HIV Patients Research Articles

Prevalence of Hypertension and Its Associated Factors Among Adults Living with HIV on Antiretroviral Treatment in Selected Public Hospitals in Addis Ababa, Ethiopia.

Hypertension significantly increases the risk of heart, brain, and renal diseases and is one of the leading causes of death and disease worldwide. It is a major comorbidity among HIV-positive people. There have been limited attempts to detect hypertension and its related variables in patients receiving antiretroviral treatment, notably in Addis Ababa, Ethiopia. The current study intended to examine the incidence of hypertension and related variables among adults aged 18 and over living with HIV on ART at selected public referral hospitals in Addis Ababa, Ethiopia. A hospital-based cross-sectional study was conducted on 411 HIV-positive individuals aged 18 on ART at Alert and St. Peter's Specialized Hospitals. The research was conducted between December 15, 2021, and January 20, 2022, using an interviewer administered standardized questionnaire. Epi-Info version 7.0 was used to enter and code the collected data, which was subsequently exported to SPSS version 23.0. Bivariate and multivariate logistic regression models were used to identify associated variables. The prevalence of hypertension among people with HIV on ART was 37.5% (95% CI: 32.8-42.5). Age groups 35-50 years (AOR: 2.18; 95% CI: 1.13-4.21), alcohol consumption (AOR: 5.58; 95% CI: 2.92-10.65), no physical exercise (AOR: 2.35; 95% CI: 1.06-5.21), family history of hypertension (AOR: 4.39, 95% CI: 2.48-7.76), duration of ART (AOR: 3.13; 95% CI: 1.20-8.12), low CD4 count (AOR: 1.87; 95% CI: 1.04-3.37), and body mass index greater than or equal to 25 kg/m2 (AOR: 2.38; 95% CI: 1.33-4.25) were factors associated with hypertension among HIV patients on ART. According to this study, hypertension is prevalent in HIV-positive people. Factors related with hypertension in PLHIV include alcohol intake, lack of physical activity, age 35-50 years, family history of hypertension, ART duration, low CD4 count, and BMI ≥25kg/m2. As a result, health education on the significance of keeping a healthy lifestyle can be effective in preventing and treating hypertension in HIV patients.

The problems of counteraction to HIV-infection and its prevention in places of imprisonment

The article considers the problem of organizing prevention and treatment of HIV-infection in suspected, accused and convicted persons in places of deprivation of liberty. The HIV-infected individuals in places of deprivation of liberty are in situation of increased risk that creates objective necessity for in-depth study of this phenomenon. The purpose of the study was to determine specific characteristics of organization of support of HIV-infected individuals, to identify ways of contamination and its main risk factors among both suspected, accused and convicted persons and penitentiary institution personnel. The study provided sorting out of main aspects that resulting in convicts' refusal to receive drugs and treatment. The corresponding recommendations for optimizing general and particular prevention of these negative phenomena were developed. The conclusion was made that it is possible to apply complex methods to motivate convicted HIV patients for treatment. Some of these methods can include such medical social psychological measures of organizational managerial character as training of specialists; participation of HIV patients in comprehensive preventive programs; group support of convicted HIV patients; positive reinforcement application; individual approach.

Improved outcomes following gastrointestinal surgery among people living with HIV in the HAART-era: A scoping review

BackgroundThis study aimed to review the varied 1–4 gastrointestinal (GI) system surgical outcomes among people living with Human Immunodeficiency Virus (PLWH) in the HAART-era. MethodsMEDLINE and EMBASE were searched for primary publications on GI surgery outcomes exclusively in HAART-treated HIV patients. NSQIP-reported complications (NRCs), all-cause complications (ACC) and HIV disease parameters were extracted. Results12 studies met study inclusion criteria, examining bowel (4), bariatric (5), cholecystectomy (1), appendectomy (1), and other general abdominal operations (1). The NRC rate was 0%, ≥44.4% and 13.3% in bariatric, bowel and appendix surgeries, respectively. Over half of NRCs were infectious. HAART-treated patients had lower ACC, LOS, and sepsis versus untreated-HIV, and higher ACC, LOS and reoperation rates versus HIV-negative patients. ConclusionHAART use is associated with markedly improved NRC outcomes post GI surgery among PLWH; however, these remained inferior to those documented among HIV uninfected individuals.

