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Despite availability of effective antiretroviral therapy (ART), many HIV patients still have a detectable viral load (VL). Predictive factors of detectable VL are not well documented. This study was done at two large multidisciplinary HIV outpatient clinics at the Centre hospitalier de l'Université de Montréal (CHUM) and the McGill University Health Centre (MUHC). This is a retrospective case-control study of patients treated between 2016 and 2018. Cases had a VL ≥50 copies/mL in 2018. Controls had an undetectable VL from 2016 to 2018. Matching was based on gender and year of HIV diagnosis. Primary objective was to identify predictive factors of detectable VL. Secondary objectives included to identify predictive factors of virologic failure, low persistent viremia, and viral blip. A forward stepwise model selection by the Akaike Information Criterion of the conditional logistic regression was used to identify predictive factors. Two hundred cases were identified and matched with 200 controls. The cohort was mostly male (68.0%) with a median age of 54 years (21-83 years). Among cases, viral blip was the most common type of detectable VL (43.0%). The strong predictive factors for a detectable VL were adherence to ART and seeking health care services. Asylum seekers were less at risk of detectable VL. Adherence to ART was the only strong predictive factor for virologic failure. Three main predictive factors of detectable VL were identified in two ambulatory clinic hospitals in Montreal. Ascertaining these factors will allow for identification of patients more at risk of detectable VL.

Introduction: Patients living with HIV/AIDS (PLWHA) have more unmet oral health care needs than the general population, outpacing unmet medical needs [1]. Poor oral health can impact a person’s confidence and ability to speak, eat, work, sleep, and socialize [2]. Lack of access to dental care is a national issue for HIV patients; providing access is a challenge faced by many health centers and practices, including Zufall Health in New Jersey, a federally qualified health center (FQHC). In collaboration with Northeast/Caribbean AIDS Education and Training Center (NECA AETC), Zufall embarked on an initiative to improve access to quality dental care for PLWHA. AETC is the training component of the Ryan White Program, a federally funded program that provides medical care, support services, and medications for PLWHA who are low income, uninsured, or underserved [3-5]. Materials and Methods: In 2019, Zufall Health launched a quality improvement project to increase oral health access and services for Ryan White patients by integrating all partners involved in providing health care: medical, dental, psychological, behavioral, and HIV/AIDS providers and case managers. The project goal was to increase the number of patients receiving dental care to improve oral and overall health. Results/Observations: As a result of the project, there were significant quantitative and qualitative improvements in the oral health and quality of life of PLWHA: more dental encounters, a higher percentage of patients with a dental home, and the surpassing of the project goal of a 10% increase in dental referrals.

Fekade Demeke Bayou,1 Shambel Nigussie Amare2 1Department of Epidemiology, College of Medicine and Health Sciences, Jigjiga University, Jigjiga, Ethiopia; 2Department of Clinical Pharmacy, School of pharmacy, College of Health and Medical Science, Haramaya University, Harar, EthiopiaCorrespondence: Fekade Demeke Bayou Email fekadedemeke12@gmail.comObjective: To determine the time to immunologic recovery and its determinant factors among adult HIV patients who initiated antiretroviral treatment at Hiwot Fana Specialized University Hospital from February, 2018 to January, 2020.Methods: A facility-based retrospective cohort study was conducted among 301 adult HIV patients who initiated antiretroviral treatment from February, 2018 to January, 2020. Five trained nurses collected the data using data abstraction checklists. The collected data were entered into the computer using EpiData version 3.1 and then exported to Statistical Package for Social Sciences (SPSS) version 25. The median survival time to immunologic recovery was described using Kaplan–Meier (KM) estimator. Cox proportional hazards regression model was used to identify the potential determinant factors of the time to immunologic recovery. An adjusted hazard ratio (AHR) with its 95% confidence interval (CI) and p-values < 0.05 were used to determine the strength and significance of associations between variables.Results: In this study, the overall median time required to reach normal CD4 count was 11 months [95% CI = (9.50, 12.51)]. Baseline functional status, ambulatory [AHR=1.383, 95% CI (1.05, 1.83)], bedridden [AHR=1.712 (1.11, 2.64)], first-line treatment classes (TDF/3TC/DTG) [AHR= 1.63, 95% CI (1.21, 2.18)], and baseline CD4 count > 350 cells/mm3 [AHR=1.65, 95% CI (1.11, 2.45)] were significantly associated with the time to immunologic recovery.Conclusion: The median time to immunologic recovery was relatively shorter. Baseline functional status (ambulatory and bedridden), baseline CD4 count, and first-line treatment class were significant predictors of time to immunologic recovery. HIV patients with working functional status should be given the necessary attention. Utilization of dolutegravir-based regimens should be encouraged to attain a normal CD4 count earlier.Keywords: time to immunologic recovery, CD4 count, Harer, Ethiopia

Background Progressive decline of immune response in HIV patients makes them susceptible to frequent bacterial infections. High usage of antibiotics influences the emergence of multidrug-resistant bacteria and worsens the clinical outcomes. In this study, the occurrence of drug-resistant genes in Gram-negative bacterial isolates from HIV patients in South India was analyzed. Methods A total of 173 Gram-negative bacterial (GNB) isolates from HIV patients were screened for antibiotic susceptibility profile using the Kirby-Bauer diskdiffusion method. Positivity of drug-resistant genes was analyzed using polymerase chain reaction method. Results In this study, 72.8% of bacterial isolates were obtained from urine specimens, and Escherichia coli (47.4%) was the predominantly isolated bacterium. Overall, 87.3% and 83.2% of GNB were resistant to 3rd generation cephalosporin antibiotics such as cefotaxime and ceftazidime, respectively, 56.6% were resistant to cephamycin (cefoxitin) and 43% to carbapenem (imipenem) antibiotics. Extended-spectrum β-lactamases (ESBL) production was noted among 79.5% of GNB isolates, followed by AmpC (57.1%) and Metallo β-lactamases (37.3%). Molecular analysis revealed that ESBL genes such as blaTEM (94.1%), blaCTX-M (89.2%), and blaSHV (24.2%) were detected at higher levels among GNB isolates. Carbapenemase-producing genes such as blaOXA-48 (20%), blaOXA-23 (2.6%), and both blaOXA-23 and blaOXA-51 like genes (2.6%) and AmpC producing genes such as blaCIT (26.7%), blaDHA (3.6%), and blaACC (1.8%) were detected at low-level. Conclusions This study concludes that ESBL producing genes are detected at high level among gram-negative bacterial isolates from HIV patients in South India.

