Number Of Opportunistic Infections Research Articles

Prevalence of chronic pulmonary aspergillosis in fibrocavitary pulmonary tuberculosis patients.

Tuberculosis (TB) is still a global health issue. While the lungs are the most commonly affected, infections can also affect other organs. Because of the rise in immunocompromised hosts, the number of opportunistic infections has skyrocketed. In instances of aspergilloma and chronic pulmonary aspergillosis (CPA), pulmonary tuberculosis (PTB) is the most usually linked condition. The current cross-sectional study was conducted on 42 study participants from January 2018 to June 2019. Aspergilloma was observed in two participants (4.8%) of the study population. Candida growth was observed in five participants (11.9%) of the study population on sputum fungal culture. Aspergillus growth and Candida growth was observed in three (7.1%) and two (4.8%) participants of the study population, respectively, on bronchoalveolar lavage (BAL) fungal culture. Aspergillus IgG antibody was positive in four particpants (9.5%) of study population. Out of the 42 participants, four were diagnosed with CPA. Since CPA and PTB patients present similar symptoms, it is virtually impossible to distinguish between the two unless serological test is performed. There has been a significant burden of patients with CPA, especially in post tuberculosis fibro-cavitation. CPA patients requires long-term anti-fungal therapy; hence an improved case detection should be undertaken.

A cross-sectional study of demographic and clinical profile of HIV patients at ART center of tertiary care hospital

Background: India has the third largest number of people living with HIV/Acquired immunodeficiency syndrome (AIDS). It is important to understand the presentation of HIV disease in the local context and culture. Aims and Objectives: The present study is aimed at identifying the socio-demographic characteristics, clinical presentations of HIV/ AIDS patients, opportunistic infections (OI), and the possible risk factors for acquiring HIV infection. Materials and Methods: A descriptive cross-sectional study was conducted on HIV patients from September 2021 to December 2021. The HIV-positive patients of all age groups and all categories were included in the study. However, the clinical staging was done according to the World Health Organization (WHO) classification of HIV/AIDS. Data were expressed as mean and percentage proportion with chi square test for measuring statistically significance. Results: Among 140 HIV patients 88 (62.9%) were males. More than half were 101 (72.1%) in the reproductive age group 18–40 years with mean age 35±11.5 years. The commonest mode of HIV transmission was heterosexual 114 (81.4%). Maximum belonged to social Class IV 51 (36.4%) and Class III 47 (33.6%) of socioeconomic status. Fever 92 (65.7%), weight loss 82 (58.7%), and cough 68 (48.6%) were the common presenting. Pulmonary tuberculosis and diarrhea were the most predominant secondary OI accounting for 46 (32.9%) and 35 (25.0%), respectively. More than half 82 (58.6%) of patients were in the WHO clinical Stage II of HIV disease. CD4 counts of the patients were significantly inversely correlated with the number of symptoms and the number of OI. Conclusion: There was a high frequency of behavioral risk factors, together with unawareness among HIV patients, socio- demographic, and clinical profile of study participants reflects an impact of early case detection and timely institution of highly active antiretroviral therapy.

HIV/AIDS Patients’ Survival Rate between One Co-infection and More Than One Opportunistic Co-infection at Haji Adam Malik General Hospital Medan in 2015-2017

Background: AIDS is a collection of disease symptoms caused by HIV that damages the human immune system. Decreased immunity causes the patient to be very susceptible to various, often fatal, infectious diseases (opportunistic infections). Aim: To determine the difference in HIV/AIDS patients' survival rate between one co-infection and more than one opportunistic co-infection at Haji Adam Malik Hospital Medan in 2015-2017. Methods: This is a retrospective cohort analytic study using secondary data from medical records of HIV patients from January 2015-December 2017. The samples were 34 HIV/AIDS patients who met the inclusion and exclusion criteria, selected by consecutive technique sampling. Descriptive statistical analysis was used for demographic data. Kaplan Meier's statistical analysis was used for endurance or survival tests. The difference was considered statistically significant if p<0.05. Results: The most opportunistic infections found were diarrhea in 265 subjects (55.67%), followed by toxoplasmosis in 159 subjects (33.40%), oral candidiasis 141 subjects (29.62%), CMV 78 subjects (16.39%), pneumonia 63 subjects (13.24%), sepsis 62 subjects (13.03%), PCP 45 subjects (9.45%), hepatitis B 38 subjects (7.98%), chlamydia 24 subjects (5.04%), hepatitis C 14 subjects (2, 94%), Herpes zoster 11 subjects (2.31%), lymphadenopathy 4 subjects (0.84%), and the least common were NHL 1 subject (0.21%) and Penicilosis 1 subject (0.21%). Conclusion: The HIV patients’ survival rates are different based on the number of opportunistic infections. According to the order, the most common opportunistic infections were diarrhea, toxoplasmosis, and oral candidiasis. Keywords: HIV/AIDS, opportunistic infections, oral candidiasis, toxoplasmosis, diarrhea.

