Human Immunodeficiency Virus Seropositive Patients Research Articles

Prevalence of Malnutrition and Associated Factors among HIV Seropositive Adults on Antiretroviral Therapy at the Regional Hospital, Buea, Cameroon

Introduction: Malnutrition refers to deficiencies, excesses, or imbalances in a person’s intake of energy and/or nutrients and HIV which infects CD4 cells causes immune suppression which can further be worsened by poor nutrition. More than 37.7 million people are living with HIV in the world out of which about 36 million are adults. Aims: The study aimed to determine the prevalence of malnutrition and associated factors among human immunodeficiency virus (HIV) seropositive adults on antiretroviral therapy at the HIV care and treatment center of the Buea Regional hospital, Cameroon. Study Design: A Hospital-based Cross sectional study design. Place and duration of study: Buea regional hospital at the HIV care and treatment centre, South West Region of Cameroon between April 2022 to June 2022. Materials and method:  We included 139 HIV seropositive individuals (17 men, 177 women age range 26 to 59 years). Nutritional status was assessed using anthropometric and clinical methods. A 24-hour dietary diversity was assessed using a questionnaire. Data was analyzed using SPSS version 25.0. Results: The prevalence of underweight, overweight and obesity among the participants were 1.4 %, 38.8%, and 24.4% respectively. In the bivariate analysis, sex of the participants (χ2 = 4.715, p = 0.030) and attendance to HIV-related counseling sessions (χ2 = 4.512, p = 0.034) were significantly associated with malnutrition. The mean dietary diversity score of the study respondents was 4.97±1.6 with only 37% of the respondents achieving a minimum dietary diversity. In the multivariate logistic regression analysis, the odds of those who received HIV-related counselling being malnourished(overweight) was 3.29 times more than those who did not receive HIV-related counselling (AOR=3.29, p=0.036).   Conclusions: There is a high burden of overweight and obesity in the HIV population of the Regional Hospital Buea. The only factor independently associated to malnutrition(overweight) was uptake of nutrition related counselling. Majority of the HIV seropositive patients in the Regional Hospital Buea had a poor dietary diversity. Nutritional counseling should be an important part of persons living with HIV/AIDS (PLWHA) routine follow-up.

Microsporidia in HIV-Positive and HIV-Negative Pediatric Patients with Diarrhea at a Tertiary Care Hospital.

Background  Human microsporidiosis presents as an important and rapidly emerging opportunistic infection. However, the exact burden of this infection especially in the pediatric population of Northern India remains unknown. In this study, we investigated the prevalence of microsporidia among human immunodeficiency virus (HIV)-positive and HIV-negative pediatric patients who presented with diarrhea. Methods  A total of 263 children were recruited consisting of 98 HIV seropositive with diarrhea and 165 HIV seronegative but with diarrhea. Morning stool samples were collected and both direct and formol ether concentrated samples were examined for the presence of intestinal parasites. The modified acid-fast staining was done for coccidian parasites and trichrome stain for microsporidia detection. Further, the species were detected using a real-time polymerase chain reaction (PCR) targeting a conserved region of the small ribosomal subunit rRNA gene of Enterocytozoon bieneusi , Encephalitozoon hellem , Encephalitozoon intestinalis , and Encephalitozoon cuniculi . Results  Overall, one or more parasites were detected in 52.04% (51/98) of HIV seropositive and 53.33% (88/165) of seronegative children ( p  = 0.8391). However, coccidian parasites were detected in a significantly huge number of HIV seropositive children (21.43% [21/98]) as compared with HIV seronegative children (4.24% [7/165]). Microsporidial DNA could be detected in HIV seropositive with diarrhea children (17.35% [17/98]) by PCR. A significant correlation between low CD4 count (≤ 200/μL) and intestinal parasite positivity could be established. Conclusion  Microsporidia is a significant cause of diarrhea in HIV seropositive pediatric patients and should be kept in mind as one of the differential diagnoses in such patients.