BackgroundUndiagnosed HIV-1 patients still account for 25% of worldwide HIV patients. Studying late presenters for HIV care may help to identify characteristics of such patients.ObjectiveThe present study aims to identify factors associated with late presentation (LP) and late presentation with advanced disease (LPAD) based on a population of patients followed in a Portuguese hospital between 1984 and 2017.MethodsSociodemographic and clinical data from infected patients with HIV-1 aged 18 years and older, followed in Egas Moniz Hospital, in Portugal were collected.ResultsOf the 907 patients included in this study, 68.7% were males and the median age was 37 years (IQR 30-47). 459 patients (50.6%) were LP and, of these, 284 patients (61.9%) were LPAD. The LP population mostly originated from Portugal and Sub-Saharan Africa (64.4% and 28.8%; p=0.004) and the HIV exposure category mainly heterosexuals and MSM (57.0% and 24.9%; ppp=0.002) and origin from Sub-Saharan Africa (aOR 2.24; 1.44-3.50; pConclusionLate presentation is a major obstacle to halt the HIV epidemic. In this population, the majority of newly diagnosed HIV-infected individuals were late presenters. Our results characterize vulnerable populations that should be frequently tested for HIV.

Background/aim: People with HIV are often reported to experience poor sleep quality. Factors that can cause poor sleep quality in HIV patients, including the use of ARV therapy. The pathophysiology of poor sleep quality in HIV patients is still unclear. Poor sleep quality is one of the complaints in the late stages of HIV infection, where it is suspected that HIV itself affects the biological center of sleep. This study was aimed to determine the comparison of sleep quality in HIV patients pre-HAART and with HAART more than 1 year. Method: This study uses data collection methods in the form of interviews with samples which will later be presented in the form of analytical observational study. Consecutive data collection on HIV patients before and after ARV therapy who was outpatient at the VCT outpatient clinic Dr. Soetomo General Hospital from June-July 2021. Data analysis using SPSS Version 23 for windows. Results: A total of 40 subjects were divided into HIV pre-HAART and on HAART. From the statistical analysis using SPSS program significant with p= 0.004 (OR 15.5 (95% CI (1.73-139.6)) Conclusion: HIV patients on HAART for more than 1 year are known to have increased 15.5 times the risk of poor sleep quality. Keywords: HIV, HAART, sleep quality.

Purpose Breast cancer outcomes in sub-Saharan Africa is reported to be poor, with an estimated five-year survival of 50% when compared to almost 90% in high-income countries. Although several studies have looked at the effect of HIV in breast cancer survival, the effect of ARTs has not been well elucidated. Methods All females newly diagnosed with invasive breast cancer from May 2015–September 2017 at Charlotte Maxeke Johannesburg Academic and Chris Hani Baragwanath Academic Hospital were enrolled. We analysed overall survival and disease-free survival, comparing HIV positive and negative patients. Kaplan-Meier survival curves were generated with p-values calculated using a log-rank test of equality while hazard ratios and their 95% confidence intervals (CIs) were estimated using Cox regression models. Results Of 1019 patients enrolled, 22% were HIV positive. The overall survival (95% CI) was 53.5% (50.1–56.7%) with a disease-free survival of 55.8% (52.1–59.3) after 4 years of follow up. HIV infection was associated with worse overall survival (HR (95% CI): 1.50 (1.22–1.85), p, Highlights • 22% of participants were HIV positive. • The 4 years overall survival was 53.5%. • The 4 years disease-free survival was 55.8%. • HIV infection was associated with poor overall and disease-free survival. • ART use was associated with better overall and disease-free survival.

Objective Systematic review and meta-analysis of lipid outcomes for human immunodeficiency virus (HIV)-positive or HIV-infected patients treated with ezetimibe. Methods We conducted a literature search from 1946 to 2021 for trials studying the effectiveness of ezetimibe in hyperlipidaemic HIV patients. We included trials of all designs in which HIV patients on highly active antiretroviral therapy (HAART)/non-nucleoside reverse transcriptase inhibitor (NNRTI) therapy had hyperlipidaemia, were treated with ezetimibe, and reported lipid outcomes. Results Of thirteen eligible trials, five were randomized controlled trials (RCTs) and eight were single-arm trials. Two of the eligible RCTs were placebo-controlled; we performed a meta-analysis across those two trials for low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglyceride (TG). LDL-C was significantly lower in the ezetimibe arm (net change: -23.56 mg/dL, 95% CI: -40.22, -6.90 mg/dL). We then performed meta-analysis of the single-arm trials examining lipid outcomes after ezetimibe treatment which, like in the RCTs, revealed significant reductions of LDL-C (-23.89 mg/dL, 95% CI -29.94 to -17.83 mg/dL). In addition, significant reductions were seen for total cholesterol (TC) (-26.17 mg/dL, 95% CI -32.81 to -19.54 mg/dL) and TG (-18.57 mg/dL, 95% CI -34.01 to -3.14 mg/dL) but HDL-C did not show a change. Conclusions Evidence for LDL-C reduction is limited in RCTs; single-arm trial LDL-C reductions are consistent with the RCTs. In addition, significant reductions in TC and TG were also seen in the meta-analysis of the single arm trials. The single-arm trials' meta-analysis corroborates evidence from RCTs to suggest that ezetimibe can be an option for hyperlipidaemia among HIV patients with mildly elevated TC and LDL-C levels, especially in cases where statins are contra-indicated due to drug-drug interactions with concomitant anti-retroviral therapy.

Background: Hepatitis C virus (HCV) a major human pathogen infecting millions of individuals worldwide, thereby in- creasing the risks for chronic liver diseases and has been discovered that HIV/HCV co-infected patients have a greater risk. Objective: To determine the prevalence of HCV infection among HIV infected people in Port Harcourt, Rivers State. Methodology: The patients were from the ages of 18 and above attending the antiretroviral clinic for over 6 months. The mean age of the participants was 36.91±8.38. Data were gotten from the 550 patients using a modified questionnaire and 5mls of blood samples were collected through venepuncture into EDTA bottles and spun at 3000rpm for 10 minutes sepa- rating the plasma from the whole blood. The CD4+ count was gotten from the patients’ file and the samples kept at -700C till analized. HCV antibody was detected using a commercially available third generation kit manufactured by Melsin Medical Co and statistical analysis was done using a Stata version 16. P value was determined using ANOVA. Result: Total number positive to the HCV antibody was 24(4.4%) of which 8(33.3%) were males, while 16(66.7%) were females. Prevalence (29.2%) was among patients in the 31–35 age range. The CD4+ count ranged from 22-864 cells/µl with a mean value of 303.08±194. Conclusion: From this study HIV/HCV co-infection occurs among HIV infected people in Port Harcourt. The CD4+ count was discovered to be low and was not age, nor gender dependent. HIV infected people should therefore be routinely screened for HCV. Keywords: Serology; HCV; HIV; CD4+ Count.

