This book tries to figure out and explain those factors associated with tuberculosis co-infection among HIV/AIDS patients taking anti retro-viral therapy. The study published in this book is conducted at Nekemte hospital, which is government owned hospital serving more than two million people in the Western part of Ethiopia. The hospital is one of few health institutions providing TB/HIV healthcare services in the country.
The world is seeing unprecedented numbers of people infected with drug-resistant tuberculosis(DR-TB) in patients who have previously failed tuberculosis (TB) treatment and also in patients newly diagnosed with TB. “Left untreated, the infectious disease is lethal, but treatment today puts people through two years of excruciating side effects, including psychosis, deafness and constant nausea, with painful daily injections for up to eight months. Barely half of people get cured” – Press release by Medecins Sans Frontieres - Access Campaign, March 19, 2013 (msfaccess.org/TBmanifesto). The advent and spread of DR-TB posses a great challenge in the treatment of TB, especially among patients also infected with the Human Immunodeficiency Virus (HIV). Namibia is an example of a country that is currently coping with a dual burden of HIV and HIV-associated TB. In 2009, 58% of all TB patients were HIV co-infected and 372 cases of DR-TB were reported. This research work, therefore, provides insights into the prevalence; outcome and risk factors of the adverse events associated with the treatment of DR-TB, and explores the potential role of HIV co-infection.
HIV/AIDS is a major public health problem in Sub-Sahara Africa. Cytomegalovirus (CMV) has been found to be a major cause of morbidity and mortality in patients with Acquired Immunodeficiency Syndrome (AIDS). The virus has been reported to enhance HIV replication and accelerate the progression of HIV to AIDS. In Nigeria there is a dearth of information on the prevalence of Cytomegalovirus infection among HIV/AIDS patients. This study was designed to determine the prevalence rate as well as risk factors for CMV infection among HIV/AIDS patients in Ilorin, Nigeria. A cross sectional study was carried out among consecutively recruited HIV sero-positive patients attending the HAART clinic at U.I.T.H, Ilorin between October 2008 to September 2009. A volume of 5 ml blood sample was collected from each consenting participant as well as age and sex matched HIV sero-positive control group . The sera was assayed for CMV IgG/IgM using Enzyme Linked Immunosorbent Assay (ELISA). A semi-structured pre-tested questionnaire was also used to assess the risk factors for CMV infection among HIV sero-positive participants
This study examines the risk factors related to HIV infection among 400 female sex workers (FSWs) aged 16-57 years in Vinh Long Proovince, Viet Nam. It uses secondary data from a cross-sectional study about knowledge, attitude, beliefs, and practice on HIV/AIDS. The main purpose is to determine the impacts of risk factors on HIV infection. Binary logistic regression showed perception of risk, perceived pay value, and using drug were significantly associated with HIV infection. FSWs who used drug were 32 times more likely to be infected with HIV than their counterparts. FSWs who reported that they had high risk of HIV infection were more likely to be infected with HIV than the ones reported that they had low risk or no risk of HIV infection. In addition, low income FSWs were more likely to be infected with HIV than high income FSWs. The findings suggested setting up a Drop-in-Center for FSWs who come to share both difficulties and experiences to protect themselves from HIV infection. Furthermore, strengthening the peer educators’ channels to provide HIV/AIDS information, knowledge, living skills and condom, needles and syringes directly to FSWs is strongly recommended.
