Disease In HIV-positive Patients Research Articles

Association of HIV-1 Nef polymorphisms with coronary artery disease in HIV-positive patients

Association of HIV-1 Nef polymorphisms with coronary artery disease in HIV-positive patients

A Retrospective Study of the Presentation and Management of Perianal Disease in HIV-Positive Patients Referred to a Surgical Outpatient Unit in Turkey.

BACKGROUND The incidence of human immunodeficiency virus (HIV) infection is on the rise, and perianal region diseases in HIV-infected patients have become increasingly prevalent. This study aimed to analyze the surgical treatment outcomes of HIV-infected patients presenting with perianal concerns. MATERIAL AND METHODS We included 311 HIV-positive patients admitted to the Infectious Diseases Clinic of Samsun Training and Research Hospital between January 2014 and December 2022. From this group, we selected those who sought care at the general surgery outpatient clinic for perianal and anal concerns, retrospectively reviewing their medical records. RESULTS Out of 311 patients, 54 (17.3%) were referred to the general surgery outpatient clinic with anal and/or perianal region complaints. Of these cases, 38 (70.3%) had a single disease, while 16 (29.6%) had combined diseases. There were 20 males (95%) and 1 female (5%). Among these 54 patients, 33 (61.1%) received medical treatment from the outpatient clinic, while 21 (38.9%) underwent surgical intervention. The diagnoses included 22 hemorrhoidal diseases, 24 anal condylomas, 15 anal fissures, 11 anal abscesses, and 4 anal fistulas. We evaluated the postoperative results and recurrence status of these patients. CONCLUSIONS Perianal diseases in HIV-positive patients can be categorized as isolated or combined. The management of patients with postoperative follow-up compliance problems and combined diseases with low CD4 counts may pose treatment challenges.

Clinical and Etiological Profile of Chronic Kidney Disease in HIV Positive Patients

Clinical and Etiological Profile of Chronic Kidney Disease in HIV Positive Patients

Abnormal Presentation of Common Sexually Transmitted Diseases in HIV-Positive Patients: A Case Series

Abstract Mucocutaneous diseases are the most common manifestation of human immunodeficiency virus and because of abnormal presentation, diagnosis and management is a challenge for clinicians. Here, we present three cases of unusual and severe presentation of common sexually transmitted diseases, out of which two patients had ulcerative lesions in genitals and one patient had cauliflower-like growth involving the pubic and anal region.

RHEUMATIC MANIFESTATIONS IN HIV PATIENTS IN TERTIARY HOSPITAL

Background: HIV infection is a common disease in India. Rheumatological manifestations ( RM) are very common in HIV infected patients. Rheumatological manifestations are signicant cause of morbidity in these patients. Aim & Objective: To study the clinical spectrum of rheumatic diseases in HIV positive patients and correlate the above with CD4+ counts. Method & Materials: This study was a cross-sectional study carried out in Motilal Nehru Medical College and associated hospitals, Prayagraj. This study was carried out on 104 patients with HIV. After obtaining informed consent, demographic characteristics and details of the diagnosis of HIV will be ascertained. Patients with self-reported history of previous diagnosis of HIV and those on treatment with anti-retroviral agents will be consider to have HIV would need to have further testing of HIV. After this the patients will go through needed investigations to fulll aims and objective of the study. Statistical analysis and interpretation of the data was done by using SPSS Software version 23. Result: This study was carried out on 104 patients with HIV. The mean (SD) of age (Years) of participant in my study was 38.95 (8.93). The maximum number of participants was in age group of 31 -40 years that were 36.5% of total case. The 54.8% of the participants were Male and 45.2% were Female. Patients with rheumatic manifestation, 6 (5.8%) of the participants had Arthritis/Arthralgia and 1 (1.0%) of the participants had Septic Arthritis and 1 (1.0%) of the participants had Osteomyelitis and 1 (1.0%) of the participants had Avascular Necrosis. 0 (0.0%) of the participants had Systemic Lupus Erythematosus and 2 (1.9%) of the participants had Rheumatoid Arthritis and 0 (0.0%) of the participants had Psoriatic Arthritis. Conclusion: The clinical spectrum of rheumatic disease in HIV patients was that, Arthritis/Arthralgia was most common rheumatic manifestation followed by Septic Arthritis and Osteomyelitis. Study showed that with increase in duration of ART regimen the incidence of rheumatic manifestation was decreases.

