Life Of HIV-positive Patients Research Articles

Health-Related Quality of Life of HIV Positive Patients with Hypertension: Is There an Association with Blood Pressure Control?

IntroductionThe presence of comorbidities could affect the health-related quality of life (HRQoL) of people living with HIV (PLHIV).AimTo assess the HRQoL of PLHIV and Hypertension, as well as its association with blood pressure (BP) control.MethodsThis cross-sectional study was conducted in the HIV clinic of the University of Uyo Teaching Hospial in Akwa Ibom State, Nigeria, between August and October 2018. The EQ-5D-5L was administered to 201 eligible outpatients in the waiting area of the clinic before consulting the physician. Patients’ socio-demographic and clinical data were obtained from the medical records. Blood pressure was measured using an automatic BP monitor. Data were analyzed with SPSS version 20.0.ResultsMajority (58.6%) of the respondents were females; mean age was 49.59 ± 8.97 years; mean systolic and diastolic BP were 152.77 ± 19.38 mmHg and 90.28 ± 11.33 mmHg, respectively. EQ-VAS and EQ-5D index scores were 80.99 ± 15.97 and 0.86 ± 0.05, respectively. There were no significant differences in EQ-VAS score (z = − 0.113, p = 0.910) or EQ-5D utility (z = − 0.523, p = 0.601) between participants with controlled and uncontrolled BP. Duration on antihypertensive drugs was associated with EQ-VAS score (χ2(2) = 6.558, p = 0.038), while employment status was associated with EQ-5D utility (z = − 2.661, p = 0.008).ConclusionsPLHIV and hypertension accessing care at a Nigerian hospital reported a high HRQoL, irrespective of BP control status. Nevertheless, there is a need to provide psychological support and employment for this population to maximise their HRQoL.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40292-022-00527-4.

Standard of Living of HIV Positive Individuals Visiting HIV Clinic Services Hospital, Lahore

HIV is caused by the Human Immunodeficiency Virus and leads to immunosuppression, thus making an individual easily susceptible to infections.This research was conducted in the HIV Clinic at Services Hospital Lahore to assess the living standards of HIV-positive patients visiting HIV Clinic. Therefore, the main objective of this study was to assess the standard of life in HIV-positive patients visiting the HIV Clinic of Services Hospital Lahore.Methods: It was a case-series study, conducted in the HIV clinic at Services Hospital Lahore. Data was collected from patients suffering from HIV-AIDS with the help of structured questionnaires. SPSS 23 software was used to enter, compile, and analyze the data.Results: Result of this study showed that 50% of patients visiting HIV clinic Services Hospital Lahore are in the age group of 31-45 years. Male and married patients are predominant. The questionnaire had 35 questions which are transformed into 11 dimensions. Cronbach's α co-efficient were calculated for all multi-item scales and four out of eight scale.Cronbach's α for perceived health is 0.72, physical functioning is 0.79, health distress is 0.78, and cognitive function is 0.70. The total mean summary scores were also calculated. The dimensions affecting physical and mental health were added together under the summary score of physical and mental health. The added mean summary score ± SD for mental health is 55.4±11.8 and for physical health is 41.5±11.3.Conclusions: The data indicates that patients with HIV/AIDS have an overall high standard of living. The stigma is that the patients consider themselves a bit exclusive, as AIDS is considered taboo in the Pakistani Muslim community. The research shows that patients with AIDS have excellent mental health, but their physical health is a bit worse depending on the burden of disease (virus). Thus, a conclusion can be made that HIV affects a person's physical health more than their mental health.

