Manifestations In HIV Patients Research Articles

Prevalence of ocular manifestations in HIV patients

Prevalence of ocular manifestations in HIV patients

Impacts of Antiretroviral Therapy on the Oral Microbiome and Periodontal Health of Feline Immunodeficiency Virus Positive Cats.

Feline immunodeficiency virus (FIV) is the domestic cat analogue of HIV infection in humans. Both viruses induce oral disease in untreated individuals, with clinical signs that include gingivitis and periodontal lesions. Oral disease manifestations in HIV patients are abated by highly effective combination antiretroviral therapy (cART), though certain oral manifestations persist despite therapy. Microorganisms associated with oral cavity opportunistic infections in patients with HIV cause similar pathologies in cats. To further develop this model, we evaluated characteristics of feline oral health and oral microbiome during experimental FIV infection over an 8-month period following cART. Using 16S metagenomics sequencing, we evaluated gingival bacterial communities at four timepoints in uninfected and FIV-infected cats treated with cART or placebo. Comprehensive oral examinations were also conducted by a veterinary dental specialist over the experimental period. Gingival inflammation was higher in FIV-infected cats treated with placebo compared to cART-treated cats and controls at study endpoint. Oral microbiome alpha diversity increased in all groups, while beta diversity differed among treatment groups, documenting a significant effect of cART therapy on microbiome community composition. This finding has not previously been reported and indicates cART ameliorates immunodeficiency virus-associated oral disease via preservation of oral mucosal microbiota. Further, this study illustrates the value of the FIV animal model for investigations of mechanistic associations and therapeutic interventions for HIV oral manifestations.

Dentists and dental hygienists' comprehension of HIV infection associated periodontal implications and management.

In an era wherein, persuasive evidence continues to witness the association between systemic and periodontal diseases, the absence of scientific data on dental professionals' comprehension concerning the HIV infection and periodontal link is lamentably backward. Thus, the key objective of this research is to ascertain the extent of comprehension possessed by dentists and dental hygienists concerning periodontal implications and their management in HIV patients. It is a quantitative cross-sectional survey employing a descriptive approach focusing on a specific cohort of dental professionals. The study setting featured an online platform for the distribution of concealed, closed-ended, structured questionnaire. The data was gathered for four sections: six comprehension statements about periodontal manifestations in HIV patients; fifteen comprehension statements about HIV patients' periodontal management; eight familiarity statements about HIV management; and two educational statements about HIV. The comparisons of comprehension scores were drawn between variables such as specialties, age groups, and genders. The survey represented 468 dental professionals representing distinct dental specialties, with a mean age of 24.26 ± 7.53 years. The mean comprehension score for all groups of participants is 10.31 ± 9.34 (33.25%). The highest scores were recorded among those aged 31-40 (20.67 ± 8.31), followed by those aged 40+ (19.38 ± 9.39), 20-30 (9.53 ± 8.96), and under 20 (8.92 ± 8.57), at p < 0.001. The female participants (15.06 ± 12.2) exhibited substantially better scores in contrast to the male participants (8.74 ± 7.57). Periodontists (27.77 ± 3.08) comprehended most, then the oral medicine practitioners (25 ± 0). Dental hygiene students (5.52 ± 3.56) and hygienists (7.67 ± 9.72) comprehended the least. The scores for all four domains assessed were disappointingly low: knowledge about HIV-periodontal manifestations (2.81 ± 2.18), knowledge about management of periodontal diseases in HIV patients (3.73 ± 4.7), familiarity with periodontal care in HIV patients (2.87 ± 3.01), and education received about HIV and periodontal diseases (0.91 ± 0.66). Dental professionals are notably incomprehensive, unfamiliar, and lacking in expertise in the realm of periodontal facets of HIV. The periodontists and oral medicine practitioners showed a substantial amount of comprehension, while the dental hygiene students and dental hygienists presented a conspicuously inadequate level of comprehension. The study outcome could potentially serve as an invaluable instrument for self-assessment by dental professionals and educators. HIV/AIDS ought not to persist as an unspoken taboo or disregarded subject within the dental field, particularly in periodontics, but rather should receive prominence in dental schools and professional development programs.

