Epidemiology of Opportunistic Infections in HIV Infected Patients on Treatment in Accredited HIV Treatment Centers in Cameroon

Kouanfack, Ornella Sybile D; Kouanfack, Charles; Billong, Serges Clotaire; Cumber, Samuel Nambile; Nkfusai, Claude Ngwayu; Bede, Fala; Wepngong, Emerson; Hubert, Chombong; Nguefack‐Tsague, Georges; Singwe, Madeleine Ngandeu

doi:10.21106/ijma.302

Cited by 13 publications

(11 citation statements)

References 21 publications

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“…This corroborates WHO reports that places Cameroon among the rst 30 countries with a high burden of HIV/TB coinfection [24]. In another study carried out in 12 HIV treatment centers in and Douala, showed that TB was the second most common opportunistic infection (20%) after shingles (25%) [25]. Correspondingly, retrospective studies conducted between 2010-2017 by [32][33][34].…”

Section: Discussionsupporting

confidence: 84%

Predictors of advanced HIV disease in patients on antiretroviral therapy at the Buea Regional Hospital and co-infection rates of Mycobacterium spp. and Cryptococcus spp

Tcheumeni

Meriki

Sam

et al. 2022

Preprint

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Background Human immunodeficiency Virus (HIV) and consequently the acquired immune deficiency syndrome (AIDS) remain a significant public health problem, having claimed 36.3 million lives so far. In 2020, approximately 680,000 people died from AIDS-related illnesses worldwide. Despite increased access to antiretroviral treatment (ART), the burden of mortality and morbidity due to advanced HIV disease (AHD) has not significantly changed over the years. AHD individuals are more prone to opportunistic infections– including Mycobacterium tuberculosis (MTB) and Cryptococcal meningitis (CM). CM has been reported as a significant cause of mortality among people living with HIV (PLHIV), accounting for 15% of the global AIDS-related deaths in 2019. To keep track of the global commitments made by governments to end the AIDS epidemic as a public health threat by 2030, knowledge of the burden of AHD and its risk factors are essential. Methods A hospital-based cross-sectional study was conducted from February 2020 to February 2021. HIV-infected individuals on ART at the Buea Regional Hospital were screened for AHD using World Health Organization (WHO) consolidated guidelines. A pre-tested semi-structured questionnaire was administered to the consented participants, and blood, sputum, and urine samples were collected. Acid fast bacilli microscopy detection and TB culture were carried out following standard microbiological procedures. Cryptococcus antigen lateral flow tests were performed using sera. Chi-square and regression analysis were carried out on SPSS at a p < 0.05 significance level. Results From a total of 3,229 PLHIV adults on care in the study period, 327 (10.1%) were suspected of having AHD, and were enrolled in the study. Most of the enrolled individuals were women (62.4%) and the mean age of the participants was 40.5 ± 24.7 years. A total of 130 (39.8%, [95% CI, 34.41–45.29]) participants presented with AHD and 41 (35.7%, [95% CI, 26.94–45.12]) and 7 (6.7%, [95% CI, 2.72–13.25) had TB and Cryptococcal infections, respectively. AHD was associated with male gender (aOR; 3.9, 95% CI; 1.40–11.70), and being on ART for more than 12 months was protective (aOR; 0.1, 95% CI; 0.01–0.35). Conclusion Even when ART uptake has dramatically improved in Cameroon, AHD (35.7%) is far beyond the UNAIDS reduction target of 10% by 2020 and thus, improvement in the management of PLHIV is warranted.

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Section: Discussionsupporting

confidence: 84%

Predictors of advanced HIV disease in patients on antiretroviral therapy at the Buea Regional Hospital and co-infection rates of Mycobacterium spp. and Cryptococcus spp