The dual protease inhibitor lopinavir/ritonavir (LPV/r) exerts genotoxic stress on lung cells

The Sub-Saharan countries, particularly South Africa has the largest number of people living with HIV, accompanied by the largest antiretroviral treatment (ART) programme in the world. The Highly Active Antiretroviral Treatment (HAART) is the most effective regimen against HIV/AIDS and has improved the lifespan and quality of life of HIV positive patients. HAART has also led to a decrease in the incidence of AIDS defining cancers (ADCs) while there is an increased incidence of the non-AIDS Defining Cancers (NADCs), such as lung cancer in the HAART era. The association between lung tumourigenesis and the use of HAART components such as the dual protease inhibitor (PI) lopinavir/ritonavir (LPV/r) is poorly understood. Using cell and molecular biological approaches, this study aimed at elucidating the effects of LPV/r on the regulation of the cell cycle related genes in normal (MRC-5) and adenocarcinoma (A549) lung cells. Initially, the nuclear integrity of these cells in response to LPV/r was determined using DAPI staining. The effect of LPV/r on cell cycle genes was evaluated through the use of a RT2 PCR gene array of 84 genes related to the cell cycle signaling pathway. The PCR array data was validated by Real-Time Quantification PCR (RT-qPCR). Ingenuity Pathway Analysis (IPA) bio-informatics tool was employed to disclose the molecular mechanism/s observed at cellular and gene expression levels. Loss of nuclear integrity and the upregulation of the p53 DNA damage response (DDR) pathway was revealed by DAPI staining, differential gene expression and IPA core analysis. Furthermore, MAD2L2 and AURKB which also play a role in the DDR pathway were shown to be differentially expressed. The activation of the CASP3 gene in response to LPV/r in A549 cells was also observed. The findings of this study suggest genotoxic properties of LPV/r in healthy normal lung fibroblasts cells and anti-tumour properties in the A549 cells.

The Early Results of Vertebral Pathological Compression Fracture of Extra- nodal Lymphoma with HIV-positive Patients Treated by Percutaneous Kyphoplasty.

Vertebral pathological compression fracture involving extra-nodal lymphoma impacts negatively on the quality of life of HIV-positive patients. The choice of a safe and effective approach to palliative care in this condition remains a challenge. The purpose of this study was to investigate the safety and efficacy of percutaneous kyphoplasty (PKP) in the treatment of vertebral pathological compression fracture of extra-nodal lymphoma in HIV-positive patients. A retrospective analysis, from January 2016 to August 2019, was performed on 7 HIVpositive patients, 3 males and 4 females, with extra-nodal lymphoma with a vertebral pathological compression fracture. The patients were treated using percutaneous kyphoplasty in our hospital. Preoperative assessment of the patients was conducted regarding their hematological profile, biochemical indicators, liver and kidney function, blood coagulation function, CD4+T lymphocyte count and viral load. Subsequently, the patients were placed on highly active antiretroviral therapy (HAART) and rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (RCHOP) regimen. Besides, antibiotics, nutritional support and immune-modulating drugs were also administered, rationally. Postoperatively, the height of the anterior edge of the injured vertebrae, Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) values were evaluated. Patients were also monitored for any complications related to the operation. The average CD4+T cell count for the patients was 164 (range 114 ~247 / ul), while the viral load was 26,269 (range 5,765 ~82,321 copies/ul). All patients received nutritional and immune support and registered significant improvements in the levels of ALB and Hb (P<0.05). In all cases, the operation was uneventful with neither cement leakage nor toxic reactions observed. Similarly, no opportunistic infections, other complications or deaths were reported. The height of the anterior vertebral body and the ODI score of the injured vertebrae were significantly improved immediately after surgery (P<0.05). Compared to the preoperative VAS (7.71±1.11), postoperative values were significantly reduced immediately after surgery (3.85±0.90) and at 2 weeks, 1 month and 6 months post-surgery: 2.71±0.76, 3.29±1.11, and 4.00±0.82, respectively (P<0.01). Supported with appropriate perioperative treatment measures, PKP is safe and effective in the treatment of pathological vertebral compression fracture due to extra-nodal lymphoma in HIV-positive patients.

Assessment of Health-Related Quality of Life and Associated Factors Among HIV/AIDS Patients on Highly Active Antiretroviral Therapy (HAART) at Ambo General Hospital, West Shewa, Ethiopia.

