The Impact of CD4 Count Level on Patterns of Respiratory Tract Infections of HIV-Infected Patients: A Study in Western India | Chapter 3 | Medical Science: Trends and Innovations Vol. 7

Background: The World Health Organisation has estimated that 25 million people have died of HIV/AIDS, including 2 million people who died in 2007. A significant proportion of these deaths were due to opportunistic pneumonias. The majority of new HIV infections are in adults aged 20 to 39 years old. Individuals with HIV infection are at increased risk for tuberculosis (TB) and other respiratory tract infections (RTIs). The altered CD4 T-cell homeostasis induced by HIV infection may play a key role in the development of respiratory tract infections in HIV-infected patients.

Aim: The aim of the study is to find out of mean CD4 count of HIV patients at which they were at higher risk of developing various RTIs and accordingly when HAART is to be started in this part of the world.

Materials and Methods: The present prospective study was conducted between 9th August 2009 to 23rd January 2012. All the 961 HIV-infected patients and 300 HIV seronegative patients’ three early morning sputum were screened for routine bacterial and fungal pathogens and even examined for AFB and few of the samples were even cultured on LJ medium. All sputum samples’ smears were also examined for Poly Morpho Nuclear Leucocytes (PMNLs) in Gram staining.

Results: Out of all these 961 HIV patients, those with probable viral respiratory tract infections (RTIs) (349 patients) had a mean CD4 count of 474.62 ± 114.89, followed by mixed polymicrobial RTI (80 patients) with mean CD4 about 392.26 + 87.14. For the patients with pure fungal etiology (66), the mean CD4 count was found to be 377.29 + 268.29 followed by 466 patients with pure monomicrobial bacterial RTI the mean CD4 count was about 223.07 + 83.21.

Conclusion: A very vague co-relationship between the pattern of RTIs and CD4 counts has been attempted. Only Fungal and Bacterial RTIs were seen first to establish in even HIV-infected patients at very high mean CD4 counts of about 377 + 268.29 and 223.07 + 83.21 respectively, but in both very high prevalence rates were observed when compared with HIV non-infected patients with probability values of <0.05 and <0.001 respectively. The probable viral etiology of RTI was significantly high in HIV-non infected subjects when compared to HIV-infected RTI patients with a probability value of P < 0.001.

 

Author (s) Details

 

Rajeev Ramanlal Shah
Microbiology Department, Shree Aurobindo Medical College and PG Institute Indore, Madhya Pradesh, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/msti/v7/4269

Anti-Retroviral Regimen Change & Subsequent Patient–Related Outcomes in South Africa | Chapter 6 | Current Practice in Medical Science Vol. 2

The purpose of the study was to discover variables that impact antiretroviral treatment (ART) regimen modification and to evaluate patient outcomes post regimen change. At a Provincial Hospital ARV Clinic in KwaZulu-Natal, from January 2008 to December 2012, a retrospective chart analysis of 269 HIV-infected non-pregnant patients (age >18 years) who underwent an antiretroviral (ARV) regimen change and were followed up for roughly one year since initiation was conducted. Findings showed that 200 of the 269 cases involved women (75 percent). Most of the patients were in the 30 to 44 age range (57.6 percent). Only five of the people were infected with TB (2 percent). Stavudine (D4T)/ lamivudine (3TC)/ efavirenz (EFV) was the first-line ART regimen that was altered the most frequently (n = 111). (41 percent ). Tenofovir (TDF)/3TC/EFV was the most often changed medication for patients (n = 89). (33 percent ). The most often used medication alternative was stavudine (35.5 percent ). ADRs with lipodystrophy were more prevalent (56.8 percent ). ADR was the reason for changing the ART regimen in 175 patients (65%), whereas treatment failure (TF) was the reason in 94 individuals (35 percent ). After changing the regimen, immunological success (CD4 counts) was seen (374.21 243.16 vs. 456.09 250.07, CI: 0.95, p 0.001). After the regimen was changed, undetectable viral levels were discovered in 172/205 (83.9%) patients. According to the findings of this study, adverse drug reactions (ADRs) were the primary reason why antiretroviral regimens were changed. Lipodystrophy was the most frequent adverse effect of stavudine, the medicine that was most frequently replaced. After changing the regimen, progress was seen in the areas of immunology and virology.

Author(s) Details:

Vereesha Soorju,

Madadeni Hospital, School of Health Sciences, University of KwaZulu - Natal, South Africa.

Panjasaram Naidoo,

Madadeni Hospital, School of Health Sciences, University of KwaZulu - Natal, South Africa.

