Malnutrition in HIV/AIDS: Aetiopathogenesis

Sashindran, VK; Thakur, Rajneesh

doi:10.5772/intechopen.90477

Cited by 14 publications

(8 citation statements)

References 122 publications

(132 reference statements)

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“…There were multiple reasons for delayed ART initiation in African children, including ART guidelines current at the time, tuberculosis co-infection, lack of human resources, socio-economic obstacles and incorrect disease classification of disease severity [22,23]. These delays in ART initiation, coupled with chronic inflammation caused by uncontrolled HIV infection, tuberculosis co-infection, recurrent opportunistic infections and poor socio-economic circumstances, all contribute to poor growth and stunting in children and adolescents living with vertically acquired HIV infection [24,25]. The current WHO recommendation regarding early infant diagnosis and immediate ART initiation in children irrespective of their age, clinical staging or CD4 count facilitates earlier treatment access, with more studies needed to assess the catch-up growth in these newer cohorts.…”

Section: Plos Onementioning

confidence: 99%

Growth and the pubertal growth spurt in South African adolescents living with perinatally-acquired HIV infection

et al. 2022

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Background The majority children living with HIV infection now survive into adulthood because of effective antiretroviral therapy (ART), but few data exist on their growth during adolescent years. This study investigated growth patterns and evaluated factors associated with suboptimal growth in adolescents with perinatally-acquired HIV infection. Methods This retrospective cohort study included HIV-infected adolescents, aged 13 to 18 years, with at least 5 years of ART follow-up at a large HIV clinic in the Gauteng Province, South Africa. Weight-for-age Z-scores (WAZ), height-for-age Z-scores (HAZ) and body mass index (BMI)-for-age Z-scores were calculated using World Health Organization (WHO) growth standards. Growth velocity graphs were generated utilising the mean height change calculated at 6-monthly intervals, using all available data after ART initiation, to calculate the annual change. Other collected data included WHO HIV disease staging, CD4%, HIV viral loads (VLs), ART regimens and tuberculosis co-infection. Results Included were 288 children with a median age of 6.5 years (IQR 4.2;8.6 years) at ART initiation, and 51.7% were male. At baseline the majority of children had severe disease (92% WHO stages 3&4) and were started on non-nucleoside reverse transcriptase inhibitor-based regimens (79.2%). The median CD4% was 13.5% (IQR 7.9;18.9) and median HIV viral load log 5.0 (IQR 4.4;5.5). Baseline stunting (HAZ <-2) was prevalent (55.9%), with a median HAZ of -2.2 (IQR -3.1;-1.3). The median WAZ was -1.5 (IQR -2.5;-0.8), with 29.2% being underweight-for-age (WAZ <-2). The peak height velocity (PHV) in adolescents with baseline stage 3 disease was higher than for those with stage 4 disease. Being older at ART start (p<0.001) and baseline stunting (p<0.001) were associated with poorer growth, resulting in a lower HAZ at study exit, with boys more significantly affected than girls (p<0.001). Conclusions Suboptimal growth in adolescents with perinatally-acquired HIV infection is a significant health concern, especially in children who started ART later in terms of age and who had baseline stunting and is more pronounced in boys than in girls.

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Section: Plos Onementioning

confidence: 99%

Growth and the pubertal growth spurt in South African adolescents living with perinatally-acquired HIV infection

et al. 2022

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“…Various causes of anorexia include oral and or esophageal candidiasis, and ART adverse effects also lead to HIV wasting. These may impact anemia incidence among them (29).…”

Section: Discussionmentioning

confidence: 99%

Predictor of Anemia Among People Living With Hiv Taking Tenofovir+lamivudine+efavirenz Therapy in Jayapura, Papua