Aim: To evaluate the levels of CD4+ and CD8+ T-cells, viral load, and some immunomodulatory trace elements in ART and ART-naïve HIV patients in Port-Harcourt, Nigeria. Methodology: A total of 150 subjects (males and females) between the ages of 20 and 79 were recruited for the study, out of which 50 subjects were apparently healthy (those who tested negative for HIV), and were used as the control group, while the remaining 100 subjects were those who tested positive for HIV, and were used as the test group; out of this 100 subjects, 70 subjects were on anti-retroviral therapy (ART), while the remaining 30 subjects were not on anti-retroviral therapy (ART naïve). About 13 mls of venous blood was collected from the antecubital fossa of each subject. 3mls was dispensed into an EDTA-anticoagulant bottle, and used for the estimation of CD4+ and CD8+ counts using a BD fluorescent activated cell sorter count (FACSC count) automation. Also, 5mls of the venous blood was dispensed into another EDTA-anticoagulated bottle; it was spun to obtain the plasma which was used to analyze the viral load using real time polymerase chain reaction (RT-PCR) COBAS TaqMan 48 Analyzer. Then, another 5 mls of the venous blood was dispensed into lithium heparin bottle; it was spun to obtain the plasma, which was used for the analysis of copper, iron, zinc and magnesium by colorimetric method using semi auto-analyzer WP 21E, and selenium using atomic absorption spectrophotometer with graphite furnace technique SN-SG 710690. Results: The results showed that there was no significant difference (p>0.05) in the mean levels of CD8+ T-cell, iron and magnesium between the HIV-positive subjects (ART HIV-positive and ART-naïve HIV-positive) and the control. However, the mean levels of CD4+ T-cell and plasma copper were significantly lower (p

HIV infected patients on Antiretroviral Therapy (ART) are exposed to various immunological disorders. Immune reconstitution is one of the most challenging problem linked to morbidity and mortality in HIV patients. This study aimed at evaluating the kinetics of CD4+ T-cell recovery amongst HIV load suppressed patients on first-line ART in Yaoundé, Cameroon. This was a retrospective cohort study performed at the care and treatment units of the Yaoundé University Teaching Hospital and Essos Hospital Center, with viral suppressed patients initiated on ART between March and July 2015. Data were collected using a standard form and analyzed using R.3.6.2 software. A p

Aim:Syphilis coinfection is common among human immune deficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) diagnosed patients. We aimed to investigate the rates of syphilis coinfection, social-demographical features, viral and immunological properties among naive HIV/AIDS patients.Methods:Socio-demographical data, CD4+ T lymphocyte counts, HIV viral load, syphilis antibody results and physical examinations at the time of diagnosis of naive HIV infected patients who were admitted to our center between January 2017 and January 2021, were evaluated retrospectively from the medical records.Results:Three hundred-two naive HIV patients were enrolled in the study. Positive syphilis antibody rate was detected as 21.5% and 86.2% of those patients were male and also found 31.4% (p

Gender differences affect the frequency and course of many diseases. This study aimed to determine the gender distribution in HIV-infected patients and investigate the relationship between gender and immune response. The study included HIV-infected patients who followed up in our hospital in 2018. The patients were divided into HIV RNA negative patients (Group 1) and HIV RNA positive patients (Group 2). Patients with diseases that may affect the immune system and those using drugs that affect the immune system were excluded from the study. The evaluation was made of 549 patients, as 305 patients (45 females 14.75%) in Group 1 and 224 patients (23 females, 9.43%) in Group 2. When the CD4/CD8 ratio of male and female patients was compared in both groups, a lower rate was determined in females (0.71-0.58) than males (0.82-0.93). A negative correlation was determined between HIV RNA and the CD4/CD8 ratio in premenopausal females (p=0.045) and males (≤45 years p=0.0001). Clinical studies of HIV infection have demonstrated better initial viremia control in females with primary infection, faster disease progression, and stronger immune activation than males for the same level of viral replication.

Early treatment of HIV infection depends on timely diagnosis, but many persons living with HIV/AIDS (PLWHA) are unaware of their infection. Though many patients seeking medical attention for sexually transmitted diseases have HIV, many patients’ HIV co-infection is undiagnosed in Japan. This is the first report to analyze the timing of syphilis infection in PLWHA of all ages through the use of the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB), containing clinical data of the largest group of HIV-positive patients available in Japan. Overall, 1521 PLWHA (male 93.2%) newly diagnosed and started on antiretroviral therapy were identified in 2016, and 646 (42.5%) patients had a diagnosis of syphilis between 2011 and 2018. Although 100 patients were diagnosed with syphilis before their HIV diagnosis, only 17 (17.0%) had been tested for HIV. Over 50 patients per year became infected with syphilis even after their HIV diagnosis (2017, n = 65 (4.3%); 2018, n = 58 (3.8%)). Although early diagnosis of HIV infection is important, most syphilis patients in Japan had not been properly tested for HIV infection. Since a certain number of HIV patients developed syphilis after HIV diagnosis, education for newly diagnosed HIV patients is important.

