Copyright (c) 2020 Divya Yedluri
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Study on Impact of Patient Related Variables on CD4 Count and Opportunistic Infections in HIV Seropositives
Corresponding Author(s) : Divya Yedluri
International Journal of Allied Medical Sciences and Clinical Research,
Vol. 6 No. 1 (2018): 2018 Volume 6- Issue -1
Abstract
Opportunistic infections are the hallmark manifestations of AIDS. To decrease the incidence of OI’s in PLHIV, there is a need to study the impact of all relevant factors which may be a key for the development of OI’s.
Aim
To study the impact of patient related variables on CD4 count and opportunistic infections in people living with HIV.
Methods and methodology
A Prospective Observational study was carried out at ART center. HIV patients who met inclusion criteria were informed consented and included in the study and relevant data was collected in a prior designed data collection form.
Results
A total of 214 patients having OI’s were included among which 55.1% (n=118) were women and 44.9% (n= 96) were men. Most of the OI’s occurred in the age group of 31- 40 yrs. (n=85; 39.17%) and when CD4 count was between 100-350 cells/mm3. TB was the most common OI (n=115; 50%) followed by candidiasis (n= 110; 47.8%). When BMI was correlated with CD4; it revealed that underweight was predominant (n=62; 79.49%) when CD4 count was < 350 cells/mm3. Grade II anemia was most common (n=97; 49.24%) and most of the patients with OI’s belong to upper lower class (n=179; 83.64%) according to KSES. Risk grading using JDPV scale reveals 107 (50%) patients fall under high risk category and 64 (29.3%) , 4 (1.87%) are with moderate and high risk respectively.
Conclusion
This study reveals that there is a positive relationship between BMI and CD4 count and it also shows that the incidence of OIs is influenced by multiple factors which should be considered to provide appropriate care to the patient.
References
-
Longo, Kasper, Fauci, Hauser, Jameson, Loascalzo. Infections due to Human Immunodeficency Virus. Harrison’s Principles of Internal Medicine 2(2), 2012, 2138-2159.
[2]. National AIDS Control Organisation. Annual report 2015-16.NACO 24, 2016, 335-395.
[3]. Maria Cheng. AIDS to be third leading cause of death. Associated Press/USA Today. 28, 2006, 2-4.
[4]. Lindsay C. Bacik, B.S, Dr. Futou Seck, Dr. Rhonda BeLue1.Spectrum of Comorbid Conditions and Their Relationship to CD4 T-lymphocyte Counts in HIV-Infected Patients in Mbour, Senegal. J Glob Health 2017.
[5]. Kumar A, Singh S, Sahu NP. Evaluation of CD4 count and correlation with development of opportunistic infection among HIV seropositives. Eastern J Med Sci 1(1), 2016, 12-16.
[6]. Bhusal KR, Devkota S, Shrestha M, Khadga P. Profile of Anaemia in HIV Positive Patients. JCMS Nepal; 12(2), 2016, 70-3.
[7]. John Rubaihayo, Nazarius M Tumwesigye1 and Joseph Konde-Lule1. Trends in prevalence of selected opportunistic infections associated with HIV/AIDS in Uganda. BMC Infectious Diseases 2015, 15:187.
[8]. Aishwarya. R. Assessment of Nutritional Status of people living with HIV/AIDS (PLWHA) in the age group of 18-55 years. IOSR-JNHS 4(2), 2015, 17-28.
[9]. Muluken Assefa M, Abegaz W, Shewamare A, Medhin M, Belay M. Prevalence and correlates of Anaemia among HIV infected patients on highly active retroviral therapy. BMC Hematology, Ethiopia, 2015, 15: 6.
[10]. Moges NA, Kassa GM. Prevalence of Opportunistic Infections and Associated Factors among HIV Positive Patients taking Anti-Retroviral Therapy in DebreMarkos Referral Hospital, Northwest Ethiopia. J AIDS Clin Res 2014, 5: 301.
Divya Y et al / Int. J. of Allied Med. Sci. and Clin. Research Vol-6(1) 2018 [165-174]
173
[11]. Catherine Martin, Poudel-Tandukar K, Poudel KC. HIV Symptom Burden and Anemia among HIV-Positive Individuals: Cross-Sectional Results of a Community-Based Positive Living with HIV (POLH) Study in Nepal. PLoS ONE 9(12), 2014, e116263.
