Showing 22 results for Hiv
B Jahangiry ,
Volume 57, Issue 2 (5-1999)
Abstract
We have compared the effects of fentanyl and pethidine in the treatment of postanaesthetic shivering. Fifty patients who were shivering after routine abdominal surgery were allocated randomly to receive fentanyl 75 µg and pethidine 25 mg. After 10 min, 23 patients in pethidine group and 22 patients in the fentanyl group had stopped shivering which was not significantly different in the two groups. We conclude that fentanyl 75 µg was effective in the treatment of postanaesthetic shivering.
Hoseinkhan Z, Behzadi M,
Volume 64, Issue 12 (11-2006)
Abstract
Background: Postoperative shivering is a common postoperative complication. The aim of this study was to compare the effects of morphine, pethidine and fentanyl in postoperative shivering control.
Methods: In this prospective, randomized, placebo-controlled, double-blinded, clinical trial, we enrolled 72 adults scheduled for elective surgery under general anesthesia at Imam Khomeini Hospital in 2003. All the patients were anesthetized in the same manner. After transferring the patients to the post-anesthesia care unit, shivering was noted and, in patients with a shivering score of one or more, morphine (2.5 mg), pethidine (25 mg), fentanyl (25 µg) or normal saline (all with a volume of 10 ml) was randomly administered intravenously by a two-minute injection. A second shivering score was recorded 10 minutes later.
Results: Pethidine and fentanyl were significantly more effective than normal saline, but there was no significant difference between normal saline and morphine groups. Pethidine was more effective than two other drugs in shivering control.
Conclusions: Pethidine was significantly more effective than two other drugs. Fentanyl decreases postoperative shivering less effectively than pethidine, but morphine had no effect on postoperative shivering with an effect comparable to normal saline.
Hadadi A, Afhami Sh, Kharbakhsh M, Hajabdoulbaghi M, Rasoolinejad M, Emadi H, Esmaeelpour N, Sadeghi A, Ghorashi L,
Volume 65, Issue 9 (12-2007)
Abstract
Background: Health care workers (HCWs) are at substantial risk of acquiring bloodborne pathogen infections through contact with blood and other potentially infectious materials. The main objectives of this study were to determine the epidemiological characteristics of occupational exposure to blood/body fluids, related risk factors of such exposure, and hepatitis B vaccination status among HCWs.
Methods: This cross-sectional study was conducted from December 2004 to June 2005 at three university hospitals in Tehran, Iran. Using a structured interview, we questioned HCWs who had the potential for high-risk exposure during the year preceding the study.
Results: With a total number of 467 exposures (52.9%) and an annual rate of 0.5 exposures per HCW, 391 (43%) of the 900 HCWs had at least one occupational exposure to blood and other infected fluids during the previous year. The highest rate of occupational exposure was found among nurses (26%) and the housekeeping staff (20%). These exposures most commonly occurred in the medical and emergency wards (23% and 21%, respectively). The rate of exposure in HCWs with less than five years of experience was 54%. Percutaneous injury was reported in 280 participants (59%). The history of hepatitis B vaccination was positive in 85.93% of the exposed HCWs. Sixty-one percent had used gloves at the time of exposure. Hand washing was reported in 91.4% and consultation with an infectious disease specialist in 29.4%. There were 72 exposures to HIV, HBV and HCV exposure to HBV was the most common. In 237 of the enrolled cases, the source was unknown. Job type, years of experience and hospital ward were the risk factors for exposure.
Conclusion: Education, protective barriers and vaccination are important in the prevention of viral transmission among HCWs.
Kashi Ah, Yadyad Mj, Hajiabdolbaghi M, Jafari S,
Volume 66, Issue 9 (12-2008)
Abstract
Background: Behavioral Consultation Centers are the main organizations responsible for providing HIV/AIDS patients with services according to the Iranian Ministry of Health guidelines. In this study we assessed provision of these supposed services to Iranian HIV/AIDS patients referring to Behavioral Consultation Centers.
Methods: One hundred seventy one clinical files were selected by systematic random sampling from the files of all new HIV/AIDS patients accepted at Imam Khomeini behavioral consultation center who were registered during 2005-2006 and were followed for at least six months. Data were extracted from files and included consultation, vaccination, laboratory and treatment services.
