Spectrum and mortality of opportunistic infections among HIV/AIDS patients in southwestern China

Meng, Sirun; Tang, Qiuling; Xie, Zhiman; Wu, Nianning; Qin, Yingmei; Chen, Rongfeng; Chen, Xiaoyu; Chen, Xiu; Li, Yueqi; Shi, Minjuan; Li, Ye; Liang, Hao; Jiang, Junjun; Zhou, Bo; Lin, Jian

doi:10.1007/s10096-022-04528-y

Cited by 5 publications

(3 citation statements)

References 20 publications

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“…Our analysis shows that WLHIV with CD4 count <500/mm 3 had a two-fold higher risk of developing OIs which is consistent with previous studies [ 8–10 , 17 , 18 , 25 , 26 ]. Similarly, a higher risk of OIs among those with VL > 1000 copies/ml [ 17 , 25 , 27 ].…”

Section: Discussionsupporting

confidence: 92%

The spectrum of opportunistic infections and malignancies among women on antiretroviral therapy in Ethiopia

Getaneh,

Getnet,

Rashid

et al. 2023

Emerging Microbes & Infections

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Background : Women are disproportionally affected by HIV and are at greater risk of OIs and malignancies. This study investigated the spectrum of OIs and malignancies among women living with HIV (WLHIV) in Ethiopia. Methods : A retrospective longitudinal study was conducted among 3,817 WLHIV on Antiretroviral Treatment (ART) from 2007 to 2019 in Ethiopia. Data on OIs, malignancies, and clinical characteristics were retrieved from medical records. Prevalence, incidence, and mortality rates were measured over 13 years of follow-up. The Kaplan-Meier survival curve and multivariable Cox-proportional hazard regression were used to estimate incidence and identify predictors of OIs and malignancies, respectively. Result : The pooled prevalence of OIs or malignancies was 47%. OIs accounted for 39% and malignancies were 23.3%. The incidence of OIs and malignancies were 19.4 (95%CI:9.2-29.5) and 11.5 (95%CI:2.2-20.8) per 100 person-years of observation, respectively. Incidence of candidiasis was 14.1 per 100 person-years followed by Lymphoma (11.9), Cervical Cancer (11.5), and TB (10.9). The risk of OIs was higher in patients with baseline CD4 count ≤500 cells/mm3 [AHR (95%CI): 2.0 (1.8-2.3)] and VL>1000 copies/ml [AHR (95%CI): 1.5 (1.1-1.9)]. Overall, 24.6% died, and of them, 62.2% had a history of OIs or malignancies. The risk of death was higher among WLHIV with a history of Toxoplasmosis, TB and PCP. Conclusion : OIs and malignancies was recently increasing and two-thirds of all deaths were associated with these co-morbidities. The high rates of OIs and malignancies were attributed to poor treatment outcomes. The finding calls to enhance the diagnosis and treatment of these co-morbidities. Abbreviations AIDS: acquired immune deficiency syndrome; CI: confidence interval; EPHI: Ethiopian Public Health Institute; HAART: highly active antiretroviral therapy; HIV: human immunodeficiency virus; HR: hazard ratio; Mg/dl: milligram per deciliter; TB: tuberculosis; PCP: pneumocystis carinii pneumonia; ZJU: Zhejiang University

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Section: Discussionsupporting

confidence: 92%

The spectrum of opportunistic infections and malignancies among women on antiretroviral therapy in Ethiopia

Getaneh,

Getnet,

Rashid

et al. 2023

Emerging Microbes & Infections

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“…People with chronic HIV infection may be vulnerable to opportunistic infections due to reduced immunity. These infections have a negative impact on the health and quality of life of people living with HIV, increasing morbidity and mortality (9,10) . During pregnancy, women with HIV may be more susceptible to STIs due to anatomical, immunological, and behavioral factors (11,12) .…”

Section: Dst -J Bras Doenças Sex Transm 2023;35:e23351384mentioning

confidence: 99%

The relationship between HIV status and clinical manifestations of urogenital infections in women during pregnancy: a scoping review

