Bamgboye E. Afolabi, R. A. Alonge, Edu Bidemi, Oguntokun O. Omolara, Oshinowo Olusola, O. Adeyemi, Ajuwon Ademola, Fawole Olubukola, A. Oladapo
Nigeria has high burden of HIV/AIDS; antiretroviral therapy (ART) availability, a blessing to HIV patients. Unfortunately, most people do not know their HIV status. Association for Reproductive and Family Health (ARFH), Nigeria introduced mobile free HIV Counseling and Testing (HCT) services to complement its clinic services for HCT uptake. The characteristics of clients patronizing ARFH’s HCT services are assessed. A retrospective review of ARFH’s clinics’ data on HCT services between 2005 and 2011 was undertaken and demographic characteristics of HCT clients were abstracted from the HIV intake register. Descriptive statistics of data were obtained using SPSS version 20.0. Significance of association between socio-demographic characteristics and reasons for HCT uptake were investigated using Chi-square test. The mean age of 6,684 clients was 29.5±9.4 years and 76% were females while 20% positive to HIV. Two-thirds in monogamous marriage and 25% had university/polytechnic education while 41% were artisans and apprentices. Nearness of HCT to patient’s residence and referral from ANC were the major reasons for HCT uptake. Mobile HCT clinic enhanced HCT uptake especially in sexually active age-group. Availability of mobile HCT services will fast-track achieving the first 90 of the 90-90-90-PEPFAR target for the control of HIV/AIDS. Proportion positive to HIV is high. Key words: HIV counseling and testing (HCT), Nigeria, HIV/AIDS, demographic characteristics, mobile, stand-alone.
{"title":"Demographic characteristics of clients up taking free counseling and testing services in Ibadan, Oyo \u0000State, Nigeria","authors":"Bamgboye E. Afolabi, R. A. Alonge, Edu Bidemi, Oguntokun O. Omolara, Oshinowo Olusola, O. Adeyemi, Ajuwon Ademola, Fawole Olubukola, A. Oladapo","doi":"10.5897/JAHR2018.0474","DOIUrl":"https://doi.org/10.5897/JAHR2018.0474","url":null,"abstract":"Nigeria has high burden of HIV/AIDS; antiretroviral therapy (ART) availability, a blessing to HIV patients. Unfortunately, most people do not know their HIV status. Association for Reproductive and Family Health (ARFH), Nigeria introduced mobile free HIV Counseling and Testing (HCT) services to complement its clinic services for HCT uptake. The characteristics of clients patronizing ARFH’s HCT services are assessed. A retrospective review of ARFH’s clinics’ data on HCT services between 2005 and 2011 was undertaken and demographic characteristics of HCT clients were abstracted from the HIV intake register. Descriptive statistics of data were obtained using SPSS version 20.0. Significance of association between socio-demographic characteristics and reasons for HCT uptake were investigated using Chi-square test. The mean age of 6,684 clients was 29.5±9.4 years and 76% were females while 20% positive to HIV. Two-thirds in monogamous marriage and 25% had university/polytechnic education while 41% were artisans and apprentices. Nearness of HCT to patient’s residence and referral from ANC were the major reasons for HCT uptake. Mobile HCT clinic enhanced HCT uptake especially in sexually active age-group. Availability of mobile HCT services will fast-track achieving the first 90 of the 90-90-90-PEPFAR target for the control of HIV/AIDS. Proportion positive to HIV is high. \u0000 \u0000 Key words: HIV counseling and testing (HCT), Nigeria, HIV/AIDS, demographic characteristics, mobile, stand-alone.","PeriodicalId":73590,"journal":{"name":"Journal of AIDS and HIV research (Online)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5897/JAHR2018.0474","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44056257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Adherence to highly active antiretroviral therapy (HAART) regimen, of at least 95%, is necessary for effective therapeutic response among people living with human immunodeficiency virus (PLWHIV). This study determined the factors associated with non-adherence of PLWHIV to HAART regimen among patients attending a healthcare facility in Akwa Ibom State, Nigeria. Two hundred and fifty one patients, aged 18 to 70 years, attending a healthcare facility in Akwa Ibom State, Nigeria from 8th July to 8th August 2018, were adequately informed and their consent was obtained to enroll in the study. The enrollees were defined as non-adherent (NA), if, for any reason, they missed at least one dose of their drug within the last 30 days. These NA enrollees were purposively selected. The data was obtained using interviewer-administered semi-structured questionnaire. The data obtained was checked for completeness, coded and technique analyzed using Statistical Package for Social Science (SPSS) version 22 software. The statistical association between variables was described using logistic regression. Of the 251 PLWHIV, 100 (39.84%) were NA enrollees. Three major reasons provided by enrollees for missing medication were: (1) forgetfulness 41%, (2) travelling with incomplete medication and difficulty in the accessing drug from a new clinic, 15% and (3) not willing to take HIV/AIDS drugs with other prescribed drugs, 10%. This study has shown that a majority of PLWHIV (60.16%) complied with therapy regimen. Forgetfulness was the most common factor reported for non-adherence by the enrollees. This suggests that there is an increasing need for healthcare personnel to encourage patients to use memory aids, and to increase the awareness of the consequences of non-adherence during drug administration. Key words: Highly active antiretroviral therapy, HIV/AIDS, medication non-adherence, healthcare facility.