ABCG2 polymorphisms and susceptibility to ARV-associated hepatotoxicity.

The ABCG2 421C/A polymorphism contributes significantly to the distribution and absorption of antiretroviral (ARV) regimens and is associated with the undesirable side effects of efavirenz. To investigate this, we examined ABCG2 34G/A (rs2231137) and 421C/A (rs2231142) genetic variations in 149 HIV-infected patients (116 without hepatotoxicity, 33 with ARV-induced hepatotoxicity) and 151 healthy controls through the PCR-restriction fragment length polymorphism (PCR-RFLP) technique. The ABCG2 34GA genotype and 34A allele indicated a risk for antiretroviral therapy-associated hepatotoxicity development (p = 0.09, OR = 1.58, 95% CI: 0.93-2.69; p = 0.06, OR = 1.50, 95% CI: 0.98-2.30). The haplotype GA was associated with hepatotoxicity (p = 0.042, OR = 2.37, 95% CI: 1.04-5.43; p = 0.042, OR = 2.49, 95% CI: 1.04-5.96). Moreover, when comparing HIV patients with hepatotoxicity to healthy controls, the haplotype GA had an association with an elevated risk for the development of hepatotoxicity (p = 0.041, OR = 1.73, 95% CI: 1.02-2.93). Additionally, the association of the ABCG2 34GA genotype with the progression of HIV (p = 0.02, OR = 1.97, 95% CI: 1.07-3.63) indicated a risk for advanced HIV infection. Furthermore, the ABCG2 421AA genotype was linked to tobacco users and featured as a risk factor for the progression of HIV disease (p = 0.03, OR = 11.07, 95% CI: 1.09-270.89). The haplotype GA may enhance the risk of hepatotoxicity development and its severity. Individuals with the ABCG2 34A allele may also be at risk for the development of hepatotoxicity. Additionally, individuals with an advanced stage of HIV and the ABCG2 34GA genotype may be at risk for disease progression.

Prevalence and Determinants of Human Immunodeficiency Virus and Tuberculosis Co-Infection at Kampala International University Teaching Hospital

Worldwide, tuberculosis (TB) was one of the top 10 causes of death, and the leading cause from a single infectious agent above HIV/AIDS. Millions of people continue to fall sick with the disease each year. Not less than one-third of people living with HIV are also infected with TB. At autopsy, studies have found that 30 – 50% of patients have evidence of TB. By the year 2013, about a quarter of all TB deaths occurred in HIV-positive persons and TB was the leading cause of death in those that had HIV. In sub-Saharan Africa, about 41% of HIV patients have TB. TB incidence still being high, especially among the HIV infected and the prevalence of TB/HIV co-infection was largely unknown, particularly in developing countries, including Uganda all but fuels the need for this study. To assess the prevalence and determinants of TB-HIV co-infection among HIV-positive patients attended at KIUTH. A review of the data study that included 500 patient records was included for this study. 37 out of 500 patient records recorded TB-HIV coinfection. This made a prevalence of 7.4%. Sex, marital status, employment status, household income, residence and history of alcohol or smoking were found significant whereas age (p-value: 0.5621) and education (pvalue: 0.08180) were found to be insignificant. The prevalence of HIV-TB coinfection was high with sex, patients, marital status, employment status, household income, residence and history of alcohol or smoking found to be significant. In contrast, age and education were found to be insignificant determinants. TB-HIV coinfection was found to have a poorer patient outcome with increased mortality among those who were TB-HIV co-infected. Awareness-creation on the adverse effects of TB-HIV coinfection needs to be up-scaled. Keywords: Tuberculosis, HIV-positive, TB-HIV co-infection, Marital status, sub-Saharan Africa

