Profile Of Human Immunodeficiency Virus Research Articles

A cross-sectional study of socio-demographic and clinical profile of HIV patients at ART plus centre, Sawai Man Singh Hospital, Jaipur, India

Background: This study aimed to understand the regional variation in the socio-demographic and clinical profile of human immunodeficiency virus (HIV) infected patients at antiretroviral therapy plus centre of Sawai Man Singh (SMS) hospital, Jaipur, India. 
 Methods: A descriptive cross-sectional study was conducted on HIV patients from January to December 2019. The HIV-positive patients of all age groups and all categories were included in the study. The socio-economic status was assessed by BG Prasad classification-based consumer price index. However, the clinical staging was done according to the World Health Organization (WHO) classification of HIV/AIDS. Data were expressed as mean ± standard deviation.
 Results: Among 525 HIV patients 59.16% were males, 40.26% females and 0.57% intersex. About half (51.0%) in the reproductive age group with mean age 36 ±13 years. The commonest mode of HIV transmission was heterosexual (89.77%). Maximum belonged to social class I (57.84%) and class II (26.05 %) of BG Prasad's socioeconomic status. Each of the non-agricultural laborers and semi-skilled workers constitutes 18.0%, and the housewives were 23.6%. At the time of presentation, baseline CD4+Tcell count was <350 /mm3 in 55.0% of HIV patients. Pulmonary tuberculosis and skin involvement were the most predominant secondary opportunistic infections accounting for 24.8% and 7.8%, respectively. More than half (52.09%) of patients were in WHO clinical stage I of HIV disease.
 Conclusion: Socio-demographic and clinical profile of study participants reflect an impact of early case detection and timely institution of highly active antiretroviral therapy.

Profile of Human Immunodeficiency Virus seropositives attending Integrated Counseling and Testing Center of a Medical College in Chhattisgarh

Background: Acquired immune deficiency syndrome (AIDS) is one of the most important public health problems of the late 20th and early 21st centuries. Hence, it is necessary to understand the sociodemographic profile and risk behavior pattern of human immunodeficiency virus (HIV)-infected individuals for better implementation of interventions. Objective: The objective of this study was to assess sociodemographic profile, risk behavior pattern, and source of referral of HIV seropositive clients attending Integrated Counseling and Testing Center (ICTC). Materials and Methods: A crosssectional study was done on all HIV-seropositive attendees who attended ICTC from July 2015 to October 2015. Results: Out of all 274 individuals, 61.31% were male, 58.39% were of 20-39 years age, 77.01% were married, and 34.39% had completed primary education. Most common occupation among males is government or private service (20.83%) and almost half of the females were homemakers (49.06%). 174 (63.50%) individuals stated heterosexual transmission as the risk behavior. 3.66% of individuals got infected because of parent to child transmission. 37.23% of individuals visited ICTC voluntarily. Conclusion: Epidemiological studies should be carried out in various settings to understand the role and complex relations of social and demographic and behavioral factors, which will help, interrupt, and control the transmission of HIV/AIDS.

Echocardiographic Profile of Human Immunodeficiency Virus (Hiv) Infected Patients in A Tertiary Care Hospital .

Background: HIV continues to be a major global public health issue. In 2014 an estimated 36.9 million people were living with HIV, a global prevalence of 0.8 % .(1). The clinical spectrum of HIV infection encompasses a spectrum ranging from an acute syndrome associated with primary infection to a prolonged symptomatic state to an advanced disease .(2) Cardiac involvement in HIV affected patients is becoming more prevalent as therapy and longevity improve Infection with HIV is one of the causes of acquired heart disease in these patients (3,4) . Methods: This was an observational study, conducted in a tertiary care centre with an aim to study 2Echographic parameters, and its co- relationship with immunological status of the patient, as measured by CD4 counts in patients with HIV/AIDS. Results: In our study 151 HIV positive patients were studied over a period of 12 months .Majority of our patients were in the age group of 20-40 years with average age of 38.7years. Male patients were 59.7% and 40.3% patients were females. Out of the 151 cases ,34.4% had CD4 count 350. 25.7% patients had some abnormal 2D echo findings which was associated with low CD4 count ( 60%) and 23.2% had low LVEF (<60%). Conclusion: Echocardiographic abnormalities are more prevalent in HIV/AIDS patients and their prevalence increases as the CD4 count falls. So we should aim at starting ART early in HIV infected patients so as to improve The quality of life of people living with HIV/AIDS.

The Causes of HIV-Associated Cardiomyopathy: A Tale of Two Worlds.