{"title":"Factors associated with non-adherence of HIV/AIDS patients to HAART regimen in a healthcare facility in Ikot Ekpene, Akwa Ibom State, Nigeria","authors":"Augustina Onwunata, O. Ebong, Geoffrey Enoh","doi":"10.5897/JAHR2018.0481","DOIUrl":"https://doi.org/10.5897/JAHR2018.0481","url":null,"abstract":"Adherence to highly active antiretroviral therapy (HAART) regimen, of at least 95%, is necessary for effective therapeutic response among people living with human immunodeficiency virus (PLWHIV). This study determined the factors associated with non-adherence of PLWHIV to HAART regimen among patients attending a healthcare facility in Akwa Ibom State, Nigeria. Two hundred and fifty one patients, aged 18 to 70 years, attending a healthcare facility in Akwa Ibom State, Nigeria from 8th July to 8th August 2018, were adequately informed and their consent was obtained to enroll in the study. The enrollees were defined as non-adherent (NA), if, for any reason, they missed at least one dose of their drug within the last 30 days. These NA enrollees were purposively selected. The data was obtained using interviewer-administered semi-structured questionnaire. The data obtained was checked for completeness, coded and technique analyzed using Statistical Package for Social Science (SPSS) version 22 software. The statistical association between variables was described using logistic regression. Of the 251 PLWHIV, 100 (39.84%) were NA enrollees. Three major reasons provided by enrollees for missing medication were: (1) forgetfulness 41%, (2) travelling with incomplete medication and difficulty in the accessing drug from a new clinic, 15% and (3) not willing to take HIV/AIDS drugs with other prescribed drugs, 10%. This study has shown that a majority of PLWHIV (60.16%) complied with therapy regimen. Forgetfulness was the most common factor reported for non-adherence by the enrollees. This suggests that there is an increasing need for healthcare personnel to encourage patients to use memory aids, and to increase the awareness of the consequences of non-adherence during drug administration. \u0000 \u0000 Key words: Highly active antiretroviral therapy, HIV/AIDS, medication non-adherence, healthcare facility.","PeriodicalId":73590,"journal":{"name":"Journal of AIDS and HIV research (Online)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5897/JAHR2018.0481","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48460182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In patients with HIV infection, wasting has been associated with increased mortality. Even in the era of Highly Active Antiretroviral Therapy (HAART), accelerated disease progression, loss of muscle protein mass, and impairment of strength and functional status are common. However, data on the magnitude of wasting and its risk factors among individuals receiving HAART are scarce in Ethiopia. The aim of this study is to determine the magnitude of wasting and identify associated factors among adults on HAART at anti-retroviral therapy clinics of Hosanna town. Facility based cross-sectional study was conducted from March 20 to April 30, 2014 among 410 adult people on (HAART) at ART health clinics of Hosanna town. Sample clients were selected by simple random sampling technique. Data were collected by face to face, record review using check list and weight scale measurement. Descriptive statistics, Bi-variate and multivariable logistic regression models were done using SPSS version 16 to identify factors associated with wasting. In total, 410 adult people on HAART participated in the study giving a response rate of 97.56%. The overall magnitude of wasting in this study was 37.1%. Food insecurity (AOR= 2.1, 95% CI: 1.28- 3.34), inadequate diversified diet (AOR= 2, 95% CI: 1.18- 3.38), low meal frequency (AOR= 2.2, 95% CI: 1.1- 4.47) and presence of opportunistic infections (AOR= 2.27, 95% CI: 1.47- 3.49) were independent predictors of wasting. Wasting was found to be high (37.1%) among adults on anti-retroviral therapy at ART Clinics of Hossana town. ART intervention should be supported by strategies that can address household food security, nutritional practices and prevention and control of opportunistic infections to improve the health status of people on HAART. Key words: Anti-retroviral therapy, HIV/AIDs, wasting, weight loss, Hosanna, town clinic.