espanolAntecedentes. Muchos estudios han indicado que la hospitalizacion y los reingresos ocurren con frecuencia, especialmente entre las personas que viven con el VIH. El objetivo del estudio fue determinar la efectividad de una intervencion farmaceutica programada y estructurada, basada en el “modelo CMO” para reducir la tasa de reingreso en pacientes con VIH de alto riesgo. Material y metodos. Se trata de un estudio prospectivo, unicentrico, basado en una intervencion sanitaria estructurada realizada entre marzo de 2017 y marzo de 2018 con 12 meses de seguimiento en servicios de farmacia ambulatoria. Al alta, los pacientes con VIH incluidos se clasificaron segun el riesgo de reingreso como pacientes de bajo o alto riesgo, siendo estos ultimos propuestos para participar. Los pacientes seleccionados fueron asignados aleatoriamente a un grupo control (atencion habitual) o grupo de intervencion (incluida la entrevista de estratificacion-motivacion y nuevas tecnologias: atencion farmaceutica CMO). El criterio de valoracion principal fue la tasa de reingreso al ano de seguimiento en cada grupo. Resultados. Se incluyeron un total de 39 pacientes. En cuanto a la variable principal, en el grupo de intervencion el 21,4% (n = 3) de los pacientes reingresaron en el primer ano tras el alta frente al 66,7% (n = 6) del grupo control (p = 0,042). Conclusion. La atencion farmaceutica personalizada basada en la estratificacion del riesgo, la entrevista motivacional y las nuevas tecnologias tiene una influencia positiva para reducir el porcentaje de readmision en pacientes con VIH de alto riesgo. EnglishBackground. Many studies have indicated that hospitalization and readmissions occur frequently, especially among people living with HIV. The aim of the study was to determine the effectiveness of a programmed and structured pharmaceutical intervention, based on “CMO PC model” to reduce the readmission rate in high-risk HIV patients. Material and methods. This was a single-center, prospective study based on a structured health intervention conducted between March-2017 and March-2018 with 12 months of follow-up at outpatient pharmacy services. At discharge, HIV patients included were classified according to the risk of readmission as low or high risk patients, being the latter proposed to participate. The selected patients were randomly assigned to a control group (usual care) or intervention group (including stratification-motivational interview and new technologies: CMO pharmaceutical care). The primary endpoint was readmission rate at one year of follow-up in each group. Results. A total of 39 patients were included. As regards the main variable, in the intervention group, 21,4% (n=3) of patients were readmitted in the first year after discharge vs. 66,7% (n=6) in the control group (p=0,042). Conclusions. Tailored pharmaceutical care based on risk stratification, motivational interviewing, and new technologies has a positive influence to reduce the percentage of readmission in high risk HIV patients.

Objectives: Human immunodeficiency virus (HIV) infection and neurological illness cause heavy financial burden to the patients. The economic costs of each of the disease have been reported in many studies, but the toll of both together on the patients has not been studied clearly. As neurological illnesses are seen in up to one-third of HIV patients, the combined costs need to be understood. Even with free public health services, there are out of pocket expenditures on the patients. Material and Methods: In the tertiary Government General Hospital, Guntur in India, we studied the out-of-pocket costs of time and money borne by 50 HIV-seropositive individuals hospitalized for a neurological illness during April and May 2019. We obtained data from the patients and caregivers by face-to-face oral questionnaires. Results: The median duration of HIV infection was 2.5 (IQR 0.4–7.8) years. A high proportion of our patients (20/50) was diagnosed with tuberculous meningitis. The total median time lost by each HIV-seropositive patient due to neurological illness (private consultation, travel, and hospital stay) was 27.5 (8.7–134.3) days. The total median financial burden due to neurological disease requiring hospitalization (travel, food and medicine, wages lost, private consultation expense, and loans incurred) on each patient was ₹19,150 (855–59881). Conclusion: HIV patients with neurological illness are burdened by heavy costs of time and money. They are forced into debt and lose substantial wages, most of it due to private consultation.

Resumen: Introducción: La infección por VIH era el principal factor de riesgo para presentar neumonía por Pneumocystis jirovecii (NPJ). En la actualidad, las características clínico-epidemiológicas de la NPJ en niños han cambiado, existiendo pocos estudios en este sentido. Métodos: Realizamos un estudio observacional retrospectivo en pacientes pediátricos diagnosticados de NPJ durante 17 años en un hospital de tercer nivel en España. Resultados: Se recogió a 23 pacientes, de los que 11/23 (47,8%) presentaban enfermedad hematológica, 5/23 (21,7%) inmunodeficiencia primaria y 4/23 (17,4%) infección por VIH. Recibían profilaxis con trimetoprima-sulfametoxazol (TMP-SMX) 11/23 pacientes (47,8%). Todos recibieron tratamiento con TMP-SMX y 18/23 (78,3%), glucocorticoides sistémicos. Fallecieron 6/23 pacientes (26,1%), de los que 1/6 (16,7%) presentaba infección por VIH. En los pacientes no VIH con mayor leucocitosis, mayor retención de CO2 y mayor frecuencia cardíaca al inicio, se evidenció mayor mortalidad, diferencias no objetivadas en pacientes con VIH. No se encontraron diferencias en mortalidad en relación con el factor predisponente, empleo de TMP-SMX ni tratamiento con glucocorticoides. Conclusiones: En la actualidad, los pacientes pediátricos con neoplasias hematológicas constituyen el principal grupo de riesgo de desarrollar NPJ en este grupo etario. No hemos encontrado diferencias de mortalidad entre pacientes con o sin infección por VIH como factor predisponente. Entre los pacientes no VIH la mortalidad fue mayor en aquellos que presentaron mayor leucocitosis, mayor retención de CO2 y mayor frecuencia cardíaca al inicio. No se objetivó mejor pronóstico en pacientes que recibían profilaxis con TMP-SMX previamente al desarrollo de la NPJ ni en los que recibieron glucocorticoides sistémicos como parte del tratamiento. Abstract: Introduction: HIV infection was the main risk of suffering Pneumocystis jirovecii pneumonia (PJP). The clinical-epidemiological characteristics of PJP have currently changed, with there being few studies on this. Methods: A retrospective observational study was carried out on paediatric patients diagnosed with PJP over a 17 year period in a third level hospital in Spain. Results: A total of 23 patients were included, of whom 7/23 (47.8%) suffered a haematological disease, 5/23 (21.7%) a primary immunodeficiency, and 4/23 (17.4%) an HIV infection. Prophylaxis with trimethoprim-sulfamethoxazole (TMP-SMX) was received by 11/23 (47.8%) patients. All were treated with TMP-SMX and 18/23 (78.3%) with systemic glucocorticoids. There were 6 (26.1%) deaths, of which one of them (16.7%) suffered an HIV infection. A higher mortality was seen in the non-HIV patients with greater leucocytosis, greater CO2 retention, and a higher heart rate at onset, differences not observed in HIV patients. No differences were found in mortality in relation to the predisposing factor, use of pTMP-SMX, or treatment with glucocorticoids. Conclusions: Paediatric patients with haematological cancers are currently the main risk group of developing PJP in this age group. No differences were found in mortality between patients with or without HIV infection as predisposing factor. The mortality among non-HIV patients was higher in those that had greater leucocytosis, greater CO2 retention, and increased heart rate at onset. A better prognosis was not seen in patients that received prophylaxis with TMP-SMX prior to the development of the PJP, or in those that received glucocorticoids as part of the treatment.

