Predictors of mortality among a cohort of HIV/AIDS patients on anti-retroviral therapy in coastal South India

“…5,6 In India, 55-60% of AIDS patients reportedly have tuberculosis and it is one of the leading causes of death among people living with HIV/AIDS (PLHA). 7 Collaborative Tuberculosis and HIV activities are essential to prevent, diagnose and treat TB among people with HIV and HIV among TB patients, for an optimal patient care.…”

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Clinical profile and outcome of HIV-TB Co‑Infection at a centre of excellence for HIV care

Narasimhamurthy¹,

Thomas²,

Krishnegowda³

et al. 2018

Asian J Med Sci

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Background: Tuberculosis (TB) and Human Imuunodeficiency Virus (HIV) co-infection has detrimental effects on both the individual and the health care system especially in resource limited countries like India. Tuberculosis ranks among the most common cause of death in HIV patients. In this review we have analysed the clinical and immunological characteristics of HIV-TB coinfected patients and their clinical outcomes. Aims and Objectives: To assess the co-relation between socio-demographic characteristics, clinical and immunological Profile of HIV-TB co-infected patients and the clinical outcome. Materials and Methods: A retrospective clinical study of patient records at the Centre of Excellence for anti-retroviral therapy was done. The records of HIV-TB co-infected patients were collected and data extracted pertaining to the socio-demographic characteristics, clinical profiles and outcomes. Results: Among the 377 cases included as per criteria, 76.9 % completed the treatment for TB while 23.1% patients died before treatment completion. Twenty-nine point seven percent of the patient population constituted women, while 0.5% was transgenders. Regarding the pattern of tuberculosis, 58.4% patients had extra pulmonary TB while 39.5% and 2.1% of the study population were diagnosed as pulmonary and disseminated TB respectively. Mean baseline CD4 count was 191 cells/mm3 and the mean CD4 count during first and second follow up were 298 and 362 cells/mm3 respectively. There was a statistically significant correlation noted with poor clinical outcomes and low baseline CD4 counts. Conclusion: Age, gender, the clinical pattern of tuberculosis and the treatment category did not have a statistically significant association on the outcome. We found that the TB associated mortality in HIV co-infected patients had a direct correlation with the stage of HIV at presentation as there was a strongly significant association between low CD4 counts and adverse clinical outcomes.

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Effects of undernutrition on mortality and morbidity among adults living with HIV in sub-Saharan Africa: a systematic review and meta-analysis

et al. 2021

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Background Undernutrition is one of the most common problems among people living with HIV, contributing to premature death and the development of comorbidities within this population. In Sub-Saharan Africa (SSA), the impacts of these often inter-related conditions appear in a series of fragmented and inconclusive studies. Thus, this review examines the pooled effects of undernutrition on mortality and morbidities among adults living with HIV in SSA. Methods A systematic literature search was conducted from PubMed, EMBASE, CINAHL, and Scopus databases. All observational studies reporting the effects of undernutrition on mortality and morbidity among adults living with HIV in SSA were included. Heterogeneity between the included studies was assessed using the Cochrane Q-test and I2 statistics. Publication bias was assessed using Egger’s and Begg’s tests at a 5% significance level. Finally, a random-effects meta-analysis model was employed to estimate the overall adjusted hazard ratio. Results Of 4309 identified studies, 53 articles met the inclusion criteria and were included in this review. Of these, 40 studies were available for the meta-analysis. A meta-analysis of 23 cohort studies indicated that undernutrition significantly (AHR: 2.1, 95% CI: 1.8, 2.4) increased the risk of mortality among adults living with HIV, while severely undernourished adults living with HIV were at higher risk of death (AHR: 2.3, 95% CI: 1.9, 2.8) as compared to mildly undernourished adults living with HIV. Furthermore, the pooled estimates of ten cohort studies revealed that undernutrition significantly increased the risk of developing tuberculosis (AHR: 2.1, 95% CI: 1.6, 2.7) among adults living with HIV. Conclusion This review found that undernutrition has significant effects on mortality and morbidity among adults living with HIV. As the degree of undernutrition became more severe, mortality rate also increased. Therefore, findings from this review may be used to update the nutritional guidelines used for the management of PLHIV by different stakeholders, especially in limited-resource settings.

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Predictors of mortality among a cohort of HIV/AIDS patients on anti-retroviral therapy in coastal South India

Cited by 3 publications

References 15 publications

Predictors of anemia among a cohort of people living with HIV on anti-retroviral therapy in a southern state of India

Predictors of anemia among a cohort of people living with HIV on anti-retroviral therapy in a southern state of India

Clinical profile and outcome of HIV-TB Co‑Infection at a centre of excellence for HIV care

Effects of undernutrition on mortality and morbidity among adults living with HIV in sub-Saharan Africa: a systematic review and meta-analysis

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