Results: Family planning and HIV prevention methods consultation were performed for 32.5% and 2.29% of patients respectively. CD4 count was done for 69% of patients. 65.6% of patients who needed anti-retroviral treatment were given medication. Hepatitis B and Td vaccination were done for 21.7% and 3.5% of patients respectively. Coverage of pneumococal and influenza vaccinations was less than 5%. 79.5% of patients who needs tuberculosis prophylaxis were given medication. TB case finding was 14% during one year and the cure rate for patients under anti TB treatment were 95.8%.
Conclusion: Coverage of consultations and vaccination services are very low. Antiretroviral therapy coverage is intermediate. TB case finding and its cure rate are appropriate.
Jafari S, Rasoolinejad M, Emadi Kouchak H, Mokarami F,
Volume 67, Issue 7 (10-2009)
Abstract
Normal
0
false
false
false
EN-US
X-NONE
AR-SA
MicrosoftInternetExplorer4
Background: CD4 T-Lymphocyte counts have proven to be a standard
laboratory marker of disease progression and severity of immunodeficiency in
adults infected with HIV is used to initiate and monitor highly active
antiretroviral therapy however, its application may not be feasible for its
expensive equipments and reagent in resource-limited setting. There is a need
to have another marker of immunodeficiency that is less resource-demanding. In
April 2002, the World Health Organization (WHO) recommended that, when CD4 cell count is not available, a
TLC of
1200cell/mm3
or less in individuals with stage 2 or 3 of the disease may be used as an indication to
initiate ART.
Methods: The aim of this study was to determine the
relationship between total lymphocyte count and CD4 count in HIV-infected
adults. This was a retrospective cross-sectional study. Subject characteristics
were patients who had positive serologic HIV test results, confirmed via western blot. Analysis unit was the
results of CBC and CD4 measurements on the same blood sample each time. Data
of 100
patients were collected. In this study, TLC accounts for the main predictor of CD4 count. The
amounts of TLC which can predict CD4 less than 200cell/mm3 were considered eligible.
Results: Our data revealed high sensitivity and specificity of TLC as a surrogate
measure of CD4 count. In this study, TLC cutoff of 1300cell/mm3 indicated the optimal combined sensitivity and specificity altogether.
Conclusion: Total lymphocyte count and its changes can be used as
alternative to CD4
count and its changes in the management of HIV-infected individuals.
Ataei B, Nokhodian Z, Babak A, Shoaei P, Mohhammadzadeh M, Sadeghi R,
Volume 67, Issue 11 (2-2010)
Abstract
Normal
0
false
false
false
EN-US
X-NONE
AR-SA
MicrosoftInternetExplorer4
Background: There
are millions of children around the world living on the street. They are at
higher risk of physical, sexual and drug abuse, and have no access to health
care facilities. Therefore they are at risk of viral infections such as HCV and HIV. The aim of
this study was determining the prevalence of HCV and HIV infection in
Isfahan street children (2005-2007).
Methods: The cross-sectional study was taken place on 386 street
children through a nonprobable-convenience sampling method. They were requested
to answer a questionnaire (demographic and behavioral data), and then they were
tested for anti HCV and anti HIV antibodies.
Results: Among 386 street children, 270
(70%) were boys and the mean age was 12.62±3.23 years.
The majority of them, 267 cases (69%), were on the street for financial reasons. 353 (91.7%), 366 (94.8%) and 375 (97.2%) of
them had no history of smoking, using alcohol or substance addiction,
respectively. 40 (34.5%) of girls and 12
(4.4%) of boys (p<0.0001) were
engaged in sex and 79 (68%) of girls and 46
(17%) of boys (p<0.0001) were
involved in physical fighting. All of the children had negative serology for HIV infection.
Nevertheless, four of them (1%) were positive for HCV
Ab.
Conclusion: The knowledge of street children about high risk
behaviors and the infectious diseases should be improved through educational
programs. They need also legal, social and health support.
Farzad Katiraee, Ali Reza Khosravi, Vahid Khalaj, Mahboubeh Hajiabdolbaghi, Ali Asghar Khaksar, Mehrnaz Rasoulinejad, Mir Saeed Yekani Nejad,
Volume 68, Issue 1 (4-2010)
Abstract
Normal
0
false
false
false
EN-US
X-NONE
AR-SA
MicrosoftInternetExplorer4
Background: Oropharyngeal candidiasis is the most frequent fungal
infection in HIV patients. The aims of this study
were to appraise prevalence of oropharyngeal candidiasis and to determine
factors associated with oropharyngeal candidiasis and oral yeast colonization
among Iranian HIV patients.