Estimation of Serum Levels of AST, LDH, CKMB AND TCK Among HIV Patients on HAART, HAART Naïve and Controls

Human Immunodeficiency virus (HIV) infection is associated with increased of developing heart disease. Information on the cardiac status of HIV-infected Nigerians is lacking. HIV/AIDS infection is a global pandemic and poses a serious health challenge in sub-Saharan Africa, Nigeria inclusive. The cardiac disease may occur at any stage of HIV infection, but important manifestations are more frequent with advanced immunodeficiency. Moreover, it has been reported that complications from HIV infection include arrhythmias, heart failure myocardial infarction and coronary heart disease. This study aimed to estimate serum levels of AST, LDH, CKMB and TCK among HIV patients on HAART, HAART naïve and controls subjects attending Bauchi State Tertiary hospital, Nigeria. The results showed that the mean serum total Creatine kinase, CK-MB, LDH and AST were significantly higher in HIV participants not on HAART compared with HIV participants on HAART at P<0.05 respectively. Similarly, the mean serum total Creatine kinase, CK-MB, LDH and AST were significantly higher in symptomatic HIV participants not on HAART compared with HIV seronegative control subjects at P<0.05 in each case. Once again, the mean serum total Creatine kinase, CK-MB, LDH and AST were significantly higher in asymptomatic HIV participants compared with HIV seronegative control subjects at P<0.05 respectively. Increased levels of some cardiac markers were seen in HIV-infected participants. The study reveals that there is a need to monitor these parameters to prevent sudden cardiovascular complications in HIV seropositive patients. Hence, it is recommended that more investigations need to be carried out to further evaluate the levels of CK-MB (cardiac-specific) isoenzyme of CK and other cardiac biomarkers such as troponins I and T, and myoglobin, among others.

The influence of low-level viremia on CD4+ cell count in human immunodeficiency virus–infected patients

Following initiation of combined antiretroviral therapy, the majority of human immunodeficiency virus-infected patients experience immune reconstitution indicated by virologic suppression and an increase in peripheral CD4+ T-cell counts. Some patients may suffer from low-level viremia, which was reported to be significantly associated with acquired immunodeficiency syndrome cases, virologic failure, and death. We aimed to further investigate the influence of low-level viremia on CD4+ T-cell count. In our study, we included human immunodeficiency virus-seropositive patients on combined antiretroviral therapy, for at least 6 months, who received at least one assessment of human immunodeficiency virus plasma viral load and CD4+ cell count every 6 months, from January 2009 to January 2019. The copy-year viremia was determined by calculating the area under the curve of the plasma human immunodeficiency virus viral load. When comparing patients with a mean CD4+ cell count <200 cells/μL, there was no significant difference between patients with a mean viral load <1000 copies/mL and patients with a mean viral load ≥1000 copies/mL (p = 0.219). Among those with a mean viral load <1000 copies/mL, a higher proportion of patients had a mean CD4+ cell count ≥500 cells/µL (p < 0.001). The mean CD4+ cell count of patients with copy-years viremia (log10) <4 (577.7, interquartile range 429.2-736.7) was significantly higher than that of patients with copy-years viremia (log10) ≥4 (443.3, interquartile range 319.0-558.4) (p < 0.001). In multivariate logistic regression analysis, we observed that malignancy without history, lower copy-years viremia, and high nadir CD4+ cell count were independent predictors of mean CD4+ cell count ≥500 cells/µL. Human immunodeficiency virus-infected patients with a history of malignancy, high copy-year viremia, and lower nadir CD4+ cell counts should be monitored carefully in clinical settings.

Stigma, perceived family support, and post-traumatic stress experienced by seropositive HIV patients in Pakistan

&lt;p&gt;&lt;strong&gt;Background and Objective: &lt;/strong&gt;Stigmatization and discrimination are phenomena familiar to all human immunodeficiency virus (HIV)-positive patients, which create a significant amount of stress; little is known about the role of family support in alleviation of this stressful condition. The current study aims to investigate the relationship between the perceptions of family support, stigmatization, and symptoms of posttraumatic stress in HIV-positive patients in Pakistan.&lt;br /&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A total of 100 seropositive patients, aged between 18 and 50 years, were approached through professional organizations in Lahore, Pakistan, based on purposive and snowball sampling strategies. The magnitude of stigma experienced by the patients was assessed by administering the Berger HIV stigma scale. The multidimensional scale of perceived social support and post-traumatic stress disorder checklist were used to assess post-traumatic stress symptoms (PTSS) and perceived family support (PFS).&lt;br /&gt;&lt;strong&gt;Results: &lt;/strong&gt;The study identified a positive relationship between experiencing stigma and the development of PTSS. Also, a significant inverse relationship between PFS and PTSS was observed, whereas a consequential negative association between experiencing stigma and PFS was evident in patients who disclosed their illness to their families.&lt;br /&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The current study documents that HIV seropositive patients in Pakistan experience high levels of stigma, especially in relation to the disease&amp;nbsp; disclosure to their families and other social contacts. An already immune compromised status and stigmatization leads to significant stress symptoms which ultimately decrease the perception about accessibility of social support in the times of crisis.&lt;/p&gt;