Incidence of Opportunistic Infections in HIV Patients at Anti-Retroviral Therapy (ART) Adherence Unit, Islamabad Pakistan

Background: Opportunistic infections (OIs) pose a considerable threat to HIV-infected individuals, especially in regions with varied environmental exposures and healthcare resources. The prevalence and severity of these infections are influenced by factors such as local pathogen profiles, host genetics, and the effectiveness of antiretroviral therapy (ART). Objective: This study aimed to determine the prevalence and types of opportunistic infections among male HIV-positive patients at an ART adherence unit in Islamabad, Pakistan, and to compare these with regional trends. Methods: An institution-based cross-sectional study design was utilized, encompassing a review of medical records from 533 male HIV-positive patients over a seven-month period. Data collection focused on demographic details, infection types, and treatment regimens. Exclusion criteria included incomplete files and unspecified OIs. The analysis was performed using SPSS version 25, with frequencies and percentages calculated to assess the prevalence of each infection type. Results: Out of 533 patients, 149 (27.95%) developed at least one opportunistic infection. Respiratory infections were most common, with tuberculosis (TB) found in 25 (16.77%) patients. Skin-related infections were observed in 37 (24.83%) patients, primarily associated with intravenous drug use. Oral thrush was present in 11 (7.38%) patients. Other infections included urinary tract infections in 5 (3.35%) patients and various less common OIs. Conclusion: The study revealed that OIs remain a significant health challenge for HIV-positive individuals, with a notable prevalence of respiratory and skin infections. Early and sustained ART, along with preventive healthcare measures, are crucial in managing and reducing OIs.

Spontaneous Penile Amputation in a HIV Patient: Case Presentation

Penile tumor is the rarest urogenital tumor in males (1%). Around 95% of penile tumors are squamous cell carcinomas. We report a case of penile squamous cell carcinoma in a 69-year-old male who presented spontaneous penile amputation with a necrotic stump. The patient was tested positive for HIV1. He benefitted from a total penectomy with a supra-pubic cystostomy (SPC) and antiretroviral therapy. The suprapubic catheter is changed monthly while awaiting perineal urethrostomy.

In-hospital outcomes of pulmonary hypertension in HIV patients: A population based cohort study

BackgroundPulmonary hypertension (PH) is a known complication of HIV infection. Outcomes of HIV-infected patients with PH (HIV-PH) have not been well established. We aim to assess various in-hospital outcomes such as mortality, resource utilization, and health care burden associated with HIV patients with concurrent PH. Materials and methodsWe used National Inpatient Sample (NIS) 2015 Quarter 4 through 2019 for this study. We identified patients using International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) diagnostic codes with both HIV and pulmonary hypertension. Cohorts were weighted by NIS-provided algorithm which allows for national estimates. Univariate and multivariate regression analyses were used to determine odds ratios. ResultsA total of 910,120 patients were identified with HIV, among which 28,175 (3.19%) were identified to have concurrent PH. When compared to HIV alone, HIV-PH patients were older (54.53(±11.61) vs. 49.44(±13.11), predominantly black (64.45% vs. 51.8%%), more often male (57.2%), all p < 0.001. HIV-PH cohort had higher comorbidities with higher Charlson Comorbidity Index (CCI) (7.07(±3.53) vs. 5.17(±3.65), had slightly longer LOS [adjusted mean difference (aMD) 0.79], higher healthcare burden corrected for inflation (aMD $17,065); all p < 0.001.In univariate regression analysis, patients with HIV-PH had significantly higher rates of developing heart failure (aOR 10.44), cardiogenic shock (aOR 5.67), cardiomyopathy (aOR 4.97), in-hospital cardiac arrest (aOR 1.94), respiratory failure (aOR 3.29), invasive mechanical ventilation (aOR 1.71), aspiration pneumonia (aOR 1.29), acute kidney injury (aOR 2.14). Lastly, patients with HIV-PH had higher in-hospital mortality within 30 days of admission (aOR 1.28) & overall in-hospital mortality (aOR 1.23); p < 0.005). ConclusionIn patients with concomitant HIV and PH, there is a higher burden of comorbidities, and is associated with worse outcomes including mortality. Through this study, we highlight outcomes that will better risk stratifying patients with concurrent HIV and PH.