Methods: The patients were composed 150 Iranian HIV positive individuals referred to Iranian Research Center for HIV & Aids (IRCHA), Imam Khomeini Hospital complex
in Tehran, Iran. Oral samples were obtained and cultured on mycological media. TCD4 lymphocyte count/percentage was
measured and patients were categorized. Patients evaluated for some risk
factors for oropharyngeal candidiasis and oral candida colonization.
Results: Fifty nine percent of patients
were presented with oropharyngeal candidiasis and the carriage rate of yeasts
was 116 (77.2%). The most frequent isolated candida
species were Candida albicans (102) 50.2% and Candida glabrata (45) 22%. Thrush in 57(38%), perleche in 30(20%) and erythematous lesions in 7(4.7%) of patients were observed.
Significant differences in TCD4 count (p=0.01), gender (p=0.02), antifungal therapy (p=0.001), smoking (p=0.02), and intravenous drug use (p=0.03), between asymptomatic and
symptomatic patients were observed.
Conclusion: Oral candidiasis is a frequent complication among Iranian HIV individuals. C. albicans and C. glabrata are most important etiologic agents of oral candidiasis. In Iranian HIV individuals TCD4 count, antifungal
therapy, gender, smoking and intravenous drug use are important risk factors for oropharyngeal
candidiasis. Denture wearing and age are predisposing factors for oral colonization.
Rasoulinejad M, Bouyer M, Emadi Kouchak H, Hasibi M, Mollazadeh N, Moradmand Badie B,
Volume 68, Issue 10 (1-2011)
Abstract
Background: Tuberculosis with high prevalence in HIV/AIDS
patients is the main reason for morbidity and mortality in these patients.
About one-third of patients with HIV infection
have concomitant tuberculosis. Lack of appropriate infection control on many
social and economic communities will impose. Comprehensive study on the effects
of anti-tuberculosis drugs in patients with HIV infecting
less done, also due to the importance of reducing morbidity and mortality,
reduce the cost of disease, identifying drug pharmacokinetics, the importance
of completing treatment tuberculosis, this study was performed to evaluate the
effects of anti- tuberculosis drugs on HIV infection
and to identify the drug pharmacokinetics and so more complete tuberculosis
treatment.
Methods: A historical cohort study was performed on
patients referring to the research center for HIV/AIDS,
consultation center, department of infection diseases of Imam
Khomeini Hospital
in Tehran, Iran. A
total number of 75 cases with HIV
negative versus HIV positive patients
with pulmonary tuberculosis and positive sputum smear in accordance with
inclusion and exclusion criteria were selected.
Results: In this study, the frequency of peripheral neuropathy 27(73%),
arthralgia 31(83.8%), vomiting 18(48.6%),
headache 26(70.3%), dizziness 20(54.1%),
renal toxicity 4(10.8%) and of skin rash 10(27%)
in patients with HIV virus infection were
significantly more than HIV- negative patients.
Hepatotoxicity, fever and anemia were not significantly more common in patients
who infected with HIV virus.
Conclusion: The HIV patients, who have not received antiretroviral
drugs during tuberculosis treatment, may show higher incidence of
anti-tuberculosis drugs complications.
Katiraee F, Khosravi Ar, Khalaj V, Hajiabdolbaghi M, Khaksar Aa, Rasoulinejad M,
Volume 70, Issue 2 (5-2012)
Abstract
Background: Oropharyngeal candidiasis and antifungal drug resistance are major problems in HIV positive patients. The increased reports of antifungal resistance and expanding therapeutic options prompted the determination of antifungal susceptibility profile of Candida species isolates in Iranian patients living with HIV/AIDS (PLWHA) in the present study.
Methods: One hundred fifty oral samples from Iranian HIV positive patients were obtained and cultured on CHROMagar and Sabouraud's dextrose agar. All isolates were identified according to assimilation profile, germ tube, colony color and other conventional methods. Disk diffusion testing and Broth Microdilution of six antifungal agents were performed according to the methods described in CLSI.
Results: Candida albicans (50.2%) was the most frequent isolated yeast, followed by C. glabrata (22%). Non-Candida albicans species were isolated from 71 (61%) positive cultures. 25.7% of Candida albicans isolates were resistant to fluconazole (MIC≥64 µg/ml) as were 21.9% and 16.4% to ketoconazole and clotrimazole (MIC>0.125 µg/ml), respectively. Resistance to polyene antifungals including amphotericin B and nystatin, and caspofungin were scarce. 57.7% of candida glabrata isolates were resistant to fluconazole, 31% to ketoconazole and 35% to clotrimazole.