{"title":"Prevalence of wasting and its predictors among adults receiving highly active antiretroviral therapy in ART clinics of Hosanna town, Hadiya Zone, Southern Ethiopia A cross-sectional study","authors":"M. Asfaw, Tariku Eshetu, Fanos Yonas","doi":"10.5897/JAHR2018.0469","DOIUrl":"https://doi.org/10.5897/JAHR2018.0469","url":null,"abstract":"In patients with HIV infection, wasting has been associated with increased mortality. Even in the era of Highly Active Antiretroviral Therapy (HAART), accelerated disease progression, loss of muscle protein mass, and impairment of strength and functional status are common. However, data on the magnitude of wasting and its risk factors among individuals receiving HAART are scarce in Ethiopia. The aim of this study is to determine the magnitude of wasting and identify associated factors among adults on HAART at anti-retroviral therapy clinics of Hosanna town. Facility based cross-sectional study was conducted from March 20 to April 30, 2014 among 410 adult people on (HAART) at ART health clinics of Hosanna town. Sample clients were selected by simple random sampling technique. Data were collected by face to face, record review using check list and weight scale measurement. Descriptive statistics, Bi-variate and multivariable logistic regression models were done using SPSS version 16 to identify factors associated with wasting. In total, 410 adult people on HAART participated in the study giving a response rate of 97.56%. The overall magnitude of wasting in this study was 37.1%. Food insecurity (AOR= 2.1, 95% CI: 1.28- 3.34), inadequate diversified diet (AOR= 2, 95% CI: 1.18- 3.38), low meal frequency (AOR= 2.2, 95% CI: 1.1- 4.47) and presence of opportunistic infections (AOR= 2.27, 95% CI: 1.47- 3.49) were independent predictors of wasting. Wasting was found to be high (37.1%) among adults on anti-retroviral therapy at ART Clinics of Hossana town. ART intervention should be supported by strategies that can address household food security, nutritional practices and prevention and control of opportunistic infections to improve the health status of people on HAART. \u0000 \u0000 Key words: Anti-retroviral therapy, HIV/AIDs, wasting, weight loss, Hosanna, town clinic.","PeriodicalId":73590,"journal":{"name":"Journal of AIDS and HIV research (Online)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5897/JAHR2018.0469","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45666538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Addis G. Mariam, Techalew Shimelis, Agete Tadewos, Fanuel Belayneh, D. Niguse
Human immunodeficiency virus (HIV) and Helicobacter pylori (H. pylori) infections are worldwide healthcare burdens. This study aimed to assess the prevalence and associated factors of H. pylori infection among HIV patients at Southern-Ethiopia. A Hospital based cross-sectional study was conducted at Hawassa University comprehensive specialized hospital on 390 HIV infected adults on antiretroviral therapy from September to November 2017. All vital data were collected by designed questionnaires and stool samples were collected using appropriate sample cap for H. pylori stool antigen diagnosis. The overall prevalence of H. pylori infection of HIV infected patients was 17.9%. About 42.6% of the participants had a history of dyspepsia and of them, 4.3% were positive for H. pylori infection. In addition, 48.9% of patients were using either aqua tablet (67 mg-Trocloresene sodium) or water filters for drinking water, of them 11.5% were positive for H. pylori infection. Having a history of dyspepsia: the adjusted odds ratio [AOR (95% CI): 4.8 (1.6–14.7)], and age ≤30 years [AOR (95% CI):3.7(1.6–8.8)] were associated factors of H. pylori infection. Moreover, the association of H. pylori infection ≤ 30 years old and history of dyspepsia indicates the need of further large-scale and cohort type studies to determine the other possible associated factors for the infection. Key words: Helicobacter Pylori, HIV, stool antigen test, South-Ethiopia.