Cardiovascular Risk Factors amongst the Patient Living with HIV Attending at Anti-Retroviral Therapy Center of Bangladesh

Human immunodeficiency Virus (HIV) seropositive individual is at risk of developing disease of cardiovascular system (CVD). There are scarce of research work regarding this field in Bangladesh. Considering scarcity, this study was conducted at anti-retroviral therapy (ART) center of Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh to find out the frequency of the CVD and their common risk factors in HIV seropositive patients from March 2017 to September 2019. Different CVD risk factors were assessed in this study. The demographic data were assessed and World Health Organization STEPS questionnaire were used to collect demographic data. The 10-year CVD risk was calculated by using the Framingham coronary risk score (FRS).  Mean age of study population was 38, SD= 9.8. Among them sixty-five (65%) were men and thirty-five (35%) were women. About one third were overweight followed by 5% were obese. High cholesterolemia, high triglyceridemia, high low-density lipoprotein (LDL) and low high-density lipoprotein (HDL) were found in 23%, 58%, 14%. and 63% of the HIV patent, respectively.  Hypertension was present in 19% and diabetes in 15% of the patients. In Framingham risk score, 19% of the participants had intermediate to high risk of cardiovascular disease within 10 years. The cardiovascular risk factors were common in HIV patients attending ART center of BSMMU, where base line 10-years CVD risk was low. People living with HIV appear to be an imminent risk to develop CVD. Bangladesh Med J. 2021 May; 50(2) : 40-44

Stigmatization and discrimination towards human immunodeficiency virus seropositive patients in psychiatric and mental health facilities.

Stigmatization and discriminatory attitudes of nurses towards human immunodeficiency (HIV) patients have been reported in many countries. The current study was undertaken to assess the knowledge, attitudes and factors associated with stigmatizing attitudes and discrimination among psychiatric and mental health nurses and nurse interns towards patients diagnosed with the human immunodeficiency virus; utilizing a single-centre hospital-based survey design. Primary data were collected using a previously validated questionnaire in a large mental health care hospital in Riyadh, Saudi Arabia. Knowledge, attitudes, acts of discrimination and associated factors on the part of mental health nurses towards those diagnosed with the HIV were identified. The study described herein is in accordance with the STROBE guideline. A total of 241 psychiatric and mental health nurses completed the questionnaire, yielding a completion rate of 74.4%. Overall, more than half of the nurses demonstrated gaps in knowledge and reported higher stigmatizing attitudes and acts of discrimination. Factors associated with stigmatization and/or discrimination include higher exposure to seropositive patients, no formal HIV training, lower religiousness, lower awareness of HIV testing policy and lower level of knowledge about HIV infection. There is an urgent need to implement a training program that will help to reduce stigma among nurses caring for people diagnosed with this illness.

Mucocutaneous Manifestations in HIV/AIDS Patients

Background: The main target of human immunodeficiency virus (HIV) is cluster of differentiation 4 (CD4) T lymphocytes and several other immune cells that have CD4 receptors. They are also present in skin and mucosa, such as Langerhans cells (LC). Mucocutaneous lesions are one of the first clinical presentations of immunosuppression in HIV seropositive patients that manifest at different stages of the infection and require early diagnosis and prompt treatment. Purpose: To determine the clinical characteristics and the pattern of various mucocutaneous manifestations in Human immunodeficiency virus/Acquired immune deficiency syndrome (HIV/AIDS) patients at Intermediate Care and Infectious Diseases Dr. Soetomo General Academic Hospital Surabaya. Methods: This is a descriptive retrospective study with a cross-sectional design. The study subject was classified as all HIV-AIDS patients with mucocutaneous manifestations treated in Intermediate Care and Infectious Diseases Dr. Soetomo General Academic Hospital Surabaya in 2019. Result: Out of the 614 patients who participated in the study, 72.1% were males. The majority of patients were in the age group 25–49 years (75.4%). The most common risk factor was heterosexuality (41.7%). Based on the distribution of mucocutaneous manifestations, the most common mucocutaneous manifestation was candidiasis mucocutan 387 patients (49.4%) followed by the pruritic papular eruption (PPE) 118 patients (15.1%) and human papillomavirus infection 57 patients (7.3%). Conclusion: Mucocutaneous manifestations occur throughout the course of HIV infection, and they can be considered as good clinical indicators for the progression of the disease and underlying immune status in resource-poor settings.