Distinct genetic clusters in HIV-1 CRF01_AE-infected patients induced variable degrees of CD4+ T-cell loss.

Retroviruses swiftly adapt, employing error-prone enzymes for genetic and phenotypic evolution, optimizing survival strategies, and enhancing virulence levels. HIV-1 CRF01_AE has persistently undergone adaptive selection, and cluster 1 and 2 infections display lower counts and fast loss of CD4+ T cells than other HIV-1 sub-types and CRF01_AE clusters. Its mechanisms are associated with increased CXCR4 tropism due to an envelope structure change favoring a tropism shift from CCR5 to CXCR4, thereby shaping viral phenotype features and impacting pathogenicity. This underscores the significance of consistently monitoring HIV-1 genetic evolution and phenotypic transfer to see whether selection bias across risk groups alters the delicate balance of transmissible versus toxic trade-offs, since virulent strains such as CRF01_AE clusters 1 and 2 could seriously compromise the efficacy of antiviral treatment. Only through such early warning and diagnostic services can precise antiviral treatments be administered to those infected with more virulent HIV-1 strains.

Immuno-Diagnostic Interest in Monitoring CD16+CD56+ (Natural Killer) Cells and CD19+CD45+ (B Lymphocytes) in Individuals Newly Diagnosed with HIV in a Tertiary Care Center.

Monitoring multiple cellular markers of immune cells may provide a more accurate evaluation of the immune status of people living with human immunodeficiency virus (PLHIV). This study assessed the value of CD16+CD56+ cells (NK cells) and CD19+ lymphocytes (B cells) phenotyping in indicating viral load, AIDS status, and treatment efficacy. A retrospective, laboratory-based study was conducted at the Diagnostic immunology division of a referral tertiary hospital. It involved 82 newly diagnosed HIV patients treated between 2009-2016. We explored three objectives: (1) the paired change in CD16+CD56+ and CD19+CD45+ cells counts and percentages from baseline to 2-to-6 months after treatment; (2) the association of these phenotypes with 5 gradual categories of viral load; and (3) the accuracy of CD16+CD56+ and CD19+CD45+ cells counts in indicating AIDS stage defined as CD4+ < 200 cells/mm3. The second and third objectives were tested using a pooled analysis (N = 300-373). The median CD19+CD45+ and CD16+CD56+ counts increased by 1.9-fold and 1.3-fold after treatment respectively (p < 0.001). A negative correlation of viral load with both CD16+CD56+ (ρ = -0.29, p < 0.001) and CD19+CD45+ (ρ = -0.34, p < 0.001) counts was observed. CD16+CD56+ count < 73 cells/mm3 and CD19+CD45+ count < 166.5 were indicative for AIDS with 95.5% and 63.6% sensitivity respectively. Findings advocate for the usefulness of CD16+CD56+ and CD19+CD45+ phenotyping in characterizing the severity of HIV infection and its impact on both the humoral and cellular immunity, as well as monitoring the effectiveness of treatment.

Spectrum of Opportunistic Infections in People Living with HIV: A Tertiary Care Center Experience from North India

