Electrolyte imbalance and sleep problems during anti-retroviral therapy: an under-recognized problem

Manzar, Dilshad; Peter, Sony; Salahuddin, Mohammed; Kumalo, Abera; Geneto, Mathewos; Pandi-Perumal, Seithikurippu R.; Moscovitch, Adam; BaHammam, Ahmed S.

doi:10.5935/1984-0063.20170011

Cited by 12 publications

(8 citation statements)

References 19 publications

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“…Lastly, although all HIV-infected participants were already on ART, they were not stratified based on the duration of the infection, nor were they classified based on CD4+ T-cell counts or the duration that they had been on ART. All 3 factors could have possible confounding effects on the various electrolyte and hematological factors we measured, 26 , 32 and as such it is possible that the differences for some parameters observed between the HIV-infected and the HIV-uninfected groups could be due to other comorbidities.…”

Section: Discussionmentioning

confidence: 99%

HIV infection has a profound effect on hematological factors but not on electrolyte profile of Malawian adults presenting with uncomplicated malaria and severe malaria

Munyenyembe

Gausi

Nyirenda³

et al. 2018

JBM

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AimAlthough malaria and HIV infections independently affect the electrolyte and hematologic profiles, little is known of how these profiles are affected in individuals coinfected with malaria and HIV. We therefore conducted this study to investigate the electrolyte and hematologic profiles of Malawian adults presenting with either uncomplicated malaria (UM), severe malaria (SM), and those presenting with HIV and UM or HIV and SM.MethodsStudy participants were recruited at Queen Elizabeth Central Hospital, and malaria infection was confirmed by rapid diagnostic test and malaria slides, and full blood count, HIV, and wet chemistries were analyzed.ResultsSodium, potassium, calcium, and chloride levels of all 4 study groups were similar to those of healthy controls. Both HIV-infected groups (UM and SM) had lower red blood cell counts and lower hemoglobin concentration than the reference range. Platelet counts were lower in both HIV-uninfected SM cases (64×109/L) and in the HIV-infected SM cases (66×109/L) compared to the reference range (115–290×109/L). HIV− UM cases had higher proportion and absolute counts of neutrophils and white blood cell counts compared to the HIV+ UM cases.ConclusionHIV infection did not affect the electrolyte profile of Malawian adults presenting with UM or SM but had an effect on red blood cells, Hb concentration, neutrophils, and platelet counts.

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Section: Discussionmentioning

confidence: 99%

HIV infection has a profound effect on hematological factors but not on electrolyte profile of Malawian adults presenting with uncomplicated malaria and severe malaria

Munyenyembe

Gausi

Nyirenda³

et al. 2018

JBM

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“…This relationship persisted after adjusting for the effects of mood, stress, and disease status, suggesting that the relationship was independent of such factors (500). Of note, even after the initiation of antiretroviral therapy, HIV-positive patients continue to report lower sleep quality (359, 539, 591), and in a recent study in a South African-treated HIV-positive population, an increase in CD4 T-cell counts was associated with lower sleep quality (461). In animals, injection of the HIV envelope glycoprotein 120 in the brain of rats caused an increase of hypothalamic mRNA expression of IL-1 and IL-10 and an increase of NREM sleep, further suggesting that alteration in cytokine concentrations may underlie sleep alterations observed in HIV infections (413).…”

Section: The Sleep Response To Immune Activationmentioning

confidence: 99%

The Sleep-Immune Crosstalk in Health and Disease

Besedovsky

Lange

Haack

2019

Physiological Reviews

950

759

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Sleep and immunity are bidirectionally linked. Immune system activation alters sleep, and sleep in turn affects the innate and adaptive arm of our body’s defense system. Stimulation of the immune system by microbial challenges triggers an inflammatory response, which, depending on its magnitude and time course, can induce an increase in sleep duration and intensity, but also a disruption of sleep. Enhancement of sleep during an infection is assumed to feedback to the immune system to promote host defense. Indeed, sleep affects various immune parameters, is associated with a reduced infection risk, and can improve infection outcome and vaccination responses. The induction of a hormonal constellation that supports immune functions is one likely mechanism underlying the immune-supporting effects of sleep. In the absence of an infectious challenge, sleep appears to promote inflammatory homeostasis through effects on several inflammatory mediators, such as cytokines. This notion is supported by findings that prolonged sleep deficiency (e.g., short sleep duration, sleep disturbance) can lead to chronic, systemic low-grade inflammation and is associated with various diseases that have an inflammatory component, like diabetes, atherosclerosis, and neurodegeneration. Here, we review available data on this regulatory sleep-immune crosstalk, point out methodological challenges, and suggest questions open for future research.

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“…Stress is common in various sections of the Ethiopian population such as university students [6], epilepsy patients [7], HIV-infected patients [8], nurses [9], and females students with childhood sexual abuse [10]. Moreover, many risk factors, i.e., substance use [11–13], sleep problems [6, 11, 12], HIV [14], food insecurity [15], poverty [15], and risky sexual behavior [14] for stress and related mental problems are commonly prevalent in Ethiopian populations. It can therefore arguably be considered that there is a prospect of the undiagnosed and under-recognized magnitude of stress in the Ethiopian population.…”

Section: Introductionmentioning

confidence: 99%

Psychometric properties of the perceived stress scale in Ethiopian university students

et al. 2019

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BackgroundStress is a common psychological condition usually associated with many psycho-physical disorders. Stress and its risk factors are frequently seen in Ethiopians including university students. In such circumstances, a valid measure to screen for stress in Ethiopians is necessary. Therefore, we assessed the psychometric properties of the Perceived Stress Scale (PSS) in Ethiopian university students.MethodsA cross-sectional study with a simple random sampling method was performed on students of Mizan-Tepi University, Mizan-Aman, Ethiopia. The study presents a psychometric investigation on a sample of 387 students (age = 21.8 ± 3.8 years, and body mass index = 20.8 ± 3.2 kg/m2) who completed PSS, Generalized anxiety disorder-7 scale (GAD-7), and a socio-demographics tool. McDonald’s Omega (internal consistency), factor validity for ordinal data and convergent validity (Spearman’s correlation) were assessed.ResultsNo ceiling/floor effect was seen for the total or factor scores of the PSS-10 and PSS-4. Two factor model of the PSS-10 was favored by fit indices with Comparative Fit Index> 0.95, Weighted root mean square residual<.05 and root mean square error of approximation<.08. McDonald’s Omega was 0.78 and 0.68 for the PSS-10: Factor-1 and PSS-10: Factor-2, respectively. McDonald’s Omega was 0.70 and 0.54 for the PSS-4: Factor-1 and PSS-4: Factor-2, respectively. There were moderate-strong correlations (r = 0.62–0.83) between PSS factors and respective items loading on them. PSS scores were correlated with GAD-7 (r = .27–.40, p < .01).ConclusionThe psychometric measures support the validity of the PSS-10 in Ethiopian university students.Electronic supplementary materialThe online version of this article (10.1186/s12889-018-6310-z) contains supplementary material, which is available to authorized users.

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Electrolyte imbalance and sleep problems during anti-retroviral therapy: an under-recognized problem

Cited by 12 publications

References 19 publications

HIV infection has a profound effect on hematological factors but not on electrolyte profile of Malawian adults presenting with uncomplicated malaria and severe malaria

HIV infection has a profound effect on hematological factors but not on electrolyte profile of Malawian adults presenting with uncomplicated malaria and severe malaria

The Sleep-Immune Crosstalk in Health and Disease

Psychometric properties of the perceived stress scale in Ethiopian university students

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