The aim of this research is to assess the level of knowledge on HIV/AIDS and its risk factors, attitude towards HIV/AIDS and AIDS patients and its transmission and to identify high risk behaviors associated with HIV/AIDS among university students in Xinjiang. A cross–sectional survey was conducted among students enrolled Xingjiang University and Xinjiang Medical University. Data was collected using self-administered standardized questionnaire on KAP re HIV/AIDS among 400 students. Mean knowledge scores is significantly different by ethnicity, sex, subject major, and year of study in university. Only 33.3% of the respondents had positive attitude towards HIV/AIDS patient. With regards high risk behavior associated with HIV transmission, 15.8% had at least 1 risk behavior related to unprotected sexual exposure Conclusion: HIV/AIDS health education efforts should be intensified in non-medical universities, among female, first year and Uyghur and other minorities’ students. About two-thirds of the students had negative attitude towards HIV/AIDS and HIV/AIDS patients. Around 15% of these students reported having at least 1 high risk behavior related to unprotected sex
Both HIV and Tuberculosis infections are associated with lipid peroxidation and antioxidant imbalance. Pathology of the two produce free radicals which lead to lipid peroxidation indices one of which is Malondialdehyde (MDA) and to disease progression due to CD4 cells apoptosis. The study was carried out with the objective of determining Serum MDA, Vitamin E, CD4, CD8 and lipid peroxidation index (LPI) in four different subgroups comprising of HIV, Tuberculosis and HIV/TB co-infected patients and the Controls with a view to assessing the interaction between oxidants and antioxidants in the course of HIV/TB co-infection. The higher MDA result from the subjects supports the assertion that HIV/TB co-infection is associated with increased lipid peroxidation and lower antioxidant potential. It can therefore be concluded that co-infection with Tuberculosis exacerbates oxidative stress in HIV patients, while treatment enhances their anti-oxidant status and ameliorates the oxidative stress.
Tuberculosis (TB) remains a leading cause of morbidity and mortality in developing countries. With the advent of the Human Immunodeficiency Virus (HIV) pandemic, the problem of TB has got worse. The incidence of TB in patients with HIV infection / AIDS is nearly 500 times higher than in the general population. In HIV infected patients tuberculosis may frequently present in sites other than the lungs, lymphadenitis being the most common but it may be in the bone, liver, or in almost any organ of the body. Disseminated tuberculosis (DTB) is also more common in patients with HIV infection. Diagnosis of TB is also difficult in patients with HIV infection as rate of sputum AFB positivity is less and chest X-Ray changes are also atypical. The prevalence of extrapulmonary TB is also higher in patients with HIV infection were obtaining clinical samples is difficult. The present work is done to evaluate role of Mycobacteremia, which is a simple and convenient test done by blood culture using MB\Bact method, in diagnosis of tuberculosis with or without HIV infection.
Injecting drug users (IDUs) are at risk of infection with Human Immunodeficiency Virus (HIV) and Hepatitis C Virus (HCV). Independently, each of these viruses is a serious threat to health, with HIV ravaging the body’s immune system, and HCV causing cirrhosis, liver cancer and liver failure. Furthermore, co-infection with HIV/HCV weakens the response to antiretroviral therapy in HIV patients. IDUs with HIV/HCV co-infection are at a 20 times higher risk of having liver-related morbidity and mortality than IDUs with HIV alone. In Viet Nam, studies to ascertain the prevalence of HIV in IDUs have found high rates, but little is known about their HCV status. Therefore this book provides IDU HIV/HCV co-infection rates, in addition to the prevalence of HCV and HIV, and identifies factors associated with these viruses among 455 IDUs at four drug treatment centers in Ha Noi, Viet Nam. The availability of information about HIV/HCV co-infection in this vulnerable group will be of benefit to investigators and programmers addressing the problems of identifying and providing more appropriate treatment to HIV-positive IDUs.
