Caracterización clínica del binomio madre-hijo de recién nacidos hijos de madres con VIH en el Hospital Barrio Obrero, años 2016 al 2021

Introducción : El virus de la inmunodeficiencia humana (VIH) es un miembro de la familia Retroviridae, actualmente agrupado dentro del género Lentivirus. Objetivos: Describir las características clínicas de los recién nacidos hijos de madres con diagnóstico de VIH positivos. Materiales y Métodos : Se realizó un estudio descriptivo, transversal, retrospectivo del binomio madre-hijo de recién nacidos hijos de madres con VIH, internados en el Servicio de Neonatología del Hospital General Barrio Obrero en el periodo comprendido de enero de 2016 a diciembre 2021. Se procedió a la recolección de los datos de las fichas del periodo correspondiente al estudio. Resultados : Un total de 31 individuos (binomios madre-hijo) fueron analizados, la mayoría del sexo masculino, un tercio de los niños nació con bajo o muy bajo peso, se registraron 11 madres con controles prenatales insuficientes o nulo, lo que dio lugar a 5 partos vaginales, éstos sin control prenatal. El motivo de internación fue la hiperbilirrubinemia, la profilaxis recibida por los RN fue monoterapia con Zidovudina. Conclusiones : Esta investigación ha demostrado que a pesar del esfuerzo de los programas de control de VIH y maternos, los niños aún nacen con bajo o muy bajo peso, se observan controles prenatales insuficientes y partos vaginales.

Introduction: The human immunodeficiency virus (HIV) is a member of the Retroviridae family, currently grouped within the Lentivirus genus. Objectives: To describe the clinical characteristics of newborns born to mothers diagnosed with HIV. Materials and Methods: This was a descriptive, cross-sectional and retrospective study of the mother-child pairing of newborns born to mothers with HIV, admitted to the Neonatology Service of the Barrio Obrero General Hospital from January 2016 to December 2021. We proceeded to collect the data from the records of the period corresponding to the study. Results: A total of 31 individuals (mother-child pairs) were analyzed, most of the infants were male, one third of the children were born with low or very low weight, 11 mothers had insufficient or no prenatal care, which resulted in 5 vaginal deliveries in those without prenatal care. The most frequent reason for infant hospitalization was hyperbilirubinemia, the prophylaxis received by the newborns was Zidovudine monotherapy. Conclusions: This research has shown that despite the efforts of the HIV and maternal control programs, children are still born with low or very low weight, we found insufficient prenatal care and vaginal deliveries.

Sexual behavioral characters of 321 HIV-positive MSM in Wuhan Jingyingtan Hospital / 公共卫生与预防医学

Objective To study the sexual behavioral characters of HIV-positive men who have sex with men(MSM) with different age group and different sexual orientation. Mehtods A total of 321 newly-diagnosed HIV-positive MSM were selected by convenience sampling from January 2016 to February 2019 in Wuhan Jingyingtan Hospital. All the interviews were performed by doctors one by one and face by face. Spss 23.0 software was used to analyse the difference of sexual behavioral characters in different age groups and sexual orientations. Results Among 321 MSM patients , 44.24% were ≤35 years, 33.02% were 36-59 years, 22.74% were ≥60 years. Homosexuality accounted for 44.86%, bisexuality 20.25%, heterosexuality were 24.30%, and other sexual orientation accounted for 10.59%. Internet was the main way for ≤35 years old group to look for fixed partners, while friends, colleagues and classmates were the main way for 36-59 years old group and ≥60 years old group. There was significant difference in the ways of looking for partners among different age groups（χ2=136.50，P=0.00）. The main way for ≤35 years old and 36-59 years old group to find temporary partners was internet, and the main way for ≥60 years old group to find temporary partners was from friends, colleagues and classmates, there was a significant difference in different age groups in the way to find temporary partners（χ2=69.66，P=0.00）. The age of first male sexual activity was the lowest in homosexual MSM cases, followed by bisexual MSM cases, and the highest in heterosexual MSM cases. The age of first male sexual activity was significantly different in different homosexual orientation MSM cases （F=32.52，P=0.00）. Conclusion When taking intervention measures, the sexual behavior difference in different age groups and different sexual orientations should be considered.

Prevalence of violence towards men living with HIVAIDS in rural communities of Southwestern Uganda

Background: Violence towards HIV positive men is one of the silent barriers to utilization of HIV care services. HIV positive men are potential victims of violence from other people including women, and violence may interfere with treatment outcomes. This study determined the prevalence of violence towards HIV positive men in rural communities of southwestern Uganda. Methods: A cross-sectional study was conducted among 307 HIV positive men at selected health centers using an interviewer administered questionnaire. Data were analyzed in SPSS version 23 using chi-square and multivariate regression at 95% level of significance and a precision of 0.05. Results: Of the 307 participants, 45.3% had experienced violence. Of these, 23.8% (n=73) had experienced kicking or slapping while 12.7% (39) reported sexual violence. Factors associated with violence were; using alcohol and drugs (aOR 0.26, 95% CI 0.09-0.76, p=0.014), knowledge of support structures (OR 2.25, 95% CI 1.33-3.78, p=0.002) and owning land for farming (aOR 0.26, 95% CI 0.10-0.70, p=0.011). Conclusion: The prevalence of violence at 45.3% is quite high especially since violence against men is rarely talked about. This should not be ignored there should be strategies to support this vulnerable group