Clinical Significance of Plasma CD9-Positive Exosomes in HIV Seronegative and Seropositive Lung Cancer Patients

Simple SummaryThe role of exosomes in HIV (human immunodeficiency virus) as well as in cancer patients seems to be pivotal. The aim of our retrospective study was to assess the potential clinical value of CD9-positive plasma exosomes in lung cancer patients, patients with lung granulomas, healthy individuals, and HIV-positive patients with or without lung cancer. This study shows that CD9-positive plasma exosome concentrations differ between healthy controls, patients with immunocompetent pulmonary granulomas and patients with lung cancer. In addition, CD9-positive plasma exosomes are increased in HIV seropositive and HIV seronegative lung cancer patients compared to healthy controls, while chemotherapy-treated lung cancer patients have lower plasma exosome levels. This study also shows that in chemotherapy-naïve patients, plasma exosome levels are directly correlated with a prognosis with higher concentrations being associated with a longer, overall survival. These findings further support previous literature on the translational significance of total plasma exosomes in cancer patients, despite different immunological contexts.Recently, the role of exosomes in the progression of both cancer and HIV (human immunodeficiency virus) has been described. This study investigates the clinical significance of CD9-positive plasma exosomes in lung cancer patients, healthy individuals, and HIV-positive patients with or without lung cancer. Using a verified with transmission electron microscopy double-sandwich ELISA technique, plasma-derived exosomes were isolated and quantified from 210 lung cancer patients (including 44 metastatic patients with progressive disease after chemotherapy), 49 healthy controls, 20 patients with pulmonary granulomas, 19 HIV+ patients with lung cancer, 31 HIV+ patients without cancer, and 3 HIV+ patients with pulmonary granulomas. Plasma exosome concentrations differed between healthy controls, patients with immunocompetent pulmonary granulomas and patients with lung cancer even after chemotherapy (p < 0.001). Lung cancer patients after chemotherapy had lower exosome concentrations compared to patients with untreated lung cancer or granuloma (p < 0.001 for both). HIV+ patients without lung cancer had significantly higher exosome concentrations compared to HIV+ patients with lung cancer (p = 0.016). Although exosome concentrations differed between all different lung cancer histologies and healthy controls (p < 0.001 for all histologies), adjusted statistical significance was oµy retained for patients with granulomas and SCLC (Small-cell lung cancer, p < 0.001). HIV-induced immunodeficient patients with or without lung cancer had lower plasma exosomes compared to immunocompetent granuloma and lung cancer patients (p < 0.001). Finally, higher plasma exosomes were associated both on univariate (p = 0.044), and multivariate analysis (p = 0.040) with a better 3-year survival in stage II and III NSCLC (Non-small-cell lung carcinoma) patients. In conclusion, our study shows that CD9-positive plasma exosomes are associated with both lung cancer and HIV, prior chemotherapy, as well as with survival, suggesting a possible prognostic value.

Genotyping and Drug Susceptibility Patterns of M. Tuberculosis Isolated from HIV Seropositive Patients in Tehran Iran

to investigate the prevalence and drug-resistance M. tuberculosis isolated from HIV seropositive individuals in Tehran, Iran. Human immunodeficiency virus (HIV) is one of the most important risk factors for developing active tuberculosis (TB). To determine the rate of transmission and drug resistant M. tuberculosis (MTB) strains isolated from HIV seropositive patients in Tehran province, Iran. This study consecutively enrolled 217 TB/HIV coinfected patients from April 2018 to August 2019 at Emam Khomeini referral hospital and 5 other health centers in Tehran province. The isolates were genotyped using 15 loci Mycobacterial interspersed repetitive unit-variable number tandem repeats (MIRU-VNTR). Minimum inhibitory concentration (MIC) was determined for 6 drugs. In addition, mutations were assessed in rpoB, katG, inhA, and ahpC genes using Reverse Blot Hybridization Assay System. A 20 (9.2%) patients were culture-positive for M. tuberculosis and typed by MIRU-VNTR, 13 (65%) strains formed 5 clusters, but 6 (30%) isolates had a unique pattern. The total Hunter-Gaston discrimination index (HGDI) for all 15 loci was 0.846, and the cluster size was 2 to 4 patients. The estimated proportion of recent transmission was 45%. The mutation was identified in 1 isolate, lost inhAW1 and mutation in MT1 loci, which was resistant to isoniazid (INH). Moreover, 1 (5%) and 3 (15%) isolates were resistant to INH and ethambutol (EMB), respectively, of which 1 was resistant to INH and EMB. The transmission rate of TB in HIV patients was relatively high; however, the prevalence of drug-resistant strains and TB infection in females was insignificant in this study (p < 0.05); none of the isolates was MDR strains.