Profile of fungal opportunistic infection in HIV/ AIDS patients: An appraisal at Indian tertiary care

AIDS is characterized by a number of opportunistic infections which are responsible for high morbidity and mortality. The spectrum and distribution of opportunistic infection (OIs) in AIDS patients is due to viral, Bacterial, Fungal cytopathology and are secondary to the failure of both cellular and humeral response with CD4 count of <200 mm leads to morbidity and mortality. To document the spectrum of Fungal opportunistic infections in various age groups of HIV/AIDS patients and to note the CD4 counts among the group This is a descriptive study. Clinically and laboratory confirmed fungal cases of opportunistic infections in HIV patients are recorded, during the one year period from June 2017 - May 2018. Blood of these patients processed for CD4 counts, by Partec flow cytometery to assess the immune status among them. Out of 500 HIV seropositive cases, we found 65 of fungal opportunistic infections accounting for 13% of the cases. Majority of opportunistic infections, were in the age group of 31-40 years (37.8%) with predominance of male accounting for 55.2% of the cases. Out of 65 cases, 9.2% had oral candidiasis followed by 1% of vaginal candidaisis with CD4 count <100 mm. In our study, predominant lesion observed was oral candidiasis among all the fungal opportunistic infections. Our study will help in programme management and to plan appropriate strategies for the investigation and treatment of common OIs as a part of management programme for HIV infected populations.

Bayesian Joint Modelling of Survival Time and Longitudinal CD4 Cell Counts Using Accelerated Failure Time and Generalized Error Distributions

Survival of HIV/AIDS patients is crucially dependent on comprehensive and targeted medical interventions such as supply of antiretroviral therapy and monitoring disease progression with CD4 T-cell counts. Statistical modelling approaches are helpful towards this goal. This study aims at developing Bayesian joint models with assumed generalized error distribution (GED) for the longitudinal CD4 data and two accelerated failure time distributions, Lognormal and loglogistic, for the survival time of HIV/AIDS patients. Data are obtained from patients under antiretroviral therapy follow-up at Shashemene referral hospital during January 2006-January 2012 and at Bale Robe general hospital during January 2008-March 2015. The Bayesian joint models are defined through latent variables and association parameters and with specified non-informative prior distributions for the model parameters. Simulations are conducted using Gibbs sampler algorithm implemented in the WinBUGS software. The results of the analyses of the two different data sets show that distributions of measurement errors of the longitudinal CD4 variable follow the generalized error distribution with fatter tails than the normal distribution. The Bayesian joint GED loglogistic models fit better to the data sets compared to the lognormal cases. Findings reveal that patients’ health can be improved over time. Compared to the males, female patients gain more CD4 counts. Survival time of a patient is negatively affected by TB infection. Moreover, increase in number of opportunistic infection implies decline of CD4 counts. Patients’ age negatively affects the disease marker with no effects on survival time. Improving weight may improve survival time of patients. Bayesian joint models with GED and AFT distributions are found to be useful in modelling the longitudinal and survival processes. Thus we recommend the generalized error distributions for measurement errors of the longitudinal data under the Bayesian joint modelling. Further studies may investigate the models with various types of shared random effects and more covariates with predictions.

Contemporary microbiology and identification of Corynebacteria spp. causing infections in human.