Challenges encountered by human immunodeficiency virus positive pregnant women on taking antiretrovirals in a public health unit of the Manzini region, Swaziland

In Swaziland, the Ministry of Health adopted the prevention of mother-to-transmission (PMTCT) Option A as a feasible and less costly way to expand the PMTCT services nationwide. Despite major success since the programme started, some barriers, such as the challenge of follow-up care for human immunodeficiency virus (HIV)-positive pregnant mothers still exist. The present study aimed to describe the challenges that HIV-positive pregnant mothers encountered on taking antiretrovirals (ARVs) in a health unit of the Manzini region, Swaziland. A qualitative, exploratory and descriptive research design was used, and data were collected through semi-structured individual interviews and field notes. Purposive sampling was used to select the study site and the population. Permission was requested from the participants to record the interviews. The study population were HIV-positive pregnant mothers, aged between 18 and 40 years, which were enrolled in the PMTCT B+ programme. The PMTCT B+ programme was perceived as preventing the transfer of HIV transmission from mother to child. It boosts the mother's immune system, prevents opportunistic infections and prolongs life. Challenges of taking ARVs emerged as a theme. The participants displayed knowledge and understanding of the programme, yet discrimination and no support from families and partners were mentioned. (Afr J Reprod Health 2022; 26[5]: 41-49).

Infant feeding knowledge and practice among HIVpositive mothers attending HIV treatment centres in Lagos

Background: Twenty five to forty percent of children will be infected with HIV in the absence of any form of intervention which is Prevention of Mother to Child Transmission (PMTCT). Objectives: This study determined the infant feeding knowledge and practices among HIV positive mothers attending HIV treatment centers in Lagos. Methods: A descriptive crosssectional design was used for the study. A multistage sampling technique was used to select / recruit 290 HIV positive mothers with babies between the ages of 2weeks to 18months, attending PMTCT services into the study Pre-tested interviewer administered structured questionnaire was used to collect data and analysis was done using Epi-info software. Chi-square and Fischer exact tests were used to determine association between the dependent and independent variables. The pvalue was set at 0.05. Results: Majority of the respondents (58.9%) were within the age range of 31 ­ 40 years and about half had a secondary school level of education. Exclusive formula feeding (40.3%) and exclusive breast feeding (42.4%) were feeding options known by the majority of the respondents. More than half (55.5%) of the mothers had a good knowledge of infant feeding options. Exclusive breastfeeding (EBF) was practiced by majority (55.5%) of the respondents, 21.4% practiced exclusive formula feeding (EFF) while only 6% practiced mixed feeding (MF). Knowledge of infant feeding options and the attitude towards exclusive breast feeding being enough in the first 6 months of life were associated with infant feeding options practiced; those with good knowledge of infant feeding options did not practice MF (9.7%) (p = 0.013). Conclusion: knowledge of infant feeding options was good and poor knowledge was associated with exclusive formula feeding. Majority practiced EBF. Educational programmes targeted at improving the knowledge of HIV and infant feeding options as well as strengthening of counseling sessions at PMTCT clinic would help reduce the risk of HIV transmission to the child.

Experiences of Living with HIV: Social Stigma and Discrimination among HIV-Positive Mothers in Southern Thailand

@#Introduction: This paper discusses the lived experience of mothers living with HIV/AIDS in the southern region of Thailand. Methods: We employed semi-structured interviewing and drawing method with 30 HIV-positive mothers. Thematic analysis method was used to analyse the data. Results: Most mothers living with HIV found their HIV status through a blood test service at the Antenatal Care Clinic of local hospitals while some visited the doctors because their partner showed severe symptoms of illness. When they learnt about the infection, they experienced a great shock and feared that illness would be disclosed to others in the community. The women were concerned about keeping HIV secret because they would be blamed by people in locality, labeled as “disgusting” people, and excluded from social networks. Nevertheless, we found that social support played a crucial role in assisting these mothers to cope with their HIV status. Religious beliefs and living positively also helped them to deal with their health conditions. Conclusion: Health care providers should design sensitive programs to promote self-confidence for HIV-positive mothers as this could increase their quality of life. The findings revealed that tangible and emotional support from family members and religious sources, as well as positive thinking, played a significant role in supporting these women to deal with their health and well-being, and negative effect associated with their HIV condition. These can be incorporated into the provision of health care, which would enhance their well-being and reduce the feeling of isolation and discrimination among these vulnerable women.

