Current Issue : January - March Volume : 2019 Issue Number : 1 Articles : 6 Articles
In individuals with HIV/AIDS, 47% of the deaths are attributed to invasive fungal infections\n(IFIs), despite antiretroviral (ARV) therapy. This is a retrospective study carried out in the Hospital\nRegional de Alta Especialidad Oaxaca (HRAEO), southwest Mexico, where IFIs that occurred\nduring 2016â??2017 are described. A total of 55 individuals were included. Histoplasmosis (36%)\nand possible-IFIs in neutropenic fever (20%) were the most frequent cases, followed by cryptococcosis\n(14%). The HIV/AIDS subpopulation corresponded with 26 cases (47%), all from an indigenous\norigin. The incidence of IFIs among them was 24% (95% CI = 15â??33%). The CD4+ T cells median was\n35 cells/mL (IQR 12â??58). Four cases (15%) of unmasking IRIS were identified, three of histoplasmosis\nand one coccidioidomycosis. Co-infections were found in 52% (12/23), and tuberculosis in 50% (6/12)\nwas the most frequent. The mortality rate was 48%. The general characteristics of the HIV individuals\nwho died were atypical pneumonia (70% vs. 9%, p = 0.01), acute kidney injury, (70% vs. 9%, p = 0.008)\nand ICU stay (80% vs. 9%, p = 0.002). In conclusion, IFIs are diagnosed in one out of four individuals\nwith HIV/AIDS along with other complicated infectious conditions, leading to major complications\nand a high mortality rate....
Objective. To investigate effectiveness of systematic periodontal treatment in the long term in HIV-infected patients undergoing\nhighly active antiretroviral treatment. Methods. Longitudinal, prospective, open-label case series over a period of nine years.\nPeriodontal treatment was performed by scaling and root planing and supportive periodontal care (SPC) at regular intervals. To\nmeasure effectiveness, reductions of pocket probing depths were defined as primary study endpoint. Results. During the study\nperiod, there was a proportional increase in periodontal pockets .... and in pockets ... Mean pocket\ndepth reductions on patientâ??s level were, however, 0.4mm nine years after scaling and root planing and supportive periodontal\ncare .... No teeth were lost during the observation period. Conclusions. In terms of best evidence available, it is concluded\nthat systematic periodontal treatment including SPC is effective in virologically controlled HIV infection and can be performed in\ndental practice safely....
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Background: Community-based test and start (TAS) models have shown the\npotential to improve clinical outcomes for key populations because early\naccess to treatment will have population level impact by reducing transmission\nthrough the promotion and provision of hassle-free quality HIV testing,\non the spot ART initiation and unrestricted access to culturally competent\nhealth professionals. We assessed the effectiveness of a pioneer community-\nbased test and start (TAS) model for key populations in Lagos along\nUNAIDS 90/90/90 cascade. Methods: Men who have sex with men (MSM),\nfemale sex workers (FSW), and persons who inject drugs (PWID), >14 years\nof age were recruited through peer-referral for HIV testing services (HTS) at\na community-based KP-friendly clinic in Lagos between June 2015 and September\n2016. The clinic provides comprehensive HIV services, including HIV\ntreatment. Those who test positive are enrolled and provided with TAS services.\nUsing routine service data, we deployed descriptive cross tabulations at\np < 5% to determine the performance along the 90/90/90 cascade. Results: In\ntotal, 8812 KPs comprising MSM (51.6%), FSW (32.7%) and PWID (15.7%)\nwere tested during this period. About one-half (46.4%) were young KP (15 -\n25 years). The majority (76.1%) were male, single (86.1%), almost all (99%)\nhad at least primary school level education, and about one-quarter (25.1%)\nwere employed. Among MSM, 506 (11.1%) tested positive, 276 (54.5%) were\ninitiated on ART, of whom 155 conducted viral load testing and 88 (56.7%)\nhad achieved viral suppression (<1000 copies per milliliter). Among FSW, 88\n(3.1%) tested positive, only 28 (31.8%) were initiated on ART, of whom 15\nconducted viral load testing and 9 (60%) achieved viral suppression. Among\nPWID, of 15 (1.1%) who tested positive, only 2 (13%) were initiated on ART and none had conducted viral load testing. Client satisfaction index was\n96.1%. Conclusion: The current community-based model showed excellent\ncapacity to achieve the first 90 goal among target KP communities. However,\nlinkage to care and treatment, adherence, and retention remain major challenges\nin achieving the second and third nineties at the community level....
Co-infection between malaria and HIV has major public health implications. The aims\nof this study were to assess the malaria prevalence and to identify predictors of positivity to\nmalaria Test in HIV positive patients admitted to the health center São Lucas of Beira, Mozambique.\nA retrospective cross-sectional study was performed from January 2016 to December 2016. Overall,\n701 adult HIV patients were enrolled, positivity to malaria test was found in 232 (33.0%). These\npatients were found to be more frequently unemployed (76.3%), aged under 40 (72.0%), with a HIV\npositive partner (22.4%) and with a CD4 cell count <200 (59.9%). The following variables were\npredictors of malaria: age under 40 (O.R. = 1.56; 95%CI: 1.22â??2.08), being unemployed (O.R. = 1.74;\n95%CI: 1.24â??2.21), irregularity of cotrimoxazole prophylaxisâ??s (O.R. = 1.42; 95%CI: 1.10â??1.78), CD4 cell\ncount <200 (O.R. = 2.01; 95%CI: 1.42â??2.32) and tuberculosis comorbidity (O.R. = 1.58; 95%CI: 1.17â??2.79).\nIn conclusion, high malaria prevalence was found in HIV patients accessing the out-patients centre\nof São Lucas of Beira. Our findings allowed us to identify the profile of HIV patients needing more\nmedical attention: young adults, unemployed, with a low CD4 cell count and irregularly accessing to\nART and cotrimoxazole prophylaxis....
Diagnosis of sexually transmitted infections is very important considering the\nspread of HIV and the extensive use of highly active antiretroviral therapy\nworldwide. This will assist in planning of treatment schedule in controlling\nthese infections. The study therefore aimed at determining the prevalence of\nsyphilis in HIV positive antiretroviral therapy naive patients in Cape Coast\nand the associated risk factors involved in infection. A cross-sectional study\nwas carried out using initial HIV rapid and confirmation tests, and then Venereal\nDisease Research Laboratory test with the Ultra Rapid Test Kits for\nsyphilis. Demographic data, risky sexual behaviours capable of co-transmission\nof both HIV and Syphilis, were also collected through the use of questionnaires.\nIn all, 150 HIV positive antiretroviral naive subjects were studied and\n15 (10%) were positive for VDRL test, with females (6.00%) and males\n(4.00%), who were mainly within the age group of 20 - 39 years. A significant\nnumber of males (p = 0.019) and females (p = 0.015) participants were not\nsmoking with a fewer number of the females (p = 0.002) having multiple sexual\npartners. Also a smaller number of those who were infected with the bacteria\n(p = 0.004) did not support the control of sexually transmitted infection\n(p = 0.022). The result showed that co-infection of Syphilis in HIV positive\nantiretroviral therapy naive patients persist in Cape Coast Metropolis. An indication\nof prominent STIs which require further study in a larger scale to\nascertain the extent of the co-infection and to formulate policy for treatment\nto helps minimize the rate of infection....
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