This study investigates the impact of various factors on the lifespan and diagnostic time of HIV/AIDS patients using advanced statistical techniques. The Power Chris-Jerry (PCJ) distribution is applied to model CD4 co...This study investigates the impact of various factors on the lifespan and diagnostic time of HIV/AIDS patients using advanced statistical techniques. The Power Chris-Jerry (PCJ) distribution is applied to model CD4 counts of patients, and the goodness-of-fit test confirms a strong fit with a p-value of 0.6196. The PCJ distribution is found to be the best fit based on information criteria (AIC and BIC) with the smallest negative log-likelihood, AIC, and BIC values. The study uses datasets from St. Luke hospital Uyo, Nigeria, containing HIV/AIDS diagnosis date, age, CD4 count, gender, and opportunistic infection dates. Multiple linear regression is employed to analyze the relationship between these variables and HIV/AIDS diagnostic time. The results indicate that age, CD4 count, and opportunistic infection significantly impact the diagnostic time, while gender shows a nonsignificant relationship. The F-test confirms the model's overall significance, indicating the factors are good predictors of HIV/AIDS diagnostic time. The R-squared value of approximately 72% suggests that administering antiretroviral therapy (ART) can improve diagnostic time by suppressing the virus and protecting the immune system. Cox proportional hazard modeling is used to examine the effects of predictor variables on patient survival time. Age and CD4 count are not significant factors in the hazard of HIV/AIDS diagnostic time, while opportunistic infection is a significant predictor with a decreasing effect on the hazard rate. Gender shows a strong but nonsignificant relationship with decreased risk of death. To address the violation of the assumption of proportional hazard, the study employs an assumption-free alternative, Aalen’s model. In the Aalen model, all predictor variables except age and gender are statistically significant in relation to HIV/AIDS diagnostic time. The findings provide valuable insights into the factors influencing diagnostic time and survival of HIV/AIDS patients, which can inform interventions aimed at reducing transmission and improving early diagnosis and treatment. The Power Chris-Jerry distribution proves to be a suitable fit for modeling CD4 counts, while multiple linear regression and survival analysis techniques provide insights into the relationships between predictor variables and diagnostic time. These results contribute to the understanding of HIV/AIDS patient outcomes and can guide public health interventions to enhance early detection, treatment, and care.展开更多
This study investigates the impact of various factors on the lifespan and diagnostic time of HIV/AIDS patients using advanced statistical techniques. The Power Chris-Jerry (PCJ) distribution is applied to model CD4 co...This study investigates the impact of various factors on the lifespan and diagnostic time of HIV/AIDS patients using advanced statistical techniques. The Power Chris-Jerry (PCJ) distribution is applied to model CD4 counts of patients, and the goodness-of-fit test confirms a strong fit with a p-value of 0.6196. The PCJ distribution is found to be the best fit based on information criteria (AIC and BIC) with the smallest negative log-likelihood, AIC, and BIC values. The study uses datasets from St. Luke hospital Uyo, Nigeria, containing HIV/AIDS diagnosis date, age, CD4 count, gender, and opportunistic infection dates. Multiple linear regression is employed to analyze the relationship between these variables and HIV/AIDS diagnostic time. The results indicate that age, CD4 count, and opportunistic infection significantly impact the diagnostic time, while gender shows a nonsignificant relationship. The F-test confirms the model's overall significance, indicating the factors are good predictors of HIV/AIDS diagnostic time. The R-squared value of approximately 72% suggests that administering antiretroviral therapy (ART) can improve diagnostic time by suppressing the virus and protecting the immune system. Cox proportional hazard modeling is used to examine the effects of predictor variables on patient survival time. Age and CD4 count are not significant factors in the hazard of HIV/AIDS diagnostic time, while opportunistic infection is a significant predictor with a decreasing effect on the hazard rate. Gender shows a strong but nonsignificant relationship with decreased risk of death. To address the violation of the assumption of proportional hazard, the study employs an assumption-free alternative, Aalen’s model. In the Aalen model, all predictor variables except age and gender are statistically significant in relation to HIV/AIDS diagnostic time. The findings provide valuable insights into the factors influencing diagnostic time and survival of HIV/AIDS patients, which can inform interventions aimed at reducing transmission and improving early diagnosis and treatment. The Power Chris-Jerry distribution proves to be a suitable fit for modeling CD4 counts, while multiple linear regression and survival analysis techniques provide insights into the relationships between predictor variables and diagnostic time. These results contribute to the understanding of HIV/AIDS patient outcomes and can guide public health interventions to enhance early detection, treatment, and care.展开更多