Influencing factors of the effect of anti-retroviral therapy in female commercial sex workers with human immunodeficiency virus positive in Guangxi Zhuang Autonomous Region / 中华传染病杂志

Objective:To investigate the effect and influencing factors of anti-retroviral therapy (ART) in human immunodeficiency virus (HIV)-positive female commercial sex workers (CSW) in Guangxi Zhuang Autonomous Region.Methods:A retrospective cohort study was used in this study. A total of 661 HIV-positive CSW receiving ART from the Guangxi Zhuang Autonomous Region′s municipal and county-level Centers for Disease Control and Prevention (CDC) reported to Guangxi Zhuang Autonomous Region CDC from January 1, 2009 to December 31, 2018 were included.The demographic information of the patients, marital status, past medical history, acquired immunodeficiency syndrome (AIDS)-related diseases after six to 12 months of ART, medications, CD4 + T lymphocytes, virological and immunological effects after receiving ART for six to 12 months were collected. Logistic regression model was used to analyze the influencing factors of virological failure and immunological failure of HIV-positive CSW after six to 12 months of ART. Results:Among 661 HIV-positive CSW, 50(7.6%) cases experienced virological failure, 80(12.1%) cases experienced immunological failure, and 13(2.0%) had both virological failure and immunological failure.There were 85 cases (12.9%) who had a history of sexually transmitted diseases. Multivariate logistic regression analysis showed that unmarried (adjusted odds ratio (a OR)=3.298, 95% confidence interval ( CI) 1.285 to 8.461), AIDS-related diseases after six to 12 months of ART (a OR=4.391, 95% CI 1.555 to 12.402) and missed medications in the last seven days (a OR=3.731, 95% CI 1.942 to 7.166) were risk factors for virological failure. Compared with CD4 + T lymphocytes<200.00/μL at baseline, 350.00≤CD4 + T lymphocytes <500.00/μL (a OR=3.543, 95% CI 1.631 to 7.701) and CD4 + T lymphocytes≥500.00/μL (a OR=2.358, 95% CI 1.002 to 5.547) were risk factors for immunological failure. Conclusions:HIV-positive CSW in Guangxi Zhuang Autonomous Region have a better treatment effect, with low rates of virological failure and immunological failure. Marital status, baseline CD4 + T lymphocyte counts, AIDS-related diseases after six to 12 months of ART, and missed medication in the last seven days are factors influencing the effect of six to 12 months of ART.

Plasmablastic lymphoma of transverse colon: a rare case report

Plasmablastic lymphoma (PBL) is a rare aggressive subtype of non-Hodgkin's lymphoma with large neoplastic cells. It is usually associated with human immunodeficiency virus (HIV) infection but also identified in patients with solid organ transplantation and in immunocompetent patients. It frequently presents as a mass in oral cavity, but has also been described in other extra-oral sites like gastrointestinal track, skin, genitourinary track, nasal cavity, paranasal sinuses, etc. It is characterized by plasmablastic features and an immunoprofile close to plasma cells, Epstein–Barr virus (EBV) positivity and MYC gene dysregulation. We report a case of a 40 year old HIV positive male who presented with intestinal obstruction having mass in transverse colon. Histopathological examination of the excised mass revealed submucosa and muscularis propria infiltrated by monotonous population of medium to large sized lymphoid cells with plasmacytic differentiation. The tumour cells were immunoreactive for EMA, CD138 and Vimentin and immunonegative for LCA, CK, S-100, Chromogranin, CD20, CD30, CD3. Thus the final diagnosis of Non-Hodgkins Lymphoma – Consistent with Plasmablastic Lymphoma was made. PBL should be carefully differentiated from Plasmablastic Plasma cell myeloma, other CD20 negative B-cell neoplasma i.e. primary effusion lymphoma, anaplastic lymphoma Kinase (ALK)-positive large B-cell lymphoma, large B-cell lymphoma arising in human herpesvirus 8 (HHV-8)-associated multicentric Castleman disease.

Estudio comparativo de los resultados del tratamiento del carcinoma anal escamoso en los pacientes HIV positivos y negativos / Comparative study of the results of the treatment of squamous anal carcinoma in HIV positive and negative patients