Chest CT Imaging Features of HIV/SARS-COV-2 Infected Patients from the Capital of Amazonas State

The impact of the COVID-19 pandemic caused by SARS-CoV-2 on global public health, emphasizing its severity and the efforts made to enhance diagnostic practices and clinical management. Chest Computed Tomography (CT) has been widely used to assess complications caused by the virus, particularly in patients coinfected with HIV. The study evaluated 29 chest CT scans, comparing HIV+ and HIV- patients. Among HIV+ patients, 66.7% reported regular antiretroviral therapy, and 43.8% had a CD4+ T cell count below 200 cells/mm3 . Coinfections were observed, including neurotoxoplasmosis and pulmonary tuberculosis. Clinical outcomes showed that 90% of patients were discharged, 3.5% were transferred, and 7% died, all of whom were HIV+ . CT findings revealed that HIV+ patients exhibited fewer ground-glass opacities, but a higher rate of consolidation. The severity score was lower in HIV+ patients, with the lower lobes of HIV- patients more affected. The text also discusses the variability in CT manifestations in HIV patients, highlighting the importance of considering previous conditions. The study suggests that HIVrelated immunosuppression may paradoxically protect against severe COVID-19 manifestation, but low CD4 counts (&lt;200 cells/ µL) can predispose patients to more severe forms of the disease. However, the study acknowledges limitations, such as a small sample size and the need for follow-up CT examinations to understand the complete disease course.

Severity of COVID-19 manifestations in HIV patients: a systematic review and meta-analysis.

The incidence of coronavirus disease 2019 (COVID-19) pandemic among people living with HIV (PLWH) is experiencing major increases. This demographic is vulnerable due to compromised immune function, but the individuals are subjected to antiretroviral therapy (ART), which shows potential as a treatment for the pandemic. Therefore, this study aimed to investigate the severity of various forms of COVID-19 in PLWH as opposed to the general population. The study followed PRISMA guidelines and included a systematic review of literature from Pubmed, Science Direct, and Cochrane Library, comprising English-language articles from 2019 to 2022. This study included articles discussing HIV and COVID-19 case prevalence data by severity. A random effect model was used to demonstrate the pooled prevalence of COVID-19 among PLWH, as well as the prevalence of moderate and critical severity of COVID-19 among PLWH. The Joanna Briggs Institute checklist was used to assess the quality of studies. This study is registered in INPLASY No. INPLASY2023100063. Out of a total of 1,965 articles relevant to the specified keyword combination, 13 articles conformed with inclusion and exclusion criteria. For HIV and non-HIV COVID-19 patients, the mean age was 52.98 ± 6.45 years and 55.84 ± 9.73 years, respectively. Approximately 73% of HIV COVID-19 patients were male. Symptoms among PLWH included fever (57%), cough (48.9%), and shortness of breath (37%). The pooled prevalence of COVID-19 among PLWH was 3.0% (95% CI, 1.0 - 8.5%), with critical, moderate, and mild severity in 4.8% (95% CI, 1.6 - 13.3%), 24.4% (95% CI, 1.9 - 29.8%), and 9.9% (95% CI, 1.9 - 38%), respectively. PLWHs and HIV-negative individuals showed comparable rates and intensity of COVID-19. ART users exhibited immunological health comparable to immunocompetent people, demonstrating the essential role of ART in reducing the severity and mortality of PLWH with COVID-19.

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.