Contribución de las imágenes PET/TC con 18F-FDG en el diagnóstico y manejo de pacientes VIH positivos

Introduction and objectivesThe human immunodeficiency virus [HIV] is a lentevirus, primarily infects certain cells of the immune system, thereby greatly weakens the body's own defenses against diseases. This study was aimed to explore the value and significance of 18F-FDG PET/CT in the assessment of patients with HIV infection and to examine the presence of quantitative alterations in 18F-FDG uptake among patients with HIV-related infections or malignant diseases in HIV-positive patients. Patients and methodsForty patients with HIV infection were scanned on PET/CT system. The data were registered according to immune status, antiretroviral therapy, and definitive diagnosis. All pathologic lesions and disease related areas were described, 18F-FDG uptake patterns were evaluated. Semiquantitative analysis of 18F-FDG uptake was performed and SUVmax were calculated. ResultsTwenty-eight patients [70%] were diagnosed with HIV-related infection or malignant diseases. The sensitivity of PET/CT was shown to be 100% and the specificity 92% for concomitant diseases requiring additional treatment to antiretroviral therapy. The SUVmax and CD4 counts were not statistically different between HIV-related reactive lymphadenopathy, HIV-related malignancy, and HIV-related infections. ConclusionsThe pattern of distribution of nodal/extranodal uptake on 18F-FDG PET/CT may facilitate distinction between HIV-related generalized lymphadenopathies, HIV-related opportunistic infections, and malignancies. In this context, 18F-FDG PET/CT should be preferred for routine use in the management of patients infected with HIV.

Prevalence of cardiovascular diseases in HIV positive patients: A comparative study between seropositive and seronegative patients living in Libreville, Gabon

The profile of HIV-associated cardiovascular disease has changed with the high coverage of antiretroviral treatment (ART). Data are lacking in Gabon. To compare the type and the frequency of cardiovascular manifestations in hospitalized HIV-infected patients (PLHIV) and seronegative ones. This was a retrospective analytical study performed by analyzing the files of patients hospitalized for a cardiovascular diseases and who benefited from an HIV serology in the cardiology department of the centre hospitalier universitaire de Libreville from January 2015 to December 2018. The files of 82 PLHIV and 150 HIV negative were analyzed. The mean CD4 count in PLHIV was 189 ± 170/mm 3 and 45.1% were on ART. PLHIV were more frequently less than 50 years old (70.6% vs. 43.3% of HIV negative; P < 0.01) and they were more frequently female (67.1% vs. 36.0% of HIV negative; P < 0.01). Pericarditis (25.6% vs. 11.3% in seronegatives; P = 0.01) mainly due to tuberculous (85.2%), myocarditis (14.6% vs. 4.0% in seronegatives; P = 0.03) and repolarization disorders (32.9% vs. 15.3% in HIV negative; P < 0.01) predominated in PLHIV. Atheromatous vascular diseases were more frequent in HIV negative patients (23.1%) compared to seropositive (6.1%) ( P < 0.01). The death of PLHIV was mainly due to pericarditis (71.4%) while HIV negative patients died more frequently for heart failure (46.7%). The cardiovascular manifestations linked to HIV immunosuppression are still frequent in Libreville.

Contribution of 18F-FDG PET/CT imaging in the diagnosis and management of HIV-positive patients