Acquired immunodeficiency syndrome (AIDS) is one of the greatest public health and social problems threatening the human race. The trend of annual AIDS deaths is showing a steady decline since the implementation of the free Anti-Retroviral Therapy (ART) program in India (2004). HIV infection is characterized by replication of virus by abnormal non specific immune activation and persistent inflammation. Adenosine deaminase (ADA) has a cytokine-like co-stimulatory role in T cell proliferation which is independent of catalytic activity. Therefore, we decided to study the role of ADA as an indicator of immune status in HIV patients treated with combination antiretroviral therapy (cART). Adenosine deaminase activity (ADA) in HIV patients was estimated before and after 3 months interval of antiretroviral therapy (ART) up to 9 months. The study included 150 HIV positive patients between age group of 20-50 years from ICTC (Integrated Counseling and Testing Centre) and ART centre. Venous blood samples were collected in plain bulb to estimate serum ADA activity before and after 3 months interval upto 9 months of ART. Serum ADA activity was estimated using colorimetric method of Giusti and Galanti. Activity of serum ADA was significantly raised before and after 3 months interval of ART with decrease in CD4 cell count. After 6 months, increased ADA activity started declining and comes to near normal after 9 months of ART (p

El objetivo del estudio fue describir las características demográficas, clínicas y terapéuticas de pacientes con VIH-SIDA que desarrollaron algún tipo de cáncer. Se identificaron 276 casos de cáncer diagnosticados en el Hospital Nacional Cayetano Heredia entre el 2000 y 2018. El 80,8% (223/276) correspondieron a neoplasias definitorias de sida (NDS), siendo el más frecuente el sarcoma de Kaposi; mientras que, entre las neoplasias no definitorias de sida (NNDS), el más frecuente fue el linfoma de Hodgkin. La mediana de edad fue 36,5 años, siendo más alta entre los casos diagnosticados de NNDS. Con respecto al nivel de linfocitos CD4 al diagnóstico de cáncer, la mediana entre las NDS fue mucho menor que las NNDS, 87,5 células/μL y 216 células/μL, respectivamente. Por tanto, las NNDS tuvieron una historia más larga de infección por VIH, y una edad más avanzada al diagnóstico de cáncer, así como niveles de células CD4 más altos.

Thanks to advances in the field over the years, HIV/AIDS has now become a manageable chronic condition. Nevertheless, a new set of HIV-associated complications has emerged, related in part to the accelerated ageing observed in people living with HIV/AIDS, the cumulative toxicities from exposure to antiretroviral drugs over decades and emerging comorbidities. As a result, HIV/AIDS can still have a negative impact on patients’ quality of life (QoL). In this scenario, it is reasonable to believe that the concept of therapeutic success, traditionally associated with CD4 cell count restoration and HIV RNA plasma viral load suppression and the absence of drug resistances, needs to be redefined to include other factors that reach beyond antiretroviral efficacy. With this in mind, a group of experts initiated and coordinated the RET Project, and this group, using the available evidence and their clinical experience in the field, has proposed new criteria to redefine treatment success in HIV, arranged into five main concepts: rapid initiation, efficacy, simplicity, safety, and QoL. An extensive review of the literature was performed for each category, and results were discussed by a total of 32 clinicians with experience in HIV/AIDS (4 coordinators + 28 additional experts). This article summarizes the conclusions of these experts and presents the most updated overview on the five topics, along with a discussion of the experts’ main concerns, conclusions and/or recommendations on the most controversial issues.

Asymptomatic leishmaniasis cases have continuously increased, especially among patients with HIV who are at risk to develop further symptoms of cutaneous and visceral leishmaniasis. Thus, early diagnosis using a simple, sensitive and reliable diagnostic assay is important because populations at risk mostly reside in rural communities where laboratory equipment is limited. In this study, the highly sensitive and selective determination of Leishmania infection in asymptomatic HIV patients was achieved using dual indicators (SYBR safe and gold-nanoparticle probe; AuNP-probe) in one-step LAMP method based on basic instruments. The assay can be simply evaluated under the naked eye due to clear interpretation of fluorescent emission of LAMP-SYBR safe dye-complex and colorimetric precipitate of specific AuNP-probes. The sensitivities and specificities of fluorescent SYBR safe dye and AuNP-probe indicators were equal, which were as high as 94.1 and 97.1%, respectively. Additionally, detection limits were 102 parasites/mL (0.0147 ng/µL), ten times more sensitivity than other related studies. To empower leishmaniasis surveillance, this inexpensive one-step SYBR safe and AuNP-LAMP assay is reliably fast and simple for field diagnostics to point-of-care settings, which can be set up in all levels of health care facilities including resource limited areas, especially in low to middle income countries.

HIV has been introduced as a causative agent for AIDS which is still considered as a major health problem for the country and a burden on the health care system. Raising awareness and knowledge plays a critical role in controlling HIV infection in all social groups. Therefore, this study aimed to investigate the awareness and attitudes of factory workers regarding HIV/AIDS infection in Shiraz, Iran. This cross-sectional study was conducted on 92 factory workers in Shiraz, selected via the random sampling technique. A standard researcher-made questionnaire was used to collect data. Around 84% of participants were male and 65.2% had 30 years of age or more. The majority of responders considered shared syringe as the main transmission route in Iran. The awareness level of the general aspects of HIV infections and possible transmission modes were high. A large proportion of responders believed that patients should be supported by the governments and that they have the right to lead a normal life, meanwhile they were scared for their children having an infected classmate. It can be concluded that the public programs to increase awareness had a positive effect on factory workers' knowledge. However, some misconceptions toward HIV patients were identified that need to be corrected. In addition, further studies should be conducted in other cities to reach an accurate estimate of HIV/AIDS awareness among factory workers as a big part of our society.

The condition in which an individual is affected by TB and HIV/AIDS in his body is called a TB-HIV/AIDS coinfection. This research aims to minimize the populations of TB-HIV/AIDS coinfection with a minimum expenditure on medical expenses, that means minimizing the objective’s function ( ) or purpose function. In this research, modification of the model was carried out by adding the treatment population for HIV patients with ARV ( ). The population used was 11 classes with the use of three controls including treatment for individuals with latent TB ( ), active TB ( ), and HIV ( ). After performing numerical simulation using the forward backward fourth order Runge-Kutta, the results show that scenario 7 is the best scenario in controlling the spread of TB-HIV/AIDS coinfection because it resulted a minimum value of 1401,44. This means that providing the treatment for individuals with latent TB, active TB, and HIV in tandem can reduce the populations of TB-HIV/AIDS coinfection in the minimum treatment cost.