The number of opportunistic infections caused by Corynebacteria is increasing due to increase in number of immunocompromised patients. New Corynebacterium species and new human infections, caused by this group of bacteria, has been described recently. However, identification of Corynebacteria is still a challenge despite application of sophisticated laboratory methods. In the study we present possibilities and limitations of various commercial systems for identification of Corynebacteria.

Analysis of the association opportunistic infections with c-reactive protein focus toxoplasma, cytomegalovirus, rubella,and hepatitis in human immunodeficiency virus

Opportunistic infections occur more often severe in people with HIV. C-reactive protein is known to have a prognostic value in HIV and those with HIV-related opportunistic infections. High level of CRP will increase therisk of infection toxoplasma, CMV, rubella,and hepatitis in HIV.Analyzing association of opportunistic infections toxoplasma, CMV, rubella,and hepatitis with the level of CRP in HIV, a cross-sectional analytic study wasduring January-July 2017 on both outpatientand inpatient HIV subjects at Wahidin Sudirohusodo Hospital, Makassar. Each HIV patient is categorized into agroup of opportunistic infections: toxoplasma, CMV, rubella, hepatitis. CRP levels will be assessed in each group, defined by normal values <5 mg/L and increased when ≥5 mg/L.From 49 patients, 34 people with toxoplasma, 48 CMV, 41 rubella, 3 HBV and 1HCV with amean of age 34.55±8.434 years and CRP 59.74±74.787 mg/L. The only toxoplasma had a significant association with high CRP levels (p <0.05). There was no meaningful relationship between the number of opportunistic infections with high levels of CRP (p>0.05).

Clinico-demographic profile of HIV patients at ART centre of a tertiary care referral hospital in North India

Background: According to the National AIDS Control Organization (NACO), HIV prevalence in India is 0.36% and people living with HIV are around 2.47 million. Although antiretroviral treatment (ART) does not cure HIV/AIDS, but effective ART regimens inhibit the efficient replication of the HIV virus, and reduce viremia to undetectable levels. Methods: HIV positive patients qualified to be enrolled in to the study were those who attended the infectious diseases clinic at least twice (one follow-up visit at least six months apart), between January 2009 to December 2011. The protocol was approved by the Ethical Committee of the IMS, BHU. History and detail of patients were recorded on a pre-designed performa which included the socio-demographic profile of the patients, mode of transmission, presenting symptoms, opportunistic infections and many others. Results: 5308 HIV positive patients were registered during three year of study period at the ART Centre of IMS, BHU. Of these 3379 (63.7%) were males and 1929 (36.3%) were females. Heterosexual mode of transmission was commonest in the study group and amounted to 70.5% of total HIV patients on ART. Pulmonary tuberculosis was most common opportunistic infection and was present in 1045(19.7%) of patients on ART. CD4 counts of the patients were significantly inversely correlated with the number of symptoms and the number of opportunistic infections. Conclusions: HIV infection is one of the major infectious diseases in this part of India, and being chronic and lifelong in nature, its impact is huge compared to other infectious diseases. People with high risk behavior and the spouse of the affected couple need to be educated for primary and secondary prevention of the disease.

Spatial clusters of AIDS in Indonesia

ObjectiveThis study seeks to determine whether distinctive clusters of case rates, number of new cases, treatment types, and other socio-demographic characteristics exist among provinces in Indonesia. Hierarchical Agglomerative and k-means clustering techniques are used to empirically derive the patterns of AIDS among Indonesian provinces by forming clusters of provinces with similar characteristics. MethodsCluster analysis is used to segment the Indonesian provinces in terms of how their rates of medical care and number of new cases of AIDS vary with respect to the socio-economic characteristics and sustainable health system of the province. Data from the 2011 Statistik Indonesia (2014–2015) and the 2006 Governance and Decentralization Survey were used. ResultsCluster analysis yielded three distinct clusters: the high incidence rates and moderately high case rates cluster, the low case and incidence rates cluster, and the high case and incidence rates cluster. ConclusionAddressing the socioeconomic, demographic, and health inequalities that exist among the provinces should be a priority. Preventive interventions should consider provincial poverty and illiteracy rates, the population and its density, the type of self-treatment sought, the unmet need for healthcare services, the density of medical professionals, as well as the number of opportunistic infections.

