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Search Results: 1 - 10 of 6248 matches for " HIV "
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Routine Screening for HIV Infection in a Low Risk Population  [PDF]
Mary Bessesen, Patricia Stamper, James Shaw, Neelam Ojha, Anthony Currans, Don Weinshenker, Daniel Merrick
Advances in Infectious Diseases (AID) , 2012, DOI: 10.4236/aid.2012.22004
Abstract: Context: Despite advances in therapy for HIV infection, treatment is often compromised by delayed diagnosis. Strate-gies are needed to improve broad based testing in all medical settings. Objective: To compare HIV screening rates in a primary care setting following implementation of an electronic reminder system to rates produced solely by provider educational efforts. Design: Prospective, observational study of HIV screening, comparing rates during implementation of strategies. Setting: Multiple clinic healthcare system affiliated with a tertiary care medical center. Patients: Veterans receiving care in the clinics affiliated with the Department of Veterans Affairs-Eastern Colorado Healthcare System. Intervention: Provider education and a provider clinical reminder system embedded in the electronic medical record. Main Outcome Measure: Proportion of primary care clinic appointments at which the veteran was screened for HIV infection. Results: The proportion of visits at which screening occurred increased from 2.7% during the provider edu-cation period to 16.7% during the provider clinical reminder period (p < 0.0001). All of the cases identified by the re-minder were antiretroviral therapy candidates, and there was a trend to earlier diagnosis in the screening group than in the diagnostic testing group (CD4 count 329 vs. 109, p = 0.13). Conclusions: An electronic clinical reminder system in a primary care setting is an effective strategy to increase testing for HIV infection, and may lead to fewer delayed diag-noses.
Rapid HIV diagnostics
NK Afridi
International Journal of Infection and Microbiology , 2012, DOI: 10.3126/ijim.v1i1.6937
Abstract: DOI: http://dx.doi.org/10.3126/ijim.v1i1.6937 Int J Infect Microbiol 2012;1(1):1-2
Case report: Rhabdomyolysis in the setting of acute human immunodeficiency virus infection  [PDF]
Jason C. Huang, Stephanie Gold, Kathleen A. McManus, Brian Wispelwey
Case Reports in Clinical Medicine (CRCM) , 2013, DOI: 10.4236/crcm.2013.23054
Abstract:

Acute HIV infection (AHI) is often marked by nonspecific and vague complaints, which make detection difficult. An 18-year-old man presented with one week history of subjective fevers with chills, nonproductive cough and generalized body aches. He was found to have rhabdomyolysis due to AHI. This report adds the most thoroughly investigated case of AHI-associated rhabdomyolysis to date, having ruled out erlichia, legionella, parainfluenza, adenovirus, enterovirus, metapneumovirus, RSV and DILS.

Levels of Immunoglobulin Classes Are Not Associated with Severity of HIV Infection in Nigerian Patients  [PDF]
Oluwaseun O. Akinpelu, Yetunde A. Aken'Ova, O. Ganiyu Arinola
World Journal of AIDS (WJA) , 2012, DOI: 10.4236/wja.2012.23030
Abstract: The serum concentrations of immunoglobulin G (IgG), immunoglobulin A (IgA), immunoglobulin M (IgM), total protein and albumin were measured in 35 Human Immunodeficiency Virus—positive, HAART (highly active antiretroviral therapy) na?ve subjects attending the PEPFAR (President's Emergency Plan for AIDS relief) clinic, University College Hospital, Ibadan and in 30 apparently healthy control subjects to assess the relationship between serum protein, immunoglobulin concentrations and laboratory indices of HIV disease (CD4 cell counts and viral load). Serum IgG (1008.6 ± 530.7 mg/dl), IgA (170.4 ± 69 mg/dl) and total protein (9.9 ± 1.7 g/dl) levels were higher among HIV positive subjects compared with mean values in healthy subjects (549.8 ± 193.8 mg/dl, 106.8 ± 26.4 mg/dl and 7.8 ± 0.5 g/dl respectively). The median serum IgM concentration (131mg/dl) was significantly higher in HIV positive subjects compared with 35 mg/dl in healthy controls (p < 0.001). Mean serum albumin concentration was significantly lower among HIV positive subjects (3.7 ± 0.7 g/dl), compared with 4.3 ± 0.3 g/dl in healthy subjects (p < 0.001). There were no significant differences observed in the levels of the immunoglobulin classes when HIV subjects with CD4 counts of <200 cell/μL were compared with subjects with CD4 counts > 200 cells/μL. There was also no statistically significant correlation observed between viral load and serum immunoglobulin levels.