Please see the link here: https://stm.bookpi.org/CPMS-V2/article/view/7345

Investigating the Effects of Standardised Treatment Protocols for Opportunistic Infection in Children Living with HIV/AIDS on Their Clinical Profile | Chapter 6 | New Frontiers in Medicine and Medical Research Vol. 16

 Introduction: AIDS has spread throughout the world. Pediatric HIV/AIDS, like adult HIV/AIDS, is on the rise all throughout the world. Since 1981, over 25 million people have died as a result of HIV around the world. The risk of HIV transmission from mother to child varies by country and even within a country, depending on the facilities available.

Aims and Objectives: To look into a standardised treatment approach for HIV/AIDS children with opportunistic infections.

Methodology: From July to December 2007, a cross-sectional study on children living with HIV/AIDS was done at the A.R.T. Centre, a government medical college and hospital in Aurangabad. The development of a uniform treatment strategy for the management of opportunistic infections in HIV/AIDS-infected children was one of the project's main objectives. The necessary permissions from NACO, MSACS, and the consent of the parents or caretakers were obtained. A total of 280 children were included in the study, with 50 of them receiving antiretroviral therapy.

In the study group, tuberculosis was the most common OI, followed by diarrhoea and acute respiratory illness. There was an overall increase in height, weight, and CD4 count after starting the Standard Treatment Protocol in Children with HIV/AIDS.

Conclusion: There was a positive response in the form of increased height, weight, and overall increase in CD4 Count after starting the Standard Treatment Protocol in Children with HIV/AIDS, indicating that these standard protocols should be strictly followed for a better prognosis for opportunistic infections in children with HIV/AIDS.

Author (S) Details

Shilpa Yashwant Pawar
Department of Pediatrics, Government Medical College, Aurangabad, Maharashtra, India.

Sadhana Jagannath Raut
Department of Pediatrics, Government Medical College, Aurangabad, Maharashtra, India.

Smita Mundada
Department of Pediatrics, Government Medical College, Aurangabad, Maharashtra, India.

Amol Suryawanshi
Department of Pediatrics, Government Medical College, Aurangabad, Maharashtra, India.

P. S. Patil
Department of Pediatrics, Government Medical College, Aurangabad, Maharashtra, India

View Book :- https://stm.bookpi.org/NFMMR-V16/article/view/3780

Liver Enzymes and HIV-infected Adults on HARRT: Evidence from a Randomised Cross-sectional Study in UPTH | Chapter 4 | Recent Research Advances in Biology Vol. 5

 This research looked at the levels of liver enzymes in HIV-infected adults who had been on highly active antiretroviral therapy (HAART) for at least a year. The study was planned as a randomised cross-sectional study to compare the aspartate aminotransferase [AST], alanine transaminase [ALT], and alkaline phosphatase [ALP] levels of 129 HIV-infected adult patients (46 males and 83 females). The University of Port Harcourt Ethics Committee issued ethical clearance (Ref: UPH/CEREMAD/REC/19) prior to the report. Clinical Chemistry Analyser (VS10) manufactured by Vitro Scient was used to collect venous blood samples and analyse liver enzyme levels. The findings were then split into two categories: usual and abnormal. The data was analysed using SPSS version 21 (IBM® Armonk, USA) and Graph Pad Prism (Version 8.0.2). The sex differences in mean were compared using the T-test, while the sex differences in categorised data were tested using Chi-square analysis. Males' mean AST (27.6517.93 IU/L) and ALP (135.1310.87 IU/L) values were higher than females' AST (27.2518.93 IU/L) and ALP (132.659.96 IU/L) values, while females' ALT (34.6622.29 IU/L) values were higher than males' (33.7518.14 IU/L); however, the discrepancies were not important. In conclusion, cholestatic abnormalities were found in more than 80% of the patients, while hepatocellular abnormalities were found in less than 35% of the patients. When compared to males with isolated (ALT/AST) abnormalities, more females were found to have mixed abnormalities. As a result, this research proposes that a randomised case-control study be performed to assess the degree of deviation from standard values.

Author (s) Details

Dr. Chinwe F. Anyanwu
Department of Pharmacology, Faculty of Basic Clinical Sciences, University of Port Harcourt, Nigeria.

Dr. Eric O. Aigbogun Jr.
Department of Anatomy, Faculty of Medical Sciences, Kampala International University, Western Campus, Uganda.

View Book :- https://stm.bookpi.org/RRAB-V5/issue/view/36