scholarly journals A double-blind, randomized controlled trial to examine the effect of Moringa oleifera leaf powder supplementation on the immune status and anthropometric parameters of adult HIV patients on antiretroviral therapy in a resource-limited setting

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261935
Author(s):  
Aisha Gambo ◽  
Indres Moodley ◽  
Musa Babashani ◽  
Tesleem K. Babalola ◽  
Nceba Gqaleni
Keyword(s):  
Moringa Oleifera ◽  
Anthropometric Parameters ◽  
Double Blind ◽  
Cd4 Counts ◽  
Cell Counts ◽  
Resource Limited ◽  
Cd4 Cell Counts ◽  
Leaf Powder ◽  
Cd4 Cell ◽  
Limited Setting

Background People living with HIV (PLHIV) in resource-limited settings are vulnerable to malnutrition. Nutritional interventions aimed at improving food insecurity and malnutrition, together with antiretroviral therapy (ART), could improve treatment outcomes. In Nigeria, there is a high awareness of the nutraceutical benefits of Moringa oleifera. Thus, this study aimed to evaluate the effects of Moringa oleifera leaf supplementation on the CD4 counts, viral load and anthropometric of HIV-positive adults on ART. Methods This was a double-blind, randomized study. Two hundred HIV-positive patients were randomly allocated to either the Moringa Oleifera group (MOG) given Moringa oleifera leaf powder or the control group (COG) given a placebo. Changes in anthropometric parameters [weight; body mass index (BMI)] and CD4 cell counts were measured monthly for six months, while HIV-1 viral loads were measured at baseline and the end of the study for both groups. Results Over the study period, the treatment by time interaction shows a significant difference in CD4 counts by treatment group (p<0.0001). A further estimate of fixed effects showed that the CD4 counts among MOG were 10.33 folds greater than COG over the study period. However, the viral load (p = 0.9558) and all the anthropometric parameters (weight; p = 0.5556 and BMI; p = 0.5145) between the two groups were not significantly different over time. All tests were conducted at 95CI. Conclusion This study revealed that Moringa oleifera leaf supplementation was associated with increased CD4 cell counts of PLHIV on ART in a resource-limited setting. Programs in low-resource settings, such as Nigeria, should consider nutritional supplementation as part of a comprehensive approach to ensure optimal treatment outcomes in PLHIV.

scholarly journals Initiating antiretroviral therapy when presenting with higher CD4 cell counts results in reduced loss to follow-up in a resource-limited setting

AIDS ◽  
2013 ◽  
Vol 27 (4) ◽  
pp. 645-650 ◽  
Author(s):  
Kate Clouse ◽  
Audrey Pettifor ◽  
Mhairi Maskew ◽  
Jean Bassett ◽  
Annelies Van Rie ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Resource Limited Setting ◽  
Loss To Follow Up ◽  
Cell Counts ◽  
Resource Limited ◽  
Cd4 Cell Counts ◽  
Cd4 Cell ◽  
Limited Setting

scholarly journals The correlation of tuberculosis smear results and immuno-suppression with CD4+ counts as a surrogate marker among HIV infected patients.

2021 ◽  
Author(s):  
Kingsley Kamvuma ◽  
Yusuf ademola ◽  
Warren Chanda ◽  
Christopher Newton Phiri ◽  
Sam Bezza Phiri ◽  
...  
Keyword(s):  
Cell Count ◽  
Surrogate Marker ◽  
Hiv Positive ◽  
Sputum Smear ◽  
Cd4 Cell Count ◽  
Cd4 Counts ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Study Participants ◽  
Cd4 Cell

