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Acute Malnutrition and Infection with the Human Immuno-Deficiency Virus (HIV) in Children Followed up at the Pediatrics University Hospital Charles de Gaulle: Evolution of Anthropometric Parameters on antiretroviral treatment

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Open Journal of Pediatrics 2016年第1期6卷 34-41页

作者： Aïssata Kaboré Sylvie Armelle P. Ouédraogo Lassina Dao Fla Koueta Diarra Yé Service de Pédiatrie Médicale Centre Hospitalier Universitaire Pédiatrique Charles De Gaulle de Ouagadougou Ouagadougou Burkina Faso

Burkina Faso, a country with very scarce resources, undertook to fight against HIV infection. In 2013, according to UNAIDS, 110,000 persons were living in this country with HIV infection. 18,000 children among these persons were under 15. We conducted a retrospective study from January 2003 to December 2012 at the Pediatrics University Hospital Charles De Gaulle, Ouagadougou (CHUP CDG), Burkina Faso. The study aimed at assessing the children’s ponderal growth when under antiretroviral treatment. The children who were under 15 and who had been on antiretroviral treatment for at least 5 years were included in the study. Acute malnutrition concerned children whose height/weight ratio (H/W) was lower at -2 width type (or Z score) of the median of reference regarding age according to WHO. Two categories of malnutrition were outstanding in our study: moderate acute malnutrition, (-3 Z-score ≤ H/W -2 Z-score) and severe acute malnutrition (W/H -3 Z-score). The clinical and paraclinical data recorded during previous consultations were extracted from the ESOPE (Monitoring and follow-up of patients) data basis and exported to the ENA software and SPSS for their analysis. In total, 210 out of 529 children’s cases were considered. These children’s average age was 6.9 years. There were 55.7% of male and 44.3% of female children. HIV1 was found in 97.6% of the children against 2.4% for HIV2. In a 5 year follow-up, 46 among the children, namely 20.4% were on a second line protocol of antiretroviral treatment and 164 among them were still on a first line protocol of antiretroviral treatment. When they were admitted at hospital, 38% of the children showed characteristics of acute malnutrition. 17.8% of these children presented characteristics of severe form of acute malnutrition. During this 5-year follow-up, the average of the W/H index of the children gradually rised from -1.62 Z-score when being admitted to -0.18 Z-score at after a 60-month antiretroviral treatment. Our study sho

关键词： Acute Malnutrition HIV-Infected Children antiretroviral treatment Burkina Faso

Insights into gastrointestinal manifestation of human immunodeficiency virus:A narrative review

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World Journal of Virology 2025年第1期14卷 51-62页

作者： Pratiksha Moliya Anmol Singh Navdeep Singh Vikash Kumar Aalam Sohal Department of Transplant Hepatology University of Nebraska Medical CenterOmahaNE 69198United States Department of Medicine Tristar Centennial Medical CenterNashvilleTN 37203United States Department of Medicine Government Medical CollegeAmritsar 143001PunjabIndia Department of Gastroenterology and Hepatology Creighton University School of MedicinePhoenixAZ 85012United States

Human immunodeficiency virus(HIV)modifies CD4-positive cells,resulting in immunodeficiency and a wide range of gastrointestinal(GI)*** burden of HIV-related GI illnesses has significantly evolved with the widespread use of antiretroviral therapy(ART).While ART has effectively reduced the occurrence of opportunistic infections,it has led to an increase in therapy-related GI *** esophageal conditions in HIV patients include gastroesophageal reflux disease,idiopathic esophageal ulcers,herpes simplex virus,cytomegalovirus(CMV),and candidal ***’s sarcoma,a hallmark of acquired immunodeficiency syndrome,may affect the entire GI *** and peptic ulcer disease are also frequently seen in patients with ***,often linked to both opportunistic infections and ART,requires careful *** diarrhea,often a sign of colitis caused by bacterial infections such as Shigella or Clostridium difficile,is *** bowel lymphoma,although rare,is increasing in *** disorders,including proctitis,fissures,and anal squamous cell carcinoma,are particularly relevant in homosexual men,underlining the importance of timely *** review comprehensively explores the epidemiology,pathogenesis,and treatment considerations for the various GI disorders associated with HIV,highlighting the importance of accurate diagnosis and effective treatment to improve outcomes for HIV-infected patients.