Tcheumeni

Meriki

Sam

et al. 2022

Preprint

View full text Add to dashboard Cite

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“…HIV causes immunodepression by depleting CD4 cells, thus reducing the capacity of the organism to defend against bacterial, fungal, parasitic, and viral infections such as COVID-19 [20,22]. This vulnerability to infection is greater when the immunodepression is severe and the patient is not on ART making the patient at risk of opportunistic infections [23,24]. The presence of 38 million people worldwide with HIV during this period of COVID-19, could therefore be challenging for health systems worldwide as more aggressive preventive and therapeutic measures might be needed for this population.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of patients with HIV and COVID-19 co-infection: a systematic review and meta-analysis

et al. 2022

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Background Data on the association of human immunodeficiency virus (HIV) infection with adverse outcomes in patients with COVID-19 are conflicting. This systematic review and meta-analysis aimed to summarize the available information on the risk of hospitalization, severe disease, and death attributable to HIV in patients with COVID-19. Methods PubMed, EMBASE, Web of Science, and SCOPUS were searched through October 25, 2021, to identify relevant studies, without language restriction. A random-effects model was used to pool estimates. Results We included 44 studies reporting information from 38,971,065 patients with COVID-19. The pooled prevalence of HIV among COVID-19 patients was 26.9 ‰ (95% CI 22.7–31.3) and was significantly higher in studies conducted in Africa compared to those conducted elsewhere (118.5‰ [95% CI 84.8–156.9, 11 studies] vs 10.9‰ [95% CI 8.8–13.2, 27 studies]). In pooled analyses of unadjusted odds ratio, HIV-positive individuals were more likely to be admitted to hospital (OR: 1.49; 95% CI 1.01–2.21, 6 studies) compared to HIV-negative individuals. In the adjusted (for age and sex) analyses, HIV was associated with an increased risk of death (hazard ratio: 1.76, 95% CI 1.31–2.35, 2 studies). However, HIV was not associated with the severity of the disease (OR: 1.28; 95% CI 0.77–2.13, 13 studies), or death (OR: 0.81; 95% CI 0.47; 1.41, 23 studies) in patients with COVID-19 in the meta-analysis of unadjusted odds ratio. Conclusion Our findings suggest that patients with HIV have an increased risk of hospital admission for COVID-19. HIV seems to be independently associated with increased risk of mortality in COVID-19 patient in adjusted analysis. However, this evidence was derived from only two studies.

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“…One possible explanation for these discordant findings is the incidence of tuberculosis in both countries. The incidence of tuberculosis in Africa is 276 cases per 100,000 inhabitants, while in Peru 119 cases per 100,000 inhabitants have been reported [28].…”

Section: Discussionmentioning

confidence: 99%

HIV therapy adherence and outcomes in Peruvian military personnel over a 30-year period

et al. 2023

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Objectives: We aimed to describe the sociodemographic, clinical, and therapeutic characteristics of Peruvian military personnel diagnosed with HIV. Furthermore, we determined the frequency of highly active antiretroviral therapy (HAART) adherence, the complications and mortality. Methods: We retrospectively reviewed the medical records of patients diagnosed with HIV, confirmed by Western blot at a single institution from 1989-2020. Descriptive analyses were performed for all the variables using mean and standard deviation (SD) in the case of quantitative variables, and frequency and percentage for qualitative variables. Results: Of the 161 patients included, 95.7% were males and the mean age was 39.59 years (SD= 16.45 years). Most had college or higher education (67.7%) and were on active duty at diagnosis (77%). 35.4% had AIDS at diagnosis; 28.6% opportunistic infections; and 8.1% tuberculosis. The median follow-up was five years. 94.4% of the patients received HAART as the principal treatment; of these, 88.8% was adherent to treatment, and death was reported in 6.8%. There were no factors associated with adherence. Conclusions: Although the sociodemographic characteristics of Peruvian military personnel are similar to those of other countries, our findings suggest that Peruvian military personnel present higher adherence to HAART compared to previous studies in other military populations from South American countries. Further studies are recommended to assess specific factors attributed to these successful outcomes in the military personnel that can be applied in other hospitals.

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Epidemiology of Opportunistic Infections in HIV Infected Patients on Treatment in Accredited HIV Treatment Centers in Cameroon

Cited by 13 publications

References 21 publications

Predictors of advanced HIV disease in patients on antiretroviral therapy at the Buea Regional Hospital and co-infection rates of Mycobacterium spp. and Cryptococcus spp

Predictors of advanced HIV disease in patients on antiretroviral therapy at the Buea Regional Hospital and co-infection rates of Mycobacterium spp. and Cryptococcus spp

Outcomes of patients with HIV and COVID-19 co-infection: a systematic review and meta-analysis

HIV therapy adherence and outcomes in Peruvian military personnel over a 30-year period

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