Associated oral manifestations with HIV southeastern Brazilian patients on antiretroviral therapy

ObjectivesThis study aimed to assess the prevalence of oral lesions in patients living with HIV infection and their association with CD4 count, viral load, and antiretroviral therapy in patients with HIV. MethodsA cross-sectional study was conducted on a sample of 161 patients attending the… All the patients were examined for their oral lesions, current CD4 counts, type, and duration of the therapy. Data analyses were carried out using Chi-Square, Student T/Mann-Whitney, and logistic regression tests. ResultsOral lesions were observed in 58.39% of patients with HIV. Periodontal disease with 78 (48.45%) or without mobility 79 (49.07%) was observed more frequently, followed by hyperpigmentation of oral mucosa 23 (14.29%), Linear Gingival Erythema (LGE) 15 (9.32%), candidiasis pseudomembranous 14 (8.70%). Oral Hairy Leukoplakia (OHL) was observed only in 3 (1.86%). A relationship between periodontal disease with dental mobility and smoking was found (p=0.04), as well duration of treatment (p=1.53e-3) and age (p=0.02). Hyperpigmentation was related to race (p=0.01) and smoking (p=1.30e-6). CD4 count, CD4:CD8 ratio, viral load, or type of treatment were not associated with oral lesions. Logistic regression showed that the duration of treatment has a protective effect on the periodontal disease with dental mobility (OR = 0.28 [−2.27 to −0.25]; p-value=0.03), independent of age or smoking. To hyperpigmentation, the best model included smoking (OR=8.47 [1.18–3.10], p= 1.31e-5), without race or type and duration of treatment. ConclusionAmong HIV patients undergoing antiretroviral treatment, oral lesions can be observed, predominantly periodontal disease. Pseudomembranous candidiasis and oral hairy leukoplakia were also observed. No relationship was found between associated oral manifestations in HIV patients and the start of the treatment, TCD4+ and TCD8+ cell count, TCD4:TCD8 ratio, or viral load. The data indicate that there is a protective effect of duration of treatment with relation to periodontal disease with mobility and that hyperpigmentation seems to be more related to smoking than type and duration of treatment. Level of evidenceLevel 3 (OCEBM Levels of Evidence Working Group*. "The Oxford 2011 Levels of Evidence").

Study of Neurological and Biochemical Manifestations in HIV Patients

Study of Neurological and Biochemical Manifestations in HIV Patients

A STUDY OF OCULAR MANIFESTATIONS IN HIV/AIDS PATIENTS ATTENDING ART CENTRE AT TERTIARY CARE HOSPITAL OF SOUTH GUJARAT

Introduction:AIDS is a multisystem disease, which can affect any part of the eye&amp; can lead to significant morbidity and mortality. Around 40-70% of patients with HIV infection develops one of the ocular manifestations during lifetime. Introduction of HAART had significantly reduced occurrence of opportunistic infections and neoplasia in these patients. Purpose:This study was conducted to study various ocular manifestations in HIV patients and to find out their prevalence and correlation with CD4 T Cell count. Material &amp; Methods:We conducted a Cross-Sectional Study on 100 confirmed HIV patients taking HAART. We conducted detailed ocular examination of these patients including vision assessment, IOP measurement, slit lamp examination and fundus examination. CD4 T Cell count and Duration of the Disease was also noted. Results:We found 52% prevalence of HIV related ocular manifestations. Anterior Segment manifestations were more common than Posterior Segment. Dry Eye was the most common ocular finding accounting for 44.23% of the patients with ocular manifestations. Other Anterior Segment diseases included Cataract, Conjunctival Microvasculopathy, Blepharitis, Stye, Pterygium, Allergic Conjunctivitis, Anterior Uveitis and Viral Keratitis. Only 7 patients had Posterior Segment Diseases. 1 patient each of CMV Retinitis and PORN was seen, both having CD4 T Cell count below 100 cells/µl. Occurrence of these ocular manifestations were not related to age &amp; gender of the patient or to the duration of the disease. Conclusions:All patients with HIV should undergo Ophthalmic examination, irrespective of the CD4 T Cell count, Duration of Disease or presence of symptoms. Screening help in detecting these ocular diseases at early stage and thereby with early initiation of appropriate treatment help in reducing the visual morbidity.