关键词： Human immunodeficiency virus Opportunistic infections antiretroviral treatment Gastrointestinal

Survival of antiretroviral Therapy Patients at the Outpatient treatment Centre of the Community University Hospital of Bangui from 2015 to 2020

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Advances in Infectious Diseases 2023年第3期13卷 389-406页

作者： Sylvain Honore Woromogo Paulette Rose Josephat Mbay Yamotende Jesse Saint Saba Antaon Derguedbé Nebardoum Hermann Ngouakam Pierre Marie Tebeu Inter-State Centre for Higher Education in Public Health of Central Africa Brazzaville Republic of Congo Unit for Research and Intervention in Public Health Department of Public Health Faculty of Health Sciences Bangui Central African Republic Faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaounde Cameroon

Background: The advent of antiretroviral treatment has considerably increased the life expectancy of people living with HIV in recent years. The Central African Republic, despite challenges related to the socio-political context, is committed to achieving the UNAIDS 90-90-90 targets and to the elimination of AIDS by 2030 advocated by the WHO. Objective: To analyze survival among HIV-positive adult patients on antiretroviral therapy from 2015 to 2020. Methods: This was a history-based cohort study of patients started on ART. The main variable was survival. The Kaplan-Meier method was used to describe the survival curve since inclusion in the cohort and a multivariate Cox model was used to investigate factors associated with mortality on ART. Results: A total of 145 naive patients started ART at the Outpatient treatment Centre (OTC) in 2015. A female predominance was observed in our study with 78.08% of cases. The analysis of the patients’ fate at the time of point of treatment showed that 58.62% of them were still in active care and 13.10% died. The probability of survival at 5 years was 0.82 and mortality was significantly associated with very advanced disease (WHO stage IV) (p = 0.047) and anemia (p = 0.039). Conclusion: The majority of patients were still in care at the endpoint and mortality was significantly related to advanced disease and anemia. Early management of people living with HIV combined with better quality of care would improve their survival.

关键词： Survival Patients antiretroviral treatment Bangui

Sensitive detection of HIV-1 resistance to Zidovudine and impact on treatment outcomes in low-to middle-income countries

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Infectious Diseases of Poverty 2017年第1期6卷 1449-1461页

作者： Richard M.Gibson Gabrielle Nickel Michael Crawford Fred Kyeyune Colin Venner Immaculate Nankya Eva Nabulime Emmanuel Ndashimye Art F.Y.Poon Robert A.Salata Cissy Kityo Peter Mugyenyi Miguel E.Quinones-Mateu Eric J.Arts Department of Microbiology and Immunology University of Western Ontario1151 Richmond St.Dental Sciences Bldg.Rm 3014LondonOntario N6A 5C1Canada Division of Infectious Diseases Department of MedicineCase Western Reserve UniversityClevelandOHUSA Department of Molecular Biology and Microbiology Case Western Reserve UniversityClevelandOHUSA Department of Pathology Case Western Reserve UniversityClevelandOHUSA Center for AIDS Research Uganda Laboratories Joint Clinical Research CentreKampalaUganda Department of Pathology and Laboratory Medicine University of Western OntarioKampalaUganda TREAT Joint Clinical Research CentreKampalaUganda