Introducción: El tratamiento del carcinoma anal escamoso (CAE) en los pacientes HIV positivos resulta controvertido. Si bien las guías actuales recomiendan realizar en los pacientes con buen estado inmunológico la quimiorradioterapia (QRT) concurrente estándar, algunos autores consideran que estos pacientes presentan mayor toxicidad y peores resultados a largo plazo, por lo que requerirían un abordaje diferente. El objetivo de este trabajo es comparar los resultados del tratamiento del CAE en los pacientes VIH positivos y negativos. Diseño: Estudio retrospectivo comparativo. Pacientes y métodos: Se revisaron retrospectivamente las historias clínicas de los pacientes tratados en el Sector Coloproctología, Hospital Fernández, entre 01/2007 y 10/2018. Los del conducto anal se dividieron en: Grupo I: VIH negativos y Grupo II: VIH positivos. Se compararon variables demográficas, factores de riesgo específicos, estadificación, QRT (drogas, toxicidad y respuesta), tratamiento quirúrgico curativo/paliativo, persistencia/recurrencia y supervivencia específica y global. Resultados: Se incluyeron 28 pacientes (18 mujeres); margen: 2, conducto: 26 (Grupo I: 15. Grupo II: 11). Los VIH positivos eran en su mayoría hombres que tienen sexo con hombres vs. 100% de mujeres VIH negativas (p<0,01), más jóvenes (45,2±0,9 vs. 63,6±8; p<0,01) y tabaquistas (82% vs. 27%; p=0,005). No hubo diferencia significativa en la estadificación, aunque el Grupo II tuvo tumores con complicaciones más severas. Pudieron completar el tratamiento: Grupo I: 93%, Grupo II: 64% (p<0,05). Tuvieron respuesta completa a la QRT 13/14 (93%) pacientes del Grupo I y 3/7 (43%) del Grupo II (p<0,01). Hubo 3 recurrencias, 2 locorregionales y 1 a distancia (p=NS). Los VIH positivos requirieron más cirugías (82% vs. 27%; p<0,01). A 5 pacientes (4 del Grupo II) se les realizó una resección abdominoperineal (RAP). Tuvieron colostomía definitiva, con o sin RAP, el 46% de los pacientes, la mayoría VIH positivos (82% vs. 27%; p=0,002). En los VIH positivos el RR de mortalidad por cáncer fue 4 (IC95%: 1,01-16,5; p=0,02) y el RR de mortalidad global fue 5,45 (IC95%: 1,42-20,8; p=0,002). Tuvieron menor supervivencia, tanto global (p=0,001) como libre de enfermedad (p=0,01). Mediana de seguimiento: 27 meses (4-216).Conclusiones: Los pacientes VIH positivos con CAE se diferenciaron de los VIH negativos en una menor tasa de respuesta completa a la QRT y una mayor necesidad de tratamiento quirúrgico. Además, tuvieron una supervivencia global y libre de enfermedad significativamente menor que los VIH negativos. (AU)

INTRODUCTION: The treatment of anal squamous cell carcinoma (SCC) in HIV-positive patients is controversial. Although current guidelines recommend performing standard concurrent chemoradiotherapy (CRT) in patients with good immune status, some authors believe that these patients have greater toxicity and worse long-term results, so they would require a different approach. The purpose of this study was to compare the results of SCC treatment in HIV-positive and HIV-negative patients.DESIGN: Comparative retrospective study.PATIENTS AND METHODS: The records of patients treated in the Coloproctology Section, Hospital Fernández, between 01/2007 and 10/2018 were retrospectively reviewed. Those of the anal canal were divided into: Group I: HIV-negative and Group II: HIV-positive. Demographic variables, specific risk factors, staging, CRT (drugs, toxicity, and response), curative/palliative surgical treatment, persistence/recurrence, and cancer-specific and global survival were compared.RESULTS: 28 patients (18 women), margin: 2, conduit: 26 (Group I: 15. Group II: 11). The HIV-positive were mostly men who have sex with men (vs. 100% HIV-negative women; p<0.01), younger (45.2 ± 0.9 vs. 63.6 ± 8; p<0.01) and smokers (82% vs. 27%; p=0.005). There was no significant difference in staging, although Group II had tumors with more severe complications. Completed the treatment: Group I: 93%, Group II: 64% of patients (p<0,05). Thirteen out of 14 (93%) patients in Group I, and 3/7 (43%) patients in Group II had a complete response to CRT (p<0.01). There were 3 recurrences, 2 loco-regional and 1 distance (p=NS). HIV-positive required more surgery (82% vs. 27%; p<0.01). 5 patients (4 of Group II) underwent an abdominal-perineal resection (APR). Forty six percent of patients had permanent colostomy, with or without APR, most of them were HIV-positive (82% vs. 27%; p=0.002). In HIV-positive patients, the RR of cancer mortality was 4 (95% CI: 1.01-16.5; p=0.02) and the RR of overall mortality was 5.45 (95% CI: 1.42-20, 8; p=0.002). They also had lower overall (p=0.001) and disease-free survival (p=0.01). Median follow-up: 27 months (4 - 216).CONCLUSION: HIV-positive patients with anal SCC were different from HIV-negative patients in that they had a lower complete response rate to CRT, and a greater need for surgical treatment. They had a significantly lower overall and disease-free survival than HIV-negative patients. (AU)

Ocular Diseases in HIV-positive Patients in a Tertiary Hospital in Nigeria

Aims:To determine the pattern of ocular disorders in HIV-positive patients in a tertiary ospital in Nigeria.Study Design:A cross-sectional hospital based study on confirmed HIV positive adult patients attending the HIV clinic in University of Port Harcourt Teaching Hospital.Duration of Study:November and December 2011. Methodology:Consecutive patients within the inclusion criteria were recruited until the required sample size was met. The visual acuity was tested using the Snellen’s chart and the illiterate E-chart. Ocular examination of the adnexial and anterior segments were done using a pen torch and a slit lamp biomicroscope. Fundoscopy was done using a direct and indirect ophthalmoscope as well as with a 90D lens. Other information such as CD4 count and HIV serotype were retrieved from the patient’s case notes. The data was analysed using EPI-info version 7.0. Statistical methods such as the frequency and chi-square were used to test the significance of association.Level of significance was drawn at P<0.05.Results: A total of 411 patients were enrolled in this study. The age range was between 18-69 years with a mean age of 36.9 years. There was a female preponderance with a male to female ratio of 1:2. Ocular disorders were seen in 37.1% of patients studied. The commonest manifestation was the ocular adnexial manifestation and conjunctival microvasculopathy ranked highest (15.6%) in this group. Herpes zoster ophthalmicus was seen in 5 (1.2%) patients, presumed squamous cell carcinoma in 12(2.9%) and Kaposi sarcoma in 3(0.7%). Chorioretinitis was found in 12(2.9%), retinal microvasculopathy in 19(4.6%) and maculopathy in 15(3.6%). There was no case of CMV retinitis. Conclusion: Ocular findings seen in HIV-positive patients were mostly adnexial and occurred in 37% of the study population

