Correlations between clinical features and CD4 cell count in HIV patients with tuberculosis

Background: The correlation between tuberculosis and HIV is evident from the higher incidents of tuberculosis estimated 5-8% per year among HIV infected person with lesser CD4cell count. The high seroprevalence with tuberculosis in occurrence among AIDS patients.Methods: 100 HIV positive patients with tuberculosis who were admitted to medicine department and who visited to ARTS center were taken up for study for period of two years from December 2014 to 2016. Type of study is a observational comparative cross sectional study The investigation for HIV and TB were done as per NACO and WHO recommendation ELISA test CD4 cell counts AFB staining chest X-ray FNAC Mountoux test pleural fluid analysis Ascitic fluid analysis CSF fluid analysis USG of thorax CT scan of thorax.Results: It is seen that the maximum number of patients belong to the age group 31-40 years male 40 (40%) and female 4(4%) the common occupation in the study group was driver 36 (36%) the common constitutional symptom was weight loss physical examination reveal underweight (BMI <16-18.5) 54 (54%) among the study extra-pulmonary TB 63 (63%) X-ray chest finding pleural effusion found in 21% of patients CD4 cell counts 200-500 /µl was seen maximum number of patients.Conclusions: The CD4cell counts is important investigation in HIV and TB patients it is main investigation to know prognosis of HIV also important for initiation of ARV drugs.it is evident from this study the decrease the CD4cell counts there is increase the incidence of tuberculosis.

Variation of CD4+ T-Lymphocyte Counts and Transaminases in HIV and HIV/HBV Co-infected Patients on Therapy at Nylon Hospital Douala, Cameroon.

Objective: This study was aimed at determining the prevalence of Hepatitis B and associated risk factors such as CD4+ counts variation and liver enzymes among HIV co– infected patients and those with HIV mono-infections only. Design and Methods: Three hundred and fourteen (314) HIV patients took part in this cross sectional case control study. Socio-demographic information and history of exposure to risk factors such as scarification, blood transfusion, and unprotected sexual intercourse and alcohol consumption, were obtained through a well-structured questionnaire. Serological tests were done to determine the presence of Hepatitis B (HB) surface Antigen, liver enzymes’ activities were estimated and CD4+ cell counts evaluated using standard laboratory methods. Results: Out of the 314 HIV patients, 20 (6.4%) tested positive for hepatitis B surface antigen (HBsAg) while 294 (93.6%) were negative. Most HIV patients co–infected with HBV were in the age group 31 to 45 years. There was no significant variation when co-infection and mono-infection groups were compared based on age and sex (p=0.7405 and p=0.3361). More males, 7 (2.23%) against 2 (0.64%) females (P=0.02) co–infected with HBsAg had a CD4+ cell counts in the range 201-350cells/µL. No significant difference of liver transaminases (SGPT and SGOT) levels between mono and co-infection groups (P>0.05) was observed. No association of HBsAg with observed risk factors among HIV patients was noted. Conclusion: The study concluded that the prevalence of hepatitis B among HIV patients was 6.4% with majority of the patients having CD4+ cell counts within 201-350. The liver function parameters (transaminases) were not affected with HIV/HBV co-infection.

HIV Prevalence and the Correlation of Different Opportunistic Infection with CD4 Cell Count.

In India, an opportunistic infection with HIV and associated complications accounts for considerable proportion of mortality. There exists definite CD4 cell count correlation with opportunistic infection in HIV patients. Objectives: To document the prevalence of HIV with correlation of different opportunistic infection with CD4 cell count. Material and Method: A total of 174 HIV positive patients either hospitalised or ART POD were studied for finding the spectrum of opportunistic infection and for HIV prevalence. Various samples were collected as per symptoms and clinical presentation. Result: Among opportunistic infection, most common were bacterial infection with 72.5%, followed by fungal infection 42.1% and parasitic infection with 25.8%. TB in 21 patients and candidacies in 5 patients were found in CD4 cell count <500 cell/μl followed by chronic diarrhoea with CD4 cell count <200 cell / μl. Conclusion: Prevalence of HIV infection in persons attending ICTC is 11.3%. TB is the most common opportunistic infection followed by candidacies and diarrhoea.