BackgroundDetermining the degree of health-related quality of life (HRQoL) and associated factors in human immunodeficiency virus (HIV)-positive people is of great importance.ObjectiveThe aim of this study was to assess the HRQoL and associated factors among HIV-infected patients who were on highly active antiretroviral therapy (HAART) at Ambo General Hospital.MethodsA study with a cross-sectional design was conducted on 296 HIV-infected patients who were on HAART at Ambo General Hospital from February 20 to May 20, 2019. Patients were recruited by a random sampling technique and a P-value <0.05 was set as statistically significant. Th main outcome measure was HRQoL.ResultsThe majority of study participants were female (56.8%). More than half (53%) of the participants had low overall HRQoL. Those who were married and who earned <1500 ETB were less likely to experience low overall HRQoL than single people (AOR: 4.41, P=0.024) and those who earned more (AOR: 4.27, P=0.000), respectively. Those with current illness and who had no HIV-positive family members were more likely to experience lower overall quality of life than those with no current illness (AOR: 32.29, P=0.000) and with one HIV-positive family member (AOR: 4.03, P=0.003), respectively. Those with recent WHO clinical stage I were less likely to experience a lower overall quality of life than those with stage II (AOR: 0.07, P=0.000).ConclusionCurrent illness, recent WHO stage and having no HIV-positive family members were found to be strongly associated with lower quality of life in HIV-positive patients on antiretroviral therapy.

Effect of Self-Care Education Based on Virtual Networks on Quality of Life in HIV-Positive Patients

Effect of Self-Care Education Based on Virtual Networks on Quality of Life in HIV-Positive Patients

An Assessment of Health Related Quality of Life of HIV Positive Patients in Warangal Region

An Assessment of Health Related Quality of Life of HIV Positive Patients in Warangal Region

Stigma against patients with HIV/AIDS in the rapid expansion of antiretroviral treatment in large drug injection-driven HIV epidemics of Vietnam

BackgroundDespite existing efforts to provide antiretroviral treatment (ART) for all HIV-diagnosed people, stigma deprives them of the highest attainable health status and challenges the effectiveness of ART program in Vietnam. This study aimed to assess five dimensions of HIV-related stigma and explore its associated factors among ART patients in a multisite survey. Implications of this study support the development of HIV policies to improve patients’ access, utilization, and outcomes of ART program toward the 90-90-90 goal in Vietnam.MethodsA total of 1133 ART patients who were recruited by convenience sampling method from 8 ART clinics in Hanoi and Nam Dinh in a cross-sectional study from January to August 2013. Multivariate logistic regression was employed to identify factors associated with stigmatization.ResultsThe majority of participants reported experiencing stigmatization due to shame (36.9%), blame/judge (21.6%), and discrimination (23.4%). Further, 91.5% of participants disclosed their HIV status with others. The likelihood of experiencing stigmatization did not only associate with the patients’ socioeconomic status (e.g., age, occupation, education) and HIV status disclosure, but also their health problems. Those with anxiety or depression and perceived lower quality of life were more likely to experience stigma.ConclusionsTo maximize the efficiency of the ART program, it is essential to develop interventions that reduce stigma involving individuals, families, and communities, and recognize and address complex health problems especially those patients showing depressive symptoms. Increasing quality of life of HIV-positive patients by providing vocational training, financial, family, and peer support will reduce the likelihood of experiencing stigma.

Skin Manifestation among HIV Patients and Its Correlation with CD4 Count and WHO Clinical Staging in Jimma University Specialized Hospital, Southwest Ethiopia

Background: More than 90% of human immunodeficiency virus (HIV+) infected patients develop skin lesions at some time throughout the course of the disease. Several skin diseases have proved to be sensitive and useful indicators of progression of HIV+ infection. Although these conditions may be seen in general healthy population, their occurrence in patients with acquired immunodeficiency syndrome is often atypical, more severe and explosive. Objective: The aim of the study was to assess the magnitude and prevalence of skin manifestation among HIV patients in JUSH ART Clinic. Methods: A retrospective study was conducted among HIV patients in JUSH ART Clinic using a structured data collection format and the data was collected from patient’s record (card) and was analyzed by using SPSS version 20. The result was presented using numbers, ratios and tables. Results: Of 268 HIV/AIDS, patients who have follow-up in Jimma University Specialized Hospital (JUSH) Antiretroviral therapy (ART) clinic 137 (51.1%) were having skin manifestations. The commonest type of skin lesion identified was Herpes Zoster, 74 (54%). This study showed that HIV positive (HIV+) patients with advanced stages of skin disorders had relatively lower CD4+ cell counts. Skin manifestation was significantly associated with WHO clinical stage with P=0.019 and CD4+ cell count with a P-value 0.0001. Conclusion: Skin diseases are highly prevalent among HIV- Positive patients and the frequency and number of these manifestations are well correlated to the patient’s immune status and World Health Organization (WHO) staging. Therefore, examination of skin disorders, as early diagnosis and management of skin problems will improve the quality of life in HIV positive patients.