A Clinicopathological Study of Mucocutaneous Lesions in Correlation with CD4 Counts in HIV Seropositive Cases at a Tertiary Care Centre in South India

Background: Mucocutaneous lesions are one of the first clinical presentations of immunosuppression in Human Immunodeficiency Virus (HIV) seropositive patients that manifest at different stages of the infection that requires early diagnosis along with prompt treatment(1). Objectives: (1) To study the prevalence of mucocutaneous manifestations in HIV‑seropositive patients attending the ART center of our hospital in Visakhapatnam, Andhra Pradesh. (2) To correlate mucocutaneous manifestations with CD4 cell counts. Materials and methods: 150 HIV positive patients above 18 year old with definite cutaneous manifestations attending ART center and OPD in the Department of Dermatology and venereology in a tertiary care centre Visakhapatnam (Andhra Pradesh, India) were studied from May 2020 to May 2021. Results: Out of 150 HIV patients, who aged 20 -80 years with a mean age of 25, (23.8%) were 60 (40%) female and 90 (60%) were males, majority of the patients were labourers 50 (33.3%) by occupation , 41 (27.3%) had CD4 counts &lt; 200, 73 (48.6%) had CD4 counts of 200–500, and 54 (36%) had CD4 counts &gt; 500. The most common dermatological presentation was pruritic papular eruptions 24 (16.%) followed by cutaneous drug reaction 19(12.67%) and scabies 12 (8%). Conclusion: At the end of study we concluded that cutaneous manifestations can be considered as good clinical indicators for the progression of disease and underlying immune status in resource poor settings

Prevalence of intestinal parasitic infections in HIV-infected individuals and their relationship with immune status

Background and Objectives: Intestinal parasitic infection is a common entity in patients infected with human immunodeficiency virus (HIV). These infections may lead to fatal complications in the immuno suppressed individuals. The aim of the present study was to determine the prevalence of intestinal parasitic infections in HIV sero-positive patients and their relationship with the immune status of individuals. Materials and Methods: Fecal samples from 100 HIV sero-positive and an equal number of HIV sero-negative individuals were collected and examined for enteric parasites by direct microscopy. CD4 counts were carried out in only HIV sero-positive patients. Prevalence of intestinal parasites in patients with CD4 count <200 cells/μl, 200-499 cells/μl, and ≥500 cells/μl in HIV-infected patients were compared. Results: Enteric parasites were detected in 59.3% HIV-infected patients with CD4 count <200 cells/μl as compared with 23.5% in patients with CD4 count>200 cells/μl (P < 0.01). Prevalence of coccidian parasites was significantly (P < 0.01) higher (14%) in HIV sero-positive subjects compared with HIV sero-negative subjects (2%). Isospora belli (25%) was the most common parasite with CD4 count <200 cells/μl, followed by Cryptosporidium parvum (12.5%). Prevalence of intestinal parasitic infections was significantly higher in patients with diarrhea, 73.6% than without diarrhea, 25.9%, (P < 0.05). The mean CD4 count of HIV sero-positive patients presenting with diarrhea was significantly (P < 0.01) lower (181.26 ± 135.14) than without diarrhea (352.02 ± 204.03). Conclusion: This study emphasizes the need for routine screening of parasites especially in patients with lower CD4 count so as to decrease the morbidity by ensuring the early treatment of the cases.