Genital mycoplasma & Chlamydia trachomatis infections in treatment naïve HIV-1 infected adults.

Background & objectives: Sexually transmitted infections (STIs) enhance the transmission of human immunodeficiency virus (HIV). Thus, screening for STIs is a routine component of primary HIV care. There are limited data for selective screening guidelines for genital mycoplasmas and Chlamydia trachomatis in HIV-infected adults. The aim of the present study was to determine the frequency of genital infections with Ureaplasma spp., Mycoplasma hominis, M. genitalium and C. trachomatis in treatment naïve asymptomatic HIV-1 - infected adults and study their association with CD4+ T-cell count. Methods: First-void urine samples were collected from 100 treatment-naïve HIV-1-infected adults and 50 healthy volunteers. C. trachomatis and M. genitalium were detected by polymerase chain reaction (PCR). Ureaplasma spp. and M. hominis were detected by both culture and PCR. Circulating CD4+ cell counts of HIV-1-infected patients were determined from peripheral blood by flow-cytometry. Results: C. trachomatis was detected in 7 per cent of HIV-1-infected adults compared to none in control population. Ureaplasma spp. and M. hominis showed infection rates of 6 and 1 per cent in the HIV group and 2 and 0 per cent in the control group, respectively. None of the individuals from the patient and control groups was tested positive for M. genitalium. A significant association was found between CD4 cell count and detection of C. trachomatis in HIV-infected adults (P = 0.01). Interpretation & conclusions: Screening of HIV-infected individuals for C. trachomatis infection could be recommended as a routine component of HIV care. The role of mycoplasmas as co-pathogens of the genitourinary tract in HIV-1 infected patients seems to be unlikely. Further longitudinal studies need to be done to confirm these findings.

Impacto de la inmunodepresión basal y su grado de recuperación al año de terapia antirretroviral en sobrevida, complicaciones oportunistas y reacción de recuperación inmune / Impact of baseline CD4 count, immune recoveny and viral suppression at 7 year of first highly active antiretroviral therapy on survival, AIDS defining events and immune recovery reactions

Background: Baseline (BL) CD4 cell count is a major factor in outcome of highly active antiretroviral therapy (HAART); treatment induced immune recovery and viral response can modulate this outcome. Aim: To evaluate the association between baseline CD4 cell count and outcome during the first HAART régimen. Material and methods: Prospective study in 2,050 patients on first HAART with a follow up (f/u) ofat least 1 year. All had BL CD4 and viral load (VL) counts which were repeated at least twice a year. Patients were grouped according to BL CD4 (cells/mm³) in <100 (Gl), 100-199 (G2) and ≥ (G3). Groups were further divided according to immune and vírologícal response at 1 year in CD4 > or < 200 and VL detectable or undetectable (<80 copies/mL). Outcome measures were death, ALUS defining events (ADE) and, as a surrogate marker of immune recovery reaction, herpes zoster (HZ). Resulte: During the first year of follow up, 113 patients (10.8 percent) diedin Gl (n =1,044), 17 (2.5 percent) in G2 (n =675) (Gl-2 p <0.05) and 9 (2.7 percent) in G3 (n =331) (G2-3 p NS). One hundred twenty five of919 (13.6 percent) patients alive at 1 year had ADE in Gl, 55/643 (8.5 percent) in G2 (p <0.05) and 20/320 (5.2 percent) in G3 (G2-3 p NS). ADEs with follow up CD4 >vs< 200 were: 25/274 (9.1 percent) vs 100/643 (15 7 percent) in Gl (p <0.005); 28/404 (6.9 percent) vs 27/235 (11.2 percent) in G2 (p NS) and 18/281 (6.4 percent) vs 2/41 (4.8 percent) in G3 respectively (p NS). Detectable VL was an additional risk for ADE only in Gl without CD4 recovery. HZ was seen in 6.6 percent of Gl vs 4 percent in G2 (p <0.05) and 4.3 percent in G3. HZ rate was higher in all groups reaching a follow up CD4 >200 than those who did not, with a statistically significant difference at p <0.05 only in Gl (9.5 percent vs 5.3 percent). Conclusions: The occurrence of death and ADE during the first year of HAART was significantly higher in patients with aBL CD4...