AIDS-Defining Illnesses at Initial Diagnosis of HIV in a Large Guatemalan Cohort

Reinhardt, Samuel W.; Spec, Andrej; Meléndez, Johanna; Alonzo, Andrea; Ross, I.; Powderly, William; Mejía, Carlos

doi:10.1093/ofid/ofw172.1722

Cited by 4 publications

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“…This makes older PLWH more susceptible to many chronic diseases including cardiovascular, lung, liver and renal diseases, cancers, and neuropsychiatric disorders. Older PLWH also have higher risk of diseases related to the acquired immune deficiency syndrome (AIDS), such as Mycobacterium tuberculosis, Pneumocystis jirovecii pneumonia, and toxoplasmosis [8,9].…”

Section: Introductionmentioning

confidence: 99%

Association between social capital and mental health among older people living with HIV: the Sichuan Older HIV-Infected Cohort Study (SOHICS)

et al. 2020

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Background: Mental health problems are common among older people living with HIV and associated with poorer health outcomes. Social capital is an important determinant of mental health problems but under-studied in this population. This study investigated the association between social capital and mental health problems among older people living with HIV in China. Methods: The study was based on the baseline data of a cohort study investigating mental health among older people living with HIV in Sichuan, China during November 2018 to February 2019. Participants were people living with HIV aged ≥50 years living in Sichuan province. Stratified multi-stage cluster sampling was used to recruit participants from 30 communities/towns; 529 out of 556 participants being approached completed the face-to-face interview. Social capital was measured by two validated health-related social capital scales: the Individual and Family scale and the Community and Society scale. Presence of probable depression (CES-D-10 score ≥ 10) and probable anxiety (GAD-7 score ≥ 5) were used as dependent variables. Two-level logistic regression models were applied to examine the association between social capital and probable depression/anxiety. Results: The prevalence of probable depression and probable anxiety was 25.9% (137/529) and 36.3% (192/529), respectively. After adjusting for significant covariates, the individual/family level of social capital was inversely associated with both probable depression (odds ratios (OR): 0.89, 95% CI: 0.84-0.93, p < 0.001) and probable anxiety (OR: 0.90, 95% CI: 0.86-0.95, p < 0.001). The community/society level social capital was associated with probable depression (OR: 0.91, 95% CI: 0.84-0.99, p < 0.001) but not probable anxiety (p > 0.05).

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Section: Introductionmentioning

confidence: 99%

Association between social capital and mental health among older people living with HIV: the Sichuan Older HIV-Infected Cohort Study (SOHICS)

et al. 2020

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“…Furthermore, the high proportion of deaths related to AIDS (52%) was in the range of 51-54% reported among late initiators who died within 1 year post ART initiation in other cohorts [2,13], indicating that AIDS-defining illnesses are an important cause of death in late-presenting PLHIV [2]. Common AIDS-defining illnesses among those with low CD4 counts in sub-Saharan Africa and South America are TB and PCP [4][5][6]. In our study, we obtained similar results to those reported in the literature, with TB (18%) and PCP (16%) being the most common types of AIDS-defining illness.…”

Section: Discussionmentioning

confidence: 99%

“…Another common cause of death in the population of late ART initiators is opportunistic infections (OIs). While studies in sub-Saharan Africa have shown tuberculosis (TB), cryptococcal meningitis (CM), and pneumocystis pneumonia Pneumocystis carinii pneumonia (PCP) to be prevalent OIs [4], studies in South America did not find CM to be a leading AIDS-defining illness [5,6]. In addition, poor ART adherence, intolerability of antiretroviral drugs, and very low CD4 cell counts with slow response to ART have also been found to be contributing factors [7,8].…”

Section: Introductionmentioning

confidence: 99%

Early mortality after late initiation of antiretroviral therapy in the TREAT Asia HIV Observational Database (TAHOD) of the International Epidemiologic Databases to Evaluate AIDS (IeDEA) Asia‐Pacific