English

BACKGROUND Tuberculosis is often more difficult to diagnose and more complicated to treat among people who are human immunodeficiency virus (HIV) positive. This study was conducted to assess the clinical, microbiological, laboratory and radiological spectrum of tuberculosis (TB) in HIV seropositive patients, and explore its possible correlation with their CD4 count. METHODS A total of 104 patients who were western blot positive for HIV and co-infected with tuberculosis were studied in Salem district of Tamil Nadu. A detailed history was obtained and patients were examined clinically. CD4 count, sputum smear for acid fast bacilli (AFB), chest x-ray, and tuberculin test, were done along with other relevant investigations. The relationship between CD4 count, and the type of tuberculosis, sputum smear, chest x-ray, and tuberculin test, were analysed statistically, and P &lt; 0.05 was considered significant. RESULTS Most of the patients were between 30 to 39 years. Males (84.6 %) outnumbered females (15.4 %). Pulmonary tuberculosis alone was seen in 47 patients, while extra pulmonary tuberculosis in 36 cases, and both pulmonary and extra pulmonary occurred in 21 cases. They had a mean CD4 count of 237.7 cells / μL, 135.2 cells / μL and 120.9 cells / μL respectively. Extrapulmonary tuberculosis and combined forms were associated with lower CD4 counts (P-value 0.005). The mean CD4 count of sputum positive, sputum negative, and multiple drug resistant (MDR) tuberculosis were 294.2, 168.3 and 90.2 cells / μL respectively. Lower CD4 count was associated with sputum - ve TB (P &lt; 0.041). Lower CD4 counts were associated with atypical chest X-ray findings (P &lt; 0.006) and negative tuberculin test (P &lt; 0.001). CONCLUSIONS Sputum smear positivity for AFB decreases as CD4 count reduces. Involvement of lungs tend to be atypical in immunocompromised patients. The diagnosis of TB in HIV positive individuals is complex and a high index of suspicion is needed. KEYWORDS HIV, Tuberculosis, CD4 Cell Count, Sputum Smear for AFB, Chest X-Ray

Depression and suicidal ideation among HIV seropositive patients attending the special treatment clinic of the University of Calabar Teaching Hospital, Calabar, Nigeria

Objectives: The introduction of highly active antiretroviral therapy and innovations in healthcare has contributed in improving the lives of persons living with human immunodeficiency virus (HIV)/AID. Patients infected with HIV are more susceptible to develop psychiatric illnesses. Depression is common among patients suffering from chronic illness such as HIV/AIDS and can exacerbate these illnesses. Depression has been observed to be twice as common in HIV seropositive individuals than in the general population. Undiagnosed and untreated depression in patients suffering from HIV/AIDS could lead to poor adherence to medications and lower quality of life. Depression is associated with rapid HIV disease progression. The diagnosis of HIV infection may be associated with feelings of anger, denial, sadness, guilt feelings, loss of self-esteem among others. These negative feelings could lead to suicidal ideation and attempted suicide or suicide. We sought to determine the prevalence rates, sociodemographics and predictors, of depression and suicidal ideation among study participants. Material and methods: Two hundred and two adult participants who met the inclusion criteria were recruited into the study. Mini International Neuropsychiatric Interview English version 6.0.0 was employed to diagnose depression and suicidal ideation. Data were analyzed using Statistical Package for the Social Sciences version 20.0. Significant levels were set at P &lt; 0.05. Results: This study revealed prevalence rates of 11.4% for depression and 7.9% for suicidal ideation among study participants. Majority of the participants were females in the young age group category of 30–40 years (45%) with mostly secondary education (47.8%), most had a higher CD4 count greater than 200 cells/µL (82.6%) and were mainly on zidovudine/lamivudine/nevirapine combination therapy (56.5%). Mean age, CD4 count, and viral load levels were lower in HIV patients with depression but were not statistically significant (P &gt; 0.05). CD4 count and viral load were not significantly associated with suicidal ideation. Lower age (30–40 years) was significantly associated with suicidal ideation (P &lt; 0.05). Suicidal ideation is a predictor of depression in the same way depression is a predictor of suicidal ideation (P &lt; 0.05). Conclusion: Routine screening for depression and suicidal ideation especially among younger HIV/AIDS patients is recommended in the clinic setting.