A comparison of treatment outcomes among HIV positive tuberculosis patients receiving DOTS and fixed dose combination in Visakhapatnam

Background: Tuberculosis is a communicable disease which requires special attention in HIV patients. According to newer guidelines, the treatment regimen for tuberculosis has been changed from intermittent DOTS to daily FDC. This study was taken up to explore effectiveness of fixed dose combination in comparison to intermittent DOTS. Objective was to compare the treatment outcomes for tuberculosis among HIV positive TB patients receiving intermittent DOTS with those receiving daily fixed dose combination (FDC).Methods: A retrospective cohort study was done during November 2017. The data was collected from patient records in an ART centre, attached to King George Hospital, Visakhapatnam. All the HIV patients newly registered for anti-tubercular treatment at the ART center, during 1st quarter of 2016(intermittent DOTS) were compared with those registered during 1st quarter of 2017(FDC). The treatment outcomes include (1) treatment success (completed/ cured), and (2) other treatment outcomes (lost to follow up (LFU), Death). Data was analysed using MS Excel. Association of factors affecting treatment outcomes was tested using chi-square test.Results: Out of a total 83 patients, 34 were on intermittent DOTS and 49 on FDC. The percentage of treatment success in intermittent DOTS was higher than FDC (p=0.06, chi-square value=3.42). The percentage of deaths in FDC is high when compared to intermittent DOTS (P=0.74, chi-square=3.1762). In subject receiving FDC, it was observed that more females had treatment success as compared to males (p=0.28, chi square=1.13).Conclusions: There is no statistically significant difference in the TB treatment outcomes of intermittent DOTS and FDC.

Pattern of hepatobiliary involvement in HIV/AIDS patients: study in a tertiary care centre

Background: Diseases of hepatobiliary system is a major problem in patients with HIV infection. It has been estimated that approximately one third of the death of patients with HIV infection are in some way related to liver disease. While this is predominantly a reflection of the problems encountered in the setting of co-infection Hepatitis B or C, it is also a reflection of the hepatic injury in the form of hepatic steatosis, that can be due to antiretroviral therapy. There had been little work done on liver function tests in HIV patients without pre-existing liver disease like viral hepatitis, or alcoholic hepatitis. So, this study was designed to assess the pattern of liver function test derangement in HIV patients. Aims and objective was to study the different pattern of hepatobiliary involvement in HIV positive patients, and to gauge the extent of liver damage.Methods: The study included 50 HIV positive patients coming to SMS hospital and Medical College, Jaipur, in medicine and HIV clinic of skin and VD department. Subjects having HIV test positive by ELISA, are included in this study. Other causes of liver function derangements were excluded from the study.Results: Maximum number of the patients were in the age group of 23-32 years. Out of 50 cases studied, 41 (82 %) cases had abnormal liver function tests, while 9 (18%) had normal liver function tests. Most of the cases had liver function abnormalities, and most common abnormality was raised SGOT/SGPT.Conclusions: Almost all types of liver function tests are found to be deranged in HIV patients. The pattern of hepatobiliary involvement varied from fatty liver, cholestasis to Toxic necrosis and granulomas.

Incidence and profile of Helicobacter pylori infection among HIV positive patients

Background: People having HIV infection present with a number of symptoms related to gastrointestinal tract like dyspepsia. HIV itself as well as opportunistic infections is responsible for such symptoms. Notably is Helicobacter pylori infection causes variety of such symptoms. The objective of the present research was to study incidence and profile of Helicobacter pylori among HIV positive patients.Methods: A hospital based cross sectional study was carried out over a period of two years among 101 HIV positive patients in the Department of General Medicine, Madurai Medical College, Madurai in collaboration with Department of Medical Gastroenterology and also Department of Venereology and Leporology. Rapid urease test was done. HIV status was confirmed by ELISA test. Data was analysed with the help of EPI statistical software.Results: Majority (40.6%) had CD4 count of 200-500. It has been observed that incidence of Helicobacter pylori was low in groups with low CD4 count. It was also observed that those with higher CD4 count had higher incidence of RUT positivity. This association was found to be statistically significant. The incidence of Helicobacter pylori positivity was not significantly different among those patients who were on ART (18%) and those who were not on ART (21%).Conclusions: The incidence of Helicobacter pylori infection was less in HIV positive patients. Those with CD4 cell count less than 100 had lower incidence of Helicobacter pylori infection than those with CD 4 cell count more than 500. Incidence of Helicobacter pylori infection was not affected by ART.