Many aspects of acquired immunodeficiency syndrome [AIDS] have been described in detail in the literature. However, there has been very few articles on the phenomenon of Deep Vein Thrombosis [DVT] in the lower extremities of human immunodeficiency virus [HIV/AIDS] infected patients. There is reason to believe that the number of patients being admitted with Deep Vein Thrombosis in our hospital recently has increased compared with past records. Many patients have also been admitted with pulmonary embolism some of which were actually diagnosed at autopsy. Of note is that most of these patients admitted either with DVT or thrombosis at other sites are also infected with Human Immunodeficiency Virus (HIV). Although some of them have other risk factors for thrombosis like obesity, infections (e.g. Tuberculosis) etc, the relationship between thrombosis and HIV infection has been documented by many researchers. It has been found that HIV infection predisposes to a hypercoagulable state and that the risk of venous thromboembolism is about 10times that expected among people without HIV. In addition, various abnormalities leading to a hypercoagulable state have been detected in HIV patients
Tuberculosis (TB) is the most common opportunistic infection among HIV-infected and one of the major global public health challenges of this era.In Nepal, the burden of TB among HIV infected had been seen range from 10% - 20 % mainly the people of productive age. This study was designed to assess the public health burden of opportunistic TB infection among HIV infected. Information was collected from 144 HIV/AIDS patient who had visited the ART clinic of Bharatpur Hospital, Chitwan during the period of 10th May to 30th May 2012. Study showed the 9.7 percent prevalence of opportunistic TB among HIV infected and extra pulmonary TB rate was higher. The status of TB co-infection during the diagnosed HIV infected period was 28.4 percent including prevalence TB cases. The common health problems faced by HIV-TB co-infected were weakness , fever, weight loss and cough. Having history of TB infection before HIV diagnosis were at 4.8 times greater risk of getting opportunistic TB. Access to health related local non government organization in the community had a great impact for significantly low risk of HIV-TB co-infection.
Human Immunodeficiency Virus infection (HIV) and Acquired Immunodeficiency Syndromes (AIDS) continue to be major global health priorities. Although forced displacement is believed to fuel HIV/AIDS epidemic in countries affected by conflict, factors associated with forced displacement and HIV risk in conflict-affected populations are not well understood. The aims of this study were therefore (1) to describe factors that influence risk for HIV infection in a Utah-based Burundi refugee population and (2) explore relationship between Knowledge, Attitudes, and Behavior/Practices (KABP) in order design targeted HIV/AIDS prevention interventions for the population. Results were controlled for known confounders. Attitude towards HIV/AIDS (b = 0.5071, p > 0.001) was a significant predictor of HIV/AIDS knowledge. Behavior/ practices were strongly associated with knowledge, attitudes, self-efficacy, gender, and household size. Overall, men were more knowledgeable than women and had higher self-efficacy. Women had more positive attitudes and scored higher behavior/practices.
In the Sub Saharan Africa and on global scope, Uganda has an outstanding account of HIV/AIDS infection. HIV/AIDS is a chronic infection which requires huge resources in its management, besides knowledge on the rate of HIV infection transition from one stage to another is scanty. This paper sheds light on the estimates of HIV infection progression within resource limited settings and its co-factors among children. The paper is framed in lifecourse theoretical perspective to appraise the chronological effect of demographic and socioeconomic factors on the lifecourse of HIV-AIDS. Using Kaplan Meier and Cox proportional hazard model as methods of analysis, the paper indicates that, the duration of exposure to HIV infection contributed in each stage decreases with progressive amplification in the infection, increasingly short expectation of life once a child progresses from asymptomatic stage. Thus, to optimize survival time on HIV infection lifecourse, HIV/AIDS care and treatment should strive to maintain HIV infection within asymptomatic levels yet initiating treatment on the earliest time possible.
Malnutrition is one of the earliest complications of HIV infection. This cross-sectional study (involving 100 newly diagnosed HIV positive patients) was carried out to evaluate the relationship between the nutritional status and immune status of HIV positive patients, and to look into the various factors contributing to malnutrition in these patients. In the study sample, 46% of the patients were malnourished according to body mass index, 85% were malnourished according to triceps skin-fold thickness and 98% were malnourished according to mid arm muscle circumference. Tuberculosis, chronic diarrhea, candidiasis and depression were associated with malnutrition. Nutritional, anthropometric and laboratory parameters were found to have significant correlation with the immune status. Hence, nutritional assessment of HIV-infected persons can identify those at risk for adverse outcomes from nutritional deficiencies and help in planning appropriate interventions.
This book try to show the effect of CD4 count WHO staging TB exposure and age on survival of HIV/AIDS patients in two district Hospitals in southern Ethiopia in addition to that it shows the impact of some routine laboratory result on survival of HIV patients and in Ethiopia this routine activity is not done in standard way and this has a negative impact on survival of patients living with HIV/AIDS who are on ART treatment in some district Hospitals in southern Ethiopia