Introduction and objectivesThe human immunodeficiency virus [HIV] is a lentevirus, primarily infects certain cells of the immune system, thereby greatly weakens the body’s own defenses against diseases. This study was aimed to explore the value and significance of 18F-FDG PET/CT in the assessment of patients with HIV infection and to examine the presence of quantitative alterations in 18F-FDG uptake among patients with HIV-related infections or malignant diseases in HIV-positive patients. Patients and methodsForty patients with HIV infection were scanned on PET/CT system. The data were registered according to immune status, antiretroviral therapy, and definitive diagnosis. All pathologic lesions and disease related areas were described, 18F-FDG uptake patterns were evaluated. Semiquantitative analysis of 18F-FDG uptake was performed and SUVmax were calculated. ResultsTwenty-eight patients [70%] were diagnosed with HIV-related infection or malignant diseases. The sensitivity of PET/CT was shown to be 100% and the specificity 92% for concomitant diseases requiring additional treatment to antiretroviral therapy. The SUVmax and CD4 counts were not statistically different between HIV-related reactive lymphadenopathy, HIV-related malignancy, and HIV-related infections. ConclusionsThe pattern of distribution of nodal/extranodal uptake on 18F-FDG PET/CT may facilitate distinction between HIV-related generalized lymphadenopathies, HIV-related opportunistic infections, and malignancies. In this context, 18F-FDG PET/CT should be preferred for routine use in the management of patients infected with HIV.

Sonographic Assessment of Kidneys in Human Immunodeficiency Virus Seropositive Patients: A systematic Review

Background: Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) remains a major challenge globally, and approximately 180,000 people died from AIDS-related illnesses in Nigeria in 2015. HIV associated nephropathy is the third most common cause of end-stage renal failure.&#x0D; Objectives: To review published original research articles on the sonographic evaluation of kidneys in HIV seropositive patients, identifying missing gaps and coming up with an area of further study.&#x0D; Methodology: The study was retrospective and a secondary source of data from published original research articles was used. The search was performed through Google search using Google Scholar, EMBASE, PubMed and Medline. All the published original research articles in the English language and the availability of full-text articles were included in the study.&#x0D; Results: An electronic search using the search terms had identified 58 related published articles, but only 12 articles were reviewed. This study found out that human immunodeficiency virus-associated nephropathy (HIVAN) to be a most predominant renal disease in HIV positive patients leaving in sub-Saharan Africa with increased renal parenchymal echogenicity and decreased corticomedullary differentiation sonographically, which correlate in raised of serum creatinine level and the degree of patients immune competence (CD4 count). Few studies correlated the sonographic findings with histopathological feature and none uses Doppler ultrasound.&#x0D; Conclusion: This study has identified a correlation of the sonographic findings with the histopathological features and the use of Doppler ultrasound as the missing gaps from the previously published research articles in the subject area.

Biologic Treatment of 4 HIV-Positive Patients: A Case Series and Literature Review.

Report four cases of HIV-positive patients managed on biologic therapy and summarize the cases of psoriasis in HIV-positive patients managed on biologic therapy that have been published in dermatologic literature to date. We searched PubMed and Embase databases using the terms HIV and psoriasis or HIV and psoriatic arthritis combined with one of the eleven biologics currently approved for treating psoriasis. We identified 48 cases of anti-psoriasis biologic therapy (including adalimumab, infliximab, etanercept, ustekinumab, and guselkumab) in HIV-positive patients and added four. While data is limited, the evidence available suggests biologic agents are safe and efficacious in moderate-to-severe psoriasis and may even have a favorable effect on CD4 and HIV viral counts when used with concomitant HAART. Further research would be helpful to establish practical guidelines for the use of anti-psoriasis biologic therapy in the HIV population, including that of newer agents.

Patterns of cardiovascular risk and disease in HIV-positive adults on anti-retroviral therapy in Mozambique.

With improved access to anti-retroviral therapy (ART) the focus of HIV treatment is changing to reducing chronic co-morbidities and their effects, but guidelines for HIV care in many African countries do not include screening for cardiac disease. Our study aimed to determine the pattern of cardiac abnormalities in HIV-positive patients on ART. We implemented a prospective, observational study for 24 months on a random sample of adult patients seen at a dedicated HIV clinic in Mozambique. Demographic, clinical and full cardiovascular evaluations were performed on all participants. We enrolled 264 HIVvpositive patients (mean age 39.3 years; 186 female, 70.5%). The mean time on ART was 46 (SD 36) months and most had low viral load (174, 65%). Obesity (45, 17%), overweight (65, 24.6%), hypertension (54, 20.5%) and severe anaemia (21, 8.3%) were frequent. Diabetes was present in four patients (1.5%). The most important conditions in 252 patients submitted to echocardiography (88, 34.9% had cardiac abnormalities) were: severe rheumatic heart valve disease (six), severe dilated cardiomyopathy (five), aortic degenerative disease and congenital heart disease (in three patients each). At 24-month follow up, six of the 252 patients had died; of the 196 reviewed on echocardiography 29 had progressed and two had improved ventricular systolic function. This young cohort of HIV-positive patients on ART showed lower occurrence of tuberculous pericarditis and dilated cardiomyopathy but high cardiovascular risk, as assessed by the presence of obesity, hypertension and anaemia. Cardiac abnormalities needing multidisciplinary care were also found. There is a need for tailored cardiovascular risk stratification and screening for cardiovascular disease in HIV-positive patients on ART in Africa.