Silva,

Santos,

Nascimento

et al. 2023

J Bras Doenças Sex Transm

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Introduction: Maternal and child health are essential to public health, especially during pregnancy, where urogenital infections can affect mothers and fetuses. Sexually transmitted infections (STIs) increase obstetric risks and have complex connections with the human immunodeficiency virus — HIV. In Brazil, pregnant women with HIV are a growing concern, requiring focus and appropriate interventions. Objective: This study aimed to examine the clinical and epidemiological characteristics of urogenital infections in pregnant women with and without HIV and to assess whether there are notable differences between these groups. Methods: A scoping review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses — Extension for Scoping Reviews (PRISMA-ScR) and Joanna Briggs Institute guidelines. Databases such as Medical Literature Analysis and Retrieval System Online (MEDLINE), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), and Scientific Electronic Library Online (SciELO) were explored using relevant terms. Inclusion/exclusion criteria selected nine studies for analysis. A Population, Intervention, Comparison, Outcome, and Study Design (PICOS) approach directed the search. Results: Pregnant women with HIV had a high prevalence of STIs, including Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, and bacterial vaginosis. HIV infection appears to influence the risk and severity of urogenital infections. Pregnancy increases the risk of STIs, regardless of HIV status. Male partners may also influence the presence of STIs in pregnant women, especially those with HIV. Conclusion: This study highlights the association between HIV status and urogenital infections in pregnant women, indicating the need for appropriate screening and care. Prevention and treatment of STIs in pregnant women are essential for maternal and child health, regardless of HIV status. An in-depth understanding of these issues can improve public policies, clinical practices, and preventive interventions that target the overall health of these vulnerable populations.

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“…Guangxi, China has a high HIV/AIDS burden and the third highest cumulative cases count. Hospitalized HIVinfected individuals have a high T. marneffei infection rate (up to 16.1%), and a higher mortality rate than most common HIV-related complications (AHR = 4.52) [8][9][10]. T. marneffei infection often causes delayed or incorrect diagnosis due to non-specific symptoms, allowing for disease progression in these individuals.…”

Section: Introductionmentioning

confidence: 99%

Characteristics and risk factors for readmission in HIV-infected patients with Talaromyces marneffei infection

Shi,

Qin,

Chen

et al. 2023

PLoS Negl Trop Dis

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Objectives Talaromyces marneffei (T. marneffei) is an opportunistic fungal infection (talaromycosis), which is common in subtropical regions and is a leading cause of death in HIV-1-infected patients. This study aimed to determine the characteristics and risk factors associated with hospital readmissions in HIV patients with T. marneffei infection in order to reduce readmissions. Methods We conducted a retrospective study of admitted HIV-infected individuals at the Fourth People’s Hospital of Nanning, Guangxi, China, from 2012 to 2019. Kaplan-Meier analyses and Principal component analysis (PCA) were used to evaluate the effects of T. marneffei infection on patient readmissions. Additionally, univariate and multifactorial analyses, as well as Propensity score matching (PSM) were used to analyze the factors associated with patient readmissions. Results HIV/AIDS patients with T. marneffei-infected had shorter intervals between admissions and longer lengths of stay than non-T. marneffei-infected patients, despite lower readmission rates. Compared with non-T. marneffei-infected patients, the mortality rate for talaromycosis patients was higher at the first admission. Among HIV/AIDS patients with opportunistic infections, the mortality rate was highest for T. marneffei at 16.2%, followed by cryptococcus at 12.5%. However, the readmission rate was highest for cryptococcus infection (37.5%) and lowest for T. marneffei (10.8%). PSM and Logistic regression analysis identified leukopenia and elevated low-density lipoprotein (LDL) as key factors in T.marneffei-infected patients hospital readmissions. Conclusions The first admission represents a critical window to intervene in the prognosis of patients with T. marneffei infection. Leukopenia and elevated LDL may be potential risk factors impacting readmissions. Our findings provide scientific evidence to improve the long-term outcomes of HIV patients with T. marneffei infection.

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Spectrum and mortality of opportunistic infections among HIV/AIDS patients in southwestern China

Cited by 5 publications

References 20 publications

The spectrum of opportunistic infections and malignancies among women on antiretroviral therapy in Ethiopia

The spectrum of opportunistic infections and malignancies among women on antiretroviral therapy in Ethiopia

The relationship between HIV status and clinical manifestations of urogenital infections in women during pregnancy: a scoping review

Characteristics and risk factors for readmission in HIV-infected patients with Talaromyces marneffei infection

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