Pneumocystis Pneumonia in Patients with Autoimmune Diseases: A Retrospective Study Focused on Clinical Characteristics and Prognostic Factors Related to Death.

BackgroundWith the increasing use of immunosuppressive agents, the number of opportunistic infections has risen in patients with autoimmune diseases. Pneumocystis pneumonia (PCP) is one of these opportunistic infections that have a high mortality rate. However, only a few studies have described PCP in these patients, and these studies are limited in scope. We conducted this retrospective study to describe the clinical characteristics and factors associated with outcomes of PCP in patients with autoimmune diseases.MethodsA retrospective study was performed in laboratory diagnosed PCP patients with autoimmune diseases in an academic hospital over a 10-year period. Patients with human immunodeficiency virus (HIV) infection were not included. Clinical characteristics were collected and the factors related to death were analysed.ResultsA total of 69 patients with PCP during the study period were included. Common clinical features included fever (81%), cough (56%), and dyspnea (35%). Ground glass opacity (81%) and reticulation (52%) were the most common radiological findings. Concurrent pulmonary infections including bacterium, aspergillus and cytomegalovirus were found in 34% of the patients. The overall in-hospital mortality rate was 32%. High mortality was associated with lower PaO2/FiO2 ratios and albumin levels. The lymphocyte count, CD4+ T cell count, previous usage of immunosuppressive agents, the duration and dose of glucocorticoids did not affect the outcome.ConclusionsThe mortality rate in PCP patients with autoimmune diseases is high. Low PaO2/FiO2 ratios and albumin levels are independent prognostic factors of mortality.

EVALUAREA EFECTULUI ANTIMICROBIAN AL UNOR SPECII DE BACTERII LACTICE

At the gastrointestinal tract level there is a balance between microbiota and the digestive tract which has as effect differentiation of pathogenic bacteria commensal species. Lately, due to the development of new therapies and use of a wide spectrum antimicrobian compounds we can notice an increase in the number of opportunistic infections caused by potentially pathogenic bacterial and fungal strains. Lactic acid bacteria produce compounds with antimicrobian action, such as hydrogen peroxide, diacetyl, acetaldehyde, D-amino acids isomers, reutin and bacteriocines. The use of probiotics can represent a supplementary alternative for increasing and maintaining the well-being of the human body.

Clinical and Socio demographic profile of attendees at ART centre in a tertiary care hospital in Mangalore, India

Introduction: India has the third largest number of people living with HIV/AIDS. There is a need to study the profile of patients who come to ART centers and link their clinical and socio-demographic variables in the management. Moreover, it is important to understand the presentation of HIV disease in the local context and culture. The present study is aimed at identifying the socio-demographic characteristics, clinical presentations of HIV/AIDS patients, opportunistic infections and the possible risk factors for acquiring HIV infection at an ART centre of Government Wenlock hospital, situated in Karnataka state of India. Materials and Methods: In this study 102 HIV patients attending the HIV clinic were enrolled and they were followed for a period of one year with relevant investigations.Results: Of 102 patients 69 were males and 33 were females.The mean age of the study subjects at the time of diagnosis was 38.06. Heterosexual contact was the commonest mode of transmission in96 (94.12%) patients. History suggestive of a risk factor for HIV transmission could not be elicited in 4 (3.92%) patients. Fever (71.5%), weight loss (62.74%), cough (51.96%) and chronic diarrhea (43.9%) were the common presenting symptoms. The most common opportunistic infection was oral candidiasis (66.67%) followed bytuberculosis (22.54%) and pneumocystis pneumonia (13.72%). Significant number of patients (30.37%) developed Zidovudine induced anemia and females were more prone for Zidovudine induced anemia as compared to males. CD4 counts of the patients were significantly inversely correlated with the number of symptoms and the number of opportunistic infections. Conclusion: Majority of patients were of low socioeconomic status and in productive age group with heterosexual contact being commonest mode of transmission.Significant number of patients developed Zidovudine induced anemia and females were more prone. DOI: http://dx.doi.org/10.3126/ajms.v6i5.11622Asian Journal of Medical Sciences Vol.6(5) 2015 61-65

Review of Radiologic Infectious and Non-infectious Pulmonary Complications in Human Immunodeficiency Virus Patients