Conclusion: Screening for antifungal resistant candida isolates by disk diffusion or broth dilution methods in clinical laboratories is an ideal surveillance measure in the management of oral thrush in patients with HIV/AIDS. Although nystatin is widely used in clinical practice for HIV positive patients, there was no evidence of enhanced resistance to it. Regarding no resistance to caspofungin, its administration is suggested.
Abdi Z, Alijani N,
Volume 70, Issue 2 (5-2012)
Abstract
Background: Thrombocytopenia is a common finding in individuals infected with HIV and its incidence increases with progressive immunosuppression. Thrombocytopenia due to AIDS is divided into primary and secondary forms and primary HIV associated thrombocytopenia (PHAT) is the most common cause of thrombocytopenia in these patients.
Case presentation: The patient was a 35-year old man with HIV since 1996, who was admitted to Imam Khomeini hospital in August of 2010 with petechiae, purpura, ecchymosis around the eyes and on the limbs and subconjunctival hemorrhage. In laboratory investigation, platelet count was 5000/µL. After ruling out the secondary causes of thrombocytopenia, Primary HIV Associated Thrombocytopenia (PHAT) was diagnosed. Due to the presence of severe thrombocytopenia and bleeding symptoms and considering the fact that antiretroviral agents require 4- 6 weeks to reach therapeutic effects, prednisone and antiretrovirals (AZT) were prescribed. After about two weeks of steroids administration, platelet count reached 50,000/µL and about eight weeks after antiretroviral (AZT) therapy platelets reached nearly 140,000/µL.
Conclusion: Prednisone can be used safely in conjunction with antiretrovirals for primary thrombocytopenia in HIV infected patients with severe thrombocytopenia and bleeding symptoms.
Biranvand E, Abediankenari S, Khalilian A, Biranvand B,
Volume 70, Issue 5 (8-2012)
Abstract
Background: Tuberculosis is one of the most important diseases with annually 8 million new cases worldwide. The purpose of this study was to investigate the risk factors for tuberculosis (TB) infection.
Methods: In this descriptive study performed in Health center of Maznadaran province during 2010-2011, 183 patients with pulmonary and extrapulmonary TB infection were recruited. After measuring fasting blood sugar, and human immunodeficiency virus (HIV) antibodies, history of smoking was taken by using a questionnaire.
Results: The mean age of the participants was 46.8±19.8 years. The most common risk factor was diabetes and the lowest was HIV infection. Moreover, the prevalence of diabetes in women compared with that of men (OR=0.19, 95% CI=0.07±0.46) and smoking in men compared with women (OR=12.4, 95% CI=2.8±54.4, P<0.05) had statistically significant differences (P<0.05).
Conclusion: The results of this research show that diabetes and smoking could be risk factors for tuberculosis infection. It is concluded that, in case of respiratory symptoms in patients with diabetes and smoking, tuberculosis can be considered as an important differential diagnosis.
Mehrnaz Rasoolinejad , Azar Hadadi , Mojtaba Hedayat Yaghoobi , Banafshe Moradmand Badie , Neda Alijani ,
Volume 71, Issue 7 (10-2013)
Abstract
Background: HIV infection reduces the immune system and is the most significant factor in the spread of TB in recent years and one of the causes of death in HIV -seropositive patients. TB is the most commonly diagnosed opportunistic infection and the most frequent direct cause of death among HIV infected patients. The HIV infection can accelerate progression of TB infection to active TB disease. Among patients with active TB, those with HIV co-infection have the greatest risk for relapse. Regardless of increasing rate of TB and HIV in Iran, we decided to s urvey outcome of TB in HIV positive patients who treated with standard regimens in the years 2003-2012.
