Incidence Of Opportunistic Diseases Research Articles

Incidence of opportunistic diseases after the “treat all” strategy: 10 years cohort for HIV

Incidence of opportunistic diseases after the “treat all” strategy: 10 years cohort for HIV

Association of oral candidal carriage, candidal density and CD4 count among normal, HIV patients with HAART and without HAART

ObjectivesOral candidiasis is considered one of the most frequent opportunistic infections in Human Immunodeficiency Virus (HIV) individuals. Symptomatic candida colonization of the oral and vaginal mucosal surfaces is closely correlated with the severity of cellular immunodeficiency in HIV infection. HAART is considered as the mainstay treatment that shows a decrease in the incidence of opportunistic diseases, including oral lesions. The current study was designed to analyse the candidal carriage rate and candidal density in HIV patients undergoing HAART and without HAART. MethodsThe study population comprised of 120 subjects and was equally distributed into 3 groups: Group 1 (HIV patients with HAART), Group 2 (HIV patients without HAART), and Group 3 (healthy subjects as controls). The oral rinse samples from all the groups were collected and incubated for candidal growth. The complete growth of any candidal colonies on the culture plates was recorded as a positive candidal carriage. The number of colonies forming units per mL was calculated for candidal density. ResultsThe candidal carriage rate in the HIV patients undergoing HAART was higher than in subjects naïve to HAART. A higher number of patients with HAART therapy showed candidal density <2000 CFUs/mL. There was a reduction of oral candidiasis seen in patients with non-protease inhibitor HAART therapy. There was no significant association found between the candidal carriage rates and candidal density with CD4 lymphocyte count. HIV individuals undergoing HAART therapy showed higher candidal carriage rate and lower candidal density than the non-HAART group. ConclusionCandidal density is a more valuable marker in predicting the development of oral candidiasis than candidal carriage rate. Reduction in the occurrence of oral candidiasis is also seen in patients who are on NNRTI HAART therapy.

Zinc-enriched cookies improve immunity and decrease opportunistic diaseases in AIDS patients

Introduction: Acquired Immunodeficiency Syndrome (AIDS) is a disease of the human immune system resulting from infection by the Human Immunodeficiency Virus (HIV) virus. Methods: The study was carried out between 2015 and 2016 with patients who attended a Specialized Center for Parasitic Infectious Diseases in Paraná. The research was divided into two stages, where the effects of supplementation on TC4 + cells, viral load (LV) and number of opportunistic diseases were verified. 20mg / day of zinc was added to the cookies for 3 months. Results: Data analysis does not show statistical differences in VL and Zinc supplementation; however, supplementation shows that it is able to promote an increase in the TCD4 + count. Patients reported an improvement in their well-being and a decrease in the incidence of opportunistic diseases. Conclusion: Thus, it was observed that zinc supplementation was highly effective in increasing TCD4 + positively improving the immune response and quality of life. In addition, the supplementation in the form of biscuits proved to be innovative and very effective.

The importance of pharmaceutical performance in orientation and reception to HIV patients: can we make a difference?

The objective of this work was to carry out a bibliographic review highlighting the social importance of the pharmaceutical professional in welcoming and guiding people living with HIV / AIDS (PLHIV). This is a narrative-type bibliographic review, which included articles, monographs, dissertations and theses published during the years 2007 to 2020. It is possible to verify that the reception provides a closer contact between pharmacists and PLHIV. In this way, it can directly contribute to improvements in terms of adherence and effectiveness of pharmacotherapy, observed from the decrease in viral load, hospitalizations, medical care and exams. In addition, there is a reduction in complications inherent to HIV, such as the incidence of opportunistic diseases that can lead those affected to hospitalizations and death. Thus, the pharmacist who receives and advises patients with HIV has proved to be a key part in adhering to treatment, improving health and reducing costs for the Sistema Único de Saúde.