{"title":"Prevalence and associated factors of Helicobacter pylori Infection among HIV positive adults on Anti-retroviral Therapy","authors":"Addis G. Mariam, Techalew Shimelis, Agete Tadewos, Fanuel Belayneh, D. Niguse","doi":"10.5897/JAHR2018.0479","DOIUrl":"https://doi.org/10.5897/JAHR2018.0479","url":null,"abstract":"Human immunodeficiency virus (HIV) and Helicobacter pylori (H. pylori) infections are worldwide healthcare burdens. This study aimed to assess the prevalence and associated factors of H. pylori infection among HIV patients at Southern-Ethiopia. A Hospital based cross-sectional study was conducted at Hawassa University comprehensive specialized hospital on 390 HIV infected adults on antiretroviral therapy from September to November 2017. All vital data were collected by designed questionnaires and stool samples were collected using appropriate sample cap for H. pylori stool antigen diagnosis. The overall prevalence of H. pylori infection of HIV infected patients was 17.9%. About 42.6% of the participants had a history of dyspepsia and of them, 4.3% were positive for H. pylori infection. In addition, 48.9% of patients were using either aqua tablet (67 mg-Trocloresene sodium) or water filters for drinking water, of them 11.5% were positive for H. pylori infection. Having a history of dyspepsia: the adjusted odds ratio [AOR (95% CI): 4.8 (1.6–14.7)], and age ≤30 years [AOR (95% CI):3.7(1.6–8.8)] were associated factors of H. pylori infection. Moreover, the association of H. pylori infection ≤ 30 years old and history of dyspepsia indicates the need of further large-scale and cohort type studies to determine the other possible associated factors for the infection. \u0000 \u0000 Key words: Helicobacter Pylori, HIV, stool antigen test, South-Ethiopia.","PeriodicalId":73590,"journal":{"name":"Journal of AIDS and HIV research (Online)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5897/JAHR2018.0479","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48563141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Barriers of adherence to antiretroviral therapy among HIV/AIDS infected persons in Nekemte referral Hospital, East Wollega, Oromia Regional State, Western Ethiopia, 2017","authors":"Tegegne Bidu Kassahun, Kaba Babure Zalalem","doi":"10.5897/jahr2018.0462","DOIUrl":"https://doi.org/10.5897/jahr2018.0462","url":null,"abstract":"","PeriodicalId":73590,"journal":{"name":"Journal of AIDS and HIV research (Online)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5897/jahr2018.0462","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71135373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Human immunodeficiency virus (HIV) has emerged as one of the leading causes of childhood mortality and morbidity in sub Saharan Africa. But, the attention given to HIV-infected children in terms of providing antiretroviral treatment (ART) had so far been ranked second. The study had the objectives of identifying predictors that had significant impacts on the survival status of HIV infected children who received antiretroviral treatment care in the University of Gondar Comprehensive Specialized Hospital, Gondar, Ethiopia. The data used in the study was based on secondary data from hospital records of HIV infected children aged below 15 years who started ART between 2008 and 2013 and who followed through April 2015 in University of Gondar Comprehensive Specialized Hospital, Gondar, Ethiopia. The Multivariable Cox Proportional model was fitted to identify factors affecting the survival of children after initiation of ART. The median survival time frame was found to be 55 months. At the end of the follow up, 46 (17.1%) children died due to the disease, the remaining 223 (82.9%) were alive and lost to follow-up. The multivariate analysis of the Cox Regression model showed that the age of a patients (for age < 1.5 years HR: 3.590 ; 95% CI: 1.439, 8.953; P = 0.006, baseline hemoglobin level (for hemoglobin level < 7g/dl HR: 6.286; 95% CI: 2.328, 16.973; P=0.000, WHO clinical stage (For stage III HR: 0.308 ; 95% CI: 0.150, 0.630; P = 0.001); and baseline CD4 count(HR: 0.180 ; 95% CI: 0.084, 0.388; P = 0.000) are significant factors of survival of HIV infected children during the 92 months of follow up. Therefore, special attention should be given to younger children in ART; patients with low CD4 cell count, patients with advanced WHO clinical staging (stage III and IV); and patients with low hemoglobin level to improve the survival of HIV infected children treated with ART. Key words: Children, antiretroviral therapy (ART), HIV, survival, Ethiopia.