A Study To Compare The Health Status And Psychosocial Problems Among Hiv Positive And Hiv Negative Children Of Hiv Positive Mothers In Salem District

A survey and descriptive correlational study was undertaken to find out the current health status and psychosocial problems among HIV positive and HIV negative children of HIV positive mothers in Salem District. 300 samples were selected between the age group of 8-12 years. An observational check list was used to assess health status and PedQLinterview schedule questioner was used to assess psychosocial problems. HIV positive children 107(71.3%) had moderate health problems, 43(28.7%) had intense health problems among HIV negative children 106 (70.7%) had normal health 44 (29.3%) had moderate health problems and HIV positive children had more psychosocial problems than HIV negative children. Conclusion of the study shows HIV positive and HIV negative children had health and psychosocial problems at different level, whereas, HIVpositive children had more problems compared to HIVnegative children

A clinical study of neurological manifestations in HIV positive patients in a tertiary care hospital of Telangana, India

Background: Human Immunodeficiency Virus (HIV) infection is a global pandemic, India has second largest burden of HIV illness. Nervous system is most frequent and serious target of HIV infection. Aim: The main aim of our study was to evaluate the occurrence of various neurological manifestations in HIV positive patients and to correlate them with CD4 count at the time of presentation. Materials and methods: This prospective study was carried out for a period of 2 years from January 2014 to December 2016 in the Department of Neurology, Gandhi Hospital, Hyderabad, India. Those patients, who satisfied the inclusion criteria (>18 year of age; HIV positive; any gender) were included in our study. Patients who were HIV positive but having non neurological medical conditions were excluded. Those with various neurological symptoms were subjected to thorough neurological examination, whenever indicated neuroimaging, CSF analysis, NCS, Toxoplasma serology were done. CD4 count was done in all patients. KameraSateesh Kumar, VeenaNarisetty, P. Chandra Shekar, Changala Praveen, AlluriNeeraja. A clinical study of neurological manifestations in HIV positive patients in a tertiary care hospital of Telangana, India. IAIM, 2018; 5(1): 42-49. Page 43 Results: Our study enrolled a total of 1011 HIV positive patients, out of them 354(35%) patients had neurological manifestations. Among them, 239 (67.51%) were male and115 (32.48%) were female. We analyzed patients presented with various neurological symptoms, 187(52%) patients presented with parasthesias. CD4 count was done to all patients. Out of 354 patients, 188 (39.4%) patients had low CD4 count (<200μL). NCS was abnormal in 182 (51.4%) patients. Axonal sensory neuropathy was the most common abnormality found in 82 (45.0%) patients. The most common neurological manifestation was peripheral neuropathy, seen in 166 (46.8%) patients. Conclusion: HIV infection can affect all levels of the neuronal axis. Neurological manifestations are common in 4th decade of life and males affect more than females. Peripheral neuropathy was the most common neurological manifestation and Tuberculosis was the prominent infectious etiology. Neurological manifestations are seen with low CD4 count and there is a significant correlation between them hence can be stated that, these are the manifestations of the late stage of the disease.

O estigma de usuários do sistema público de saúde brasileiro em relação a indivíduos HIV positivo / The stigma of HIV positive users of the public health system

O conceito inicial de que a AIDS era uma doença que ocorria em indivíduos com atitudes desaprovadas pela sociedade causou estigmatização e preconceito em indivíduos HIV positivo. Objetivo: Analisar a existência de preconceito e atitudes discriminatórias de usuários do Sistema Único de Saúde (SUS) em relação a indivíduos soropositivos, considerando sua classe socioeconômica. Métodos: Trata-se de uma pesquisa descritiva, com caráter transversal e abordagem quantitativa. Aplicou-se o Critério de Classificação Econômica Brasil, para a classificação econômica da população, e um questionário estruturado com questões relacionadas ao preconceito e à discriminação, à percepção sobre esterilização e ao contágio de doenças; além de questões de manual do Ministério da Saúde que aborda o assunto. Resultados: A população estudada foi composta por 150 indivíduos, dos quais 77,3% afirmaram que aceitariam ser atendidos após um paciente soropositivo, e 92%, após um presidiário. Entretanto, 42% prefeririam o atendimento antes de um indivíduo soropositivo, e 23,3%, antes de um presidiário. A maioria relatou preocupação quanto à esterilização do material odontológico (98%), embora 42% não soubessem como o procedimento ora realizada. Existiu diferença significativa entre os indivíduos que inicialmente afirmaram aceitar o atendimento após um paciente HIV positivo (p=0,0029) ou um presidiário (p<0,0001) e os que posteriormente disseram preferir o atendimento antes. Não houve associação entre classe econômica e preconceito. Conclusão: Os usuários do SUS apresentam preconceito e atitudes discriminatórias em relação a pessoas soropositivas, expressa, às vezes, de maneira velada, independentemente da classe econômica do indivíduo.