Management and Outcome of Pregnant Women with HIV Acquired by Vertical Transmission  [PDF]
Verónica Serrano de la Cruz Delgado, Alicia Martínez Varea, María José Nú?ez Valero, Vicente Diago Almela, Vicente Maiques Montesinos, Amparo García Tejedor, Alfredo Perales Marín
Open Journal of Obstetrics and Gynecology (OJOG) , 2015, DOI: 10.4236/ojog.2015.59068
Abstract: The majority of children with perinatally acquired human immunodeficiency virus (HIV) do not survive beyond childhood but this is changing due to the benefit of antiretroviral therapy for the perinatally infected cohort, so affected children are now approaching the age to be mothers. The aim of this article is to evaluate the outcomes of pregnant women with HIV acquired by vertical transmission in our centre and encourage the results obtained in “Thirty Years Later: Pregnancies in Female Perinatally Infected with Human Immunodeficiency Virus-1”, a review article published in this journal in 2012 [2]. We report 6 patients with eight pregnancies with HIV acquired by vertical transmission. They delivered a total of nine newborns between 2004 and 2013. In any case, mother-to-child transmission was reported. The management of pregnant women with HIV acquired by vertical transmission is complicated, since the patients are the most of the cases young and the compliance to the treatment may be poor. The prematurity was the more frequent complication and the cesarean section was the more frequent form of ending. In our case series, mother-to-child transmission was absent.
Profiles of HIV-Affected Households in Ghana  [PDF]
Amos Laar, Daniel Fiaveh, Matilda Laar, Sandra Boatemaa, James Abugri, Richard Amenyah, Kyeremeh Atuahene, Andrew Anthony Adjei, Isabella Quakyi, Angela El-Adas
Health (Health) , 2014, DOI: 10.4236/health.2014.615235
Abstract: Background: To contribute to a fuller appreciation of Ghana’s HIV epidemic, this paper presents various profiles of the Ghanaian HIV-affected household. To comprehensively tackle the HIV epidemic in Ghana, the profiles would provide stakeholders with ready information for policy formulation. Methods: We used data from a nationally representative survey that measured livelihood activities, household asset wealth, household composition, health, and nutrition variables of 1745 HIV-affected households. From these emerged various profiles. Results: About 50% of the households are headed by females. Households headed by men have an average size of three members, compared to two for female-headed households. There are far more AIDS widows than widowers. The annual death rate among the surveyed households was about 1000 per 100,000-households. Relatively more deaths occurred in male-headed households. Two-thirds of the households were asset poor. Various coping strategies were instituted by the households in reaction to threat of food insecurity. The national prevalence of chronic energy deficiency is 16%. Conclusions: Our data show that age of household head, hosting of a chronically ill member, and average size of household differed by sex of household head. The annual death rate of 1000 per 100,000 households is very high.
Knowledge of HIV and Safety Sexual Practices among Adolescent Girls in Benin City, Nigeria  [PDF]
K. A. Digban, V. Aigbogun, O. Agofure
Open Journal of Clinical Diagnostics (OJCD) , 2014, DOI: 10.4236/ojcd.2014.43022
Abstract:

Adolescence is a time of emotional, physical and psychological development and contributes substantially to the well being of the individual in adulthood. Consequently, understanding their social and reproductive behaviour is of tremendous policy importance. This study was designed to investigate HIV knowledge and safety sexual practices among adolescent girls in Benin-city, Edo State, Nigeria. Methods: A cross sectional study was conducted among 100 randomly selected female students in SS1 and 2 from two secondary schools in Benin-city. A semi structured questionnaire was self administered to obtain information on respondents’ socio-demographic characteristics, knowledge of HIV and safety practices. A 10-point knowledge scale graded, <5 and ≥6 as poor and good knowledge respectively, was used to measure knowledge of HIV; while a 5-point practice scale graded <2 and ≥3 was used as unsatisfactory and satisfactory safety sexual practices on HIV prevention respectively. Descriptive statistics, chi-square test and logistic regression were used to analyse the data with level of significance set at 0.05. Results: The mean age of respondents was 12.70 ± 1.2 years, 50.0% were in SS2 and 65.0% had been in Benin-city from birth. The overall mean knowledge score of respondents was 14.70 ± 4.43 with 60.0%, 20.0%, 40.0% and 70.0% having good knowledge on perinatal/vertical transmission, sexual and parenteral transmission, epidemiological factors and preventive measures respectively. Misconceptions about HIV transmission include: HIV cannot be transmitted through oral sex, HIV can be transmitted by mosquitoes and naked eyes can detect who is infected. In addition, there was a significant difference between class of respondents and their general knowledge of HIV (P < 0.05). Respondents in SS2 were more likely to have good knowledge of HIV than their SS1 counterpart (OR = 3.43 95% CI = 1.461 - 8.057). Furthermore, respondents whose mothers attained at least secondary school are more likely to exhibit satisfactory safety sexual practices on HIV prevention than their counterpart whose mothers had no formal education (OR = 2.67 95% CI = 0.619 - 11.493). Conclusions: There were knowledge deficiencies in sexual and parenteral transmission, epidemiological factors of HIV as well as some misconceptions about the transmission of the HIV virus. Therefore, more awareness and health education interventions are needed at the post primary level to curb the spread of the virus.