Characteristics of Aneurysmal Disease in Human Immunodeficiency Virus-Positive Patients

The advent of antiretroviral therapy has substantially improved the survival of human immunodeficiency virus (HIV)-positive patients. However, this increased longevity has led to the emergence of HIV-related diseases, including HIV-associated vasculopathy and aneurysm formation. However, the majority of the literature regarding HIV-associated vasculopathy has been limited to case reports. Thus, our aim was to investigate the characteristics of aneurysmal disease in HIV-positive patients in a multicenter study. All patients with a diagnosis of aneurysmal disease and HIV were retrospectively identified from 2011 through 2018 across two institutions. Comorbidities, HIV-related characteristics, and associated imaging were reviewed. There was a total of 104 HIV-positive patients with aneurysmal disease. Ascending (43.3%), abdominal (22.1%), and cerebral (11.5%) aneurysms were the most commonly identified aneurysms. There were 21 (20.2%) patients with aneurysms in multiple vascular beds, 9 (8.7%) patients with saccular aneurysms, 1 (1.0%) mycotic aneurysm, and 1 (1.0%) inflammatory aneurysm. The mean age at time of diagnosis was 57.7 ± 10.3 years, 80.8% of patients were male, and 32.0% had a history of AIDS. The average time from HIV diagnosis to aneurysm diagnosis was 14.1 ± 10.1 years. There were six ruptures, one dissection, and one thrombosis (descending aortic, iliac, subclavian, cerebral, ascending aortic, popliteal). There were 26 (25.0%) patients who underwent repair of their aneurysms, with the most common repair being an endovascular aneurysm repair in nine patients for an abdominal aortic aneurysm, and cerebral aneurysm repair in six patients. Although aneurysmal disease was widespread, the majority of HIV-positive patients had large-vessel aneurysms in this study. Patients were more likely to have saccular and multiple aneurysms compared to historical controls, repair was associated with good perioperative outcomes. Additional studies are necessary to characterize this rare entity.TableCharacteristics of HIV-positive patients (n = 104) with aneurysmal diseaseCharacteristicsMean ± SD or No. (%)Demographics and comorbidities Age, years57.7 ± 10.3 Male84 (80.8) RaceCaucasian58 (56.3)African American36 (35.0)Hispanic9 (8.7) Coronary artery disease44 (42.3) Myocardial infarction24 (23.1) Hypertension80 (76.9) Congestive heart failure18 (17.3) Chronic obstructive pulmonary disorder16 (15.4) Hyperlipidemia69 (66.4) Hepatitis B16 (15.4) Hepatitis C24 (23.3) Cirrhosis8 (7.8) Stroke16 (15.7) Chronic kidney disease25 (24.5) Smoking statusNever28 (27.2)Former33 (32.0)Current42 (40.8) Mean CD4 count495.9 ± 474.23 Mean viral load11,052.4 ± 33,207.1 History of AIDS33 (32.0) History of illicit drug use25 (24.0) Time to aneurysm diagnosis, years14.1 ± 10.1Medications NRTI89 (85.6) NNRTI24 (23.01) PI34 (32.7) INSTI56 (53.9)Aneurysm characteristics Aneurysm typeAscending aortic45 (43.3)Descending aortic14 (13.5)Abdominal aortic23 (22.1)Iliac7 (6.7)Visceral4 (3.9)Lower extremity3 (2.9)Subclavian3 (2.9)Carotid1 (1.0)Cerebral12 (11.5)Coronary1 (1.0)Saccular9 (8.7)Multiple aneurysms21 (20.2) Type of imagingCT66 (64.7)Ultrasound30 (29.4)MRI5 (4.9)PET1 (1.0)CT, Computed tomography; INSTI, integrase strand transcriptase inhibitor; MRI, magnetic resonance imaging; NRTI, nucleoside reverse transcriptase inhibitor; NNRTI, nonnucleoside reverse transcriptase inhibitor; PET, positron emission tomography; PI, protease inhibitor; SD, standard deviation. Open table in a new tab