<strong>Objective:</strong> This study aimed at assessing satisfaction with life among elderly HIV patients attending Mulago HIV Clinic. <strong>Methodology:</strong> A cross-sectional study de...<strong>Objective:</strong> This study aimed at assessing satisfaction with life among elderly HIV patients attending Mulago HIV Clinic. <strong>Methodology:</strong> A cross-sectional study design carried out among elderly people (>50 years old) attending Mulago HIV clinic, as stated by the WHO standard age cut-off of >50 years. A random selection of 353 elderly HIV patients was made. The study collected quantitative data to assess patient satisfaction with life, Illness related to discrimination, Barriers to healthcare and social services, and Physical wellbeing, social support and coping using quantitative data collection techniques. Interview discussions were harnessed to obtain patients’ opinions and perceptions and then results grouped into themes. EPIDATA and STATA 14.2 statistical softwares were used for statistical analysis. <strong>Results:</strong> The study showed that only variables that were significantly associated at multivariate level are, disagreeing that other patients are seen before you when you are first to arrive, which had an odds ratio of 2.87, disagreeing that your employer can never promote you which had an odds ratio of 6.87 compared to agreeing, not being sure whether friend or family member cannot share room/utensil/clothes with you reduced the odds of being satisfied by 95% when compared to agreeing and disagreeing that friend or family member blames you for not getting better with an odds ratio of 5.65 compared to agreeing. <strong>Conclusion:</strong> This study unearthed existing gaps in levels of satisfaction. These shortfalls in the service delivery can be addressed according to the following recommendations below: Create a quick way for elderly patients to see a clinician and give them priority, provide more work-related support awareness programs;Put more efforts towards counselling care takers or family members who help them to adhere or socialize with them.展开更多
Intimate Partner Violence (IPV) is a form of Gender Base Violence (GBV) where an intimate partner perpetrates violence. In the HIV care continua which has the aim of achieving epidemic control based on the goals defin...Intimate Partner Violence (IPV) is a form of Gender Base Violence (GBV) where an intimate partner perpetrates violence. In the HIV care continua which has the aim of achieving epidemic control based on the goals defined by UNAIDS, 95% of people living with HIV (PLHIV) have to know their HIV status, 95% initiated ARV treatment and 95% are virally suppressed in order to achieve epidemic control. One of the evidence-based strategies used for achieving an optimal number of PLHIV who know their HIV status is the Index Case Testing Strategy (ICT). While the ICT strategy helps the achievement of epidemic control, its implementation increases the incidence of IPV among either serodiscordant or concordant couples. Tackling information about IPV is very sensitive. A review of the literature on the management of HIV patient information has shown that shifting from paper-based management of HIV patient information to computerized Electronic Medical Records (EMR) systems, using software such as OPEN MRS has significantly improved the management of HIV patient information with high-level confidentiality of patient information. The reviews showed that the EMR systems put in place to manage HIV patient information need to integrate the stages used for the management of IPV among PLHIV.展开更多
ObjectiveTo determine the seroprevalence of anti-Toxoplasma gondii (T. gondii) IgG and IgM antibodies in HIV/AIDS patients and uninfected subjects.MethodsThis cross sectional survey was carried out on 78 healthy and 6...ObjectiveTo determine the seroprevalence of anti-Toxoplasma gondii (T. gondii) IgG and IgM antibodies in HIV/AIDS patients and uninfected subjects.MethodsThis cross sectional survey was carried out on 78 healthy and 62 HIV+/AIDS individuals in northern Iran between September 2007 and October 2008. Five mL of blood samples were collected from each person in case and control groups. Determination of CD4+ counts was performed by flow cytometry. The serum separated from blood samples was evaluated by conventional ELISA technique to determine the presence of antibodies to T. gondii.ResultsForty eight out of 62 (77.4%) HIV/AIDS serum samples were found positive for anti-T. gondii IgG antibody, compared with 59 among 78 (75.6%) HIV negative samples from the same area (P > 0.05). Six out of 62 (9.7%) HIV+/AIDS patients showed anti-T. gondii IgM antibody in their serum samples, compared with 7 among 78 (9%) HIV negative samples (P > 0.05). The mean of CD4+ counts in HIV+/AIDS was (430.8±182.3) cells/μL and in control group was (871.0±243.3)% cells/μL (P<0.01). CD4+ estimation in 5 (11.1%) of HIV+/AIDS patients was <200 cells/μL (P < 0.0001).ConclusionsSeroprevalence of latent toxoplasmosis in HIV patients is high, therefore the prevention of toxoplasmic encephalitis, administration of primary prophylaxis with co-trimoxazole to all HIV+/AIDS patients are necessary.展开更多