: Patients with human immunodeficiency virus and acquired immunodeficiency syndrome (HIV/AIDS) are proneto opportunistic infections (OIs) given their immunosuppressed state. OIs continue to cause morbidity and mortality in HIV/AIDS patients even after highly-active antiretroviral therapy (HAART); hence, attainment of the goals on health care programs,particularly in resource-poor countries, is hard to achieve. The prevalence of specific OIs varies in different countries and evenin different areas within the same country. Little information is available about the prevalence of OI in HIV patients fromdeveloping countries, especially India. Early diagnosis and prompt treatment contribute to increased life expectancy amonginfected patients delaying progression to AIDS. Hence, the present study was carried out to elucidate current frequencies andspectrum of OIs in HIV seropositive adult patients in Haryana and to evaluate the associated risk factors for OIs. Materialsand methods: This was a cross-sectional study carried out at the Dept. of General Medicine in a tertiary care hospital in NorthIndia. Basic demographic details, anthropometric measurements, symptoms of HIV/OI, clinical examination, biochemicalinvestigations and treatment details were recorded. Patients aged 18 to 70 years and HIV seropositive subjects were includedin the study. Results: The study found that about 53.21% of HIV/AIDS patients on ART had one or more OIs. Tuberculosis(TB) was the predominant OI identified, with a prevalence of 25.71%. Candidiasis and herpes zoster were the second and thethird most prevalent OIs at 13.8% (101/731) and 7.25% (53/731), respectively. Age (43.4 ± 10.7 years), low income, illiteracy,low socioeconomic status, initial 4 months since initiation of ART, CD4 count &lt;200/mm3, body mass index of &lt;18.5 kg/m², poorART adherence, hemoglobin, albumin were strongly associated with OIs. Conclusion: The present study shows that TB is thecommonest OI in adults and the overall population of people living with HIV (PLHIV) in Haryana and proves that OIs acrossdifferent patient groups vary significantly. Various factors like adherence to HAART, socioeconomic and education status ofpatients can influence the occurrence and outcome of these deadly infections.

Latent Factors Affecting Smoking Cessation Among TB and HIV Patients: Bayesian Structural Equation Modeling Approach

Latent Factors Affecting Smoking Cessation Among TB and HIV Patients: Bayesian Structural Equation Modeling Approach

Interferon-β deficiency alters brain response to chronic HIV-1 envelope protein exposure in a transgenic model of NeuroHIV

Human immunodeficiency virus-1 (HIV-1) infects the central nervous system (CNS) and causes HIV-associated neurocognitive disorders (HAND) in about half of the population living with the virus despite combination anti-retroviral therapy (cART). HIV-1 activates the innate immune system, including the production of type 1 interferons (IFNs) α and β. Transgenic mice expressing HIV-1 envelope glycoprotein gp120 (HIVgp120tg) in the CNS develop memory impairment and share key neuropathological features and differential CNS gene expression with HIV patients, including the induction of IFN-stimulated genes (ISG). Here we show that knocking out IFNβ (IFNβKO) in HIVgp120tg and non-tg control mice impairs recognition and spatial memory, but does not affect anxiety-like behavior, locomotion, or vision. The neuropathology of HIVgp120tg mice is only moderately affected by the KO of IFNβ but in a sex-dependent fashion. Notably, in cerebral cortex of IFNβKO animals presynaptic terminals are reduced in males while neuronal dendrites are reduced in females. The IFNβKO results in the hippocampal CA1 region of both male and female HIVgp120tg mice in an ameliorated loss of neuronal presynaptic terminals but no protection of neuronal dendrites. Only female IFNβ-deficient HIVgp120tg mice display diminished microglial activation in cortex and hippocampus and increased astrocytosis in hippocampus compared to their IFNβ-expressing counterparts. RNA expression for some immune genes and ISGs is also affected in a sex-dependent way. The IFNβKO abrogates or diminishes the induction of MX1, DDX58, IRF7 and IRF9 in HIVgp120tg brains of both sexes. Expression analysis of neurotransmission related genes reveals an influence of IFNβ on multiple components with more pronounced changes in IFNβKO females. In contrast, the effects of IFNβKO on MAPK activities are independent of sex with pronounced reduction of active ERK1/2 but also of active p38 in the HIVgp120tg brain. In summary, our findings show that the absence of IFNβ impairs memory dependent behavior and modulates neuropathology in HIVgp120tg brains, indicating that its absence may facilitate development of HAND. Moreover, our data suggests that endogenous IFNβ plays a vital role in maintaining neuronal homeostasis and memory function.