Antiretroviral Therapy – Changes of Basic Laboratory Parameters in Hiv-Infected Bulgarian Patients

Summary HIV-1 infection keeps on being a global problem because of its pandemic character and the impossibility for eradication. The combined antiretroviral therapy (АRТ) remains the only treatment which has proven its effectiveness for maintaining the life of HIV positive patients. Because of long term (life time) duration of this therapy, it is necessary to monitor patients for possible drug toxicity. The aim of our research is to evaluate the changes of basic laboratory examinations while conducting a long-term АRТ. We analyzed basic laboratory studies of 145 HIV-infected Bulgarian patients in the current research. The patients were separated into four groups according to their treatment regimen. They were on dispensary monitoring and were being treated in the Department for Patients with Acquired Immune Deficiency in the Specialized Hospital for Active Treatment of Infectious and Parasitic Diseases “Prof. Ivan Kirov” - Sofia. Our results showed that combined ART led to changes in blood count, alanin-aminotransferase (ALT), glucose and total cholesterol. Some of these changes are significant for some of the drugs administered. The current ART does not lead to severe toxicity and life-threatening conditions such as those which were observed in the first few years of ART introduction.

P19 What's up? Erectile dysfunction (ED) in HIV positive men

BackgroundAntiretroviral therapy in HIV positive patients has resulted in improvements in survival, quality of life and fulfilling sexual relationships. Treatment using phosphodiesterase type 5 inhibitors (PDE5i) for ED has simplified...

Long-Term Effect of Polyalkylimide Gel Injections on Severity of Facial Lipoatrophy and Quality of Life of HIV-Positive Patients

Long-Term Effect of Polyalkylimide Gel Injections on Severity of Facial Lipoatrophy and Quality of Life of HIV-Positive Patients

Long-Term Effect of Polyalkylimide Gel Injections on Severity of Facial Lipoatrophy and Quality of Life of HIV-Positive Patients

Highly active antiretroviral therapy (HAART) is associated with facial lipoatrophy, which is potentially stigmatizing for HIV-positive patients. We assessed the long-term effects of polyalkylimide gel injections on the severity of lipoatrophy and quality of life of patients on HAART. A prospective study was performed of 17 HIV-positive patients with grade 2 and grade 3 facial lipoatrophy. A mean volume of 14 cc of polyalkylimide gel (Bio-Alcamid) was injected subcutaneously at one or more sites of the face in a single stage. Each patient was seen for follow-up after 3, 12, 24, and 48 weeks. The severity of lipoatrophy and the quality of life was assessed using a self-report questionnaire containing the relevant parts of the SF-36, MOS-HIV, and CES-D. The severity of facial lipoatrophy decreased significantly from baseline over 48 weeks. Quality of life improved significantly from baseline over 48 weeks for mental health and social functioning. Depression at week 48 was significantly correlated with the extent to which lipoatrophy had disappeared at week 48. Individualized volumes of polyalkylimide gel injected in one session significantly decreased the subjective severity of lipoatrophy and improved the quality of life of HIV-positive patients with grade 2 and 3 lipoatrophy, even in the four patients who had complications.