Methods: This retrospective cohort study was conducted on HIV-positive patients with TB referred to Behavioral Diseases Consultation Center and Infectious Diseases Ward of Imam Khomeini Hospital from 2003 to 2012. Outcome was defined as failure, relapse and mortality. Moreover, the relationship between outcomes and number of CD4, co-trimoxazole and antiretroviral intake, type of TB and AIDS defining illness was studied. Results: This study had 135 patients, 8 (5.9%) were females and 127 (94.1%) were males. The mean age of the patients was 40.14+10.02 and the most way to catch HIV in this study was intravenous drug user. There were 3 (2.22%) cases of failure, 15 ( 11.1%) relapse , and 21 ( 15.8%) deaths. Antiretroviral therapy, AIDS defining illness, type of TB and co-trimoxazole intake did not soley affect relapse. CD4 level was the most effective variables in relapse [ Hazard ratio: 0.392 (0.11-1.4) Relative Risk: 0.809 (0.593-1.103) (P=0.068) ]. However, regard to CI95%, the impact of CD4 on relapse is not significant and antiretroviral intake was the most important and effective variable in increasing their survival. Hazard ratio: 0.137 (0.141-0.45) Relative Risk: 0.686 (0.513-0.918) (P=0.001) Conclusion: Overall, receiving antiretroviral was the most important factor influencing the outcome of patients. |
Mahboobeh Haji-Abdolbaghi , Mehrnaz Rasoolinejad , Laden Abbasian , Aliakbar Amir Zargar, Hamid Emadi Koochak, Pardis Moradnejad, Naseh Mohammadi , Ali Pashae Zanjani , Saeed Bayanolhagh , Parisa Sadr Poor,
Volume 72, Issue 1 (4-2014)
Abstract
Background: Abacavir is an anti-retroviral medication used to treat HIV infected/AIDS patients and its efficacy has been proven in randomized clinical trials. The most significant adverse reaction associated with abacavir is the acute hypersensitivity phenomenon which manifests in many forms and in severe cases could result in death. Hypersensitivity reaction to abacavir has been closely linked to the presence of HLA-B*57:01 allele. Avoidance of abacavir initiation in allele-positive patients is the most effective strategy in preventing possible severe hypersensitivity reactions. Previous epidemiologic studies have made great strides toward delineating HLA-B*57:01 allele frequency in different regions of the World and the available results indicate significant discrepancy between geographical regions. Despite these efforts, no study to date has determined the allele frequency among Iranian HIV-positive patients. The aim of the present study was to determine the proportion of allele-positive patients among a group of Iranian HIV-infected patients.
Methods: Between September 2012 and February 2013, 122 HIV-positive patients were selected among patients referred to Imam Khomeini Hospital’s Consultation cen-ter for high risk behaviors using the convenience sampling method. Sampling scheme was designed in a manner to include equal number of infected patients with and without clinical Acquired Immunodeficiency Syndrome (AIDS). Patient data was collected using available records and a blood sample for DNA analysis was also obtained. Presence of HLA-B*57:01 allele was determined using the Polymerase Chain Reaction- Sequence Specific Method (PCR-SSP).
Results: Seventy three patients (59.8%) were male. Co-infection with hepatitis B and C was observed in 1.7% and 40.7% of the patients, respectively. History of addiction and anti-retroviral therapy was positive in 50.0% and 60.7% of the patients, respectively. Overall, three patients were allele-positive which corresponds to a frequency of 2.46% (95% CI: 0.005-7.30). No association between presence of allele and investigated vari-ables were identified.
Conclusion: Frequency of HLA-B*57:01 allele among a group of Iranian HIV-infected patients is estimated to be 2.5%. This rate is comparable to those reported in other Middle-Eastern countries, yet is relatively lower than reports generated from South-Eastern Asia, Europe, and the United States. Future studies with larger sample sizes are needed to corroborate these findings.
Reza Beiranvand , Shahnaz Ghalavandi , Ali Delpisheh , Kourosh Sayemiri , Shokrollah Salmanzadeh ,
Volume 72, Issue 4 (7-2014)
Abstract
Background: Tuberculosis is still one of the main causes of mortality and disability in developing countries. Despite of socio-economic development of communities and controlling majority of communicable diseases, With respect to importance and high incidence of Tuberculosis in marginal provinces, the present study was aimed to assess the epidemiology of Tuberculosis.
Methods: In this Descriptive-Analytical Retrospective Study, documents of 6363 patients diagnosed with TB in the beginning of March 2005 to the end of the September 2012 in Khuzestan province, Iran, by used census sampling size, were used. Demographic variables and other necessity data were recorded by TB-Register software and then these data were analyzed by SPSS 16.0 software and Chi-square and independent t-tests with a significance level of less than 5%. For comparison Tuberculosis incidence in consecutive years used by Poisson tests (with a significance level of less than 5%).
