Cardiac & renal disease in HIV patients and their correlation with CD4 count.

Objectives: The introduction of Anti retroviral therapy (ART) for HIV disease has significantly modified the quality of life and lengthened survival of HIV infected patients. Cardiac and renal disease may be direct consequence of HIV infection, due to opportunistic infection or related to drug toxicity. Aim of our study is to determine prevalence of the cardiovascular and renal manifestations in HIV infected patients and their correlation to CD4 count. Methods: A cross sectional study was carried out over a period of 2 years at Shri Sayajirao General Hospital and Medical College Baroda. 200 consecutive HIV patients attending medical outpatient department and those admitted were screened using ECG, 2-D Echocardiography, urinary albumin, serum creatinine, serum cholesterol and sonography kidneys. CD4 count was done in all patients. Patients with echocardiography evidence of ischemic heart disease, left ventricular dysfunction, decreased ejection fraction, pericardial effusion and pulmonary hypertension were included in cardiac group. All patients with urinary albumin more than 3 gram, normal or enlarged kidney on ultrasound with or without raised creatinine were included under HIV associated nephropathy group. Renal biopsy was done in one such patient to establish the diagnosis. Results and Interpretation: Of total 200 patients screened, 20 patients had cardiac disease (10%), 22 renal disease (11%) while 2 had both. On further analysis in cardiac group, dilated cardiomyopathy (45%) was the most common. Similarly, among those with renal disease, HIV associated nephropathy (31.8%) was the most common. CD4 count showed that 27(67.5%) of 40 patients had CD4 count below 100.

Antenatal HIV Testing for Prevalence in the Remote District of Rural Andhra Pradesh and Treatment Prophylaxis with Nevirapine

This study was carried out from January 2006 to December 2008 in the rural district of Andhra Pradesh, India. It included counselling and spreading of awareness encouraging voluntary Human Immunovirus testing in antenatal cases and starting prophylactic treatment of seropositive cases with nevirapine for safe deliveries and for preventing the mother to child transmission with distinct improvement effectively.

Dyslipidemia and dysglycemia in patients with HIV infection and in patients on antiretroviral therapy.

Objective: Use of ART in HIV infected individuals’ results in reduced mortality and morbidity associated with AIDS. Long term complications of HIV & ART including dyslipidemia & dysglycemia have raise concern regarding accelerated cardiovascular risk in these patients. Aim of study is to determine prevalence of dyslipidemia & dysglycemia in HIV infected patients and its relation to CD 4 count. Material and Methods: A cross sectional two arm comparison study carried out at Shree Sayajirao General Hospital and Medical College Baroda. The treatment arm, ON ART arm, constituted 30 patients already on ART defined as a combination of at least three classes of antiretroviral drugs, namely PIs, NNRTIs and NRTIs, one of which was a PI or an NNRTI ,or a triple combination of NRTIs. Comparator arm, ART naïve arm constituted 30 HIV-positive patients, eligible for, but not yet receiving ART. Dyslipidemia & dysglycemia were defined as high total or LDL cholesterol, high triglycerides, or low HDL cholesterol according to the adult treatment panel III (ATP III) guidelines and as the presence of diabetes , impaired fasting blood sugar(FBS) , impaired post prandial blood sugar(PP2BS) or impaired glucose tolerance according to ADA (American diabetes association)criteria ,respectively. Discussion: Dysglycemia was present in 30% of study population and dyslipidemia was present in 73.33% of study population. Difference in elevation of serum Cholesterol level and serum LDL level in patients on ART arm was statistically significant. Dysglycemia and dyslipidemia was associated with low CD 4 count compare to patients with normal blood glucose level and normal lipid profile level.