapy (HAART) are usually predisposed to coronary artery diseases due to abnormal weight gain (lipohypertrophy), though with improved and unstable Cluster of Differentiation 4 (CD4) counts.The main aim of this study was to compare the effects of 6 weeks progressive resistance exercise (PRE) and moderate intensity aerobic exercise (MIAE) on CD4 count, and weight of PLWHA in Alex-Ekwueme Federal University Teaching Hospital Ebonyi State.Method:The study adopted quasi experimental research design. The population of the study was 60 Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome patients that attended HIV clinics at Alex-Ekwueme Federal University Teaching Hospital Abakaliki (AE-FUTHA) which formed 58 sample sizes for this study.Simple random sampling technique was adopted for the study and flow cytometry, Heel Densitometer (X-rite 331C), and Omron BF 400 were the instrument used for data collection of CD4 counts and weight respectively; and they are standardized hence not validated. Mean, standard deviation and Analysis of Co-variance (ANCOVA) were used to analyze the data obtained. The reliability coefficient obtained from the pilot study was 0.848 and 0.994 for CD4 and WEIGHT respectively.Results:The major findings revealed a significant difference after 6 weeks’ PRE and MIAE on CD4 and Weight of PLWHA.Conclusion:Health promotion policy maker's arm of the government and Healthcare givers should integrate and enforce the use of exercises either as a single regimen or combined exercises into the management plan of PLWHA for greater boost in absolute CD4 count bearing in mind that both have positive effects. Physiotherapist should be integrated in the managements of PLWHA for appropriate prescription and education of therapeutic exercises for body weight.