Background:Thymidine analogs,namely AZT(Zidovudine or Retrovir^(TM))and d4T(Stavudine or Zerit^(TM))are antiretroviral drugs still employed in over 75%of first line combination antiretroviral therapy(cART)in Kampala,Uganda despite aversion to prescribing these drugs for cART in high income countries due in part to adverse *** this study,we explored how the continued use of these thymidine analogs in cART could impact emergence of drug resistance and impact on future treatment success in Uganda,a low-income ***:We examined the drug resistance genotypes by Sanger sequencing of 262 HIV-infected patients failing a first line combined antiretroviral treatment containing either AZT or d4T,which represents approximately 5%of the patients at the Joint Clinical Research Center receiving a AZT or d4T containing *** generation sequencing(DEEPGEN^(TM)HIV)and multiplex oligonucleotide ligation assays(AfriPOLA)were then performed on a subset of patient samples to detect low frequency drug resistant ***4 cell counts,viral RNA loads,and treatment changes were analyzed in a cohort of treatment success and ***:Over 80%of patients failing first line AZT/d4T-containing cART had predicted drug resistance to 3TC(Lamivudine)and non-nucleoside RT inhibitors(NNRTIs)in the treatment regimen but only 45%had resistance AZT/d4T associated resistance mutations(TAMs).TAMs were however detected at low frequency within the patients HIV quasispecies(1-20%)in 21 of 34 individuals who were failing first-line AZT-containing cART and lacked TAMs by *** to lack of TAMs by Sanger,AZT was typically maintained in second-line therapies and these patients had a low frequency of subsequent virologic ***:Our findings suggest that continued use of AZT and d4T in first-line treatment in low-to-middle income countries may lead to misdiagnosis of HIV-1 drug resistance and possibly enhance a succession of second-and third-line treatment failu

关键词： antiretroviral treatment Drug resistance Uganda

Factors Associated with the Size of HIV DNA Reservoir

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Chinese Medical Journal 2017年第2期130卷 224-230页

作者： Ni-Dan Wang Tai-Sheng Li Department of Infectious Diseases Peking Union Medical College Hospital Peking Union Medical College and Chinese Academy of Medical Sciences Beijing 100730 China

Objective： To review the recent literatures related to the factors associated with the size of the HIV reservoir and their clinical significance. Data Sources： Literatures related to the size of HIV DNA was collected from PubMed published from 1999 to June 2016. Study Selection： All relevant articles on the HIV DNA and reservoir were collected and reviewed, with no limitation of study design. Results： The composition and development of the HIV- 1 DNA reservoir in either treated or untreated patients is determined by integrated mechanism comprising viral characteristics, immune system, and treatment strategies. The HIV DNA reservoir is a combination of latency and activity. The residual viremia from the stochastic activation of the reservoir acts as the fuse, continuing to stimulate the immune system to maintain the activated microenvironment for the rebound of competent virus once treatment with antiretroviral therapy is discontinued. Conclusion： The size of the HIV-1 DNA pool and its composition has great significance in clinical treatment and disease progression.

关键词： antiretroviral treatment HIV-I DNA Immune Activation, Latent Reservoir Residual Viremia

Drug Resistance Mutations and Genetic Diversity in Patients Treated for HIV Type 1 Infection in Rural Care Centers in Togo

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Open Journal of Medical Microbiology 2016年第3期6卷 111-115页

作者： Anoumou Dagnra Abla Konou Mounerou Salou Pascal Kodah Damobé Kombate Prince David Université de Lomé Centre de Biologie Moléculaire et d’Immunologie (BIOLIM/FSS/UL) Lomé Togo Centre Médico-Social (CMS) Atakpamé Atakpamé Togo Hopital d’Aného Aného Togo

Introduction: Access to antiretroviral treatment (ART) in resource-limited countries has increased signif-icantly but scaling up ART into rural areas is more recent and information on treatment outcome in rural areas is still very limited. We reported here virological outcome and drug resistance in ART in rural settings in Togo. Methods: HIV-1 infected adults (≥18 years) and infants were enrolled in routine medical visit at 12 on first-line ART in three HIV care centers. Epidemiological and demographic information and data on ART history were collected. Viral load (VL) was determined and genotypic drug resistance testing was performed on all samples with viral load above 1000 copies/ml. Results: 102 adult patients and 27 infants were consecutively enrolled. Virological failure was observed in 28 (21.5%) patients. For 25/28 patients, sequencing was successful and drug resistance mutations were observed in 23 (92%) of them. The global prevalence of drug resistance in the study population was thus at least 17.8% (23/129), with 7 (6.9%) patients infected with HIV strains that are resistant to two of the three first-line antiretroviral (ARVs) drugs and 9 (8.3%) to all three first-line ARVs. As expected, the observed drug resistance mutations were mainly associated with the drugs used in first line regimens, zidovudine, lamivudine and effavirenz/nevirapine but several patients accumulated high numbers of mutations and developed also cross-resistance to abacavir, didanosine or the new non-nucleoside reverse transcriptase inhibitor drugs, like etravirine and rilpivirine. Conclusion: The observations on ART treatment outcome from ART clinics in rural areas are the same as observed in previous observations in Lomé, the capital city. Although access to viral load will improve treatment outcome, better programme management and implementation of actions to improve factors as patient adherence, drugs stock-outs and lost to follow-up are also essential.