{"title":"Survival time of human immunodeficiency virus (HIV) infected children under 15 years of age after initiation of antiretroviral therapy in the University of Gondar Comprehensive Specialized Hospital, Ethiopia","authors":"Asrat Atsedeweyn Andargie, Yemane Asmleash","doi":"10.5897/JAHR2018.0459","DOIUrl":"https://doi.org/10.5897/JAHR2018.0459","url":null,"abstract":"Human immunodeficiency virus (HIV) has emerged as one of the leading causes of childhood mortality and morbidity in sub Saharan Africa. But, the attention given to HIV-infected children in terms of providing antiretroviral treatment (ART) had so far been ranked second. The study had the objectives of identifying predictors that had significant impacts on the survival status of HIV infected children who received antiretroviral treatment care in the University of Gondar Comprehensive Specialized Hospital, Gondar, Ethiopia. The data used in the study was based on secondary data from hospital records of HIV infected children aged below 15 years who started ART between 2008 and 2013 and who followed through April 2015 in University of Gondar Comprehensive Specialized Hospital, Gondar, Ethiopia. The Multivariable Cox Proportional model was fitted to identify factors affecting the survival of children after initiation of ART. The median survival time frame was found to be 55 months. At the end of the follow up, 46 (17.1%) children died due to the disease, the remaining 223 (82.9%) were alive and lost to follow-up. The multivariate analysis of the Cox Regression model showed that the age of a patients (for age < 1.5 years HR: 3.590 ; 95% CI: 1.439, 8.953; P = 0.006, baseline hemoglobin level (for hemoglobin level < 7g/dl HR: 6.286; 95% CI: 2.328, 16.973; P=0.000, WHO clinical stage (For stage III HR: 0.308 ; 95% CI: 0.150, 0.630; P = 0.001); and baseline CD4 count(HR: 0.180 ; 95% CI: 0.084, 0.388; P = 0.000) are significant factors of survival of HIV infected children during the 92 months of follow up. Therefore, special attention should be given to younger children in ART; patients with low CD4 cell count, patients with advanced WHO clinical staging (stage III and IV); and patients with low hemoglobin level to improve the survival of HIV infected children treated with ART. \u0000 \u0000 \u0000 \u0000 Key words: Children, antiretroviral therapy (ART), HIV, survival, Ethiopia.","PeriodicalId":73590,"journal":{"name":"Journal of AIDS and HIV research (Online)","volume":"10 1","pages":"49-55"},"PeriodicalIF":0.0,"publicationDate":"2018-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5897/JAHR2018.0459","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46558848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jackson Ireri Mrama, J. Ngeranwa, D. Mburu, W. Jaoko, C. Sekadde-kigondu
Changes in serum levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamma-glutamyl transferase (G-GT), total protein (TP), albumin (ALB), total bilirubin (T. Bil), direct bilirubin (D. Bil) are assayed to monitor liver function; while those of creatinine (CRT) and urea (UR) are for kidney functions. These two organs produce hepcidin and erythropoietins, respectively that play major roles in haemopoiesis and so may be involved in HIV- associated anemia. Anemia occurs in over 70% of HIV-infected. The objective of this study was to monitor liver and kidney derangements in HIV based on CD4+ cell levels for 6 months. This was a longitudinal descriptive study conducted at Kenyatta National Hospital Comprehensive Care Centre and involved: 184 HIV seropositive and 101 HIV seronegative blood donors as a comparative group. The comparative group demonstrated significantly higher T.Bil and D.Bil mean values in males than in females. Increases in each of: G-GT, T. Bil, D. Bil, AST, ALT and CRT above the upper limit of the control were observed. Increases in G-GT were highest in CD4+ above 200 cells /mm3; decreases in the levels of ALP and ALB were lowest in CD4+ < 200 cells / mm3 group. Increases in G-GT with decreases in ALP were possibly due to cardiac-related disorders. Serum levels of AST, ALT and CRT are not affected by CD4+ levels. Decreases in the levels of ALB in CD4+ < 200 cells/mm3 group were thought to be partly due to: anemia, malnutrition or hypercatabolism. Hypoalbuminemia may result in altered albumin: globulin ratio. Determinations of: albumin: globulin ratio, gender-based reference ranges for T. Bil and D. Bil, hepcidin and erythropoietin are recommended. Key words: Study, clinical values, HIV infection.
