Current Issue : April - June Volume : 2020 Issue Number : 2 Articles : 5 Articles
Background: Hepatitis B (HBV) and Human Immunodeficiency Virus (HIV) share common risk factors for exposure.\nCo-infected patients have an increased liver-related mortality risk and may have accelerated HIV progression. The\nepidemiology and demographic characteristics of HIV-HBV co-infection in Canada remain poorly defined. We\ncompared the demographic and clinical characteristics and factors associated with advanced hepatic fibrosis\nbetween HIV and HIV-HBV co-infected patients.\nMethods: A retrospective cohort analysis was conducted using data from the Canadian Observational Cohort\n(CANOC) Collaboration, including eight sites from British Columbia, Quebec, and Ontario. Eligible participants were\nHIV-infected patients who initiated combination ARV between January 1, 2000 and December 14, 2014.\nDemographic and clinical characteristics were compared between HIV-HBV co-infected and HIV-infected groups\nusing chi-square or Fisher exact tests for categorical variables, and Wilcoxonâ??s Rank Sum test for continuous\nvariables. Liver fibrosis was estimated by the AST to Platelet Ratio Index (APRI).\nResults: HBV status and APRI values were available for 2419 cohort participants. 199 (8%) were HBV co-infected.\nCompared to HIV-infected participants, HIV-HBV co-infected participants were more likely to use injection drugs\n(28% vs. 21%, p = 0.03) and be HCV-positive (31%, vs. 23%, p = 0.02). HIV-HBV co-infected participants had lower\nbaseline CD4 T cell counts (188 cells/mm3, IQR: 120â??360) compared to 235 cells/mm3 in HIV-infected participants\n(IQR: 85â??294) (p = 0.0002) and higher baseline median APRI scores (0.50 vs. 0.37, p < 0.0001). This difference in APRI\nwas no longer clinically significant at follow-up (0.32 vs. 0.30, p = 0.03). HIV-HBV co-infected participants had a\nhigher mortality rate compared to HIV-infected participants (11% vs. 7%, p = 0.02).\nConclusion: The prevalence, demographic and clinical characteristics of the HIV-HBV co-infected population in\nCanada is described. HIV-HBV co-infected patients have higher mortality, more advanced CD4 T cell depletion, and\nliver fibrosis that improves in conjunction with ARV therapy. The high prevalence of unknown HBV status\ndemonstrates a need for increased screening among HIV-infected patients in Canada....
Background: We previously reported that four doses or four double doses of hepatitis B vaccination regimens could\nnot significantly increase a response rate compared with standard doses. However, the antibody levels were higher\nin the four doses and four double doses groups. This study followed those patients for at least 3 years and aimed to\nevaluate the immunogenicity of the three vaccination regimens.................................
Background: To evaluate clinical outcomes after either immediate or deferred initiation of antiretroviral therapy in\nHIV-1-infected patients, presenting late with pneumocystis pneumonia (PCP) or toxoplasma encephalitis (TE).\nMethods: Phase IV, multicenter, prospective, randomized open-label clinical trial. Patients were randomized into an\nimmediate therapy arm (starting antiretroviral therapy (ART) within 7 days after initiation of OI treatment) versus a\ndeferred arm (starting ART after completing the OI-therapy). All patients were followed for 24 weeks. The rates of clinical\nprogression (death, new or relapsing opportunistic infections (OI) and other grade 4 clinical endpoints) were compared,\nusing a combined primary endpoint. Secondary endpoints were hospitalization rates after completion of OI\ntreatment, incidence of immune reconstitution inflammatory syndrome (IRIS), virologic and immunological outcome,\nadherence to proteinase-inhibitor based antiretroviral therapy (ART) protocol and quality of life.\nResults: 61 patients (11 patients suffering TE, 50 with PCP) were enrolled. No differences between the two therapy\ngroups in all examined primary and secondary endpoints could be identified: immunological and virologic outcome\nwas similar in both groups, there was no significant difference in the incidence of IRIS (11 and 10 cases), furthermore 9\nevents (combined endpoint of death, new/relapsing OI and grade 4 events) occurred in each group.\nConclusions: In summary, this study supports the notion that immediate initiation of ART with a ritonavir-boosted\nproteinase-inhibitor and two nucleoside reverse transcriptase inhibitors is safe and has no negative effects on incidence\nof disease progression or IRIS, nor on immunological and virologic outcomes or on quality of life....
Introduction: Headache disorders are common in HIV-infected patients.\nThese disorders are either primary or secondary. Objective: Determine prevalence\nand factors associated with primary headache disorders in HIV+ patients.\nMethod: It was a cross-sectional, descriptive and analytical study\nconducted from 2nd May 2017 to 2nd August 2017 which included HIV+ patients\naged 18 years and above. Diagnosis of primary headache disorders was\ncarried out by a Neurologist on the basis of ICHD-II diagnostic criteria.........................
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