Study on the Prevalence of Tuberculosis in HIV Seropositive patients attending the ART Centre, KIMS, Hubli

Background: The incidence of Tuberculosis (TB) has seen a significant rise in association with HumanImmunodeficiency Virus (HIV) infection worldwide, in the recent years. It is evident that immunosuppressiondue to the HIV infection has resulted in modification of the clinical presentation of TB, thereby presentingwith atypical signs and symptoms, and also sometimes affecting extra-pulmonary sites.Objectives: To determine the pattern of presentation and prevalence of TB in HIV Seropositive patients andto study various socio-demographic factors associated with the same seen in the patients attending the AntiRetroviral Therapy (ART) Centre, Karnataka Institute of Medical Sciences (KIMS), Hubli.Methods: A cross-sectional study was conducted among 109 HIV Seropositive patients attending ARTCentre in KIMS, Hubli, for a period of 2 months. A pretested, semi-structured questionnaire was applied tocollect the data from the study participants after obtaining the verbal informed consent.Results: The prevalence of HIV-TB among the study participants was estimated to be around 34.9%.Although HIV infection was found to be more in females in the study, TB with HIV infection was seenmajorly in males. The commonly affected age group was 31-40 years, both in HIV infection alone and TBco-existing with HIV. Pulmonary TB was the commonest type of TB i.e., 92.1% among the HIV patients ofthe study. The prevalence of TB was found to be maximum in the cases with CD4 count of range less than250 cells/cu.mm.Conclusion: The prevalence of TB in HIV Seropositive patients was more than one third as per the studyand hence it is of utmost concern that HIV patients should be screened and treated for TB as early aspossible, and the prophylaxis of TB in HIV patients must be considered.

Diagnostic value of interferon-γ release assay in HIV-infected individuals complicated with active tuberculosis: a systematic review and meta-analysis.

Although the interferon-γ release assay (IGRA) has become a common diagnostic method for tuberculosis, its value in the diagnosis of tuberculosis in human immunodeficiency virus (HIV) seropositive patients remains controversial. Therefore, this systematically reviews the data for exploring the diagnostic value of IGRA in HIV-infected individuals complicated with active tuberculosis, aiming to provide a clinical basis for future clinical diagnosis of the disease. Relevant studies on IGRA for diagnosing tuberculosis in HIV-infected patients were comprehensively collected from Excerpta Medica Database (EMBASE), Medline, Cochrane Library, Chinese Sci-tech Periodical Full-text Database, Chinese Periodical Full-text Database, China National Knowledge Infrastructure (CNKI) and China Wanfang Data up to July 2020. Subsequently, Stata 15.0, an integrated statistical software, was used to analyse the sensitivity, specificity, diagnostic odds ratio (DOR), positive likelihood ratio (PLR) and negative likelihood ratio (NLR) to create receiver operator characteristic (ROC) curves. A total of 18 high-quality articles were selected, including 20 studies, 11 of which were related to QuantiFERON-TB Gold In-Tube (QFT-GIT) and nine to T-SPOT.TB. The meta-analysis indicated that the pooled sensitivity = 0.75 (95% CI 0.63-0.85), the pooled specificity = 0.82 (95% CI 0.66-0.92), PLR = 4.25 (95% CI 1.97-9.18), NLR = 0.30 (95% CI 0.18-0.50), DOR = 14.21 (95% CI 4.38-46.09) and the area under summary ROC curve was 0.85 (95% CI 0.81-0.88). IGRA has a good diagnostic value and therefore can aid in the preliminary screening of active tuberculosis in HIV-infected individuals. Its diagnostic effectiveness can be improved by modifying and optimizing the assay design.

Association of oral candidal species with human immunodeficiency virus patients of West Godavari district, Andhra Pradesh - An in vitro study.

Introduction:Human immunodeficiency virus (HIV) infection is a major worldwide health problem characterized by progressive immunosuppression. The morbidity of HIV patients is due to its association with opportunistic infections among which oral candidiasis is common. Regardless of HIV status, candidiasis can prevail when their immune system is depressed. Oral candidiasis can thus serve as a useful marker for both restoration of immune functions and HIV disease progression. Routine identification of Candida species is laborious and time-consuming. HICHROM agar stains different species into different colors facilitating rapid reliable identification of candida species as they differ in their virulence and sensitivity to antifungal drugs.Materials and Methods:This cross-sectional study includes a total of 200 HIV seropositive patients from Anti-Retroviral Therapy Centre, West Godavari District. Unstimulated saliva samples were collected in a screw-capped universal container. Five microliters of each sample using a sterile inoculating loop is streaked on the chromogenic agar culture media. The colonies formed are counted using a magnifying glass and LAPIZ colony counter. Candidal colony-forming units per milliliter were analyzed, compared and correlated among different study groups. Different candida species were also identified in the study.Results:Nonalbicans Candida was the most common species isolated in our study accounting for 53% and Candida albicans accounting for 47%. Considering initial and final CD4 counts, there is improvement in patients on retroviral therapy.Conclusion:Identification of the species is important for epidemiological reasons and for treatment purposes to ensure a better prognosis since some species present reduced susceptibility to azoles.