Depression, Internalized HIV Stigma and HIV Disclosure  [PDF]
Elialilia S. Okello, Glenn J. Wagner, Bonnie Ghosh-Dastidar, Jeffrey Garnett, Dickens Akena, Noeline Nakasujja, Seggane Musisi
World Journal of AIDS (WJA) , 2015, DOI: 10.4236/wja.2015.51004
Abstract: Purpose: There is extensive evidence regarding the relationship between HIV related stigma and disclosure; however, the influence of depression in this relationship is not well understood, and thus is the focus of our analysis. Methods: Baseline data from a prospective longitudinal cohort of 798 HIV patients starting ART in Kampala, Uganda were examined. A staged-approach regression analysis was used to examine variables associated with HIV disclosure to most people (general disclosure) and disclosure to primary sex partner. Internalized HIV stigma plus demographic and background covariates were first entered into the model; the binary indicator of clinical depression was added on step two, followed by the addition of the interaction of stigma and depression in step three. Separate analyses were conducted for each of the two disclosure outcomes. Results: 39% indicated that they kept their HIV status as a secret from most people, while 19% of respondents with a regular sex partner had not disclosed their HIV status to the partner. In bivariate analysis, respondents who preferred to keep their HIV status as a secret from most people had higher internalized HIV stigma (p < 0.001) and depression (p < 0.01), and were more likely to be clinically depressed (p < 0.01) compared with others in the sample. Similarly, participants who had not disclosed their HIV status to their main sex partner had higher internalized HIV stigma (p < 0.01) and depression (p < 0.05), and were more likely to be clinically depressed (p < 0.01) compared with those who had informed their partner of their HIV status. The regression analysis revealed that internalized HIV stigma was strongly negatively correlated with disclosure to primary partner, while depression was not associated. In the regression analysis for general disclosure, both stigma and depression were negatively correlated with disclosure when the interaction term was included in the model. Further analysis showed that internalized HIV stigma was more strongly associated with general disclosure among participants who were not depressed. Conclusions: Although there was clearly a strong and consistent association between internalized HIV stigma and depression symptoms, the strong association between internalized HIV stigma and general disclosure among respondents who were not depressed indicated that HIV stigma was in itself remained a strong barrier to HIV disclosure. Therefore, interventions to reduce internalized HIV stigma may aid in efforts to decrease secondary transmission of HIV.
Chronic obstructive pulmonary disease in adults with human immunodeficiency virus infection: a systematic review  [PDF]
Elpis Giantsou, Duncan Powrie
Health (Health) , 2011, DOI: 10.4236/health.2011.34039
Abstract: Objective: To determine the prevalence of chro- nic obstructive pulmonary disease (COPD) in adults with Human Immunodeficiency virus infection (HIV). Design: Systematic review of Medline, Embase, CINAHL, PsycINFO and references from identified papers. Study selection: Studies determining the prevalence of COPD in adults with HIV infection. Independent duplicate data extraction. Study quality was assessed in terms of whether consecutive patients were en- rolled, recruitment and follow-up periods were defined, <10% of subjects were lost to follow-up, subjects with missing data, method of COPD diagnosis and antiretroviral treatment were described. Data synthesis and results: Of the 911 citations identified, 8 North American studies conducted from 2005 to 2010 were reviewed. The demographics were: mean age 43 - 50.3yrs, >60% males, <50% African Americans, 37.1% - 83.3% active smokers, >60% on antiretroviral therapy. COPD was diagnosed by post-bronchodilator FEV1/FVC < 0.7 in three studies, by International Classification of Diseases (ICD-9) codes in three studies, by FEV1/FVC < 5% of lower adjusted normal in one and by pre- bronchodilator FEV1/FVC < 0.7 in another study. The prevalence was 10% - 35%, except for one study that recorded prevalence of 4% by postbronchodilator FEV1/FVC < 0.7, but <38% of patients with prebronchodilator FEV1/FVC < 0.7 had post-bronchodilator spirometry in that study. Conclusion: COPD is becoming increasingly common in HIV infected as they smoke and live longer due to efficient antiretrovirals. However, definite conclusions cannot be drawn and more longitudinal studies are needed. In the meantime health care providers should be vigilant to screen for undiagnosed COPD and hesitant to attribute respiratory symptoms solely to HIV infection.
Health Care Discrimination in HIV Care  [PDF]
Jayakumar Palanisamy, Senthilkumar Subramanian
World Journal of AIDS (WJA) , 2011, DOI: 10.4236/wja.2011.13015
Abstract: Human Immunodeficiency Virus (HIV) infected population is experiencing enormous amount of social discrimination and stigmatization compared to other patients with any other chronic illness. Healthcare setup is not an exception where the HIV infected patients are shuttled from one place to another to get their basic services compared to HIV negative patients. This referral game of manipulation imparts additional stress to the already stressed HIV infected population. The physical and psychological impacts caused by other chronic conditions will be supplemented by social impact in the HIV infected population. This referral game in healthcare can cause the HIV infected to avoid their health seeking behavior and it may bring them back to their high risk activities, which can result in higher mortality/morbidity and failure in prevention and intervention strategies.
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