{"title":"A prospective study on the changes of clinical values in HIV-Infected patients attending Kenyatta National Hospital Comprehensive Care Center","authors":"Jackson Ireri Mrama, J. Ngeranwa, D. Mburu, W. Jaoko, C. Sekadde-kigondu","doi":"10.5897/JAHR2018.0457","DOIUrl":"https://doi.org/10.5897/JAHR2018.0457","url":null,"abstract":"Changes in serum levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamma-glutamyl transferase (G-GT), total protein (TP), albumin (ALB), total bilirubin (T. Bil), direct bilirubin (D. Bil) are assayed to monitor liver function; while those of creatinine (CRT) and urea (UR) are for kidney functions. These two organs produce hepcidin and erythropoietins, respectively that play major roles in haemopoiesis and so may be involved in HIV- associated anemia. Anemia occurs in over 70% of HIV-infected. The objective of this study was to monitor liver and kidney derangements in HIV based on CD4+ cell levels for 6 months. This was a longitudinal descriptive study conducted at Kenyatta National Hospital Comprehensive Care Centre and involved: 184 HIV seropositive and 101 HIV seronegative blood donors as a comparative group. The comparative group demonstrated significantly higher T.Bil and D.Bil mean values in males than in females. Increases in each of: G-GT, T. Bil, D. Bil, AST, ALT and CRT above the upper limit of the control were observed. Increases in G-GT were highest in CD4+ above 200 cells /mm3; decreases in the levels of ALP and ALB were lowest in CD4+ < 200 cells / mm3 group. Increases in G-GT with decreases in ALP were possibly due to cardiac-related disorders. Serum levels of AST, ALT and CRT are not affected by CD4+ levels. Decreases in the levels of ALB in CD4+ < 200 cells/mm3 group were thought to be partly due to: anemia, malnutrition or hypercatabolism. Hypoalbuminemia may result in altered albumin: globulin ratio. Determinations of: albumin: globulin ratio, gender-based reference ranges for T. Bil and D. Bil, hepcidin and erythropoietin are recommended. \u0000 \u0000 \u0000 \u0000 Key words: Study, clinical values, HIV infection.","PeriodicalId":73590,"journal":{"name":"Journal of AIDS and HIV research (Online)","volume":"10 1","pages":"56-63"},"PeriodicalIF":0.0,"publicationDate":"2018-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5897/JAHR2018.0457","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42750609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. N. Marceline, Guiateu Tamo Ida Marlene, Ambassa Axel Cyriaque, Fepa Kwesseu Gaëlle Armelle, M. F. Paul
This study investigates the current status of HIV/HCV co-infection through viral sero-prevalence and correlation with liver markers and CD4 count in three hospital settings in Cameroon. Blood samples of 75 newly diagnosed HIV patients, and 546 people attending the target hospitals were screened for HCV(antigen-antibodies) using enzyme-immunoassay. Biochemical liver markers (ALT-AST-g-GT-Bilirubin) and CD4-cell count were also analyzed. Statistical analysis was performed using student’s t-test, χ2-test and Pearson correlation. The statistical significance was set at the threshold p≤0.05. Out of 75 people with HIV, 10(13.33%) were diagnosed with HIV/HCV co-infection; 56(10.25%) individuals from the cohort of 546 participants were diagnosed with HCV infection and 5(8.93%) were confirmed HIV positive. Results showed that HCV infection rate is higher among HIV patients than among the general population. For the two populations, co-infection rate was higher in women: 7(9.3%) and 3(4%) respectively in HIV positive patients, 3(5.35%) and 2(3.57%) in HCV patients. Women comprised the majority of people with HIV (72%) while men were the majority in the HCV-infected population (78.57%). Mean age in co-infected individuals was higher, with 93.33% aged 50 years or above. A negative and significant correlation was associated with CD4 count, ALT activity and bilirubin concentration in people with HIV, whereas in HIV/HCV co-infected patients, positive and significant correlations were associated with ALT, AST and g-GT. HIV/HCV co-infection is a concern in hospital settings in Cameroon. HCV screening should be compulsory for patients and integrated in the existing guidelines/policies in Cameroon. Key words: Seroprevalence, HIV/HCV, co-infection, risk factor, correlation, disease stage.