We aimed to identify “high-cost” patients with HIV (PWH) and determine drivers behind higher costs. All PWH at the Southern Alberta HIV Clinic, Canada, and active in 2017 were included. Sociodemographic, clinical, and healthcare utilization data were collected. The direct care costs from the payers’ perspective including antiretroviral drugs (ARV), outpatient visits, and hospital admissions were determined for 2017. Patients’ annual total costs were grouped into top 5% (i.e., high-cost), top 20%, middle 60%, and bottom 20%. High-cost patients were older, Caucasian or indigenous Canadian, and more likely acquired HIV from intravenous drug use (all p < 0.05). High-cost patients had lower nadir CD4, more comorbidities, missed more clinic appointments, had more ARV interruptions, and developed more ARV resistance ( p < 0.01). The overall median cost of HIV care was US$14,064 [IQR US$13,121–US$17,883] (2017 Cdn$). High-cost patients had a median cost of US$29,902 [IQR US$27,229–US$37,891] and accounted for 14% of total costs and 84% of all inpatient costs. Hospitalizations constituted 58% of costs for high-cost patients. Although heterogeneous, high-cost patients have distinct sociodemographic and clinical characteristics driving their healthcare utilization. Addressing these social determinants of health and using novel ARV administration approaches may preserve health and save costs.

OBJECTIVE The 'JumpstART' program in New York City (NYC) public Sexual Health Clinics (SHC) provides patients newly diagnosed with human immunodeficiency virus (HIV) with antiretroviral medication (ART) (1-month supply) on day of diagnosis and active linkage to HIV care (LTC). We examined viral suppression (VS) among patients who did and did not receive JumpstART services. DESIGN Retrospective cohort. METHODS Among newly diagnosed SHC patients (23 November 2016-30 September 2018) who were matched to the NYC HIV surveillance registry to obtain HIV laboratory test results through 30 June 2019, we compared 230 JumpstART and 73 non-JumpstART patients regarding timely LTC (≤30 days), probability of VS (viral load

Background Integrase inhibitors (INIs)-based antiretroviral therapies (ART) are more recommended than efavirenz (EFV)-based ART for people living with HIV/AIDS (PLWHA). Yet, the advantage of integrase inhibitors in treating TB/HIV coinfection is uncertain. Therefore, the objective of this systematic review is to evaluate the effects and safety of INIs- versus EFV-based ART in TB/HIV coinfection, and demonstrate the feasibility of the regimens. Methods Four electronic databases were systematically searched through September 2020. Fixed-effects models were used to calculate pooled effect size for all outcomes. The primary outcomes were virologic suppression and bacteriology suppression for INIs- versus EFV-based ART. Secondary outcomes included CD4+ cell counts change from baseline, adherence and safety. Results Three trials (including 672 TB/HIV patients) were eligible. ART combining INIs and EFV had similar effects for all outcomes, with none of the point estimates argued against the INIs-based ART on TB/HIV patients. Compared to EFV-based ART as the reference group, the RR was 0.94 (95% CI 0.85 to 1.05) for virologic suppression, 1.00 (95% CI 0.95 to 1.05) for bacteriology suppression, 0.98 (95% CI 0.95 to 1.01) for adherence. The mean difference in CD4+ cell counts increase between the two groups was 14.23 cells/μl (95% CI 0− 6.40 to 34.86). With regard to safety (adverse events, drug-related adverse events, discontinuation for drugs, grade 3–4 adverse events, IRIS (grade 3–4), and death), INIs-based regimen was broadly similar to EFV-based regimens. The analytical results in all sub-analyses of raltegravir- (RAL) and dolutegravir (DTG) -based ART were valid. Conclusion This meta-analysis demonstrates similar efficacy and safety of INIs-based ART compared with EFV-based ART. This finding supports INIs-based ART as a first-line treatment in TB/HIV patients. The conclusions presented here still await further validation owing to insufficient data.

Infections, including opportunistic infections, are a major and frequent cause of morbidity and mortality in patients with systemic autoimmune and rheumatic diseases. Pneumocystis jirovecii pneumonia, classically considered to be typical of HIV patients, transplanted patients or patients treated with oncological chemotherapy, is appearing increasingly frequently in these patients. Therefore, rheumatologists should know its mechanism of production, clinical manifestations, treatment and prophylaxis, all of which are addressed in this review.

Setegn Bayabil,1 Awoke Seyoum2 1Department of Statistics, Debre Tabor University, Debre Tabor, Ethiopia; 2Department of Statistics, Bahir Dar University, Bahir Dar, EthiopiaCorrespondence: Setegn Bayabil Email setegnbayabil@gmail.comBackground: Globally, for individuals infected with HIV, the presence of other infections including TB tends to increase the rate of HIV replication. Of the 8.8 million TB cases worldwide, an estimated 1.1 million (13%) were found to be co-infected with HIV. This research was conducted with the objective to identify potential predictors for the status of TB and CD4 cell count under PLWHIV at Felege Hiwot Specialized Hospital, North-west Ethiopia.Methods: A retrospective repeated measurement was taken from a sample of 226 HIV patients. Separate and joint models were conducted for data analysis of CD4 cell count and TB status of people living with HIV.Results: The descriptive statistics indicated that among the HIV patients receiving HAART, 26.6% had additional TB. AIDS clinical stage, weight, and hemoglobin level had a significant positive association with CD4 cell count, but a negative association with TB status. Weight and CD4 cell count have a negative relationship with the event of HIV/TB co-infection. Hence, the expected number of CD4 cell count of HIV patients who were co-infected with TB was decreased by 2.34 as compared to people living with HIV without TB. As visiting times of patients to hospitals for treatment increased by one unit, the odds of being co-infected with TB was decreased by 0.05, and the expected number of CD4 cell count was increased by 0.2. As patients’ age increased by one year, the expected number of CD4 cell count was decreased by 0.025 cells per/mm3.Conclusion: Having lower CD4 cell count, lower weight, late WHO clinical stage, being non-adherent, having opportunistic infection, having lower hemoglobin, being ambulatory and bedridden were associated with a higher risk of co-infection of HIV/TB and were indicators of progression of the disease.Keywords: CD4 cell, TB status, separate model, joint model, HAART

To describe a retrospective review of HIV patients with noninfectious uveitis. Data collected included: demographics, anatomic classification and phenotypic diagnosis of the uveitis, systemic immune-mediated disorders (IMD), time from HIV diagnosis to uveitis, CD4 count, viral load, treatment and complications of treatment and time of follow-up.Twenty patients (18 males) were included. The time lag between HIV diagnosis and the onset of uveitis was 9 ± 8.5 years. Mean CD4 count was 670 ± 294 cells/ml. Viral load was undetectable in 14 out of 18 cases. In 6 patients IMD was diagnosed prior to or concurring with the uveitis diagnosis. The use of immunosuppressive therapies was necessary in 6 patients (including biologics in 4 cases). The mean follow-up was 42.2 months.noninfectious uveitis could be the first manifestation of IMD in patients with well-controlled HIV infection. Immunosuppression appeared to be a safe therapeutic option in our cohort of patients.