Antiretroviral therapy (ART) has transformed the clinical profile of human immunodeficiency virus (HIV) from an acute infection with a high mortality into a treatable, chronic disease. As a result, the clinical sequelae of HIV infection are changing as patients live longer. HIV-associated cardiomyopathy (HIVAC) is a stage IV, HIV-defining illness and remains a significant cause of morbidity and mortality among HIV-infected individuals despite ART. Causes and clinical manifestations of HIVAC depend on the degree of host immunosuppression. Myocarditis from direct HIV toxicity, opportunistic infections, and nutritional deficiencies are implicated in causing HIVAC when HIV viral replication is unchecked, whereas cardiac autoimmunity, chronic inflammation, and ART cardiotoxicity contribute to HIVAC in individuals with suppressed viral loads. The initiation of ART has dramatically changed the clinical manifestation of HIVAC in high income countries from one of severe, left ventricular systolic dysfunction to a pattern of subclinical cardiac dysfunction characterized by abnormal diastolic function and strain. In low and middle income countries, however, HIVAC is the most common HIV-associated cardiovascular disease. Clear diagnostic and treatment guidelines for HIVAC are currently lacking but should be prioritized given the global burden of HIVAC.

A profile of human immunodeficiency virus seroconcordant/serodiscordant couples.

Heterosexual route is the most common mode of human immunodeficiency virus (HIV) transmission among married couples in India. The aim of the study was to determine HIV seroconcordance and serodiscordance among couples when one of the partners is HIV positive. A retrospective study which included HIV positive married cohabiting cases was carried out at the Department of Skin-VD, Medical College, Baroda. Detailed history of high-risk sexual behavior, blood transfusion (BT) and sexually transmitted infections (STIs) was taken. All the cases were examined for the presence of STIs and all males were examined for circumcision. The spouses of these cases were tested for HIV to know the seroconcordance/serodiscordance. A total of 66 HIV positive cases were studied which included 34 males and 32 females. Forty-five cases had seropositive spouses that consisted of 20 out of 34 HIV positive males and 25 out of 32 HIV positive females. History of STI was present in 13 cases. History of BT in one of the spouses was present in 15 of 45 seroconcordant couples while in 6 out of 21 serodiscordant couples. Among 34 HIV positive males, circumcision was present in 8 cases out of which 6 were serodiscordant. About 68% concordance suggests continued intramarital transmission probably due to lack of spousal communication and late testing. In cases having transfusion transmitted HIV, seroconcordance rate was found to be high. Such cases are usually asymptomatic and hence tested late but continue to transmit HIV by unprotected sexual activity.

Evolving molecular epidemiological profile of human immunodeficiency virus 1 in the southwest border of China.

BackgroundWe have previously reported in Xishuangbanna (Banna) Dai Autonomous Prefecture, a well-developed tourist destination in the southwest border of China, that HIV-1 transmitted dominantly through heterosexual contact with less divergent genotypes and few drug resistant mutations [1]. Due to the rapid increase of newly diagnosed HIV-1 cases per year in Banna in recent years, it’s important to evaluate the evolution of HIV-1 molecular epidemiology for the better understanding of ongoing HIV-1 outbreak in this region.Methodology/Principal FindingsBy sequencing of HIV-1 pol genes and phylogenetic analysis, we conducted a molecular epidemiologic study in 352 HIV-1-seropositive highly active antiretroviral treatment (HAART)-naïve individuals newly diagnosed at the Banna Center for Disease Control and Prevention between 2009 and 2011. Of 283 samples (84.1% taken from heterosexually acquired adults, 10.6% from needle-sharing drug users, 2.8% from men who have sex with men, 0.4% from children born from HIV-1-infected mothers, and 2.1% remained unknown) with successful sequencing for pol gene, we identified 108 (38.2%) HIV-1 subtype CRF08_BC, 101 (35.7%) CRF01_AE, 49 (17.3%) CRF07_BC, 5 (1.8%) C/CRF57_BC, 3 (1.1%) B’, 1 (0.4%) B/CRF51_01B, and 16 (5.7%) unique recombinants forms. Among these infected individuals, 104 (36.7%) cases showed drug resistant or resistance-relevant mutations, and 4 of them conferring high-level resistance to 3TC/FTC, EFV/NVP or NFV. Phylogenetic analysis revealed 21 clusters (2–7 sequences) with only 21.2% (60/283) sequences involved.Conclusion/SignificanceIn contrast to our previous findings, CRF08_BC, replaced CRF01_AE, became the dominant genotype of HIV-1 in Banna prefecture. The viral strains with drug resistance mutations were detected frequently in newly diagnosed HIV-1-infected individuals in this region.