Sonographic Assessment of Kidneys in Human Immunodeficiency Virus Sero-Positive Patients: A systematic Review

Background: Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) remains a major challenge globally, and approximately 180,000 people died from AIDS-related illnesses in Nigeria in 2015. HIV associated nephropathy is the third most common cause of end-stage renal failure. Objectives: To review published original research articles on the sonographic evaluation of kidneys in HIV seropositive patients, identifying missing gaps and coming up with an area of further study. Methodology: The study was retrospective and a secondary source of data from published original research articles was used. The search was performed through Google search using Google Scholar, EMBASE, PubMed and Medline. All the published original research articles in the English language and the availability of full-text articles were included in the study. The results: An electronic search using the search terms had identified 58 related published articles, but only 12 articles were reviewed. This study found out that human immunodeficiency virus-associated nephropathy (HIVAN) to be most predominant renal disease in HIV positive patients leaving in sub-Saharan Africa with increased renal parenchymal echogenicity and decreased corticomedullary differentiation sonographically, which correlate in raised of serum creatinine level and the degree of patients' immune competence (CD4 count). Few studies correlated the sonographic findings with histopathological feature and none use Doppler ultrasound. Conclusion: This study has identified a correlation between the sonographic findings with the histopathological features and the use of Doppler ultrasound as the missing gaps from the previously published research articles in the subject area.

Ocular Diseases in HIV-positive Patients in a Tertiary Hospital in Nigeria

Aims: To determine the pattern of ocular disorders in HIV-positive patients in a tertiary ospital in Nigeria.&#x0D; Study Design: A cross-sectional hospital based study on confirmed HIV positive adult patients attending the HIV clinic in University of Port Harcourt Teaching Hospital.&#x0D; Duration of Study: November and December 2011.&#x0D; Methodology: Consecutive patients within the inclusion criteria were recruited until the required sample size was met. The visual acuity was tested using the Snellen’s chart and the illiterate E-chart. Ocular examination of the adnexial and anterior segments were done using a pen torch and a slit lamp biomicroscope. Fundoscopy was done using a direct and indirect ophthalmoscope as well as with a 90D lens. Other information such as CD4 count and HIV serotype were retrieved from the patient’s case notes. The data was analysed using EPI-info version 7.0. Statistical methods such as the frequency and chi-square were used to test the significance of association. Level of significance was drawn at P&lt;0.05.&#x0D; Results: A total of 411 patients were enrolled in this study. The age range was between 18-69 years with a mean age of 36.9 years. There was a female preponderance with a male to female ratio of 1:2. Ocular disorders were seen in 37.1% of patients studied. The commonest manifestation was the ocular adnexial manifestation and conjunctival microvasculopathy ranked highest (15.6%) in this group. Herpes zoster ophthalmicus was seen in 5 (1.2%) patients, presumed squamous cell carcinoma in 12(2.9%) and Kaposi sarcoma in 3(0.7%). Chorioretinitis was found in 12(2.9%), retinal microvasculopathy in 19(4.6%) and maculopathy in 15(3.6%). There was no case of CMV retinitis.&#x0D; Conclusion: Ocular findings seen in HIV- positive patients were mostly adnexial and occurred in 37% of the study population.

In-hospital and long-term outcomes of HIV-positive patients undergoing PCI according to kind of stent: a meta-analysis.