The initial idea of AIDS as a disease that affects individuals with attitudes disapproved by society has caused stigmatization and prejudice among HIV positive individuals. Objective: To analyze the existence of prejudice and discriminatory attitudes of Unified Health System ("Sistema Único de Saúde" ­ SUS) users towards HIV positive individuals, according to socioeconomic class. Methods: This is a cross-sectional, descriptive research, with quantitative approaches. We categorized the population according to the Brazilian Criterion of Economic Classification, and applied a structured questionnaire related to prejudice, discrimination, and perceptions regarding sterilization and infectious diseases; as well as questions from a relevant Ministry of Health publication. Results: The study population consisted of 150 individuals, 77.3% of which asserted they would agree to be treated immediately after an HIV positive patient and 92% after a prisoner. However, 42% preferred being examined before HIV positive individuals, and 23.3% before a prisoner. The majority reported concern about the sterilization of dental material (98%), though 42% did not know how the procedure was carried out. There was significant difference between individuals who initially said they would not mind being received after HIV positive patients (p=0.0029) or inmates (p<0.0001), and those who later said they would rather be received before individuals in these conditions. There was no association between socioeconomic class and prejudice. Conclusion: SUS users show prejudicial and discriminatory attitudes toward HIV patients, often expressed in subtle manners, regardless of economic class of the individual.

Perfil epidemiológico das gestantes HIV positivas e de seus recém-nascidos em um hospital de referência no interior do Rio Grande do Sul no período de 2012-2013 / Epidemiological profile of HIV positive pregnant women and their newborns in a reference hospital in the interior of Rio Grande do Sul in the 2012-2013 period

Introdução: A transmissão vertical tem se tornado um desafio de saúde pública, uma vez que a incidência/prevalência do HIV tem aumentado entre as mulheres. O diagnóstico precoce, diretamente relacionado ao pré-natal, é de fundamental importância para a profilaxia e manejo adequado durante o trabalho de parto. Assim, busca-se analisar a eficácia do serviço prestado nessa unidade. Metodologia: Trata-se de um estudo exploratório descritivo com abordagem quantitativa retrospectiva. Utilizaram-se prontuários para o levantamento de dados sobre o perfil epidemiológico de gestantes HIV positivas e dos seus neonatos em um hospital de referência no período de 2012-2013. Resultados: A faixa etária variou de 15 a 44 anos, com média de 29 anos. A profissão mais frequente foi "do lar", sendo que 70% das pacientes tinham ensino fundamental incompleto e 75% eram solteiras. Quanto à paridade, a média foi de três gestações. O pré-natal variou de 1-14 consultas, com média de oito. A idade gestacional média foi de 38,5 semanas e a via de parto foi 100% cesárea. Quanto aos neonatos, a média de peso ao nascer foi de 2965g, o comprimento médio foi de 47,3cm e o APGAR no quinto minuto foi nove. A totalidade dos recém-nascidos recebeu quimioprofilaxia adequada nas primeiras horas de vida e fez-se uso exclusivo de fórmula infantil. Conclusão: O serviço de referência está qualificado, pois não houve alterações clínicas consideráveis com as pacientes soropositivas e com seus neonatos. Ademais, a totalidade deles teve quimioprofilaxia adequada em tempo hábil, consistindo em cuidados prudentes durante e após o nascimento (AU)

Introduction: Vertical transmission has become a public health challenge, since HIV incidence/prevalence has increased among women. Early diagnosis, directly related to prenatal care, is of fundamental importance for prophylaxis and proper management during labor. Here we seek to analyze the effectiveness of the service provided in this unit. Methods: This is an exploratory descriptive study with a retrospective quantitative approach. Records were used to collect data on the epidemiological profile of HIV positive pregnant women and their newborns in a reference hospital in the 2012-2013 period. Results: Patient age ranged from 15 to 44 years, with a mean of 29 years. The most frequent profession was "homemaker", with 70% of the patients having incomplete elementary education and 75% being single. As for parity, the mean was three pregnancies. Prenatal care ranged from 1-14 visits, with an average of eight. The mean gestational age was 38.5 weeks and the delivery route was 100% cesarean section. As for neonates, the mean birth weight was 2965g, the mean length was 47.3 cm and the fifth-minute APGAR was nine. All newborns received adequate chemoprophylaxis in the first hours of life and infant formula only. Conclusion: The reference service is qualified, since there were no clinically significant changes in seropositive patients and their neonates. In addition, all of them had adequate chemoprophylaxis in a timely manner, consisting of prudent care during and after birth (AU)

Demographic Profile and Clinical Features of Admitted HIV Positive Patients and their Correlation with CD4 Counts in a North India Tertiary Care Hospital.