Assessment of Knowledge and Attitude of Dental Students towards HIV and Its Oral Manifestations in Saudi Arabia-A Cross-Sectional Study.

Background: It is essential for practicing dentists to have adequate knowledge of HIV/AIDS and its implications in the dental practice. Their attitudes should also be up to the professional expectations. This study aimed to assess knowledge of HIV/AIDS infection and attitudes towards its patients among dental students in Saudi Arabia. Methods: A questionnaire was prepared and distributed among a sample of dental students in Saudi Arabia. Twenty questions related to knowledge, attitudes, and oral manifestation of HIV were presented. Results: A total of 405 questionnaires were completed (67% response rate). Participants showed low knowledge of safety regarding HIV (39.5%) and 44.2% indicated that they would take an HIV test after needle stick injury. The proportion of correct answers regarding transmission of HIV through saliva, cardiopulmonary resuscitation, and aerosols by hand pieces was 41%, 37.5%, and 26.4%, respectively. Almost 50% of the surveyed dental students expressed unwillingness to treat HIV-positive patients. Poor knowledge was noted regarding oral manifestations of HIV (32.7%). Of the participants, 57.8% indicated that infection control procedures are very important for the treatment of HIV patients and 50.6% believed that a dentist can make a decision to reject the treatment of HIV patients. According to the participating dental students, the three major oral manifestations in HIV patients are hairy leukoplakia (47.4%), oral candidiasis (44.7%), and Kaposi’s sarcoma (43.5%). Conclusion: Inadequate knowledge and unprofessional attitude towards HIV/AIDS patients were identified among this group of dental students in Saudi Arabia. Dental educators and health care planners in Saudi Arabia should plan to promote the knowledge and attitudes of dental students in Saudi Arabia towards the treatment of HIV patients.

Ocular manifestation in human immunodeficiency virus patients presenting to tertiary eye care centre in rural area

The ocular manifestations of HIV/AIDS may lead to visual impairment or blindness. The need of hour is an understating of ocular sequelae of HIV infection leading to an early diagnosis of AIDS so that we can start early and effective treatment as per conditions.1. To study the prevalence of ocular manifestations in HIV patients; 2. To study relation of CD4 T Cell count with ocular diseases. The study concluded that HIV/AIDS is a significant cause of ocular disease. Almost around 39% patients having HIV/AIDS have eye disease. HIV Retinopathy is most common in posterior segment and lens involvement is most common in anterior segment manifestations. Usually, early presentation of ocular manifestations in HIV/AIDS patients is asymptomatic or with very less symptoms, which leads to delay in diagnosis and treatment.

Cardiac manifestations in HIV patients and their correlation with CD4 count

Cardiac manifestations in HIV patients and their correlation with CD4 count

Correlation of CD4 counts with oral and systemic manifestations in HIV patients.

Aim:Aim of the study was to correlate CD4 counts with oral and systemic manifestations in HIV patients.Materials and Methods:Study population comprised of newly diagnosed 100 confirmed seropositive patients, before starting any antiretroviral therapy, were included. The oral lesions were diagnosed based on clinical manifestation using international criteria and CD4 count was determined within maximum 1 week of oral examination. Oral and systemic manifestations of HIV-positive patients were recorded and correlated with CD4 counts.Results:It was found that decrease in CD4 count is associated with a wide range of oral and systemic manifestations which can be used as prognostic marker for immune suppression in AIDS patient.Conclusion:Correlation of CD4 count with oral and systemic manifestation in HIV patient demonstrate the role of oral physician in identification, diagnosis, and treatment of HIV-associated lesions, providing proper guidance to the patient and allowing for an early diagnosis and treatment of the disease, which is fundamental for a successful management of the life conditions of HIV infected patients.

