Opportunistic Infections among People Living with HIV (PLHIV) with Diabetes Mellitus (DM) Attending a Tertiary Care Hospital in Coastal City of South India

Indira, P.; Kumar, Pramod; Srivastav, Shalini; Kulkarni, Vaman

doi:10.1371/journal.pone.0136280

Cited by 14 publications

(18 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The average age of our patients was higher than that of other studies conducted among the general population as well as specifically in PLHIV [7,13]. In our study, the age factor did not have much influence in diabetes diagnosis but was significant in the study conducted by Mohammed [9].…”

Section: Para Clinical Aspectscontrasting

confidence: 70%

“…In our study, the circumstances of the discovery of HIV/AIDS infection are globally similar to those of most studies conducted elsewhere where the entry point to health care is dominated by opportunistic infections because patients often come to consult at a late stage [13,14].…”

Section: Para Clinical Aspectssupporting

confidence: 53%

“…During follow-up, the rate of CD4 increased gradually. In the study of Indira [13], PLHIV, diagnosed with diabetes had a better CD4 count than non-diabetic PLHIV even though ARV therapy was prescribed at the same time in both groups. Diabetic PLHIV could benefit from more frequent follow-up visits, which may have the indirect impact of better adherence to antiretroviral therapy leading to a higher CD4 count.…”

Section: Paraclinical Aspectsmentioning

confidence: 99%

“…In the study of Kra in Côte d'Ivoire [39], the three main diseases were tuberculosis (34.2%), cerebral toxoplasmosis (17.9%) and neuromeninging cryptococcosis (8%). In the study of Indira [13], in the groups, patients with diabetes were older and all PLHIV with diabetes had at least one opportunistic infection, with one third having more than one. Although PLHIV with diabetes had a higher proportion of oral candidiasis and meningeal cryptococcosis than their counterparts, this study did not identify a significant difference in the profile of opportunistic infections among PLHIV with and without diabetes.…”

Section: Evaluative Aspectsmentioning

confidence: 99%

See 3 more Smart Citations

Prevalence and Characteristics of Diabetes Mellitus in Patients Living with HIV (PLHIV) in Dakar (Senegal)

2018

AIDT

View full text Add to dashboard Cite

Objectives: Determine prevalence of diabetes mellitus in patients on or not on antiretroviral (ARV) therapy and describe the epidemiological, clinical, evolutionary and therapeutic aspects. Patients and Methods: This was a study carried out from 1 January 2006 to 31 May 2014 in PLHIV followed at four health care facilities dedicated to HIV patients treatment in Dakar, known to be diabetic, naïve or not to ARV treatment. Results: Fifty-two cases of diabetes mellitus were included among 4370 HIV cases, representing a hospital prevalence of 1.2%. Average age of patients was 50.83 ± 8.72 years and sex ratio 1.26. In 28 patients (54%), diabetes was discovered accidentally, 23 patients were not reported (44%) and one patient found during complication. In 98.1%, diabetes was noninsulin-dependent. In 23 (44%), diabetes mellitus was diagnosed after HIV infection, 23 before and 6 (12%) at the same time. The mean time for diabetes mellitus diagnosis during follow-up of HIV infection was 47.83 months ± 33 months and 43.4 months ± 30.9 months after initiation of ARV therapy. At initial examination, average CD4 T cell count was 297.4 cells ± 257.9 cells / mm3 and average blood glucose at empty stomach was 1.75 ± 0.73 g/l. The number of pathologies occurring during follow-up period was 1.08 ± 0.88. Four patients died. Conclusion: Despite low prevalence of diabetes in PLHIV in Dakar, burden of relating co-morbidity is heavy and raises two main concerns namely management of HIV infection and metabolic disorders.

show abstract

Section: Para Clinical Aspectscontrasting

confidence: 70%

Section: Para Clinical Aspectssupporting

confidence: 53%

Section: Paraclinical Aspectsmentioning

confidence: 99%

Section: Evaluative Aspectsmentioning

confidence: 99%

See 2 more Smart Citations

Prevalence and Characteristics of Diabetes Mellitus in Patients Living with HIV (PLHIV) in Dakar (Senegal)

2018

AIDT

View full text Add to dashboard Cite

show abstract

“…in Sub-Saharan Africa [3,4]. Though once known to be rare, cryptococcosis has occurred at a high frequency in India in the past two decades [5,6].Furthermore, prevalence of HIV-associated CM is also found to be common in many parts of India including North-eastern and as well as in Southern India [7,8].Cryptococcal meningitis is the fourth most commonly recognized cause of life-threatening infection among AIDS patients [9].Despite availability of antiretroviral therapy, the rise in rate of infections due to HIV/AIDS, suppress the cell mediated immune system and subjects are predisposed for opportunistic infections. Additionally, In AIDS patients, it is characterized by lack of meningeal signs and diminished inflammatory response [10].…”