The objective of our study was to explore the possibility of the antifungal efficacy of various micafungin dosage regimens against <i>Candida spp</i> in HIV positive patients with EC. According to pharmaco...The objective of our study was to explore the possibility of the antifungal efficacy of various micafungin dosage regimens against <i>Candida spp</i> in HIV positive patients with EC. According to pharmacokinetic/pharmacodynamics parameters of micafungin in HIV positive patients and MICs distribution of micafungin against <i>Candida spp</i>. in published studies, the dosage regimens of micafungin were 50, 100 and 150 mg QD iv. Monte Carlo Simulation analysed the probability of target attainment and cumulative fraction of response. The results showed that micafungin has good antifungal effect in treating HIV positive patients with EC when pathomycetes are <i>Candida albicans</i>, <i>Candida glabrata</i> or <i>Candida tropicalis</i>, in dosage at 100 mg QD and 150 mg QD.展开更多
Objective: This study aims to understand the distribution of pathogenic bacteria in the region of HIV/AIDS patients with opportunistic infection. Methods: To count the number of the bacterial culture of HIV/AIDS patie...Objective: This study aims to understand the distribution of pathogenic bacteria in the region of HIV/AIDS patients with opportunistic infection. Methods: To count the number of the bacterial culture of HIV/AIDS patients in our hospital from October 2011 to December 2014, and observe the distribution of all kinds of pathogenic bacteria. Results: From the 4269 cases of HIV/AIDS patients’ bacteria, 5045 cases were cultured whose main flora distribution wasCandida albicans, 1759 cases. The second one was penicillium, 982 cases. The third one was mycobacteria, 557 cases. And then there are 213 cases ofCryptococcus neoformans, 212 cases of?Klebsiella pneumonia, 209 cases of?E. coli, 157 cases of coagulase-negative staphylococci, 112 cases of?Candida tropicalis, 90 cases of glabrata, 81 cases of?Staphylococcus aureus, 75 cases of?Pseudomonas aeruginosa, 60 cases of Salmonella, 48 cases of Acinetobacter and the distribution of the rest of cultured bacterial was less than 40 cases. Conclusion: There are many kinds of types of Pathogenic bacteria in HIV/AIDS patients with the opportunity to infectious. And the majorities are?Candida albicans,?Penicillium marneffei,?Penicillium,?Mycobacterium,?Cryptococcus neoformans?and so on. The infection sites are widely distributed;respiratory and circulatory are the main infected system. Improving the detection rate and reducing the contamination rate can truly reflect the distribution of pathogenic bacteria, and the distribution can guide the infection work in hospital. At the same time, it’s good to predict and prevent opportunistic infection. Thus, the patients can get immediate treatment.展开更多
We describe an observational study of clinical, virologic and drug resistance profiles in HIV-positive antiretroviral adherent subjects with stable low level viremia (LLV) 50 - 1000 copies/mL for more than 12 months. ...We describe an observational study of clinical, virologic and drug resistance profiles in HIV-positive antiretroviral adherent subjects with stable low level viremia (LLV) 50 - 1000 copies/mL for more than 12 months. Subjects were followed from time of first detectable viral load (VL). In total, 102 episodes of LLV were detected among 80 individuals. The median (mean, range) HIV copy number at genotyping was 250 (486, - 3900) copies/mL after 14 (17.9, 0 - 58) months of LLV. Few patients maintained LLV for the entire 9 years period of observation, with half (52%) experiencing viremic progression following a stable period of LLV either spontaneously or after treatment interruption or failed regimen intensification. In the setting of prolonged periods of sustained LLV, mean duration 22 (range 8 - 106) months, drug resistance (DR) was almost universal. Resistance to ≥1 on-treatment drugs was defined in 97% of specimens and DR to all drugs in the treatment regimen in over half of all patients. Evolution of DR mutations during the period of LLV was observed in 20/28 (71%) subjects with specimens available for follow-up testing. This evolution was associated with viremic progression to levels >1000 copies/mL (p = 0.03). Our data suggest that DR present in patients with LLV is likely to impact long term clinical outcomes, highlighting the importance of optimizing techniques to detect the presence of drug resistant HIV in the setting of LLV and the need for larger prospective studies to assess the emergence of DR in the setting of sustained LLV and the impact of this DR on treatment outcomes.展开更多