Adiningsih¹,

Kridaningsih²,

Widiyanti³

et al. 2023

JBE

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Background: The most common hematological abnormality among people infected with Human Immunodeficiency Virus (HIV) is anemia. This is also related to high mortality risk among patients receiving Antiretroviral Therapy (ART). Purpose: This study aimed to identify predictorsf anemia among HIV patients taking ART using a regimen of the single-tablet drug contain tenofovir, lamivudine, and efavirenz in Jayapura, Papua. Methods: This was a cross-sectional study conducted at Jayapura regional hospital from June to September 2017. A total of 80 HIV patients were eligible for analysis. Data collection was conducted through an interview, medical record, measurement, and laboratory assay. The significance of differences among categorical variables was analyzed using Fisher’s exact test. The variables with p < 0.25 were then analyzed using binary logistic regression to determine predictors associated with anemia. A threshold of p < 0.05 indicates statistical significance. Results: This study showed that Body Mass Index (BMI) <18.50 (p = 0.01; OR = 5.63; 95% CI = 1.43 < OR < 22.19), length onRT ≤12 months (p = 0.00; OR = 4.90; 95% CI = 1.65 < OR < 14.53), and Cluster of Differentiation 4 (CD4+) percentage out of normal (p = 0.02; OR = 0.19; 95% CI = 0.05 < OR <0.77) had a significant association with anemia. Conclusion: BMI, length on ART, and CD4+ percentage were predictors of anemia among HIV patients taking antiretroviral therapy contain tenofovir, lamivudine, efavirenz regimen in Jayapura.

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“…Increased energy expenditure happens in the setting of opportunistic infections. Weight loss in patients with HIV is associated with poor prognosis, increased risk of disease progression, and opportunistic pathology [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Acquired Immunodeficiency Syndrome Presented as Atypical Ocular Toxoplasmosis

Pour

Riazi-Esfahani

Ebrahimiadib

et al. 2021

Case Reports in Ophthalmological Medicine

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Background. The aim is to report an atypical presentation of ocular toxoplasmosis which led to the diagnosis of Acquired Immunodeficiency Syndrome (AIDS). Case Report. The 38-year-old woman was referred with metamorphopsia and reduced vision in the right eye over the past 3 weeks. Slit-lamp examination revealed granulomatous keratic precipitates (KPs), 2+ cells in the anterior chamber, and posterior synechiae. Fundus examination was remarkable for a white patch surrounding a scar, inferonasal to the optic disc with fibrous bands emanating from the lesion, and the retina around this region was detached with considerable extension towards the periphery, while no breaks could be appreciated. She mentioned anorexia and losing 10 kg in the past three months, and signs of anemia like paleness of face skin, bed nails, and bilateral angular cheilitis were observed on systemic evaluation. The results of the patient’s complete blood count revealed anemia and leukopenia and CD4 lymphocytes: 79 cells/μL. Enzyme-linked immunosorbent assays (ELISA) for HIV antibodies came back positive which was later confirmed with the Western blot test. Brain magnetic resonance imaging (MRI) showed multiple ring-enhancing lesions in both cerebral cortices. The patient underwent antitoxoplasmosis and anti-HIV treatment and serous retinal detachment completely resolved. Conclusion. This report highlights the fact that sometimes, the eyes are the site of the first presentation of a systemic life-threatening condition and emphasizes the role of ophthalmologists in such cases. In cases of atypical presentation, appropriate laboratory tests and CNS imaging should be requested. Systemic treatment with antitoxoplasmosis regimens and highly active antiretroviral therapy (HAART) is mandatory in AIDS patients with ocular toxoplasmosis.

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Malnutrition in HIV/AIDS: Aetiopathogenesis

Cited by 14 publications

References 122 publications

Growth and the pubertal growth spurt in South African adolescents living with perinatally-acquired HIV infection

Growth and the pubertal growth spurt in South African adolescents living with perinatally-acquired HIV infection

Predictor of Anemia Among People Living With Hiv Taking Tenofovir+lamivudine+efavirenz Therapy in Jayapura, Papua

Acquired Immunodeficiency Syndrome Presented as Atypical Ocular Toxoplasmosis

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