Results: mean age of patients and median age of patients were 39.3±18 and 35±6.5 years, for women mean age was older 2.1 years than men and there was significant relationship to age (P=0.0001). Of all patients 75.7% were pulmonary tuberculosis, 2.7% were infected with HIV and 91.2% were new cases. Cumulative incidence in province was 148.84/100,000. Most prevalent in Non-pulmonary TB was Lymphatic glands. Poisson test showed that changing trends of TB incidence in study years was statistically significant (P<0.05).
Conclusion: Increasing concurrent of HIV infection and TB and decreasing patients mean age (39.3±18) and median (35±6.5) in southwest of Iran has high prevalence. Screening, training and preventive activities for controlling of disease is highly recommended for the whole country and in margin provinces in particular.
Anousheh Safarcherati , Masoumeh Amin-Esmaeili , Behrang Shadloo , Minoo Mohraz , Afarin Rahimi-Movaghar ,
Volume 73, Issue 10 (1-2016)
Abstract
HIV/AIDS is among the leading causes of morbidity and mortality in world. There are more than 35 million people living with HIV/AIDS in the world. Although the annual incidence of HIV infection is decreasing globally, HIV prevalence is rising due to development of more effective treatment and higher survival. Iran suffers from concentrated HIV epidemics among injecting and non-injecting drug users. There are more than 27 thousand registered cases of HIV infection and it is estimated that there are above seventy eight thousand cases in the country. Regarding the burden of disease, it is projected that HIV/AIDS will have the highest growth during the next 10 years. The outcome of this epidemics will be determined by human behavior. HIV, psychiatric disorders and substance use disorders are closely correlated and are accompanied by similar risk factors. They also share common consequences such as stigma and discrimination. Correlation of psychiatric disorders, as one of the most influential determinants of our behavior, and HIV/AIDS infection is reviewed in this narrative article. Psychiatric disorders are associated with greater risk of HIV acquisition. Substance use disorders, both injecting and non-injecting, as well as severe mental illnesses put the individual at higher risk of acquiring HIV infection. Impaired judgment, diminished inhibition and control over behaviors, lack of insight and poor self-care have been proposed as the underlying mechanisms. On the other hand, HIV infection may put the individual at greater risk of developing a mental illness. Coping with a chronic and life-threatening illness, fear of stigma and discrimination, CNS invasion of the virus as well as the adverse neuropsychiatric side effects of anti-retroviral medications may all contribute to establishment of a psychiatric disorder. Although there exists a bi-directional correlation between mental health problems and HIV/AIDS infection, this reciprocity goes beyond. Psychiatric disorders can affect the patient’s adherence, access to treatment and care and can worsen the course and clinical outcome of the infection. The clinical importance, underlying mechanism and other implications of this correlation are reviewed in this article.
Behrooz Ataei , Morteza Pourahmad , Ali Fotoohi , Katayoun Tayeri , Majid Yaran ,
Volume 75, Issue 11 (2-2018)
Abstract
Background: Hepatitis E virus (HEV) is from Hepeviridae family and genus Hepevirus. This virus is in 4 genotypes. These 4 genotypes are classified in 2 classes. In first class there are genotypes 1 and 2 which are specific for human. Genotypes 1 and 2 are not developed to chronic hepatitis is spite to genotypes 3 and 4 which may develop to chronic hepatitis in immunocompromised patients. It should say that in middle east genotypes 3 and 4 are not frequent. One of the immunodeficiency syndrome is human immunodeficiency virus (HIV) infection in which in the late phases of the disease the power of the immunity will be severely decreased in the patients. Therefore, in patients with HIV infection, HEV (specially genotypes 3 and 4) may be a problem and it may progress to a chronic viral hepatitis which may lead to liver failure. Therefore, it may need treatment and prophylactic strategies in some areas. The aim of this study was to evaluate the frequency of HEV infection in HIV patients by molecular assay.
Methods: This descriptive, cross-sectional study was conducted on 111 random selected, known HIV infection patients in 2016 in Isfahan, Iran. This study was done under supervision of Immunodeficiency Research Center of Isfahan University of Medical Sciences. The criteria for enrolling in the study, was positivity of HIV infection, and samples were selected from all known HIV infected patients in Isfahan. After blood sampling from the selected patients, HEV RNA was surveyed by RealStar® HEV RT-PCR Kit 1.0 (Altona Diagnostics, Hamburg, Germany). At the end, after isolation of HEV RNA, the cDNA was prepared and evaluated.