文摘This study investigates the impact of various factors on the lifespan and diagnostic time of HIV/AIDS patients using advanced statistical techniques. The Power Chris-Jerry (PCJ) distribution is applied to model CD4 counts of patients, and the goodness-of-fit test confirms a strong fit with a p-value of 0.6196. The PCJ distribution is found to be the best fit based on information criteria (AIC and BIC) with the smallest negative log-likelihood, AIC, and BIC values. The study uses datasets from St. Luke hospital Uyo, Nigeria, containing HIV/AIDS diagnosis date, age, CD4 count, gender, and opportunistic infection dates. Multiple linear regression is employed to analyze the relationship between these variables and HIV/AIDS diagnostic time. The results indicate that age, CD4 count, and opportunistic infection significantly impact the diagnostic time, while gender shows a nonsignificant relationship. The F-test confirms the model's overall significance, indicating the factors are good predictors of HIV/AIDS diagnostic time. The R-squared value of approximately 72% suggests that administering antiretroviral therapy (ART) can improve diagnostic time by suppressing the virus and protecting the immune system. Cox proportional hazard modeling is used to examine the effects of predictor variables on patient survival time. Age and CD4 count are not significant factors in the hazard of HIV/AIDS diagnostic time, while opportunistic infection is a significant predictor with a decreasing effect on the hazard rate. Gender shows a strong but nonsignificant relationship with decreased risk of death. To address the violation of the assumption of proportional hazard, the study employs an assumption-free alternative, Aalen’s model. In the Aalen model, all predictor variables except age and gender are statistically significant in relation to HIV/AIDS diagnostic time. The findings provide valuable insights into the factors influencing diagnostic time and survival of HIV/AIDS patients, which can inform interventions aimed at reducing transmission and improving early diagnosis and treatment. The Power Chris-Jerry distribution proves to be a suitable fit for modeling CD4 counts, while multiple linear regression and survival analysis techniques provide insights into the relationships between predictor variables and diagnostic time. These results contribute to the understanding of HIV/AIDS patient outcomes and can guide public health interventions to enhance early detection, treatment, and care.
文摘This study investigates the impact of various factors on the lifespan and diagnostic time of HIV/AIDS patients using advanced statistical techniques. The Power Chris-Jerry (PCJ) distribution is applied to model CD4 counts of patients, and the goodness-of-fit test confirms a strong fit with a p-value of 0.6196. The PCJ distribution is found to be the best fit based on information criteria (AIC and BIC) with the smallest negative log-likelihood, AIC, and BIC values. The study uses datasets from St. Luke hospital Uyo, Nigeria, containing HIV/AIDS diagnosis date, age, CD4 count, gender, and opportunistic infection dates. Multiple linear regression is employed to analyze the relationship between these variables and HIV/AIDS diagnostic time. The results indicate that age, CD4 count, and opportunistic infection significantly impact the diagnostic time, while gender shows a nonsignificant relationship. The F-test confirms the model's overall significance, indicating the factors are good predictors of HIV/AIDS diagnostic time. The R-squared value of approximately 72% suggests that administering antiretroviral therapy (ART) can improve diagnostic time by suppressing the virus and protecting the immune system. Cox proportional hazard modeling is used to examine the effects of predictor variables on patient survival time. Age and CD4 count are not significant factors in the hazard of HIV/AIDS diagnostic time, while opportunistic infection is a significant predictor with a decreasing effect on the hazard rate. Gender shows a strong but nonsignificant relationship with decreased risk of death. To address the violation of the assumption of proportional hazard, the study employs an assumption-free alternative, Aalen’s model. In the Aalen model, all predictor variables except age and gender are statistically significant in relation to HIV/AIDS diagnostic time. The findings provide valuable insights into the factors influencing diagnostic time and survival of HIV/AIDS patients, which can inform interventions aimed at reducing transmission and improving early diagnosis and treatment. The Power Chris-Jerry distribution proves to be a suitable fit for modeling CD4 counts, while multiple linear regression and survival analysis techniques provide insights into the relationships between predictor variables and diagnostic time. These results contribute to the understanding of HIV/AIDS patient outcomes and can guide public health interventions to enhance early detection, treatment, and care.