Clinical Spectrum of Rheumatologic Manifestations in HIV Patients: A Study from Southern India

Clinical Spectrum of Rheumatologic Manifestations in HIV Patients: A Study from Southern India

English

Mucocutaneous disorders often seen in HIV patients with varying morbidity. The HIV progression is characterized by the declining of CD4 cell counts and emergence of mucocutaneous manifestations. The aim of the study was to evaluate the relationship between CD4 cell counts with mucocutaneous manifestations in HIV patients. This was a cross-sectional study based on medical records at Dr. Sardjito General Hospital during the period January 2011-December 2015. Data of patient’s age, sex, risk factors of transmission, most mucocutaneous manifestations and CD4 cell count were gathered. The correlation between CD4 cell counts with muscocutaneous manifestations were analyzed using chi-square test. A total 928 patients were involved in the study. More than half of the patients were male (65.4%) and mostly, the patients aged 20-29 years (38.69%). The main risk factors for HIV transmission were unsafe sex (75%). The highest CD4 cell counts was 1094 cells/mm3 and the lowest was 1 cell/mm3. We found 306 cases of mucocutaneous manifestations. The most mucocutaneous manifestations was a fungal infection (40.4%) with the highest infection type was oral candidiasis(33.8%); then noninfection (28%) with the highest type was drug eruption(35.9%); and tumors(0.5%) that was only Kaposi sarcoma cases. We also found sexually transmitted infections (STIs) (18.85%) with the highest cases was condyloma acuminata (49.3%). Statistical analysis showed a significantly relationship between CD4 cell counts with a fungal infection (p 200 cells/mm3) increases the risk of viral infection by about 2.5 times and parasitic infections as much as 5 times.

A study of clinicopathological correlation of pruritic papular eruptions in HIV patients.

Context:Pruritic papular eruption (PPE) is a chronic eruption of papular and pruritic lesions of unknown etiology, symmetrically distributed over trunk and extremities. These are common cutaneous manifestations in HIV patients. It is an important cause of HIV-related morbidity. PPE can be the first marker of HIV. Their etiology, histopathological findings, and associated factors vary from region to region. There are no clear data available on the etiology, exact spectrum of the condition, histopathological findings, or treatment of PPE.Aims:The study is aimed at documenting the etiology, CD4 count, and its histopathological correlation in HIV-infected patients.Settings and Design:An observational study conducted in Government Medical College, Patiala.Subjects and Methods:Two-year data regarding history, HIV status, cluster of differentiation 4 (CD4) cell count, and skin biopsy of clinically suspected PPE patients with known HIV status were analyzed.Statistical Analysis Used:All the results were then statistically analyzed. Categorical data were analyzed by Chi-square test, and one-way Spearman's rho test was used for multiple group comparison.Results:Data of 50 eligible patients were analyzed. The majority of the patients were female (between 21 and 50 years of age). The most common histopathological patterns were of papular urticaria, scabies, and drug reaction, and the others less common PPE were polymorphic light eruption and eosinophilic folliculitis. Patients with papular urticaria (32%) had significantly lower mean CD4 counts (157 cells/mm3), while in scabies, the mean CD4 count (376 cells/mm3) was higher.Conclusions:We conclude that histopathology helps in specifying the pattern of PPE and its etiology. It can be a marker of advanced HIV infection. Thus, correlation between the histopathology, clinical diagnosis, and CD4 counts helps to know the disease process.