et al. 2019

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Objectives Early mortality among those still initiating antiretroviral therapy (ART) with advanced stages of HIV infection in resource‐limited settings remains high despite recommendations for universal HIV treatment. We investigated risk factors associated with early mortality in people living with HIV (PLHIV) starting ART at low CD4 levels in the Asia‐Pacific. Methods PLHIV enrolled in the Therapeutics, Research, Education and AIDS Training in Asia (TREAT Asia) HIV Observational Database (TAHOD) who initiated ART with a CD4 count < 100 cells/μL between 2003 and 2018 were included in the study. Early mortality was defined as death within 1 year of ART initiation. PLHIV in follow‐up for > 1 year were censored at 12 months. Competing risk regression was used to analyse risk factors with loss to follow‐up as a competing risk. Results A total of 1813 PLHIV were included in the study, of whom 74% were male. With 73 (4%) deaths, the overall first‐year mortality rate was 4.27 per 100 person‐years (PY). Thirty‐eight deaths (52%) were AIDS‐related, 10 (14%) were immune reconstituted inflammatory syndrome (IRIS)‐related, 13 (18%) were non‐AIDS‐related and 12 (16%) had an unknown cause. Risk factors included having a body mass index (BMI) < 18.5 [sub‐hazard ratio (SHR) 2.91; 95% confidence interval (CI) 1.60–5.32] compared to BMI 18.5–24.9, and alanine aminotransferase (ALT) ≥ 5 times its upper limit of normal (ULN) (SHR 6.14; 95% CI 1.62–23.20) compared to ALT < 5 times its ULN. A higher CD4 count (51–100 cells/μL: SHR 0.28; 95% CI 0.14–0.55; and > 100 cells/μL: SHR 0.12; 95% CI 0.05–0.26) was associated with reduced hazard for mortality compared to CD4 count ≤ 25 cells/μL. Conclusions Fifty‐two per cent of early deaths were AIDS‐related. Efforts to initiate ART at CD4 counts > 50 cell/μL are associated with improved short‐term survival rates, even in those with late stages of HIV disease.

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“…Consequently, the occurrence of these infections is possible only through international travel [ 23 ]. Moreover, in Latin America, the estimated histoplasmosis incidence is equivalent to that of TB in people living with HIV, and the highest overall prevalence of prior histoplasmosis exposure was observed in Guatemala, Mexico [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Factors influencing histoplasmosis incidence in multidrug-resistant pulmonary tuberculosis patients: A cross-sectional study in Indonesia

Khairunnisa,

Soeroso,

Abdullah

et al. 2023

Narra J

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Histoplasmosis is an infectious disease caused by the dimorphic fungus Histoplasma capsulatum, which, in chronic conditions, is generally difficult to distinguish from pulmonary tuberculosis based on its clinical appearance; therefore, diagnostic errors can occur. Meanwhile, the prevalence of multidrug-resistant pulmonary tuberculosis (MDR-TB) in Indonesia remains high. Study determining the incidence of histoplasmosis in MDR-TB is unavailable worldwide. The aim of this study was to determine the risk factors of histoplasmosis incidence in MDR-TB patients in Indonesia. A cross-sectional was conducted at H. Adam Malik General Hospital, Medan, Indonesia and the ELISA platform (semi-quantitative) was used to detect histoplasma antibodies. Factors associated with histoplasmosis incidence among MDR-TB were determined using a Chi-squared test. A total of 50 MDR-TB patients were included this study of which 14 of them (28%) had histoplasmosis. The majority of histoplasmosis occurred in males, in MDR-TB patients with a history of TB treatment and among who had chest x-rays with far-advanced lesions. However, statistical analyses indicated none of those factors (sex, TB treatment history, status of the lung) as well as age group, acid-fast bacillus result, Mycobacterium tuberculosis culture result, having pet, living in damp house, working in the field or plantation, having HIV infection and smoking status were associated with histoplasmosis incidence. This study highlights that the incidence of histoplasmosis is relatively high and therefore further studies are important to be conducted in Indonesia that has a high MDR-TB cases.

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AIDS-Defining Illnesses at Initial Diagnosis of HIV in a Large Guatemalan Cohort

Cited by 4 publications

References 0 publications

Association between social capital and mental health among older people living with HIV: the Sichuan Older HIV-Infected Cohort Study (SOHICS)

Association between social capital and mental health among older people living with HIV: the Sichuan Older HIV-Infected Cohort Study (SOHICS)

Early mortality after late initiation of antiretroviral therapy in the TREAT Asia HIV Observational Database (TAHOD) of the International Epidemiologic Databases to Evaluate AIDS (IeDEA) Asia‐Pacific

Factors influencing histoplasmosis incidence in multidrug-resistant pulmonary tuberculosis patients: A cross-sectional study in Indonesia

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