Introduction: The prognosis of HIV had changed dramatically from a deadly infectious disease into a manageable infection. Initiation of ARV, especially protease inhibitor, was thought to be associated with metabolic abnormalities. Weight gain in HIV could be a positive indicator for better prognosis. However, excessive weight gain was associated with deleterious effects. Studies regarding protease inhibitor in weight gain had different results. In this study, we intend to identify association of PI therapy duration with BMI. Methods: We conducted a cross-sectional study in Adam Malik Hospital, Medan from August to December 2019. We recruited HIV patients above 18 years old during the outpatient with at least 6-month duration of PI therapy. During visits, patients were screened for inclusion criteria and assessed for BMI. Fasting blood glucose and insulin plasma sample were taken in the morning. Data was analysed by SPSS 22.0. Results: Thirty-five subjects fulfilled inclusion criteria, 25 of subjects were males (71.4%). Mean age of subjects was 38.85 ± 9.7 years. Data analysis presented that there were no significant differences between two groups of treatment (24.33 ± 3.3 kg/m2 vs 24.39 ± 5.0 kg/m2; p = 0.966). There were significant differences between two groups regarding fasting blood glucose level (84.4 ± 6.8 mg/dL vs 114.9 ± 53.6 mg/dL; p = 0.015) and fasting insulin level (7.28 ± 3.4 µU/mL vs 26.01 ± 23.5 µU/mL; p = 0.000). Conclusion: BMI was not associated with duration of PI therapy in our study. Fasting blood glucose and fasting insulin were significantly higher between groups. Keywords: HIV, protease inhibitor, BMI, insulin, obesity, weight gain.

The prevalence of osteoporosis is about three times greater in people living with HIV than in the general population. Bisphosphonates are the only class of antiresorptive drugs which have proved to be safe and effective in HIV patients. However, bisphosphonates are not recommended in women of childbearing age due to an increased rate of associated neonatal complications. To the best of our knowledge no reports on the use of denosumab in HIV-infected individuals have been published so far. We describe a 38 year-old woman with HIV, osteoporosis and vertebral fractures treated with denosumab, a monoclonal antibody targeting RANKL. After four years of treatment, bone mineral density improved, no new fractures occurred, and neither HIV reactivation nor opportunistic infections were observed. We show that denosumab could be a safe and effective approach for osteoporosis in patients with HIV and could be considered in women of childbearing age.

The choice of an optimal antiretroviral therapy (ART) in naive patients presenting late for initial therapy with advanced HIV infection, that is, with a CD4 cell count

Artikel ini menyajikan profil kualitas hidup pasien HIV yang telah menjalani terapi secara terkontrol. Secara spesifik, peneliti mengulas kebutuhan khusus subyek penelitian terhadap dukungan psikologis dan lingkungan. Penelitian berlangsung di Rumah Sakit Umum Daerah KRT Setjonegoro Wonosobo dengan melibatkan 68 subyek penelitian. Seluruh subyek penelitian merupakan pasien HIV yang sedang menjalani terapi antiretroviral (rawat jalan) secara terkontrol dengan durasi lebih dari 6 bulan, dan berusia lebih dari 15 tahun. Investigasi profil kualitas hidup menggunakan kuesioner WHOQOL-HIV Bref versi Bahasa Indonesia. Hasil penelitian menunjukkan bahwa pasien HIV yang menjalani terapi secara terkontrol memiliki nilai kualitas hidup yang lebih baik dari pasien HIV umum. Terapi antiretroviral telah membantu mereka memiliki kualitas fisik, tingkat kemandirian, sisi spiritual dan kemampuan sosial dalam menjalani hidup. Meski begitu, mereka memerlukan intervensi psikologis dan dukungan lingkungan agar memiliki kualitas diri yang merata. Tenaga kesehatan yang terlibat dalam pengelolaan pasien HIV, perlu memberikan intervensi profesional untuk meningkatkan kemampuan mereka dalam berkonsentrasi, serta memastikan mereka senantiasa nyaman dengan kondisi fisiknya. Lebih dari itu, perlu gotong royong pula oleh relasi (keluarga, teman, komunitas) dan tenaga kesehatan dalam menjamin pasien HIV tidak mengalami kesulitan finansial, mampu menikmati waktu secara rileks, dan merasa aman sebagai bagian dari lingkungan sebagaimana masyarakat secara umum.

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

This study aims to describe the relationship between spirituality and quality of life in HIV patients, where spirituality is understood as experience and religiosity as religious rituals of religious groups. This approach emphasizes the wholeness and multidimensional needs of HIV patients, besides reviewing their lives, interpreting what they find, and applying what they have learned to their new lives with HIV. The type of research used is Literature Review. A sample of 45 people was taken from 1,595 HIV patients. There are four articles stating the relationship between spirituality and quality of life considered in this article, that is, the value obtained (p-value: p

One of the consequences caused by problems that occur in HIV patients is a change in the quality of life, particularly that relating to spirituality. This article offers a systematic review of previous studies regarding the spiritual safety of HIV patients. Inclusion criteria for article searches were studies conducted on patients with HIV, over 18 years of age, diagnosed with HIV for more than 6 months, qualitative studies, and exploring spiritual experiences. The quality assessment of each article was carried out using the standard format of the JBI Critical Appraisal Checklist for Qualitative Study. The results of this study include eight articles matching the criteria, and produce four themes that can represent all the articles analyzed: getting closer to God; having hope and life goals; needing support; and finding meaning in life. By identifying and classifying the spiritual experiences of HIV patients, it is hoped that their families will be able to provide motivation in dealing with the problems that occur. It is also hoped that practitioners will be able to use the results of this study as material in collecting assessment data on HIV patients. Keywords: Spiritual Experience, HIV, Qualitative and Literature Review

The review analyses 61 publications on the use of delamanid, a new drug for the treatment of drug resistant tuberculosis. It presents information about pharmacokinetic parameters, efficacy and safety, as well as the place of delamanid in the combination therapy of multiple drug resistant tuberculosis. It tells about specific parameters of delamanid use in children and HIV patients.