Results: Patients were between 5 to 68 years old and mean of the patients age was 38.5±11.5 years. 75 (67.6%) and 36 (32.4%) of the patients were men and women respectively. Mean count of the CD4 cells in these patients was 317.2±187.8. HBsAg and HCVAb was positive in 6 (5.4%) and 39 (35.1%) of them. No one of the studied patients were positive for HEV infection.
Conclusion: On the results of this study, there is no chance for having hepatitis E infection in Iranian HIV patients. Therefore, it seems that, hepatitis E is not an important problem in this group of patients in Iran.
Ashraf Tavanaee Sani , Lida Jarahi , Marzieh Saberi,
Volume 76, Issue 12 (3-2019)
Abstract
Background: In the last 10 years, co-infection of human immunodeficiency virus/human T-cell leukemia virus-1 (HIV/HTLV-1) has emerged as a worldwide health problem. These viruses has the same route to infect human but different effects on CD4 positive T-cells. There was controversial results about the influence of co-infection HIV/HTLV-1 pathogenesis. This study compared clinical course and laboratory findings in HIV/HTLV-1 co-infection with HIV mono infection.
Methods: This historical cohort study carried in Mashhad Consultation Center of Infective and Behavior Diseases, Mashhad, Iran, from April 2013 to march 2017. Persons who referred evaluated by the enzyme-linked immunosorbent assay (ELISA), then patients with positive ELISA test rechecked by ELISA and Western blot. Platelet count, WBC count, neutrophils count, positive CD4 T-cells, staging and disease severity evaluated at diagnosis, in starting and after of antiretroviral therapy in mono and co-infected patients. Demographic characteristics, including age, educational level, occupational state, marriage situation, past medical history and high-risk behaviors were extracted from the files.
Results: Of 64 patients enrolled in this study, 61 persons were male. Of 64 participants patients, 42 persons were infected with HIV (35 persons of them were positive for hepatitis C virus), other 22 positive HIV cases, were co infected by HTLV-1 too (18 persons were positive for hepatitis C virus (HCV). Co infected patients had more history of high-risk situations specially intravenous drug abuse. The most common opportunistic infections was cryptogenic tuberculosis (TB), candidiasis and military TB. Opportunistic infections and lab findings (except for CD4 positive T-cell) were the same in both group. Clinical severity and disease staging did not differ significantly between two groups. Death was more common in co-infected group.
Conclusion: Clinical course in human T-cell leukemia virus-1 (HTLV-1) co-infection has not obvious differences with previously HIV patients compare with only HIV infected patients. In co-infection with the onset of treatment the increase in the level of CD4 positive cells was higher than that HIV infection.
Ahmad Tavakoli , Maryam Esghaei , Angila Ataei-Pirkooh , Mohsen Moghoofei , Hadi Ghaffari , Farah Bokharaei-Salim ,
Volume 77, Issue 5 (8-2019)
Abstract
Currently, there are about 37 million people worldwide living with human immunodeficiency virus (HIV) /AIDS, with an estimated two million new cases per year globally. According to estimates from the World Health Organization (WHO), only 75% of the population with HIV know their status. Initially, HIV infection was associated with significantly increased rates of mortality and morbidity. However, the rapid advances in treatment and the advent of different classes of antiretroviral drugs over time have led to change the face of HIV/AIDS from a deadly infection to chronic and manageable disease. There is strong evidence that HIV-infected patients undergoing antiretroviral therapy have longer lives and are less likely to transmit infection to their sexual partners. Since the introduction of zidovudine in 1987 as the first antiretroviral drug, significant strides have been made in antiretroviral therapy. The introduction of potent antiretroviral drugs for the treatment of HIV infection has been one of the significant events in the evolution of modern medicine. Antiretroviral therapy refers to the use of drugs in the treatment of HIV. Generally, these drugs are categorized based on the steps of the HIV life cycle suppressed by them. There are six main classes of antiretroviral agents including nucleoside/ nucleotide reverse transcriptase inhibitors, non-nucleoside reverse transcriptase inhibitors, protease inhibitors, fusion inhibitors, co-receptor inhibitors, and integrase inhibitors. Combination antiretroviral therapy should be considered for HIV patients to achieve the highest viral suppression rate, and to reduce the risk of resistance development and morbidity and mortality associated with AIDS. Achieving and maintaining HIV viral load suppression among treated patients has remarkably increased over the last years due to the development of potent and well-tolerated agents which can be co-formulated as a once-daily single-tablet or fixed-dose combination for simplification. However, there are some limitations preventing patients to benefit from this treatment. The main goals of HIV therapy in the future are to overcome the limitations of current treatment, including side effects. This review will provide an overview of advances in the current antiretroviral drugs by focusing on their pharmacokinetics, mechanism of action, dosing recommendations, and adverse events for each drug class.