Antimicrobial resistance profile of Enterococcus species and molecular characterization of Vancomycin resistant Enterococcus faecium from the fecal samples of newly diagnosed adult HIV patients in Dar es Salaam, Tanzania

BackgroundEnterococci are becoming clinically more important especially among immunocompromised patients. Of concern are vancomycin resistant enterococci (VRE) which have both intrinsic and acquired forms of resistance. This work aimed to determine the antimicrobial resistance patterns of Enterococcus spp. and characterize VRE isolate obtained from HIV-infected patient using whole genome sequencing (WGS).Methods:Antimicrobial susceptibility testing was done on 57 enterococci isolates by both the disk diffusion method and Epsilometer test (E-Test). WGS was performed on VRE isolate determined by E-test.ResultsOut of the 57 enterococci isolates; 58% (33/57) were E. faecalis, 39% (22/57) E. faecium and 4% (2/57) were E. gallinarum. The highest antimicrobial resistance was observed in E. faecalis isolates. The most prevalent antimicrobial resistance was observed towards quinupristin-dalfopristin (56%, 32/57), followed by ciprofloxacin (28%), tigecycline (18%), daptomycin (16%), chloramphenicol (14%), ampicillin and teicoplanin (2%). Multidrug resistance (MDR) was detected in 11% (6/57) of the isolates. Vancomycin resistance and high-level gentamycin resistance (HLGR) were observed in one E. faecium and one E. faecalis isolates respectively. The VRE was typed as ST80, carried vanA and other resistance genes for aminoglycosides, tetracyclines, quinolones and ampicillin. Furthermore, the isolate had chromosomal mutations responsible for quinolone (gyrA (p.S83I) and parC (p.S80I) and ampicillin (pbp5) resistance.ConclusionsThe detection of VRE, HLGR and MDR in the study settings underscores the sustained surveillance of VRE in high-risk groups and institution of infection control measures for prompt identification and isolation of carriers to prevent the spread of VRE in the community and hospital settings.

Opportunistic Infections among newly diagnosed HIV patients in the largest tertiary facility in Ghana.

Opportunistic infections (OIs) among newly diagnosed HIV patients are a marker for inadequateness of HIV awareness and testing. Despite global efforts at creating awareness for early detection, late HIV diagnosis and its associated OIs still exist. This study sought to determine the prevalence and patterns of OIs and associated factors among newly diagnosed HIV patients in Ghana. A retrospective study using data extraction was conducted among 423 newly diagnosed HIV patients aged ≥18 years at the Korle-Bu Teaching Hospital from July 1st 2018 to December 2019. Multivariate logistic regression was adopted to assess factors associated to OIs. Analysis was performed using SPSS version 16, and p-value < 0.05 was deemed significant. The mean age of patients with a new HIV diagnosis was 40.15 ± 11.47 years. Male versus female sex differential was 30.3% and 69.7%, respectively. The prevalence of OIs among newly diagnosed HIV patients was 33.1% (95% CI = 34.6-44.1). About 70% (120/166) of patients with OIs were classified into WHO clinical stage III and IV. The most common OIs were candidiasis (oro-pharyhngeal-esophageal) (36.9%), and cerebral toxoplasmosis (19.9%). The odds of an OI at the time of HIV diagnosis among females was 51% lower than in males (aOR = 0.49, 95% CI = 0.28-0.86). Being employed increased the odds of OIs by 2.5 compared to the unemployed (aOR = 2.5; 95% CI = 1.11-5.61). Participants classified as World Health Organization (WHO) HIV clinical stage III and IV were 15.88 (95% CI = 9.41-26.79) times more likely to experience OIs. One in three patients newly diagnosed with HIV presented with an opportunistic infection, with men more likely to experience such infections. Significant attention should be given to improving case-finding strategies, especially among men.