In modern conditions, socially dangerous diseases (tuberculosis, HIV infection) are characterized not only by a high level of epidemiological indicators, but also by profound changes in the pathogens themselves (multiple drug resistance, etc.), changes in the course of diseases, its’ complications, causes of death, clinical and morphological manifestations, the appearance of co-infections, which is regarded as a negative phase of pathomorphosis or as reversion. At the same time, the pathomorphosis of diseases significantly complicates their diagnosis. There are objective reasons that do not allow to verify certain nosological units. Under conditions of nosomorphosis due to changes in the biological properties of the pathogen and reactive properties of the organism, in clinical practice and in the study of sectional, surgical and biopsy materials often have difficulties in diagnosis of various forms of tuberculosis and HIV, patho-, morpho- and thanatogenesis. Untimely diagnosis often leads to disability and mortality of patients. Therefore, in clinical practice, undiagnosed forms of socially dangerous diseases are more common. In 2018 251,000 people who had both TB and HIV are estimated to have died1. This is in addition to the 1.2 million people who died from TB alone. A total of 477,461 TB cases among HIV positive people were reported in 2018 (56% of the estimated incidence of 862,000 cases)2. Of these 86% were on antiretroviral therapy. In comparison, in Ukraine in 2019 5943 HIV deaths were reported, 1448 among them had TB and HIV coinfection (24.36%) and 811 of them were on antiretroviral therapy (56%). Due to all these statistics we can make a conclusion that TB in HIV patients is one the main causes of death in HIV-patients. Furthermore, due to the statistics even antiretroviral therapy does not have great affection on the TB and HIV coinfection course. TB/HIV coinfection is a global substantial problem and it means that all international guidelines have to be better implemented.

Leuel Lisanwork Arage,1 Haji Aman Deybasso,2 Delelegn Yilma Gebremichael,3 Binyam Gintamo Nuramo,4 Zelalem Negash Mekuria4 1The Ohio State University Global One Health, Addis Ababa, Ethiopia; 2Adama Hospital Medical College, Adama, Ethiopia; 3Ambo University, College of Medicine and Health Sciences, Department of Public Health, Ambo, Ethiopia; 4Addis Ababa Medical and Business College, Department of Research and Community Service, Addis Ababa, EthiopiaCorrespondence: Haji Aman Deybasso Tel +251 911386781Email hajia.aman9@gmail.comPurpose: The drugs for the treatment of latent Tuberculosis are potentially hepatotoxic and can lead to drug-induced hepatotoxicity. The current study aimed at identifying the determinants of anti-tuberculosis drug-induced hepatotoxicity among patients living with Human Immunodeficiency Virus taking Isoniazid and rifapentine at All Africa Leprosy Tuberculosis Rehabilitation and Training Center in Addis Ababa, Ethiopia.Methods: An unmatched case–control study was conducted from March, 21, to April 21, 2020, at All Africa Leprosy Tuberculosis Rehabilitation and Training Center. A total of 65 cases and 130 controls were interviewed. Data were collected using a data extraction tool from clinical reporting forms, follow-up charts, and patients’ logbooks. Binary and multiple logistic regressions were conducted to check the association between independent and dependent variables. Adjusted odds ratios and the corresponding 95% confidence intervals were estimated to assess the strength of association. P-values < 0.05 were used to declare statistical significance.Results: The prevalence of anti-TB drug-induced hepatotoxicity was 8%. Body mass index < 18.5 Kg/m2 (AOR = 5.8 [95% CI: 2.2– 8.9]), low CD4 count (AOR = 4.9 [95% CI: 1.6– 15.8]), and the presence of comorbid illnesses (AOR = 3.9 [95% CI: 1.7– 8.9]) were identified as independent predictors of drugs-induced hepatotoxicity among Human Immunodeficiency Virus positive patients taking Isoniazid and rifapentine.Conclusion: The prevalence of anti-TB drug-induced hepatotoxicity was higher compared to standard references. BMI< 18 kg/m2, low CD4 count, and comorbid illness were positively associated with anti-tuberculosis drug-induced hepatotoxicity among patients with HIV.Keywords: isoniazid and rifapentine, TPT, hepatotoxicity, HIV patients, Ethiopia

Background: In HIV (Human immunodeficiency virus) positive patients several factors have been proposed to explain the cardiovascular (CV) risk, which include pro-athero-thrombotic viral effect, infection-mediated immune dysfunction and possible effects of HAART(Highly active antiretroviral therapy). Presence of endothelial dysfunction, an early CV risk marker, in HIV-infected patients on long-term HAART. Endothelial dysfunction can be measured by bFMD (Brachial artery flow mediated vasodilatation). Urine albumin to creatinine ratio (UACR) is frequent in HIV patients and is predictor of cardiovascular risk. UACR and endothelial dysfunction are positively associated in HIV affected patients thereby increased UACR might help to identify endothelial dysfunction in HIV patients on HAART. Aims and Objectives: • To measure urine albumin to creatinine ratio in HIV patients on HAART. • To find out correlation between UACR and bFMD. Materials and Methods: Study was conducted on HIV Patients admitted to hospital, considering the inclusion and exclusion criteria. Detailed clinical history, examination and Blood investigations were done. Endothelial function was assessed by brachial artery flow mediated vasodilatation(bFMD). Results: Among 100 HIV patients, 14% had UACR 30 and mean UACR is 90 ±06. Mean BFMD was 8.44 ± 7.65. We identified a significant Negative correlations were found between bFMD and UACR(r=- 0.832, P=

Antiretroviral administration affects weight gain and inflammation in HIV patients. The purpose of the study was to assess the relationship of body mass index with inflamation parameters in HIV patients who ARV therapy. In 40 HIV patients (stage III-IV) treated with ARV (FDC 87%, Durival Efaviren 7.5%, Tenofovir, Huviral, Aluvia 2.5%, and Tenofovir, Huviral, Neviral 2.5%) conducted observational analytics with crosssectional design. CD4 examination was carried out flowcytometrically, BMI measured by formula weight (kg) divided by height squared (m2), waist circumference (WC) measured by ribbon between costae arcus and anterior superior iliac spine, albumin measurement with Brom Cresol Green (BCG) method. There is a significant correlation between BMI with WC and CD4 (r=0.61, p