Homayoun Sadeghi Bazargani , Jafar Sadegh Tabrizi , Mohammad Asghari Jafar Abadi , Reza Yousefi , Mehdi Mohammadzadeh , Asad Ahmadi , Masoud Mohammadi ,
Volume 77, Issue 10 (1-2020)
Abstract
Background: AIDS is an emerging disease, and despite the fact that it has not been recognized for the first half-century since its inception, it has been known as a century-old disaster. This disease, by proliferation in immune cells and ultimately by weakening the immune system, makes people vulnerable to diseases. Our study seeks to examine existing cases of HIV/AIDS patients in East Azerbaijan province in Iran and provides useful guidance for patient diagnosis, treatment, and care.
Methods: This is a descriptive-analytic study in which the target group includes all HIV-positive or AIDS patients identified or reported from 2004 to 2014 in Tabriz Medical Sciences or Health Centers of East Azerbaijan province. The demographic information of all patients were recorded by a researcher-made questionnaire during visiting the disease-management counseling centers. All data including transmission of the illness (including all possible ways), the diagnostic date, the onset of treatment and the date of death were collected, and then entered into the software Stata, version 11.0 (Stata Corp., College Station, TX, USA). The information were imported in the ArcGIS software, version 10.7.1 (ESRI Inc., Redlands, CA, USA), maps were created, and geographic and spatial data were analyzed.
Results: According to the results of this study, most patients with 89.9% were male, 28.9% were under the age of 36 years, 32.3% had elementary education, and the most common way of transmission with 42.3% is through the shared infusion.
Conclusion: According to the results of this study, the highest prevalence of AIDS in East Azerbaijan province was observed in men under the age of 36 years and primary and lower secondary education in Tabriz and Maragheh cities.
Saedeh Ebrahimi, Saeed Kalantari , Soheil Rahmani Fard , Mitra Kohandel, Zahra Amiri, Yousef Alimohamadi , Sara Minaeian,
Volume 80, Issue 2 (5-2022)
Abstract
Background: Despite the considerable advances in acquired immunodeficiency syndrome (AIDS) treatment and management, finding the cure for this disease has been hindered by emerging challenges such as virus resistance and treatment failures. The purpose of this study is to compare the cytokine profiles of patients with successful treatment and patients with unsuccessful treatment to gain a better understanding of treatment failure mechanisms.
Methods: Sixty-nine human immunodeficiency virus (HIV) positive patients who were referred to the west health center of Tehran between September 2018 and March 2021 were included in this study. Blood CD4+ cell count and viral load was measured using the flow cytometry and quantitative real-time polymerase chain reaction (RT-qPCR) methods respectively. Based on the viral load test results patients were divided into successful treatment (viral load<200 copies/ml, n=36) and unsuccessful treatment (viral load>200 copies/ml, n=33) groups. Subsequently, tumor necrosis factor-α (TNF-α) and interleukin-10 (IL-10) serum levels were measured using the enzyme-linked immunosorbent assay (ELISA) method.
Results: Analysis of data revealed that there was no difference in demographic data, medical history and clinical laboratory test results between the study groups. Elisa test results showed that serum TNF-α levels were significantly higher in the unsuccessful treatment group compared to the successful treatment group (10.43±10.17 vs 5.37±5.25, P=0.01) but no differences were observed in IL-10 levels between the study groups. Furthermore, age and sex-adjusted linear regression models showed that non-nucleoside reverse-transcriptase inhibitors (NNRTI)-based treatment regimen is positively associated with serum IL-10 levels in patients with unsuccessful treatment (B coefficient 10.88 (95% CI: 1.32-20.45), P=0.03). Moreover, based on the results of the linear regression models, no relationship between HIV viral load and serum IL-10 and TNF-α level was observed.
|
Conclusion: Results of this study showcased the importance of TNF-α in disease progression and treatment failure. Further future studies regarding this relationship can provide vital information in AIDS treatment research.
|