KIDNEY LESIONS IN HIV-INFECTED PATIENTS

Introduction. HIV prevalence is one of the most important issues of contemporary medicine. Over a 30-year history of this disease more than 75 million people have been infected with HIV, nearly 30 million adults and children of died. In the future decades, its significance in world premature mortality rates continues to rise. The objective of the study was to establish clinical and laboratory features of kidney lesions in HIV infection.&#x0D; Methods. The study involved 292 HIV-infected patients, who were managed outpatiently at the Chernivtsi Regional AIDS Center. Taking into account the main markers of kidney lesions: persistent proteinuria and glomerular filtration rate &lt;60 mL/min/1.73 m2, 48 persons were diagnosed with chronic kidney disease (CKD), which was very frequently accompanied by dysfunction of these organs.&#x0D; Results. Increasing proteinuria rate is accompanied by a significant renal dysfunction and more frequently is combined with arterial hypertension as well as hematuria without significant differences in the incidence of opportunistic diseases. The mean reciprocal correlation between the levels of proteinuria and glomerular filtration rate (r=-0.562, p&lt;0.01), as well as between the levels of proteinuria and hemoglobin (r=-0.596, p&lt;0.01) have been established as well.&#x0D; Conclusions. Kidney lesions in HIV-infected are most often characterized by tubulointerstitial lesions. At the same time, glomerular kidney lesion, which is much less common, is accompanied by a significantly higher level of HIV RNA.

Photoperiodic induced melatonin regulates immunity and expression pattern of melatonin receptor MT1 in spleen and bone marrow mononuclear cells of male golden hamster

The pineal gland transduces day length information into chemical signal of melatonin that ultimately translates photic stimulus into season-specific immune responses to promote survival of individual from incidence of opportunistic diseases. To date, the immune adjustments being a result of photoperiodic exposures for any nocturnal seasonally breeding rodent have not been systematically examined. Therefore, we evaluated the humoral and cell mediated immune responses of photoperiodically entrained male golden hamsters. Short day induced melatonin increased the immune parameters such as spleen mass, total leukocyte (TLC) and lymphocyte count (LC), proliferation of splenocytes, peripheral blood mononuclear cells (PBMCs) and bone marrow mononuclear cells (BMMNCs) along with serum IL-2 and anti-Keyhole Limpet Hemocyanin (KLH) IgG production when compared with long day experienced hamsters. Short term melatonin treatment (for two weeks) to long day hamsters enhanced to some extent the proliferation of splenocytes, PBMC and TLC/LC. We also localized the melatonin membrane receptor MT1 in spleen and BMMNCs that strongly supported our western blot analysis for the expression of MT1 in spleen suggesting that different photoperiodically induced circulatory melatonin is responsible for the immunomodulation. Therefore, photoperiod can influence the peripheral melatonin level to improve immune responses of hamsters according to season for better survival.

The International Classification of Functioning, Disability and Health and AIDS: a core set proposal

The advent of the highly active antiretroviral therapy (HAART) altered the natural history of AIDS, decreasing its mortality and the incidence of opportunistic diseases as well as increasing the life expectation of people living with AIDS. As a chronic disease, other issues started to be relevant and among them, treatment adherence, its adverse effects and the quality of life of people undergoing treatment. The International Classification of Functioning, Disability and Health (ICF) constitutes an adequate tool to identify the characteristics of functionality, the environment and personal conditions that interfere with quality of life. Tools for its application, called core sets, have been developed for several health conditions. Aiming at proposing a core set for AIDS, two preliminary steps of the proposed model were developed for the construction of these tools. The first phase, which consisted of a systematic review, searched in MEDLINE for articles that included the key words HAART and quality of life, published in English, from 200 to 2004. A total of 31 studies were selected that resulted in 87 concepts, 66 of which could be identified as ICF categories. These comprised the questions of the interview applied to 42 volunteers, who were patients at a Reference Center for STDs and AIDS in Sao Paulo, Brazil. Among the conditions more frequently associated with the treatment are changes in body image, the consequence of lipodystrophy, pointed out in 84% of the studies and 93% of the interviews. Alterations in digestive functions, intimate relationships and sexual function were important conditions identified in the study. The two phases defined 40 ICF categories as a preliminary core set proposal for AIDS patients.