Section: Introductionmentioning

confidence: 99%

Cryptococcal meningitis in HIV (AIDS) patients: A Mini Review

Sen

Chatterji

Singh

et al. 2017

AABS

View full text Add to dashboard Cite

Meningitis is a major health problem causing inflammation of the protective membranes covering the brain and spinal cord, collectively known as the meninges. Meningitis is generally caused by Meningococcus, Streptococcus pyogenes bacterial species causing bacterial meningitis: BM), Mycobacterium tuberculosis (Tubercular meningitis: TBM), Cryptococcus neoformans (fungal meningitis: CM). In recent times the CM and TBM are two most common types of chronic infectious meningitis. In adults, HIV-associated Cryptococcal meningitis has been reported in many areas of the world having high HIV seroprevalence i.e. in Sub-Saharan Africa. Cryptococcal meningitis is the fourth most commonly recognized cause of life-threatening infection among AIDS patients.Despite availability of antiretroviral therapy, the rise in rate of infections due to HIV/AIDS, suppress the cell mediated immune system and subjects are predisposed for opportunistic infections. Additionally, In AIDS patients, it is characterized by lack of meningeal signs and diminished inflammatory response. Diagnosis of CM is generally based on the collection of CSF sample and/or blood samples. Initially the CSF samples are processed for 'gold standard' culture methods, microscopy and India ink preparation. Serologically, Latex agglutination test (LAT) is the most commonly used for detection of Cryptococcal capsular antigen. Enzyme immunoassay (EIA) is another serological tool for detection of capsular polysaccharide antigens of C. neoformans in CSF.

show abstract

The Changing Epidemiology of Invasive Fungal Infections

Enoch

Yang

Aliyu

et al. 2016

Methods in Molecular Biology

315

208

View full text Add to dashboard Cite

Invasive fungal infections (IFI) are an emerging problem worldwide with invasive candidiasis and candidemia responsible for the majority of cases. This is predominantly driven by the widespread adoption of aggressive immunosuppressive therapy among certain patient populations (e.g., chemotherapy, transplants) and the increasing use of invasive devices such as central venous catheters (CVCs). The use of new immune modifying drugs has also opened up an entirely new spectrum of patients at risk of IFIs. While the epidemiology of candida infections has changed in the last decade, with a gradual shift from C. albicans to non-albicans candida (NAC) strains which may be less susceptible to azoles, these changes vary between hospitals and regions depending on the type of population risk factors and antifungal use. In certain parts of the world, the incidence of IFI is strongly linked to the prevalence of other disease conditions and the ecological niche for the organism; for instance cryptococcal and pneumocystis infections are particularly common in areas with a high prevalence of HIV disease. Poorly controlled diabetes is a major risk factor for invasive mould infections. Environmental factors and trauma also play a unique role in the epidemiology of mould infections, with well-described hospital outbreaks linked to the use of contaminated instruments and devices. Blastomycosis is associated with occupational exposure (e.g., forest rangers) and recreational activities (e.g., camping and fishing).The true burden of IFI is probably an underestimate because of the absence of reliable diagnostics and lack of universal application. For example, the sensitivity of most blood culture systems for detecting candida is typically 50 %. The advent of new technology including molecular techniques such as 18S ribosomal RNA PCR and genome sequencing is leading to an improved understanding of the epidemiology of the less common mould and dimorphic fungal infections. Molecular techniques are also providing a platform for improved diagnosis and management of IFI.Many factors affect mortality in IFI, not least the underlying medical condition, choice of therapy, and the ability to achieve early source control. For instance, mortality due to pneumocystis pneumonia in HIV-seronegative individuals is now higher than in seropositive patients. Of significant concern is the progressive increase in resistance to azoles and echinocandins among candida isolates, which appears to worsen the already significant mortality associated with invasive candidiasis. Mortality with mould infections approaches 50 % in most studies and varies depending on the site, underlying disease and the use of antifungal agents such as echinocandins and voriconazole. Nevertheless, mortality for most IFIs has generally fallen with advances in medical technology, improved care of CVCs, improved diagnostics, and more effective preemptive therapy and prophylaxis.

show abstract

Opportunistic Infections among People Living with HIV (PLHIV) with Diabetes Mellitus (DM) Attending a Tertiary Care Hospital in Coastal City of South India

Cited by 14 publications

References 14 publications

Prevalence and Characteristics of Diabetes Mellitus in Patients Living with HIV (PLHIV) in Dakar (Senegal)

Prevalence and Characteristics of Diabetes Mellitus in Patients Living with HIV (PLHIV) in Dakar (Senegal)

Cryptococcal meningitis in HIV (AIDS) patients: A Mini Review

The Changing Epidemiology of Invasive Fungal Infections

Contact Info

Product

Resources

About