Abstract Background: Human immunodeficiency virus (HIV) and M.tuberculosis are two intracellular pathogens that interact at the cellular, clinical and population levels. Since the recognition of AIDS in 1981, the number of reported cases of TB in the has increased substantially, especially in regions with high incidence of AIDS. The main aim of this study was to establish weather there is a relationship between sputum smear positives and low CD4 cell counts among HIV infected patients.Materials and methods: This was a retrospective study involving 473 participants. The patients recruited in this study were those who tested HIV positive and smear positive for TB. Their HIV status was determined by performing an HIV blood test, if they were HIV positive their CD4 cell count were then made.Results: This study examined the relation between smear positivity and low CD4 (below 200cells/µl) together with CD8 and CD3 markers as a measure of immune function among patients infected with HIV. The study participants’ constituted males 67% and females 33%. The overall mean age was 33.2 (SD 6.9) with the youngest and oldest participants being 18 and 60 respectively. It was found that smear positive results negatively (r=-0.13; p=0.021) correlated with CD4+ below 200 cells/µl. No correlation was observed between smear positives and CD8+ or CD3+ since the calculated correlation coefficient was not significant 0.007 (p=0.9) and 0.03 (p=0.6) respectively. There are more 3+ smear results below 200 cells/µl than the others while above 200 cells/µl 1+ was the most commonly reported smear result. The scanty smear positives were the least commonly reported result in the low and high CD4 counts. Conclusion: The smear positive result negatively correlated with a low CD4+ (r=-0.13; p=0.021) but no correlation with low CD+8 and CD+3 results was observed. The long held theory that low bacillary counts in patients with low CD4+ counts needs to be revisited. The reduction of CD4+ cell count parallels' that of the total lymphocyte count and is more marked in patients with high bacillary counts. Further, studies are required to confirm these findings

Differences Between Men Who Have Sex with Men (MSM) with Low CD4 Cell Counts at Their First HIV Test and MSM with Higher CD4 Counts in Bangkok, Thailand

2016 ◽  
Vol 20 (S3) ◽  
pp. 398-407 ◽  
Author(s):  
Vorapot Sapsirisavat ◽  
◽  
Nittaya Phanuphak ◽  
Jiratchaya Sophonphan ◽  
James E. Egan ◽  
...  
Keyword(s):  
Cd4 Counts ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Hiv Test ◽  
Sex With Men ◽  
Cd4 Cell

scholarly journals Spectrum of opportunistic infections with correlation to CD4 counts in newly diagnosed HIV seropositive cases

2017 ◽  
Vol 4 (1) ◽  
pp. 252
Author(s):  
Ajay Kumar Sarvepalli ◽  
Prakash Kalakappa Dharana
Keyword(s):  
Opportunistic Infections ◽  
Newly Diagnosed ◽  
Cd4 Counts ◽  
Poor Countries ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Resource Poor ◽  
The Mean ◽  
Tract Infections ◽  
Cd4 Cell

Background: A rise in HIV/AIDS is observed in resource poor countries like India despite successful implementation of control programmes. Most of these deaths recorded in cases of AIDS are because of opportunistic infections [OI] and other malignancies. The reason may be attributed to the effective destruction or decrease in CD4 cells which play a pivotal role in immune system. OI cause substantial morbidity and hospitalization, economical loss to the society and shorten the survival time of HIV patient. The objective of this study was to evaluate the different type of infections and identify the frequent pathogens affecting the HIV patients who are attending a tertiary care hospital in India. The clinical profile of these patients was studied and proportion of CD4 counts with respect to their type of infection and pathogen is also evaluated.Methods: A prospective cross sectional study was conducted for one year period. Clinical samples were collected from all the newly diagnosed cases of HIV and performed various staining techniques and cultured on appropriate culture media.  All the isolates were identified as per standard guidelines. Serological evaluation for IgM antibodies for toxoplasma was done by ELISA. CD4 counts were estimated by FACS.Results: Tuberculosis was the commonest (67%) OI in HIV cases, followed by candidiasis (61.5%), respiratory tract infections (50%), gastro intestinal tract infections (44%) and meningitis (38%) in our study. The mean CD4 cell counts in the study was 267.11cells/µl. The commonest fungal pathogen was C.albicans and Cryptosporidium parvum the parasitic pathogen. The mean CD4 cell counts were lesser in parasitic infections when compared to bacterial and fungal infections. Six cases of P.jiroveci pneumonia were identified in our study. Mortality was recorded among the HIV cases with CD4 cell counts <50 cells/ µl.Conclusions: Early diagnosis and prompt treatment of OIs contributes to increased life expectancy among infected patients, delaying the progression to AIDS. This study helps the clinicians in proper guidance to come up with right diagnosis and early response to manage the patients in resource poor countries like India.