Background: HIV Infections continues to be a burden globally and presents serious public health problems in the developing countries, especially in India. Aims and objectives: To study the demographic profile and clinical features of HIV positive admitted patients and to evaluate the correlation of clinical features with their CD4 counts. Methods: The present study was conducted to assess the socio-demographic profile and clinical features of 150 HIV+ve /AIDS patients admitted in various wards of Department of Medicine, Rajindra Hospital, Patiala from September 2013 to October 2015. For these patients a preformed questionnaire was prepared to enquire about socio-demographic characteristics such as age, sex, literacy status, marital status, occupation and socio-economic status. Thorough clinical examination was performed and correlation of clinical features with CD4 counts was evaluated using Pearson Coefficient of correlation. Results: The results of study showed that the most common age group affected was 26-45 years (56%). Male patients were 69.3% and females constituted 30.7%. Most common mode of transmission was heterosexual (73.3%), followed by intravenous drug abuse (6.7%), unsafe injections/needle stick injury (4.6%), blood transfusion (2.7%), 8% were both HS and IDU and transmission was unknown in 2.7%. The common presenting symptoms in admitted HIV patients were fever (71.3%), weight loss (50%), night sweats (39.3%), dry cough (36%), anaemia (32%), cough with expectoration (26%), lymphadenopathy (24%), shortness of breath (22%), chest pain (20.7%),diarrhoea (15.3%) and mouth ulcers (8.7%). Others were, headache (10.7%), haemoptysis (10%), icterus (6.7%), change of voice (4%), altered sensorium (14%) and neurological deficit (7.3%). 16 patients had pulmonary and 13 had extra pulmonary tuberculosis. It was also found that most patients (52%) had CD4 count in range of 200-500, with mean CD4 count of 282.61 + 14.31 cells/cmm at time of presentation. The frequency of these symptoms increased with fall in CD4 count indicating negative correlation. Conclusion: A thorough knowledge of the demographical & clinical profile of admitted patients will go a long way in managing resources and planning management of these patients. This will serve as a great step in achieving zero deaths as envisaged by NACO.

Cerebrospinal fluid examination may be useful in diagnosing neurosyphilis in asymptomatic HIV+ patients with syphilis / El examen del líquido céfalo raquídeo puede ser útil en el diagnóstico de neurosífilis en pacientes VIH + asintomáticos con sífilis

ABSTRACT Lumbar puncture in neurologically asymptomatic HIV+ patients is still under debate. There are different criteria for detecting neurosyphilis through cerebrospinal fluid (CSF), especially in cases that are negative through the Venereal Disease Research Laboratory (VDRL), regarding cellularity and protein content. However, a diagnosis of neurosyphilis can still exist despite negative VDRL. Treponema pallidum hemagglutination assay (TPHA) titers and application of the TPHA index in albumin and IgG improve the sensitivity, with a high degree of specificity. Thirty-two patients were selected for this study. VDRL was positive in five of them. The number of diagnoses reached 14 when the other techniques were added. It was not determined whether cellularity and increased protein levels were auxiliary tools in the diagnosis. According to our investigation, CSF analysis using the abovementioned techniques may be useful in diagnosing neurosyphilis in these patients.

RESUMO La punción lumbar (PL) en pacientes VIH+ neurológicamente asintomáticos es controversial. Existen diferentes criterios para detectar en el líquido cefalorraquídeo (LCR) neurosífilis (NS): el examen Venereal Disease Research Laboratory (VDRL) en primer lugar, en caso de negatividad: la celularidad y el tenor de proteinas. Sin embargo el diagnóstico de NS puede ser sostenido a pesar de la negatividad de las técnicas mencionadas. La titulación del Treponema pallidum hemagglutination assay (TPHA) y la aplicación del índice de TPHA en Albúmina e Ig G mejoran la sensibilidad asociando elevado grado de especificidad. 32 pacientes fueron seleccionados para este estudio, el VDRL fue positivo en 5. El diagnóstico se elevó a 14 cuando se sumaron el resto de las técnicas. No se evidenció que la celularidad y el aumento de proteínas fueran herramientas auxiliares para el diagnóstico. De acuerdo a nuestro trabajo el estudio del LCR con las técnicas señaladas puede ser de utilidad en el diagnóstico de NS en estos pacientes.

Factors that Influence Infant Feeding Options of HIV-Positive Mothers in Urban and Rural Communities in South-East, Nigeria.

Introduction: Infant feeding method decision making is a very vital aspect of child care. This study compares the factors influencing infant feeding options of HIV-positive mothers in urban and rural communities in southeastern Nigeria. Methods: It was a comparative cross-sectional study involving HIV-positive mothers whose babies were HIV-negative, and below 24 months using systematic sampling method. Questionnaires and Focused Group Discussion (FGD) guide were used. Results: About 123(54.7%) urban and 142(64.1%) rural dwellers intended exclusively breastfeeding (p = 0.150), however 88(39.1%) urban and 122(54.2%) rural dwellers actually exclusively breastfed (p = 0.001). The commonest reason for breastfeeding was belief that breast feeding was best for their babies (p = 0.003) while for formula feeding was that it protects the baby from HIV infection (p = 0.044). Family income with occupation for rural communities (p = 0.01, and p = 0.03 respectively) and family income for urban (p = 0.01) were significantly associated with infant feeding options. The FGD identified that disclosure of their HIV status to their husbands or relations helped the mothers in both communities maintain their feeding options. Conclusions: Infant feeding practices differed significantly between communities. Family incomes and occupation were factors influencing feeding options.