{"title":"Current status of human immunodeficiency virus and hepatitis C virus (HIV/HCV) co-infection in Cameroon: Sero-prevalence, risk factors and correlation with markers of liver function and CD4 cells rate in patients diagnosed in three hospital settings","authors":"D. N. Marceline, Guiateu Tamo Ida Marlene, Ambassa Axel Cyriaque, Fepa Kwesseu Gaëlle Armelle, M. F. Paul","doi":"10.5897/JAHR2017.0456","DOIUrl":"https://doi.org/10.5897/JAHR2017.0456","url":null,"abstract":"This study investigates the current status of HIV/HCV co-infection through viral sero-prevalence and correlation with liver markers and CD4 count in three hospital settings in Cameroon. Blood samples of 75 newly diagnosed HIV patients, and 546 people attending the target hospitals were screened for HCV(antigen-antibodies) using enzyme-immunoassay. Biochemical liver markers (ALT-AST-g-GT-Bilirubin) and CD4-cell count were also analyzed. Statistical analysis was performed using student’s t-test, χ2-test and Pearson correlation. The statistical significance was set at the threshold p≤0.05. Out of 75 people with HIV, 10(13.33%) were diagnosed with HIV/HCV co-infection; 56(10.25%) individuals from the cohort of 546 participants were diagnosed with HCV infection and 5(8.93%) were confirmed HIV positive. Results showed that HCV infection rate is higher among HIV patients than among the general population. For the two populations, co-infection rate was higher in women: 7(9.3%) and 3(4%) respectively in HIV positive patients, 3(5.35%) and 2(3.57%) in HCV patients. Women comprised the majority of people with HIV (72%) while men were the majority in the HCV-infected population (78.57%). Mean age in co-infected individuals was higher, with 93.33% aged 50 years or above. A negative and significant correlation was associated with CD4 count, ALT activity and bilirubin concentration in people with HIV, whereas in HIV/HCV co-infected patients, positive and significant correlations were associated with ALT, AST and g-GT. HIV/HCV co-infection is a concern in hospital settings in Cameroon. HCV screening should be compulsory for patients and integrated in the existing guidelines/policies in Cameroon. \u0000 \u0000 Key words: Seroprevalence, HIV/HCV, co-infection, risk factor, correlation, disease stage.","PeriodicalId":73590,"journal":{"name":"Journal of AIDS and HIV research (Online)","volume":"10 1","pages":"22-30"},"PeriodicalIF":0.0,"publicationDate":"2018-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5897/JAHR2017.0456","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47298255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Haile, Girum Zewdu, E. Klinkenberg, D. Woldeyohannes
Provision of integrated care for human immunodeficiency virus (HIV) co-infected tuberculosis (TB) patients is challenging. Many persons with TB and HIV co-infection are not yet receiving anti-retroviral therapy (ART) and initiation of ART is not always timely. This study investigated ART uptake among HIV co-infected TB patients and its time of initiation in an urban primary health care facility in Ethiopia. A retrospective cohort study was conducted using routine program data. All adult HIV co-infected TB patients registered in a large TB-HIV clinic in Addis Ababa from September, 2008 to August, 2014 were included. Both descriptive and inferential statistics were used to summarize and analyse findings. A total of 993 TB patients were registered in the study period and included. HIV counselling and testing was offered to 738 (74.5%) and HIV testing was performed for 678 (68.3%) patients. Of those tested, 226 (33.3%) were HIV co-infected of whom 125 (57.6%) were started on ART. The median period from commencement of TB treatment to starting of ART was 41 days. ART initiation was delayed beyond the period advised in the National TB-HIV Guideline for 31 (27%) of HIV co-infected TB patients. For 109 (48.2%) of co-infected TB patients the ART status evaluation could not be done due to missing data. A considerable proportion of HIV co-infected TB patients did either not receive ART or started it later than recommended by national guidelines. For better outcomes to HIV co-infected TB patients, the actual implementation of national recommendations on when to start ART needs to be monitored closely. Key words: ART-uptake delay, TB-HIV, primary health facility.