Pathogenesis of cardiovascular disease in HIV-positive patients is related to the interaction between traditional and HIV-specific factors. Limited data are available regarding the prognosis of HIV-positive patients undergoing percutaneous coronary intervention (PCI). All observational studies evaluating the prognosis of HIV-positive patients treated with PCI were included. In-hospital and long-term major adverse cardiac events (MACE) [composite endpoint of all-cause death or myocardial infarction (MI)] were the primary endpoints, whereas in-hospital and long-term all-cause death, cardiovascular death, MI, stent thrombosis, target vessel revascularization (TVR), target lesion revascularization (TLR), and bleeding complications were the secondary ones. In all, 1243 patients in nine studies were included, with a mean age of 54 years. Among them, 12% were female and 91% were admitted for acute coronary syndromes. In-hospital MACE occurred in 6.0% (5.4-6.6), death in 4.2% (2.6-5.9), and MI in 1.3% (0-2.8), whereas major bleeding occurred in 2.0% (1.7-2.3) of the patients. After 2 years (1.6-3.1), long-term MACE occurred in 17.4% (11.9-22.3), all-cause death in 8.7% (3.2-14.2), and MI in 7.8% (5.5-10.1) of the patients, whereas stent thrombosis and TVR in 3.4% (1.5-5.3) and 10.5% (7.5-13.4), respectively. In patients treated with drug-eluting stents (DES), the rate of long-term MACE was 22.3% (10.1-34.4), with an incidence of 4.9% (0.0-11.4) of MI and 5.7% (2.3-13.7, all 95% confidence intervals of TLR. HIV-positive patients have a high risk of in-hospital and long-term MACE after PCI, partially reduced by the use of DES. Further studies on the risk of recurrent ischemic events with current generation stents are needed, to offer a tailored therapy in this high-risk population.

Etiology and Severity of Liver Disease in HIV-Positive Patients With Suspected NAFLD: Lessons From a Cohort With Available Liver Biopsies.

Spectrum of liver injury among HIV-positive people is wide; in particular, prevalence of nonalcoholic fatty liver disease (NAFLD) seems to be higher compared with HIV-negative people. We retrospectively evaluated all liver biopsies performed at Royal Free Hospital from 2000 to 2017 in HIV monoinfected patients with abnormal transaminases, to assess the underlying cause of liver disease and to characterize the extent of fibrosis. We furthermore evaluated the diagnostic accuracy of FIB4 and FibroScan as noninvasive tools for fibrosis assessment. Ninety-seven patients were included. Most common histological findings were NAFLD (28%), nonspecific changes (26%), and normal histology (13%). Twenty percent of the patients had significant fibrosis and 11% had advanced fibrosis. FIB4, at a cutoff of 1.3, had a specificity of 82% and negative predictive value (NPV) of 95% for exclusion of advanced fibrosis. FibroScan was available in 28% patients and 33% had a liver stiffness ≥7.5 kPa. FibroScan showed a specificity of 77% and NPV of 94% for exclusion of significant fibrosis. Among patients with NAFLD (n = 27), 18% had advanced fibrosis, whereas the majority (56%) did not have any fibrosis. The NPV of FIB4 for advanced fibrosis in these patients was 93%. Among HIV-positive patients with elevated transaminases, a surprisingly high number of patients had nonsignificant changes or even normal histological findings. The prevalence of NAFLD was lower than reported in other series. Use of noninvasive tools with a high NPV for significant fibrosis can help reduce the number of required biopsies.

Epidemiological characteristics and access to end-stage liver disease care for HIV-positive patients with HCV and/or HBV coinfections in Central/Eastern European and neighboring countries – data from the ECEE network