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.

Analysis of blood parameters in HIV positive patients

Human immunodeficiency virus (HIV), the causative agent in AIDS has been a challenge to medical fraternity from the time since it was first discovered in 1983. About 40 million people are living with HIV infection globally and 99% of the infected people are in South East Asia (ESA). Close monitoring of HIV infected patients is essential in reducing the morbidity and mortality of HIV patients. The monitoring HIV disease progression &amp; deciding the time to initiate anti retro viral therapy requires evaluation of T CD4 cell counts and HIV/RNA viral load at regular intervals along with monitoring of biochemical parameters and hematological parameters in HIV Seropositive patients.The objective of the study was to evaluate some biochemical parameters and hematological parameters in newly diagnosed HIV seropositive patients (primary stage).A total of 300 newly diagnosed HIV patients and 200 age and sex matched healthy individuals as control were tested for CBC, lipid profile, renal function tests, liver function tests, electrolytes and some minerals (copper, zinc, iron). Our observations were subjected to statistical analysis Mean ± standard deviation calculated. Comparison was done by student t-test.HIV positive patients had significantly (p&amp;#60;0.001) decreased mean Hb (10.22 ± 1.51) and RBC count (3.99 ± 0.75) compared with HIV negative subjects with Hb (12.52 ± 1.21), RBC count (5.08 ± 0.42). We observed a decrease in total cholesterol, HDL cholesterol and LDL cholesterol, and an increase in triglyceride and VLDL levels. HIV patients increasingly require careful monitoring and evaluation for altered renal function, to prevent co morbidities of treatment and non-treatment related nephrotoxicity. In this study patients with HIV showed significant increase in the mean serum copper level when compared with the control subjects respectively, zinc and iron levels significantly decreased compared with normal subjects.It was concluded in the present study that, hematological manifestations of the HIV infection are complication associated with the disease, anaemia being a very common finding. This complications are not related to age or the sex of the patients. The lipid profile of the patients is also seen to be altered by the disease process. Decreased Lipid levels are more pronounced in anemic groups than non-anemic group.

PROFILE OF OPPORTUNISTIC INFECTIONS IN HIV SEROPOSITIVE PATIENTS: AN OBSERVATIONAL STUDY

Introduction: Human immunodeficiency virus (HIV) virus, causative agent in acquired immunodeficiency syndrome, is fast becoming a major threat in the Indian subcontinent, with an estimated 3.7 million persons being infected with HIV. HIV infection is complicated by various opportunistic infections (OIs) such as tuberculosis (TB), candidiasis, herpes zoster, Pneumocystis, cytomegalovirus (CMV) etc. This study carried out to know the clinical profile opportunistic infections in HIV seropositive patients. The aim of this study to determine the opportunistic infections in adult AIDS patients.&#x0D; Material and methods: A total of 200 patients were tested for opportunistic infections in HIV patients. All the specimens were processed as per standard procedures to detect opportunistic infections.&#x0D; Results: 200 cases that satisfied the inclusion criteria were considered for the study. Of the 200 individuals analyzed, 133 (66.5%) were males and 67 (33.5%) were females. The maximum number of patients who had opportunistic infections fell in the age group of 25-35yrs, 94 (47%), followed by the age group below 25 yrs, 53 (26.5%) and most of the occupants, who harboured opportunistic infections were labourer (49.5%), n=49, followed by driver 17.5% and then housewives 13%. The tuberculosis is the most frequent opportunistic infections accounting for 52.5% of all opportunistic infections, followed by candidiasis in 50.5% of cases and followed by pneumocystosis in 17%, cryptosporidiosis in 10.5%.&#x0D; Conclusions: Respiratory system was the most common system involved by OIs. Early diagnosis and prompt treatment of opportunistic infections is important before development of severe immunodeficiency to prevent serious and fatal outcome.&#x0D; Keywords: HIV/AIDS, Opportunistic Infections, Tuberculosis, Candidiasis