The incidence of Human Immunodeficiency Virus (HIV) has decreased from its peak in the 1980’s yet there are currently more people living with HIV than ever before. As a result of highly active antiretroviral therapy (HAART), the number of opportunistic infections has decreased, with a concurrent increase in the number of non-infectious complications, not initially observed in the initial HIV epidemic. The risk of developing HIV-related pulmonary complications is strongly influenced by the degree of immunosuppression, demographic characteristics, and the use of appropriate prophylaxis against HIV-associated opportunistic infections. This article reviews the radiographic and computed tomographic (CT) manifestations of common pulmonary infections and non-infectious pulmonary complications of HIV, and highlights the importance of clinical presentation, epidemiology and immunologic status.

Socio-Clinical Profile Of HIV Patients Visiting To An Art Centre

Introduction: Scenario of the AIDS epidemic, clinical course and pattern of opportunistic infections in HIV patients is changing world-wide. The study aims to fulfill the paucity of socio-clinical profi le among the patient of HIV with geographical population of this region. Methodology: This is a hospital based cross sectional clinical study with a sample size of 110 respondents presenting to ART center at Jayarogya Hospital (JAH) Gwalior from May 2010 to Oct 2011. Results: Mean age of study population was 35.44±9. High Frequency of weight loss &gt; 10% (P&lt;0.001), fever (P=0.0027), breathlessness (P=0.03), itching (P&lt;0.001), lymphadenopathy (P&lt;0.001), oral thrush (P=0.006), extra pulmonary tuberculosis (P=0.04), candidiasis (P=0.006) at low CD4 count (&lt;200) and difference in mean CD4 count (P=0.0039) among male (202.21) and female (291.41) was found to be statistically signifi cant. CD4 counts of the patients were signifi cantly inversely correlated with the number of opportunistic infections and the number of symptoms (R=-0.369; P&lt;0.001, R=-0.223; P=0.019 respectively). Conclusion: The study depicts male predominance, young sexually active group vulnerability, with a quite difference in clinical presentation and occurrence of opportunistic infections from other part of the world necessitating formulation of different set of guidelines for subjects of Indian subcontinent to improve life-span of such patients. SAARC Journal of Tuberculosis, Lung Diseases &amp; HIV/AIDS; 2013; X(2); 7-14 DOI: http://dx.doi.org/10.3126/saarctb.v10i2.9707

Optimal timing for initiation of antiretroviral therapy: a prospective study on treatment naive HIV patients

Method 150 treatment naive adults PLHIV with CD4 count between 250 -500/mm in WHO clinical stage 1 or 2 were included in the study and enrolled into 2 groups at 2:1 ratio and followed for 1 year. Group A with CD4 count between 250-350/mm & Group B with CD4 count between 350-500/mm. At the end of study each group was evaluated for number of opportunistic infection, ART conversion, conversion to stage III and IV, lost to follow up (LFU) and death. Statistical analysis was done by SPSS 16.0 version. Data were expressed as mean (±SD) for continuous variable and percentage for categorical variable. An independent sample t-test was used to detect differences in clinical and laboratory results.

Renal Leishmaniasis as Unusual Cause of Nephrotic Syndrome in an HIV Patient

Renal involvement is a rare complication in HIV-1-infected patients leading to various pathologies and clinical symptoms. In addition to the classic HIV-1-associated nephropathy with collapsing-type focal segmental glomerulosclerosis and characteristic tubulocystic changes, which is more common in Afro-American than in Caucasian HIV-1 patients, immune complex GNs such as membranous GN and membranoproliferative GN are particularly common renal manifestations. Besides HIV-1 itself, a number of opportunistic infections may cause renal disease in HIV-1-infected patients. In this study, we report an unusual case of HIV-1 infection with a severe renal manifestation of systemic leishmaniasis that developed years after repeated visits to Mediterranean countries. The case presents several remarkable clinical, pathologic, and therapeutic aspects that may be important for daily clinical practice.