scholarly journals Randomized, double-blind trial comparing indinavir alone, zidovudine alone and indinavir plus zidovudine in antiretroviral therapy-naive hiv-infected individuals with CD4 cell counts between 50 and 250/mm3

2000 ◽  
Vol 42 (1) ◽  
pp. 27-36 ◽  
Author(s):  
David S. LEWI ◽  
Jamal M. SULEIMAN ◽  
David E. UIP ◽  
Rogerio J. PEDRO ◽  
Rosa A. SOUZA ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Clinical Event ◽  
Double Blind Study ◽  
Double Blind ◽  
Cd4 Cell Count ◽  
Hiv Rna ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Risk Of Disease ◽  
Cd4 Cell

Treatment with indinavir has been shown to result in marked decreases in viral load and increases in CD4 cell counts in HIV-infected individuals. A randomized double-blind study to evaluate the efficacy of indinavir alone (800 mg q8h), zidovidine alone (200 mg q8h) or the combination was performed to evaluate progression to AIDS. 996 antiretroviral therapy-naive patients with CD4 cell counts of 50-250/mm3 were allocated to treatment. During the trial the protocol was amended to add lamivudine to the zidovudine-containing arms. The primary endpoint was time to development of an AIDS-defining illness or death. The study was terminated after a protocol-defined interim analysis demonstrated highly significant reductions in progression to a clinical event in the indinavir-containing arms, compared to the zidovudine arm (p<0.0001). Over a median follow-up of 52 weeks (up to 99 weeks), percent reductions in hazards for the indinavir plus zidovudine and indinavir groups compared to the zidovudine group were 70% and 61%, respectively. Significant reductions in HIV RNA and increases in CD4 cell counts were also seen in the indinavir-containing groups compared to the zidovudine group. Improvement in both CD4 cell count and HIV RNA were associated with reduced risk of disease progression. All three regimens were generally well tolerated.

scholarly journals Molecular Detection and Clinical Implications of HTLV-1 Infections among Antiretroviral Therapy-Naïve HIV-1-Infected Individuals in Abuja, Nigeria

2015 ◽  
Vol 6 ◽  
pp. VRT.S35331 ◽  
Author(s):  
Idris Abdullahi Nasir ◽  
Abdurrahman Elfulaty Ahmad ◽  
Anthony Uchenna Emeribe ◽  
Muhammad Sagir Shehu ◽  
Jessy Thomas Medugu ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Real Time ◽  
Biochemical Parameters ◽  
Enzyme Linked Immunosorbent Assay ◽  
Cd4 Counts ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Special Clinic ◽  
Cd4 Cell ◽  
Hiv 1

Background Individuals with human T-cell lymphotrophic virus type-1 (HTLV-1)/HIV-1 coinfection have been demonstrated to undergo CD4+ lymphocytosis even in the face of immunodeficiency and increased vulnerability to opportunistic pathogens that can lead to poor prognosis. Objective This study investigated the prevalence as well as the effects of HIV-1/HTLV-1 coinfection on CD4+ cell counts, routine hematology, and biochemical parameters of study participants. Materials and Methods This prospective cross-sectional study involved 184 blood samples collected from HIV-1-seropositive individuals attending HIV-special clinic of the University of Abuja Teaching Hospital, Gwagwalada, Nigeria. These samples were analyzed for anti-HTLV-1/2 IgM antibodies using enzyme-linked immunosorbent assay, CD4+ cell counts, and some routine hematological and biochemical parameters. All samples were also tested for HTLV-1 provirus DNA using real-time polymerase chain reaction (PCR) assay. Results Of the 184 subjects studied, 9 (4.9%) were anti-HTLV-1/2 IgM seropositive; however, upon real-time PCR testing, 12 (6.5%) had detectable HTLV-1 provirus DNA. The CD4+ cell count was significantly high in HTLV-1-positive (742 ± 40.2) subjects compared to their HTLV-1-negative (380 ± 28.5) counterpart ( P-value = 0.025). However, there was no significant association between HTLV-1 positivity with other hematology and biochemical parameters studied ( P > 0.05). Conclusion All subjects (100%) who were HTLV-1/HIV-1-coinfected had normal CD4+ counts. This gives contrasting finding on the true extent of immunodeficiency of subjects. So it is suggested to be very careful in using only CD4+ counts to monitor disease progression and as indicators for antiretroviral therapy (ART) in resource-limited settings. In such conditions, there may be a need to test for HTLV-1 alongside HIV viral loads in order to begin appropriate ART regimens that contain both pathogens.