Cost-effectiveness of Highly Active Antiretroviral Therapy for HIV Infection in Taiwan

Since the late 1980s, the Taiwanese government has provided all HIV-infected citizens with free access to antiretroviral therapy. Recently, there is controversy as to whether or not free access to expensive highly active antiretroviral therapy (HAART) should be continued for HIV-infected patients. This study aimed to evaluate the cost-effectiveness of HAART therapy. HAART-associated improvement in survival was obtained by analyzing the follow-up data of all HIV-positive patients identified during April 1984 to March 1997 (pre-HAART era) and May 1997 to April 2003 (HAART era) in Taiwan. Data on quality of life in HIV-positive patients was obtained from a cross-sectional survey of 224 patients using standard gamble method and World Health Organization Quality of Life-BREF instrument. Information regarding the cost of HAART was obtained from the National Health Insurance (NHI). In 2000, the average annual NHI expenditure on HAART per HIV-positive patient receiving HAART was NT$210,018 (US$6177, at an exchange rate of 34.0 NT$/US$). In the AIDS group, the cost was NT$176,441 (US$5189) per life year gained and NT$241,700 (US$7109) per quality-adjusted life year gained. For non-AIDS patients, the corresponding costs were NT$226,156 (US$6652) and NT$332,582 (US$9782), respectively. These estimates have not yet included the additional cost savings from HAART-associated reduction in hospitalization and use of antimicrobial agents for opportunistic infections, and the additional life years gained from the reduction in HIV transmission under the universal availability of HAART. HAART for HIV infection is cost-effective, especially when the societal and epidemiologic factors are considered. We recommend that the policy of providing free HAART to all HIV-infected citizens be continued.

P1897 Spontaneous virus clearance in perinatally HCV–infected children: is it a way to escape the risk of chronicisation?

Since the late 1980s, the Taiwanese government has provided all HIV-infected citizens with free access to antiretroviral therapy. Recently, there is controversy as to whether or not free access to expensive highly active antiretroviral therapy (HAART) should be continued for HIV-infected patients. This study aimed to evaluate the cost-effectiveness of HAART therapy.HAART-associated improvement in survival was obtained by analyzing the follow-up data of all HIV-positive patients identified during April 1984 to March 1997 (pre-HAART era) and May 1997 to April 2003 (HAART era) in Taiwan. Data on quality of life in HIV-positive patients was obtained from a cross-sectional survey of 224 patients using standard gamble method and World Health Organization Quality of Life-BREF instrument. Information regarding the cost of HAART was obtained from the National Health Insurance (NHI).In 2000, the average annual NHI expenditure on HAART per HIV-positive patient receiving HAART was NT$210,018 (US$6177, at an exchange rate of 34.0 NT$/US$). In the AIDS group, the cost was NT$176,441 (US$5189) per life year gained and NT$241,700 (US$7109) per quality-adjusted life year gained. For non-AIDS patients, the corresponding costs were NT$226,156 (US$6652) and NT$332,582 (US$9782), respectively. These estimates have not yet included the additional cost savings from HAART-associated reduction in hospitalization and use of antimicrobial agents for opportunistic infections, and the additional life years gained from the reduction in HIV transmission under the universal availability of HAARTHAART for HIV infection is cost-effective, especially when the societal and epidemiologic factors are considered. We recommend that the policy of providing free HAART to all HIV-infected citizens be continued.

GB virus C infection and quality of life in HIV-positive patients

It was recently shown that GBV-C infection is associated with prolonged survival of HIV-infected individuals. The GB virus C is the closest known relative of hepatitis C virus in man. The latter has been associated with significant impairment in quality of life, independent from the associated liver disease. We were thus interested in the impact of GB virus C infection on quality of life in HIV-infected individuals. We retrospectively analyzed a cohort of HIV-positive patients who previously answered the ‘HIV-SELT’ and the ‘EQ-5D’ questionnaires assessing quality of life and for whom data on GB virus C RNA status were available. In this study we identified no adverse effect of GB virus C on quality of life, but, in contrast, GB virus C viraemic patients showed better quality of life in all parameters for the scores in comparison to GB virus C-negative HIV-infected patients. HIV-positive patients with a GB virus C infection showed superior quality of life. These data further support the favourable course of HIV disease in GB virus C-positive patients.