Ocular manifestations of HIV/AIDS: A literature review* (Part 1)

No abstract available

Infecções oportunistas em indivíduos com infecção pelo HIV e relação com uso de terapia antirretroviral

The use of HAART therapy and the spread of primary and secondary prophylaxis led to a reduction in the number of opportunistic infections. The relationship between non-adherence to antiretroviral therapy and the development of resistance of the HIV virus is an established fact. This study evaluated the incidence of opportunistic infections in HIV patients and related them to the regular/irregular use of non-anti-retroviral therapy. Clinical evaluations were made and medical reports and tests consulted to detect opportunistic infections and a questionnaire was applied to evaluate the use of antiretroviral drugs. A questionnaire was applied for socioeconomic and clinical evaluation for the diagnosis of opportunistic infection. We evaluated 144 patients, 131 had opportunistic infections before the HAART therapy and 74 even after HAART therapy with an episode of opportunistic infection in 44 (59.45%) patients where 34 (45.95%) alleged irregular anti – retroviral use and 10 (13.5%), regular use. There were two episodes of opportunistic infections in 26 (35.14%) patients, 21 (28.38%) with irregular use of antiretrovirals and five (6.76%) with regular use and three episodes of opportunistic infections in four patients (5, 41%), three (4.05%) with irregular use of therapy and one (1.35%) with regular use. As is observed in other regions of Brazil, the incidence of opportunistic infections decreased with the use of HAART therapy. On the other hand, there continue to be new cases of opportunistic infections, suggesting that some people have exhausted all possibilities as to available therapies.

Tuberculosis is the leading cause of lymphadenopathy in HIV-infected persons in India: Results of a fine-needle aspiration analysis

HIV infection is associated with a number of opportunistic infections and malignancies frequently involving the lymph nodes. Lymphadenopathy may occur at any stage of HIV infection. We aimed to determine the utility of fine-needle aspiration cytology in evaluating the causes of lymphadenopathy in HIV-infected individuals. Three hundred HIV-infected individuals with lymphadenopathy were included in the study. Fine-needle aspiration (FNA) was performed on peripheral or deep-seated lymph nodes. The material was used for cytological examination using May-Grunwald-Giemsa and haematoxylin and eosin staining. Special stains such as modified Ziehl-Neelsen staining for acid-fast bacilli and periodic acid-Schiff staining for fungi were also performed. The mean age of the study group was 35.0 ± 8.0 y (range 13-74 y). The median CD4 count was 152 cells/μl. Out of the 300 FNA reports, acid-fast bacteria were reported in 130 and cytological findings indicating mycobacterial infection in a further 43 patients. Cryptococcosis was reported in 4 individuals, histoplasmosis in 2 and aspergillosis in 1. Reactive hyperplasia was seen in 89 individuals. Lymphoma was noted in 7 individuals and suppurative inflammation in 5. In conclusion, tuberculosis is the predominant cause of lymphadenitis in HIV-infected individuals in India, especially in those with low CD4 cell counts.

AIDS: A radiation oncologist′s perspective

While HIV is often associated with tuberculosis and a number of opportunistic infections, the spectrum of diseases of patients with HIV infection encompasses a number of malignancies as well. Typically, these are the AIDS-defining malignancies, though other malignancies also comprise a significant caseload. Radiotherapy plays an integral part in anti-cancer treatment and its tolerance and efficacy in HIV+ patients are therefore important. The patient's level of immunity as manifested by the CD4 count has a significant bearing on treatment outcomes. In some cases, like primary central nervous system lymphoma (PCNSL), the occurrence of the malignancy itself is tied to the patient's immunity with increased incidence in patients with CD4 counts less than 50/mm 3. The success of highly active antiretroviral therapy (HAART) has allowed administration of standard doses of radiotherapy and even chemotherapy in recent times leading to improved outcomes. In general, standard radiotherapy and concomitant chemo-radiotherapy protocols should be used wherever possible, so as not to compromise disease control. Local control and disease-specific survival rates in HIV patients are no worse than in HIV? patients, but this is only true for CD4 counts above 200/mm 3. In certain situations like cervical intraepithelial neoplasia CIN, HAART itself is associated with disease regression. The question of increased radiosensitivity in HIV patients remains unresolved in most diseases and there are sparse data with regard to non-HIV associated malignancies in these patients. Greater caution and emphasis on good supportive care and HAART would appear to be essential when treating the malignancies in HIV+ patients with standard anti-cancer regimens.