The Independent Effect of Highly Active Antiretroviral Therapy on Severe Opportunistic Disease Incidence and Mortality in HIV-Infected Adults in Côte D'Ivoire

Studies in developed countries have shown highly active antiretroviral therapy (HAART) decreases incidence of severe opportunistic diseases (ODs) in HIV-infected patients beyond that which is expected from changes in CD4+ T-cell count. To estimate the independent impact of HAART on reducing ODs and mortality in Côte d'Ivoire. Within two longitudinal studies of HIV-infected adults (1996-2003), we identified time on 'cotrimoxazole alone' and 'HAART plus cotrimoxazole' WHO stage 3-4 defining events and severe malaria were divided into those preventable and not preventable with cotrimoxazole. Incidence of ODs by CD4 count stratum was estimated using incidence density analysis. CD4+ T-cell count at time of OD was estimated using linear interpolation. Using Poisson regression, we estimated the effect of HAART on OD incidence and mortality by CD4 count stratum. Totals of 446 and 135 adults were followed during 6,216 and 3,412 person-months in the cotrimoxazole alone and HAART plus cotrimoxazole periods, respectively. There was a CD4+ T-cell-independent risk reduction for ODs and mortality during the HAART plus cotrimoxazole period compared with cotrimoxazole alone, which varied by time on HAART, CD4 count stratum and OD type. It was mainly seen after 6 months on HAART and for ODs not preventable by cotrimoxazole. The HAART effect differed significantly by CD4 count stratum (P=0.02), but was significant in all strata after 6 months on HAART. In these sub-Saharan African adults, HAART initiation reduced ODs and mortality beyond that which was expected through the HAART-induced CD4+ T-cell increase. Further studies should examine practical implications of this independent 'HAART effect' on clinical outcomes in patients on HAART.

Incidence of acquired immunodeficiency syndrome-associated opportunistic diseases and the effect of treatment on a cohort of 1115 patients infected with human immunodeficiency virus, 1989-1997.

Temporal trends in the incidence of opportunistic diseases (ODs) related to acquired immunodeficiency syndrome (AIDS) were studied during 1989-1997 in 1115 outpatients infected with human immunodeficiency virus (331 of whom had AIDS) in a hospital in Madrid, Spain. We analyzed the effect of adherence to antiretroviral therapy and Pneumocystis carinii pneumonia (PCP) prophylaxis on the incidence of OD. Diseases that showed a significant decreasing trend were esophageal candidiasis, pulmonary and extrapulmonary tuberculosis, and cerebral toxoplasmosis. Patients who adhered to antiretroviral therapy had a smaller risk of OD. Patients who adhered to PCP prophylaxis had a reduced risk of cerebral toxoplasmosis and PCP. A reduction in the incidence of AIDS-related ODs was observed, mainly in patients who underwent prophylaxis. Adherence to antiretroviral treatment and PCP prophylaxis was associated with a reduction in the risk of disease.

Morbidity and survival in advanced AIDS in Rio de Janeiro, Brazil.

Opportunistic diseases (OD) are the most common cause of death in AIDS patients. To access the incidence of OD and survival in advanced immunodeficiency, we included 79 patients with AIDS treated at Hospital Evandro Chagas (FIOCRUZ) from September 1997 to December 1999 with at least one CD4 count <or=100 cells/mm(3). The incidence of OD was analyzed by Poisson's regression, and survival by Kaplan Meier and Cox analysis, considering a retrospective (before CD4 <or=100 cells/mm(3)) and a prospective (after CD4 <or=100 cells/mm(3)) period, and controlling for demographic, clinical and laboratory characteristics. The confidence interval estipulated was 95%. Mean follow-up period was 733 days (CI = 683-782). During the study 9 (11.4%) patients died. Survival from AIDS diagnosis was a mean of 2589 days (CI = 2363-2816) and from the date of the CD4 count CD4 <or=100 cells/mm(3) was a mean of 1376 (CI = 1181-1572) days. Incidence of OD was 0.51 pp/y before CD4 <or= 100 cells/mm(3) and 0.29 pp/y after CD4 <or= 100 cells/mm(3). A lower number of ODs before CD4 < 100 cells/mm(3) was associated with lower incidence rates after CD4 <or= 100 cells/mm(3). AIDS diagnosis based on CD4+ counts <or= 200 cells/mm(3) was associated with lower incidence rates after CD4 <or= 100 cells/mm(3). Baseline CD4 counts above 50 cells/mm(3) (HR = 0.13) and restoration of baseline CD4+ counts above 100 cells/mm(3) (HR = 0.16) were associated with a lower risk of death. Controlling both variables, only restoration of baseline counts was statistically significant (HR = 0.22, p = 0.04). We found a very low incidence of OD and long survival after CD4 < 100 cells/mm(3). Survival was significantly associated with restoration of baseline CD4 counts above 100 cells/mm(3).