关键词： HIV-1 antiretroviral treatment Drug Resistance Genetic Diversity Rural Togo

Profile of the Blood Count among People Living with HIV Monitored at the Institute of Social Hygiene and the Aristide Le Dantec Hospital in Dakar

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Open Journal of Blood Diseases 2022年第4期12卷 133-141页

作者： Faye Cheikh Ibrahima Coly Mame Ngoné Makalou Demba Sène Abdoulaye Sall Abibatou Touré Awa Oumar Ly Fatouamata Hematology Laboratory of the Aristide le Dantec Hospital Dakar Senegal Health Sciences Training and Research Unit Hematology Laboratory of the Ziguinchor Peace Hospital Assane Seck University of Ziguinchor Ziguinchor Senegal Training and Research Unit in Health Sciences Hematology Laboratory of the Sickle Cell Disease Control Center of Saint Louis Gaston Berger University of Saint Louis Dakar Senegal Pharmacy and Odontostomatology Faculty of Medicine Cheikh Anta Diop University of Dakar Dakar Senegal Dermatology Department of the Social Hygiene Institute of Dakar Dakar Senegal

Introduction: The human immunodeficiency virus (HIV) is a pandemic of concern to the World Health Organization. It is all the more worrisome because if not properly managed, it can be responsible for several complications, including abnormal blood counts. These abnormalities may also be related to treatment. Objectives: The main objective of this study is to show that adequate antiretroviral therapy can correct various abnormalities exerted by HIV on patients’ blood counts. The specific objective is to determine all the abnormalities we can see in blood count before and during HIV treatment. Materials and Methods: Our study was conducted in the hematology laboratory and the dermatology departments of the Aristide Le Dantec Hospital and the Institute of Social Hygiene. It took place from December 2009 to October 2011. It is a retrospective descriptive and analytical study involving HIV-positive patients (HIV 1 and 2) and under antiretroviral treatment (at least six months of treatment). We included 110 patients in the study. Blood counts were performed at the hematology laboratory of the Aristide le Dantec hospital using a KX21 automaton. Each patient received three blood counts during the first six months of treatment (M0, M3 and M6). A univariate analysis was performed to determine the profile of the abnormalities of the blood count and the chi 2 test was used and a threshold of p 0.05 was considered significant. Results: The mean age of the patients was 38.6 ± 8.6 years (extremes of 18 and 64 years) with a sex ratio of 0.42 (77 females and 33 males). The prevalence of anemia was 80% (n = 88) at M0, 53, 63% at M3 (n = 59), and 38.20% at M6 (n = 42) (p = 0.02). We noted a favorable evolution with treatment. For the other abnormalities, the evolution was favorable for leukopenia (p = 0.011) and thrombocytopenia (p = 0.007). Conclusion: Our study showed a correction of blood count abnormalities in PLHIV with antiretroviral treatment.

