No abstract

Maintenance of the cluster of differentiation 4 (CD4) positive lymphocyte count (CD4 count) is important for human immunodeficiency virus (HIV) positive individuals. Although a higher body mass index (BMI) is shown to be associated with a higher CD4 count, BMI itself does not reflect body composition. Therefore, we examined the association of body weight, body composition and the CD4 count, and determined the optimal ranges of CD4 count associated factors in Japanese HIV positive individuals. This cross-sectional study included 338 male patients treated with antiretroviral therapy for ≥12 months. Multiple logistic regression analysis was used to identify factors significantly associated with a CD4 count of ≥500 cells (mm3)−1. The cutoff values of factors for a CD4 ≥ 500 cells (mm3)−1 and cardiovascular disease risk were obtained by receiver operating characteristic curves. Age, body fat percentage (BF%), nadir CD4 count, duration of antiretroviral therapy (ART), years since the HIV-positive diagnosis and cholesterol intake showed significant associations with the CD4 count. The cutoff value of BF% for a CD4 ≥ 500 cells (mm3)−1 and lower cardiovascular disease risk were ≥25.1% and ≤25.5%, respectively. The BF%, but not the BMI, was associated with CD4 count. For the management of HIV positive individuals, 25% appears to be the optimal BF% when considering the balance between CD4 count management and cardiovascular disease risk.

Pharmacists interventions are considered to be important at the time of starting anti-HIV therapy or changing treatment in outpatient care for HIV infection. We conducted a questionnaire survey to clarify patients assessments of pharmacists interventions in outpatient care for HIV infection. The survey was conducted at seven AIDS treatment center hospitals in the Kinki region, and the analysis was performed on 112 patients receiving the initial treatment and 79 patients experiencing treatment change. Pharmacists interventions were found to be helpful by 97.3 of the initial treatment patients and 96.2 of the treatment change patients; the former often found it helpful in understanding the necessity of receiving drugs and failure in taking drugs and acquisition of resistance , while the latter often found it helpful in understanding the difference of the new drug from the previous one and side effects. Pharmacists interventions relieved anxiety in 89.3 of the initial treatment patients and 89.9 of the treatment change patients, and produced good overall effects such as relieving anxiety as regards receiving drugs , facilitating communication with doctors , and reducing questions for doctors. The survey results showed that pharmacists interventions at the time of starting anti-HIV therapy or changing treatment met patients needs and contributed to improving the quality of medical care, such as reducing patient anxiety and the burden on doctors.