文摘<strong>Objective:</strong> This study aimed at assessing satisfaction with life among elderly HIV patients attending Mulago HIV Clinic. <strong>Methodology:</strong> A cross-sectional study design carried out among elderly people (>50 years old) attending Mulago HIV clinic, as stated by the WHO standard age cut-off of >50 years. A random selection of 353 elderly HIV patients was made. The study collected quantitative data to assess patient satisfaction with life, Illness related to discrimination, Barriers to healthcare and social services, and Physical wellbeing, social support and coping using quantitative data collection techniques. Interview discussions were harnessed to obtain patients’ opinions and perceptions and then results grouped into themes. EPIDATA and STATA 14.2 statistical softwares were used for statistical analysis. <strong>Results:</strong> The study showed that only variables that were significantly associated at multivariate level are, disagreeing that other patients are seen before you when you are first to arrive, which had an odds ratio of 2.87, disagreeing that your employer can never promote you which had an odds ratio of 6.87 compared to agreeing, not being sure whether friend or family member cannot share room/utensil/clothes with you reduced the odds of being satisfied by 95% when compared to agreeing and disagreeing that friend or family member blames you for not getting better with an odds ratio of 5.65 compared to agreeing. <strong>Conclusion:</strong> This study unearthed existing gaps in levels of satisfaction. These shortfalls in the service delivery can be addressed according to the following recommendations below: Create a quick way for elderly patients to see a clinician and give them priority, provide more work-related support awareness programs;Put more efforts towards counselling care takers or family members who help them to adhere or socialize with them.
文摘Intimate Partner Violence (IPV) is a form of Gender Base Violence (GBV) where an intimate partner perpetrates violence. In the HIV care continua which has the aim of achieving epidemic control based on the goals defined by UNAIDS, 95% of people living with HIV (PLHIV) have to know their HIV status, 95% initiated ARV treatment and 95% are virally suppressed in order to achieve epidemic control. One of the evidence-based strategies used for achieving an optimal number of PLHIV who know their HIV status is the Index Case Testing Strategy (ICT). While the ICT strategy helps the achievement of epidemic control, its implementation increases the incidence of IPV among either serodiscordant or concordant couples. Tackling information about IPV is very sensitive. A review of the literature on the management of HIV patient information has shown that shifting from paper-based management of HIV patient information to computerized Electronic Medical Records (EMR) systems, using software such as OPEN MRS has significantly improved the management of HIV patient information with high-level confidentiality of patient information. The reviews showed that the EMR systems put in place to manage HIV patient information need to integrate the stages used for the management of IPV among PLHIV.
基金supported by funds from Mazandaran University of Medical sciences(No.86-115),Iran
文摘ObjectiveTo determine the seroprevalence of anti-Toxoplasma gondii (T. gondii) IgG and IgM antibodies in HIV/AIDS patients and uninfected subjects.MethodsThis cross sectional survey was carried out on 78 healthy and 62 HIV+/AIDS individuals in northern Iran between September 2007 and October 2008. Five mL of blood samples were collected from each person in case and control groups. Determination of CD4+ counts was performed by flow cytometry. The serum separated from blood samples was evaluated by conventional ELISA technique to determine the presence of antibodies to T. gondii.ResultsForty eight out of 62 (77.4%) HIV/AIDS serum samples were found positive for anti-T. gondii IgG antibody, compared with 59 among 78 (75.6%) HIV negative samples from the same area (P > 0.05). Six out of 62 (9.7%) HIV+/AIDS patients showed anti-T. gondii IgM antibody in their serum samples, compared with 7 among 78 (9%) HIV negative samples (P > 0.05). The mean of CD4+ counts in HIV+/AIDS was (430.8±182.3) cells/μL and in control group was (871.0±243.3)% cells/μL (P<0.01). CD4+ estimation in 5 (11.1%) of HIV+/AIDS patients was <200 cells/μL (P < 0.0001).ConclusionsSeroprevalence of latent toxoplasmosis in HIV patients is high, therefore the prevention of toxoplasmic encephalitis, administration of primary prophylaxis with co-trimoxazole to all HIV+/AIDS patients are necessary.