{"title":"Time for initiation of antiretroviral therapy in HIV co-infected tuberculosis patients in Addis Ababa, Ethiopia","authors":"K. Haile, Girum Zewdu, E. Klinkenberg, D. Woldeyohannes","doi":"10.5897/JAHR2017.0454","DOIUrl":"https://doi.org/10.5897/JAHR2017.0454","url":null,"abstract":"Provision of integrated care for human immunodeficiency virus (HIV) co-infected tuberculosis (TB) patients is challenging. Many persons with TB and HIV co-infection are not yet receiving anti-retroviral therapy (ART) and initiation of ART is not always timely. This study investigated ART uptake among HIV co-infected TB patients and its time of initiation in an urban primary health care facility in Ethiopia. A retrospective cohort study was conducted using routine program data. All adult HIV co-infected TB patients registered in a large TB-HIV clinic in Addis Ababa from September, 2008 to August, 2014 were included. Both descriptive and inferential statistics were used to summarize and analyse findings. A total of 993 TB patients were registered in the study period and included. HIV counselling and testing was offered to 738 (74.5%) and HIV testing was performed for 678 (68.3%) patients. Of those tested, 226 (33.3%) were HIV co-infected of whom 125 (57.6%) were started on ART. The median period from commencement of TB treatment to starting of ART was 41 days. ART initiation was delayed beyond the period advised in the National TB-HIV Guideline for 31 (27%) of HIV co-infected TB patients. For 109 (48.2%) of co-infected TB patients the ART status evaluation could not be done due to missing data. A considerable proportion of HIV co-infected TB patients did either not receive ART or started it later than recommended by national guidelines. For better outcomes to HIV co-infected TB patients, the actual implementation of national recommendations on when to start ART needs to be monitored closely. \u0000 \u0000 Key words: ART-uptake delay, TB-HIV, primary health facility.","PeriodicalId":73590,"journal":{"name":"Journal of AIDS and HIV research (Online)","volume":"10 1","pages":"31-39"},"PeriodicalIF":0.0,"publicationDate":"2018-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5897/JAHR2017.0454","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71135503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cluster of differentiation 4 (CD4) cell count recovery is used in determining disease progression and outcome monitoring. This study was conducted to determine the trends of CD4 cell count recovery, and its determinants in Hawassa university referral hospital, Ethiopia. Retrospective cohort study design was employed to gather relevant data among human immunodeficiency virus (HIV) positive-patients visiting Hawassa University referral hospital. Data were collected from December 1, 2014 to May 15, 2015. A total of 2400 medical records of adult patients aged above 15 years were examined. Of these, 1479 were evaluated and analyzed. Multivariate logistic regression was constructed to determine predictors of change in CD cell count. The median change in CD4 cell count from baseline to six months was 124 cells/μl. 19.3% of patients were at risk of immunologic non-response at 12 months of treatment. Patients with a baseline CD4 cell count of less than 100 cells/ml were 5 times more likely to exhibit immunologic non-response compared to those with a baseline CD4 cell count > 350 cells/μl. Baseline body mass index (BMI) and sex were associated with failure to attain ≥200 cells/μl at 12 months of treatment. Rapid recovery of CD4 cell count occurred during the first six months of treatment in this study. However, significant proportions of patients were at risk of immunologic non-response. Low baseline CD4 cell counts were predictive of non-response in this setting. The findings suggest that initiation of antiretroviral therapy (ART) at a CD4 cell count greater than 500 cells/μl is associated with better immune recovery. Key words: Antiretroviral therapy, CD4 cell count, HIV/AIDS, Ethiopia.
{"title":"Pattern and predictors of cluster of differentiation 4 (CD4) cell count recovery among cohorts of human immunodeficiency virus (HIV)-infected patients on antiretroviral therapy in Hawassa University Referral Hospital","authors":"S. Deyno, A. Toma, Fiker Taddesse","doi":"10.5897/JAHR2017.0425","DOIUrl":"https://doi.org/10.5897/JAHR2017.0425","url":null,"abstract":"Cluster of differentiation 4 (CD4) cell count recovery is used in determining disease progression and outcome monitoring. This study was conducted to determine the trends of CD4 cell count recovery, and its determinants in Hawassa university referral hospital, Ethiopia. Retrospective cohort study design was employed to gather relevant data among human immunodeficiency virus (HIV) positive-patients visiting Hawassa University referral hospital. Data were collected from December 1, 2014 to May 15, 2015. A total of 2400 medical records of adult patients aged above 15 years were examined. Of these, 1479 were evaluated and analyzed. Multivariate logistic regression was constructed to determine predictors of change in CD cell count. The median change in CD4 cell count from baseline to six months was 124 cells/μl. 19.3% of patients were at risk of immunologic non-response at 12 months of treatment. Patients with a baseline CD4 cell count of less than 100 cells/ml were 5 times more likely to exhibit immunologic non-response compared to those with a baseline CD4 cell count > 350 cells/μl. Baseline body mass index (BMI) and sex were associated with failure to attain ≥200 cells/μl at 12 months of treatment. Rapid recovery of CD4 cell count occurred during the first six months of treatment in this study. However, significant proportions of patients were at risk of immunologic non-response. Low baseline CD4 cell counts were predictive of non-response in this setting. The findings suggest that initiation of antiretroviral therapy (ART) at a CD4 cell count greater than 500 cells/μl is associated with better immune recovery. \u0000 \u0000 Key words: Antiretroviral therapy, CD4 cell count, HIV/AIDS, Ethiopia.","PeriodicalId":73590,"journal":{"name":"Journal of AIDS and HIV research (Online)","volume":"10 1","pages":"40-48"},"PeriodicalIF":0.0,"publicationDate":"2018-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5897/JAHR2017.0425","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42965056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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