scholarly journals Effect of Macrolide Prophylactic Therapy on AIDS-Defining Conditions and HIV-Related Mortality

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S59-S59
Author(s):  
Mark Kristoffer Pasayan ◽  
Mary Lorraine Mationg ◽  
David Boettiger ◽  
Wilson Lam ◽  
Fujie Zhang ◽  
...  
Keyword(s):  
Sensitivity Analyses ◽  
Immune Recovery ◽  
Combination Antiretroviral Therapy ◽  
Cd4 Counts ◽  
Art Initiation ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Cd4 Cell ◽  
The Impact ◽  
Related Mortality

Abstract Background Mycobacterium avium–intracelllulare complex (MAC) prophylaxis is recommended for patients with CD4 counts of &lt; 50 cells/mm3. With the significant decrease in incidence of disseminated MAC infection and the effective immune recovery due to the availability of combination antiretroviral therapy (ART), the benefits of giving MAC prophylaxis were investigated. This study examined the impact of macrolide prophylaxis on AIDS-defining conditions and HIV-associated mortality in a cohort of HIV-infected patients on ART. Methods TREAT Asia HIV Observational Database (TAHOD) patients aged ≥18 years with a CD4 count &lt; 50 cells/mm3 at ART initiation were included. The effect of macrolide prohylaxis on HIV-associated mortality or an AIDS event (as a combined outcome) and HIV-associated mortality alone were evaluated using competing risk regression. Sensitivity analysis was conducted to assess whether results were consistent in patients with a CD4 &lt; 100 cells/mm3 at ART initiation. Results Of 1,345 eligible patients (78% male with median age at ART initiation of 34.8 years), 10.6% received macrolide prophylaxis. The rates of the combined outcome and HIV-associated mortality per 100 patient years were 7.35 [95% confidence interval (CI): 6.04–8.95] and 3.14 (95% CI: 2.35–4.19), respectively. After adjusting for possible confounders, macrolide use was associated with a significantly decreased risk of HIV-associated mortality (HR 0.10, 95% CI: 0.01–0.80, P = 0.031) but not the combined outcome (HR 0.86, 95% CI: 0.32–2.229, P = 0.764). Sensitivity analyses showed that, among patients with a CD4 &lt; 100 cells/ mm3 at ART initiation, these results were consistent. Conclusion Macrolide prophylaxis is associated with significantly improved survival among Asian HIV-infected patients with very low CD4 cell counts. The benefits of giving macrolide prophylaxis remain despite the availability of effective ART. Disclosures All authors: No reported disclosures.

Risk Factors for Nevirapine-Associated Rash Among HIV-Infected Patients with Low CD4 Cell Counts in Resource-Limited Settings

2008 ◽  
Vol 6 (1) ◽  
pp. 65-69 ◽  
Author(s):  
Sasisopin Kiertiburanakul ◽  
Somnuek Sungkanuparph ◽  
Angkana Charoenyingwattana ◽  
Surakameth Mahasirimongkol ◽  
Thanyachai Sura ◽  
...  
Keyword(s):  
Risk Factors ◽  
Resource Limited Settings ◽  
Cell Counts ◽  
Resource Limited ◽  
Cd4 Cell Counts ◽  
Cd4 Cell
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