文摘The objective of our study was to explore the possibility of the antifungal efficacy of various micafungin dosage regimens against <i>Candida spp</i> in HIV positive patients with EC. According to pharmacokinetic/pharmacodynamics parameters of micafungin in HIV positive patients and MICs distribution of micafungin against <i>Candida spp</i>. in published studies, the dosage regimens of micafungin were 50, 100 and 150 mg QD iv. Monte Carlo Simulation analysed the probability of target attainment and cumulative fraction of response. The results showed that micafungin has good antifungal effect in treating HIV positive patients with EC when pathomycetes are <i>Candida albicans</i>, <i>Candida glabrata</i> or <i>Candida tropicalis</i>, in dosage at 100 mg QD and 150 mg QD.
文摘Objective: This study aims to understand the distribution of pathogenic bacteria in the region of HIV/AIDS patients with opportunistic infection. Methods: To count the number of the bacterial culture of HIV/AIDS patients in our hospital from October 2011 to December 2014, and observe the distribution of all kinds of pathogenic bacteria. Results: From the 4269 cases of HIV/AIDS patients’ bacteria, 5045 cases were cultured whose main flora distribution wasCandida albicans, 1759 cases. The second one was penicillium, 982 cases. The third one was mycobacteria, 557 cases. And then there are 213 cases ofCryptococcus neoformans, 212 cases of?Klebsiella pneumonia, 209 cases of?E. coli, 157 cases of coagulase-negative staphylococci, 112 cases of?Candida tropicalis, 90 cases of glabrata, 81 cases of?Staphylococcus aureus, 75 cases of?Pseudomonas aeruginosa, 60 cases of Salmonella, 48 cases of Acinetobacter and the distribution of the rest of cultured bacterial was less than 40 cases. Conclusion: There are many kinds of types of Pathogenic bacteria in HIV/AIDS patients with the opportunity to infectious. And the majorities are?Candida albicans,?Penicillium marneffei,?Penicillium,?Mycobacterium,?Cryptococcus neoformans?and so on. The infection sites are widely distributed;respiratory and circulatory are the main infected system. Improving the detection rate and reducing the contamination rate can truly reflect the distribution of pathogenic bacteria, and the distribution can guide the infection work in hospital. At the same time, it’s good to predict and prevent opportunistic infection. Thus, the patients can get immediate treatment.
文摘We describe an observational study of clinical, virologic and drug resistance profiles in HIV-positive antiretroviral adherent subjects with stable low level viremia (LLV) 50 - 1000 copies/mL for more than 12 months. Subjects were followed from time of first detectable viral load (VL). In total, 102 episodes of LLV were detected among 80 individuals. The median (mean, range) HIV copy number at genotyping was 250 (486, - 3900) copies/mL after 14 (17.9, 0 - 58) months of LLV. Few patients maintained LLV for the entire 9 years period of observation, with half (52%) experiencing viremic progression following a stable period of LLV either spontaneously or after treatment interruption or failed regimen intensification. In the setting of prolonged periods of sustained LLV, mean duration 22 (range 8 - 106) months, drug resistance (DR) was almost universal. Resistance to ≥1 on-treatment drugs was defined in 97% of specimens and DR to all drugs in the treatment regimen in over half of all patients. Evolution of DR mutations during the period of LLV was observed in 20/28 (71%) subjects with specimens available for follow-up testing. This evolution was associated with viremic progression to levels >1000 copies/mL (p = 0.03). Our data suggest that DR present in patients with LLV is likely to impact long term clinical outcomes, highlighting the importance of optimizing techniques to detect the presence of drug resistant HIV in the setting of LLV and the need for larger prospective studies to assess the emergence of DR in the setting of sustained LLV and the impact of this DR on treatment outcomes.