There is currently an urgent need to harmonize hepatitis standards of care for HIV-positive patients across Europe. The HIV epidemic in Central and Eastern Europe has often been driven by injecting drug use, therefore a higher rate of co-infection with HCV and HBV is expected in this region. We have investigated the epidemiological prevalence and treatment availability for end-stage liver disease in HIV/HCV/HBV coinfections in countries represented in the ECEE Network Group. The Euroguidelines in Central and Eastern Europe (ECEE) Network Group was initiated in February 2016 to compare standards of care regarding HIV infection in the region. Information about HIV/HCV/HBV co-infections and the availability for end-stage liver disease treatment for HIV-positive patients were collected through on-line surveys. The respondents were ECEE members from 16 countries of the region. The information on co-infection prevalence was sourced from WHO, national HIV programmes, articles published in international journals, single clinic reports, and personal information in ten of the participating countries (62.5%). The HIV/HCV co-infection rate was from 3% to 99%. The range of reported of HIV/HBV coinfection percentages was 2.3% to 40%. HIV/HCV/HBV co-infection ranged from 0% to 9%. Regarding treatment for end-stage liver disease, liver transplantation was an available option for HIV-positive patients in only three countries (19%). Our findings revealed only a limited number of treatment options for the end-stage liver disease in HIV-positive patients for the vast majority of Central and Eastern European countries. There are gaps in epidemiological surveillance in this region. It appears there are many differences in the number of co-infected patients among Central and Eastern European and neighboring countries, but there is no unification of information sources.

Spectrum of disease in HIV-positive patients presenting to a tertiary care hospital: a retrospective, cross-sectional review in Kumasi, Ghana

BackgroundHIV remains a significant public health dilemma in West and Central Africa. HIV-related morbidity and mortality are unjustly high, yet little is known about the spectrum of complicating comorbidities in HIV-positive patients who are admitted to hospitals in these regions.MethodsThis study involved a retrospective chart review to determine the common comorbidities and mortality rate of HIV-infected patients admitted over a six month period to the internal medicine service at the Komfo Anokye Teaching Hospital (KATH), a tertiary care center in Ghana. Patients admitted with a known or new HIV diagnosis from January to July 2016 were included. Data were collected regarding the number of new versus known cases admitted, the most common presenting complaints, final admitting diagnoses, and causes of mortality in these patients.ResultsDuring the six-month study period, 250 HIV-positive patients were admitted to KATH, and 245 of these individuals had valid survival time recorded. Of these patients, 145/245 (59.2%) were female. Median age of patients included in the study was 42 years old (IQR 35–51). The mortality rate for HIV patients admitted to the hospital was 35.5% (87 patients). One hundred and forty-five (59.4%) patients had a known history of HIV documented in their patient charts, while the remaining patients were newly diagnosed with HIV during their inpatient stay. Pulmonary tuberculosis predominated among diagnostic findings, with 40.4% of HIV-infected patients diagnosed with the condition while admitted. Patients presenting with neurological symptoms on admission were 2.14 (95% CI: 1.27–3.61) times more likely to die than those without neurological symptoms (p = .004).ConclusionsOver 40% of HIV-positive patients admitted to KATH were newly diagnosed with HIV at admission. While pulmonary tuberculosis was the most common co-morbidity, patients presenting with neurological symptoms were at higher risk of death. This study suggests that enhanced outpatient screening is needed for early diagnosis and prompt HAART initiation, as well as increased access to diagnostic modalities and treatment for HIV-positive patients with neurological symptoms.

FRI-465 - Aetiology and severity of liver disease in HIV positive patients with suspected NAFLD: Lessons from a cohort with available liver biopsies

FRI-465 - Aetiology and severity of liver disease in HIV positive patients with suspected NAFLD: Lessons from a cohort with available liver biopsies

Emphysema in HIV Positive Patient: Diagnostic and Therapeutic Conduct

The increase of cases of patients with chronic obstructive pulmonary disease in HIV positive patients is a reality since the TAAE era. In its beginning, infectious respiratory diseases were the most frequent and prevalent. Different factors were associated to this entity such as the HIV virus itself, antiretroviral treatment, tobacco habit, the use of marijuana, anemia, coinfection with HCV, BMI, nadir and current value of CD4 and viral load. The control of the patient through dyspnea assessment scales and complementary studies such as spirometry, chest CT, 6- minute walk test and carbon dioxide diffusion test have provided tools to contribute to the diagnosis, treatment and prevention of the complications inherent in COPD. Our patient presented a severe respiratory obstruction with FCV less than 70%, FEV1 less than 80%, FEV1/CFV ratio less than 70%, diffusion test less than 80% and central emphysema and paralobulillar CT. Its CD4 values and viral load within normal parameters.