关键词： Blood Count Abnormalities antiretroviral treatment PLHIV

Prevention of Mother-to-Child Transmission of HIV: Experience of a Level 2 Health Center in Senegal

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Open Journal of Obstetrics and Gynecology 2023年第5期13卷 837-849页

作者： Soukeynatou Dia Ndour Papa Malick Ngom Louise Fortes Anna Mody Seck Thérèse Ndong Kadiatou Diallo Fatoumata Bintou Sall ModouThioro Mbaye Department of Obstetrics Gynecology Hospital Principal of Dakar Dakar Senegal

The elimination of vertical transmission of HIV from mother to child is a major global goal. In Senegal, the transmission rate was estimated at 3.2% in 2017. To reduce or even eliminate this transmission, Senegal has implemented various strategies and programs adopted and applied nationally. Thus access to services for the prevention of mother-to-child transmission of HIV has been extended to the level of the health post (the lowest level of the country’s health pyramid) with a delegation of tasks to paramedical staff (nurse, midwife) in the diagnosis and therapeutic management. Objectives: To describe the epidemiological profile of HIV (Human Immunodeficiency Virus)-positive mothers, to assess the care of children born to HIV-positive mothers, to determine the rate of HIV transmission from mother to child. Patients and Method: We carried out a retrospective, cross-sectional and descriptive study of all live newborns of HIV-positive mothers who gave birth at the Gaspard Kamara Health Center (a level 2 health center in Dakar, Senegal) between January 1, 2015 and December 31, 2018. The data were collected from prevention of mother-to-child transmission (PMTCT) prenatal follow-up registers and files, delivery files and registers, and neonatology and pediatric follow-up files, and exploited using the Epi info 7 software. Results: There were 98 children of seropositive mothers. The epidemiological profile of the HIV-positive woman was that of a young woman aged between 16 and 43 with an average of 31.31 years, pauciparous (>65% of cases) from Dakar center (>75% of cases), housewife with a low socio-economic level (63.1% of cases), married in almost all cases, with HIV profile (in almost all cases) and diagnosed before pregnancy (51.02%). The analysis of the children’s data revealed a predominance of girls (52.04%) with a good birth weight (2964g on average) and a pregnancy carried to term in more than 95% of cases. ARV prophylaxis was almost entirely respected with tripl

关键词： Mother-to-Child Transmission HIV Infection Prevention antiretroviral treatment

Human immunodeficiency virus patients with low CD4 counts are more likely to have precancerous polyps identified during index colonoscopy

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World Journal of Gastrointestinal Endoscopy 2023年第9期15卷 545-552页

作者： Michelle Likhtshteyn Evan Marzouk Fray M Arroyo-Mercado Gurasees Chawla Sabrina Rosengarten Renata Lerer Hector Ojeda-Martinez Savanna Thor Department of Gastroenterology SUNY Downstate Health Sciences UniversityBrooklynNY 11203United States Department of Internal Medicine and Pediatrics Baystate Medical CenterSpringfieldIL 01199United States Department of Gastroenterology University of New MexicoAlbuquerqueNM 87106United States Department of Emergency Medicine New York-Presbyterian Queens HospitalQueensNY 11355United States Department of Gastroenterology University of PennsylvaniaPhiladelphiaPA 19104United States Department of Infectious Disease Nuvance Health-Vassar Brothers Medical CenterPoughkeepsieNY 12601United States

BACKGROUND antiretroviral treatment(ART)has improved the life expectancy of patients living with human immunodeficiency virus(HIV).As these patients age,they are at increased risk for developing non-acquired immunodeficiency syndrome defining malignancies(NADMs)such as colon *** To determine which factors are associated with the development of precancerous polyps on screening colonoscopy in patients with HIV and to investigate whether HIV disease status,measured by viral load and CD4 count,might influence precancerous polyp *** A retrospective review of records at two urban academic medical centers was performed for HIV patients who had a screening colonoscopy between *** with a history of colorectal cancer or polyps,poor bowel preparation,or inflammatory bowel disease were *** data such as sex,age,race,and body mass index(BMI)as well as information regarding the HIV disease status such as CD4 count,viral load,and medication regimen were ***-controlled patients were defined as those that had viral load500(P=0.0276).In patients with CD4>500,53.85%of patients were female,and 70.87%of patients with CD

关键词： Colonoscopy Non-acquired immunodeficiency syndromes defining malignancies Human immunodeficiency virus Adenoma detection rate antiretroviral treatment Advanced adenoma