Prevalence of rheumatic manifestations in HIV patients: A cross-sectional study from Manipur, India

Background: To estimate the prevalence of rheumatic manifestations in HIV patients and to correlate with factors such as age, sex, duration of HIV infection, highly active antiretroviral therapy (HAART) regimen, duration of HAART, Hb%, ESR, CRP and CD4 cell count. Methods: The study involved 382 HIV patients attending a tertiary healthcare and referral centre at Imphal, Manipur for two consecutive years. A detailed history of each patient was collected and clinical examination was performed. All the subjects were tested for hepatitis B and C co-infections, and CD4 cell count. Statistical analysis was performed using SPSS software (ver. 16). Results: Rheumatic manifestations were observed in 145 (38.06%) HIV patients, with HIV- associated arthralgia (22.57%) being the most common manifestation. HIV-associated arthralgia showed significant relation with HAART regimen (0.04), Hb% (0.02), ESR (0.04), and CRP (0.001). In addition, factors such as duration of HIV infection (0.05), Hb% (0.01), ESR (0.04), CRP (0.04) and hepatitis B co-infection (0.04) showed significantly correlation with HIV-associated fibromyalgia. Conclusion: Increased prevalence of rheumatic manifestations was noted in HIV patients, with more incidence in HAART-sensitized population. The study highlights the need to review such manifestations at every follow-up and manage appropriately.

Oral manifestations and related factors of HIV positive patients in south-east of Iran

Introduction: Oral manifestations can be the first signs of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) and a useful marker for the progression of this disease. The present study aimed to determine the prevalence of oral manifestations and examine their relationship with socio-demographic factors in HIV-positive patients in the health centers affiliated to Zahedan University of Medical Sciences (Southeast Iran). Methods: In this cross-sectional study in addition to determining oral manifestations based on the classification of EC-clearing house (European Commission clearing house), information such as age, gender, marital status, residence, education, occupation, habits, oral hygiene, loss of weight in the last six months. Body Mass Index (BMI), mode of HIV transmission, stage of disease, anti-retroviral therapy (ART), and duration of HIV were gathered through direct question from the patients or the information contained in their records. Then the relationship between various factors and oral manifestations was analyzed using Chi-square, Fisher’s Exact Test, Student T Test, Mann- Whitney tests and logistic regression. Results: Oral examination was performed on 119 HIV-positive patients who were 69.7% male and 30.3% female and had a mean age of 35.4±12.7 years. Oral manifestations were found in 57.1% of the patients. Pseudomembranous candidiasis (34.1%) and linear gingival erythema (33%) were the most common lesions in these patients. The probability of oral manifestations occurrence increased with age and duration of smoking in smokers with HIV (P=0.036 and P=0.012, respectively). Conclusion: Most oral manifestations were those strongly associated with HIV infection (91%). Timely diagnosis and treatment of oral manifestations in HIV patients should be considered in conjunction with other treatments.

Mucocutaneous Manifestations in HIV Patients

Mucocutaneous Manifestations in HIV Patients

Oral manifestations of HIV/AIDS in Asia: Systematic review and future research guidelines.

Objectives The authors have conducted a systematic review of oral manifestations of HIV from studies conducted in Asia to establish the characteristics and prevalence of individual oral manifestations in Asia, and to assess the direction of future research studies on oral manifestations of HIV in Asia. Material and Methods The electronic retrieval systems and databases searched for relevant articles were PubMed [MEDLINE], EBSCO, and EMBASE. The search was for limited articles published in English or with an English abstract and articles published during the period January 1995 to August 2014. The authors reached a final overall sample of 39 studies that were conducted in Asia. Results The median population size among all studies was 312.7 patients. Oral candidiasis [OC] was the most common oral manifestation [37.7%] in studies conducted in Asia. The overall prevalence of oral hairy leukoplakia and melanotic hyperpigmentation was computed to be 10.1% and 22.8% respectively. Thailand and India are primarily countries with maximum research on oral manifestations. Conclusions The research on oral manifestations of HIV in Asia has to upgrade to more interventional and therapeutic studies rather than the contemporary cross- sectional epidemiological descriptive studies. The authors have given suggestions and future directions for the implementation of clinical research of oral manifestations in HIV patients. Key words:Oral manifestations, HIV/AIDS, Asia, Systematic review.