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 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

Identification of an HIV-1 and Neurosyphilis Cluster in Vermont

2020 ◽  
Author(s):  
Devika Singh ◽  
William M Switzer ◽  
Roy Belcher ◽  
Daniel Daltry ◽  
Jennifer S Read
Keyword(s):  
Newly Diagnosed ◽  
Viral Loads ◽  
Network Analyses ◽  
Intervention Specialists ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Sex With Men ◽  
Cd4 Cell ◽  
Hiv 1 ◽  
Sexual Networking

Abstract Background Rates of syphilis in the U.S. have more than doubled over the last several decades, largely among men who have sex with men (MSM). Our study characterizes a cluster of neurosyphilis cases among HIV-1-infected individuals in Vermont in 2017-2018. Methods Vermont Department of Health disease intervention specialists conduct interviews with all newly diagnosed HIV-1 cases and pursued sexual networking analyses. Phylogenetic and network analyses of available Vermont HIV-1 polymerase (pol) sequences identified clusters of infection. Fishers-exact and independent t-tests were used to compare HIV-1-infected individuals within or outside an identified cluster. Results Between January 1, 2017 and December 31, 2018, 38 Vermont residents were newly diagnosed with HIV-1 infection. The mean age was 35.5 years, 79% were male and 82% were white. Risk factors for HIV-1 acquisition included MSM status (79%) and methamphetamine use (21%). Eighteen cases (49%) had HIV-1 viral loads (VLs) &gt;100,000 copies/mL and 47% had CD4 cell counts &lt;200/mm 3. Eleven of the 38 (29%) cases had positive syphilis serology, including four (36%) with neurosyphilis. Sexual networking analysis revealed a ten-person cluster with higher VLs at diagnosis (90% with VLs &gt; 100,000 copies/mL vs. 33%, p=0.015). Phylogenetic analysis of pol sequences showed a cluster of 14 cases with sequences that shared 98-100% HIV-1 nucleotide identity. Conclusions This investigation of newly infected HIV-1 cases in Vermont led to identification of a cluster that appeared more likely to have advanced HIV-1 disease and neurosyphilis. Identification of a cluster was strongly supported by both phylogenetic and network analyses of HIV-1 pol sequences.

The Relationship of Preventable Opportunistic Infections, HIV-1 RNA, and CD4 Cell Counts to Chronic Mortality

2002 ◽  
Vol 30 (4) ◽  
pp. 421-428
Author(s):  
George R. Seage ◽  
Elena Losina ◽  
Sue J. Goldie ◽  
A. David Paltiel ◽  
April D. Kimmel ◽  
...  
Keyword(s):  
Opportunistic Infections ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Relationship Of ◽  
Cd4 Cell ◽  
The Relationship ◽  
Hiv 1

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 Baseline CD4 Cell Counts of Newly Diagnosed HIV Cases in China: 2006–2012

PLoS ONE ◽  
2014 ◽  
Vol 9 (6) ◽  
pp. e96098 ◽  
Author(s):  
Houlin Tang ◽  
Yurong Mao ◽  
Cynthia X. Shi ◽  
Jing Han ◽  
Liyan Wang ◽  
...  
Keyword(s):  
Newly Diagnosed ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Cd4 Cell

scholarly journals Linear Mixed Modeling of CD4 Cell Counts of HIV-Infected Children Treated with Antiretroviral Therapy

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Belay Belete Anjullo ◽  
Derbachew Asfaw Teni
Keyword(s):  
Cell Count ◽  
Stage Iv ◽  
Observation Time ◽  
Square Root ◽  
Cd4 Cell Count ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
History Of ◽  
The Mean ◽  
Cd4 Cell

Background. Human immunodeficiency virus (HIV) is a major health problem in the world, and failure to implement prevention programs results in an increased number of infections among newborns. The goal of this study was to investigate the evolution and determinants of cluster of differentiation four (CD4) cell count among HIV-infected children who were under antiretroviral therapy (ART). Methods. We follow up a cohort of 201 children aged under fifteen years from October 2013 to March 2017 at Adama Hospital in Ethiopia. To get insight into the data, exploratory data analysis was performed on the change in the longitudinal CD4 cell count. Results. At the baseline, the average number of CD4 cell counts was 468.5 cells/mm3 of blood with a standard deviation of 319.11 cells/mm3. Here, we employed the random intercept and the random slope linear mixed-effects model to analyze the data. Among predictor variables, observation time, baseline age, WHO clinical stage, the history of tuberculosis (TB), and functional status were determinant factors for the mean change in the square root of the CD4 cell count. Conclusions. The finding revealed that the change in the square root of the CD4 cell count increases with an increment of age at diagnosis. Regarding WHO clinical stages of patients, those who were in stage III and stage IV of the HIV/AIDs disease stages relatively had lower CD4 cell counts than stage I patients. This shows the change in the square root of CD4 cell counts of stage III and stage IV patients was 6.43 and 9.28 times lower than stage I patients, respectively. Similarly, we noticed that observation time, the history of TB, and functional status were significantly associated with the mean change in the square root of the CD4 cell count.

scholarly journals Pneumocystis pneumonia in patients with primary nephrotic syndrome: analysis of 18 cases

2020 ◽  
Author(s):  
Xiaohan You ◽  
Ji Zhang ◽  
Qiongxiu Zhou ◽  
Jianna Zhang
Keyword(s):  
Nephrotic Syndrome ◽  
Pneumocystis Pneumonia ◽  
Prednisone Dose ◽  
Primary Nephrotic Syndrome ◽  
Cd4 Cell Count ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
The Mean ◽  
Cd4 Cell ◽  
Syndrome Analysis

Abstract Background The aim of this study was to analysis the clinical features, risk factors and outcomes of patients with primary nephrotic syndrome (PNS) who developed pneumocystis pneumonia (PCP). Methods We systematically reviewed medical records from 18 PNS patients with PCP admitted to our hospital from April 2007 to April 2019. A total of 180 cases were randomly selected as controls from PNS inpatients without infection. Results In PCP patients, the mean age at presentation was 48.5 years, mean duration of prednisone treatment was 3.7 months and mean prednisone dose on admission was 31.3 mg/d, the most common clinical manifestation was fever (100%) and average PaO 2 on admission was 59.5 mmHg. Eight patients (44.4%) had coexisting infections, most often was cytomegalovirus (4 patients), 11 patients (61.1%) had ICU admission and 9 patients (50%) had mechanical ventilation. PCP patients had more prednisone, more immunosuppressive therapy, lower CD4+ cell counts and hemoglobin, and higher serum creatinine than those without infections (p<0.05). Logistic regression analysis showed that patients with prednisone usage and lower CD4+ cell counts were more likely to have PCP compared to controls (p<0.05). All patients survived after treatment. Conclusion PCP was not unusual in PNS patients, and the most important risk factor was a lower CD4+ cell count, but however, these patients had a good outcome after enough treatments.

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.

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