Clinical Correlation of CD4 Count and Dry Eye Disease (DED) Severity Among HIV Patients: A Case Study in Voluntary Counseling and Testing Clinic Prof Ngoerah General Hospital, Bali

Abstract&#x0D; Introduction &amp; Objectives : Dry Eye Disease is a multi-factorial ocular surface and tear film instability disease. It has been reported as one of the most frequent anterior segment ocular manifestations in HIV patients, occurring late in the disease. The study aimed to investigate clinical correlation of CD4 count and severity of the disease.&#x0D; Methods : This study was a hospital based cross-sectional study where 75 HIV patients (150 eyes) aged 18-50 years old were referred to ophthalmology clinic in VCT for ocular surface related complaints and were included in the study.&#x0D; Results : The study showed significant moderate positive correlation between CD4 count with Tear Break Up Time (TBUT) (r-value=0.509;p-value=0.05) and negatively correlated with Ocular Surface Disease Index (OSDI) score (r-value=-0.252, p-value=0.035). There were a significant difference in CD4 count between mild and moderate dry eyes (p-value=0.005) and between mild and severe dry eyes (p-value=0.005), however no significant difference was observed between moderate and severe dry eyes (p value=0.435). The severity of dry eye in HIV patients also tends to differ in-between clinical stage of the disease (p value=0.513) and with the presence of co-infection (p value=0.228), although the result was not statistically significant.&#x0D; Conclusion : There is a correlation between CD4 Count and Dry Eye Disease severity among HIV patients. The lower the CD4, the higher the risk for HIV patients to get severe dry eye disease. This shows the importance of CD4 control and monitoring to prevent various ocular disease and manifestations related to HIV.

Ocular Manifestations Of Hiv Patients At Ophthalmology Polyclinic Of Prof.Dr.I.G.N.G.Ngoerah Hospital January 2019 - December 2021

Abstract&#x0D; Introduction &amp; Objectives : Human Immunodeficiency Virus (HIV) is a disorder that affects many organs including the eyes. It is highly recommended that HIV patients be referred to an ophthalmologist before experiencing symptoms.To determine the ocular manifestations in HIV patients&#x0D; Methods : This was an observational study with anayltic cross-sectional approach. Data was collected retrospectively from medical records of HIV patients who visited Ophthalmology Polyclinic at Prof.Dr.I.G.N.G. Ngoerah Hospital Denpasar for the period 1 January 2019 – 31 December 2021. Data analysis was performed using chi-square test in SPSS version 22&#x0D; Results : There were 52 patients included, mostly were male (61.5%), aged 30-39 years (40.4%), WHO stage IV (63.5%) taking 1st Highly Active Antiretroviral Theraphy (HAART) (75%), have been diagnosed with HIV and consume (HAART) for 1-5 years, CD4 100-249 (42.3%), BCVA &lt;3/60 (46.2%), and had not ckecked their HIV RNA (77.2%). There were 71 occurrences of HIV ocular manifestations with dry eye as the most common type (31%), followed by ocular CMV (26.8%). In patients with CD4 &lt; 250, the most ocular manifestations were dry eye, in CD4 250-500 were dry eye and ocular syphilis, whereas in CD4 &gt; 500 were ocular toxoplasmosis and ocular syphilis. There is no relationship between the use of HAART and dry eye syndrome&#x0D; Conclusion : The most common ocular manifestations of HIV patients at the Ophthalmology Polyclinic of Prof.Dr.I.G.N.G.Ngoerah Hospital was dry eyes. Ocular manifestations in patients with CD4 &lt;500 was dry eye whereas those with CD4&gt;500 was ocular toxoplasmosis and syphilis.