Association of Hematological Profile of Human Immunodeficiency Virus-Positive Patients with Clinicoimmunologic Stages of the Disease

Aim:This work was carried out to study the hematologic profile of human immunodeficiency virus (HIV)-positive patients and its association with the clinicoimmunologic stage of the disease.Materials and Methods:A total of 187 patients with HIV, whether symptomatic or asymptomatic, diagnosed by enzyme-linked immunosorbent assay (ELISA) method according to the National AIDS Control Organization (NACO) guidelines were included in this study. Patients in the study population were divided into two groups: (1) Group A (antiretroviral therapy (ART) included patients receiving ART [ART-Y]) and (2) Group B included treatment naïve patients (ART-N). The patients were tested for hemoglobin (Hb), total red blood cells (RBC) count, RBC indices, reticulocyte count, packed cell volume (PCV), total lymphocyte counts(TLC), differential leukocyte counts (DLC), platelet count, and erythrocyte sedimentation rate (ESR). Cut-off values were determined as Hb < 10 g/dl, platelet count < 1.5 lakh/cumm, and TLC < 4,000/cumm. The group or categorical data were tested for statistical significance using Chi-square test and Z-test. The difference was reported as significant if P < 0.05.Results:(1) Anemia (predominantly normocytic normochromic) was prevalent in 40.1%, with slightly higher prevalence in those not receiving ART. It occurred with high frequency in patients with immunological (42.05%) and clinical acquired immunodeficiency disease syndrome (AIDS) (70.58%) compared with those who had an asymptomatic HIV infection with CD4 > 200/μl (28.57%). Patients on zidovudine (AZT) therapy had 34.6% anemia with increased mean corpuscular volume (MCV). (2) Thrombocytopenia was seen in 3.74% patients (higher percentage in untreated patients). (3) Leucopenia was observed in 5.88% in ART-Y (Group A) and 8.14% in ART-N (Group B) patients. (4) Pancytopenia was found in 1.6% patients.

Antiretroviral therapy-associated dyslipidemia in patients from a reference center in Brazil

The aim of this study was to determine the impact of antiretroviral therapy on the lipid profile of human immunodeficiency virus (HIV) patients before and after the initiation of highly active antiretroviral therapy (HAART). This was a cross-sectional analysis of patients receiving HAART at a reference center in Belo Horizonte, Brazil, on the basis of medical records from 2002 to 2006. Patients were included if they had at least one lipid test or a clinical or laboratory diagnosis of dyslipidemia/lipodystrophy. Among the 692 patients, 620 met the eligibility criteria. The majority were males (66.5%), middle age (average 39 years), had a low educational level (60.4%), and low income (51.0%). HAART duration ranged from 11 days to 4.6 years, with a mean of 28.6 months (SD = ± 470.19 days). The prevalence of dyslipidemia/lipodystrophy nearly tripled (11.3% pre- and 32.4% post-HAART). Dyslipidemia was associated with older age (P = 0.007), nucleoside reverse transcriptase inhibitor (NRTI) + protease inhibitor (PI) regimens (P = 0.04), NRTI + non-NRTI (NNRTI) regimens (P = 0.026), the use of stavudine (d4T) in any regimen (P = 0.002) or in NRTI-based regimens (P = 0.006), and longer exposure to HAART (P < 0.000). In addition, there was no correlation between dyslipidemia and gender (P = 0.084). Only 2.0% of the patients received treatment for dyslipidemia during the trial. These results show a need for continuous monitoring of patients under antiretroviral therapy, particularly those using NRTI-based regimens, especially when combined with d4T and PIs. Secondly, interventions should be developed to correct metabolic changes.

A Comparison of the Relative Risks of Substance Abuse, Mental Health Conditions, and HIV Opportunistic Infections on Survival Between HIV Positive U.S. Born Hispanics and Foreign-Born Hispanics in Houston, Texas 1990 – 2001

To examine the behavioral risk factors and survival profile of human immunodeficiency virus (HIV) infection of U.S. born Hispanics in comparison to Foreign-born Hispanics with respect to basic demographic characteristics in Houston, and factors associated with early mortality. We analyzed from the Adult and Adolescent Spectrum HIV Diseases Project (1990–2001) of a cohort of 876 patients of Hispanic origin. Incidence densities were calculated using first episode of mental health conditions and opportunistic diseases, and were expressed as incidence rate per 100 person-years. Patients who developed one condition were still considered at risk for other conditions. The statistical analysis was performed using Multivariate, Kaplan-Meier, Log Rank test, and Cox proportional regression analysis. There was significantly increased relative risks of substance abuse and mental health conditions among U.S. born Hispanics compared to Foreign-born Hispanics: substance abuse (RR=2.0, 95% [CI]:1.8–2.2); mental health conditions (RR=1.4, 95% [CI]:1.3–1.5). By Kaplan Meier analysis early death was associated with U.S. Born Hispanics (log rank test p = .0015). A Cox proportional regression analysis, in which gender, age, and social risk factors were introduced as controls, drug/alcohol abuse were shown to be predictors to a less favorable survival experience (Hazard Ratio [HR] = 1.3, 95% [CI] : 1.1 – 1.6). The findings of this study lend support to other investigations which have suggested that factors such as acculturation, coupled with a loss of support systems, may explain a negative survival outcome for U.S. born Hispanics in comparison to those that are foreign-born.