Disease-Related Stigma, Emotional Regulation and Depression in Patients with HIV

Background: HIV/AIDS has become one of the major global health burdens. Self-stigma and emotion dysregulation in people living with HIV (PLWH) have become urgent issues and have attracted the attention of both physicians and epidemiologists. Aim: To examine the relationship between disease-related stigma, emotional regulation, and depression in patients with HIV. Method: A cross-sectional study was conducted. A purposive sample of 100 patients—70 male and 30 female diagnosed with HIV/AIDS was collected from two public hospitals in southern Punjab. Patients who had been diagnosed as being HIV positive for at least three months were included in the study. The age range of participants was 18 to 50 years. Patients with other medical issues were excluded from the study. Measures for data collection were the Discrimination and Stigma Scale (DISC), Difficulties in Emotional Regulation Scale (DERS), and Hamilton Depression Scale. The data was evaluated using SPSS version 24. Pearson’s correlation was applied. Results: There is an inverse relationship (-.34**) obtained between disease-related stigma and emotional regulation, whereas a significant positive relationship (r =.41**) is found between disease-related stigma and depression. A negative relationship (r=-.59**) is also examined between emotional regulation and depression. Emotional regulation is a mediator between disease-related stigma and depression in patients with HIV. There is a significant gender difference in depression. The mean score of depression is high among females as compared to males. Practical Implication: It improved the psychological health of HIV-positive patients by categorizing the issues they face. Conclusion: It was concluded that disease-related stigma is positively related to depression while emotional regulation is inversely related to depression. Emotional regulation also plays a mediating role between self-stigma and depression in patients with HIV positive. Women scored higher on depression as compared to men. Keywords: HIV Patients, Psychological Impact, Psychological Distress and Social Stigma.

Differences of Endothelial Corneal Cells Morphology in HIV Patients With and Without Dry Eye Disease

Abstract&#x0D; Introduction &amp; Objectives : Dry eye is a multifactorial disease that affects tear production. Furthermore, the secretion of tears is significantly reduced in patients with HIV. This study aimed to determine whether these changes would make differences in the morphology of corneal endothelial cells.&#x0D; Methods : Our research used an analytic observational method with a cross-sectional approach at the Waihaong Health Center in Ambon City and the Ambon Vlissingen Eye Clinic in March 2023. The sample for this study came from 40 HIV-positive patients who had previously been examined by an ophthalmologist and were diagnosed with dry eye syndrome. Chi-Square analyses were conducted to determine differences in corneal endothelial cell morphology (Cell density, coefficient of variation, hexagonal cells).&#x0D; Results : This study showed that of the 80 eyes of people living with HIV examined, 43,8% had dry eyes. No abnormal hexagonality was found in the corneal endothelial cells in all eyes examined. Decreased endothelial cell density was found in only four eye (5%). Although no significant difference was found for the coefficient of variation of corneal endothelial cells between dry eyes and those without (p=0.764), this study showed that the percentage of coefficient of variation of corneal endothelial cells that were increased/abnormal was higher in dry eye conditions (34.3%) compared to non-dry eyes (31.1%).&#x0D; Conclusion : This study showed no significant differences in the morphology of the corneal endothelial cells of HIV patients with dry eyes. Further research is required with a larger sample size.

Effect of Combined HAART Plus ATT in Patients of Extrapulmonary Tuberculosis in HIV Patients and Effect on Quality of Life.

HIV is a disease which reduces human resistant to fight. When our immunity becomes so weak that we are not able to fight even the common commensals of our body, this leads to what is called as an opportunistic infection. Tuberculosis is one of those most common type of opportunistic infection and in this pulmonary tuberculosis is more common. Extrapulmonary tuberculosis with HIV is the area of lesser research. In this study we tried to prove the Prevalence of extrapulmonary tuberculosis in AIDS patients and also the effect of combined HAART and ATT on prevalence of extrapulmonary tuberculosis and also its effect on Quality of life of the patient. This is a retrospective study conducted in a tertiary centre in the Department of Otorhinolaryngology & head and neck surgery from January 2020 to December 2020. A total of 80 patients were studied for 1year. Confirmed cases of AIDS with extra pulmonary tuberculosis in head and neck region were studied, keeping all ethical issues in mind and after complete treatment of ATT along with HAART. After treatment, a significant number of patients got resolved with EPTB and gave positive response on their quality of life. Not only pulmonary tuberculosis, extrapulmonary tuberculosis with HIV is on the rise nowadays. Combined treatment of both can help in decreasing prevalence of extrapulmonary tuberculosis and improves quality of life.