[12]. Woldesellassie M. Bezabhe, Leanne Chalmers, Luke R. Bereznicki, Gregory M. Peterson, Mekides A. Bimirew, Desalew M. Kassie. Barriers and Facilitators of Adherence to Antiretroviral Drug Therapy and Retention in Care among Adult HIV-Positive Patients: A Qualitative Study from Ethiopia. PLoS ONE 9(5), 2014, e97353.
[13]. Debasu Damtie, Gizachew Yismaw, Desalegn Woldeyohannes and Belay Anagaw. Common opportunistic infections and their CD4 cell correlates among HIV-infected patients attending at antiretroviral therapy clinic of Gondar University Hospital, Northwest Ethiopia. BMC Research Notes 2013, 6:534.
[14]. Bach Xuan Tran, Long Thanh Nguyen, Nga Hoang Nguyen, Quynh Van Hoang and Jongnam Hwang. Determinants of antiretroviral treatment adherence among HIV/AIDS patients: a multisite study. Glob Health Action 2013, 6: 19570.
[15]. Sandeep Rai, Bidhubhusan Mahapatra, Subhashish Sircar, Pinnamaneni Yujwal Raj, Srinivasan Venkatesh, Mohammed Shaukat, Bharat Bhusan Rewari. Adherence to Antiretroviral Therapy and Its Effect on Survival of HIV-Infected Individuals in Jharkhand, India. PLoS ONE 8(6), 2013, e66860.
[16]. Banwat ME, Yakubu NW, Olalude EO, Ogunsakin JA. An Assessment of the Nutritional Knowledge, Practice and Status of Adult HIV/Aids Patients Attending an Art Centre in Jos, North Central Nigeria. Health Care Current Reviews (1), 2013, 101.
[17]. Ana Célia Oliveira dos Santos and Ana Maria Rampeloti Almeida. Nutritional status and CD4 cell counts in patients with HIV/AIDS receiving antiretroviral therapy. Revista da Sociedade Brasileira de Medicina Tropical, 46(6), 2013, 698-703.
[18]. Iroezindu MO, Ofondu EO, Hausler H, Wyk BV. Prevalence and Risk Factors for Opportunistic Infections in HIV Patients Receiving Antiretroviral Therapy in a Resource-Limited Setting in Nigeria. J AIDS Clinic Res 2013, S3:002.
[19]. Shen Y, Wang Z, Lu H, Wang J, Chen J. Prevalence of Anemia among Adults with Newly Diagnosed HIV/AIDS in China. PLoS ONE 8(9), 2013, e73807.
[20]. Anant A. Takalkar, G.S. Saiprasad, V .G. Prasad, Narendra S. Madhekar. Study of Opportunistic Infections in HIV Seropositive Patients Admitted to Community Care centre (CCC), KIMS Narketpally. Biomedical Research 23(1), 2012, 139-142
[21]. Carolline de Araújo Mariz, Maria de Fátima P. Militão de Albuquerque, Ricardo Arraes de Alencar Ximenes, Heloísa Ramos Lacerda de Melo, Francisco Bandeira, Thaís Gelenske Braga e Oliveira, Érico Higino de Carvalho, Adriana Paula da Silva, Demócrito de Barros Miranda Filho . Body mass index in individuals with HIV infection and factors associated with thinness and overweight/obesity. Cad. Saúde Pública, Rio de Janeiro; 27(10), 2011, 1997-2008.
[22]. N. Joglekar, R. Paranjape, R. Jain, G. Rahane, R. Potdar, K.S. Reddy & S. Sahay. Barriers to ART adherence & follow ups among patients attending ART centres in Maharashtra, India. Indian J Med Res 134, 2011, 954-959.
[23]. Samuel N. Obi, Ngozi A. Ifebunandu, Azubuike K. Onyebuchi. Nutritional status of HIV-positive individuals on free HAART treatment in a developing nation. J Infect Dev Ctries 4(11), 2010, 745-749.
[24]. Crum-Cianflone N, Roediger MP, Eberly L, Headd M, Marconi V, et al. Increasing Rates of Obesity among HIV-Infected Persons during the HIV Epidemic. PLoS ONE; 5(4), 2010, e10106.
[25]. Manisha Ghate , Swapna Deshpande , Srikanth Tripathy , Madhura Nene ,Preeti Gedam , Sheela Godbole , Madhuri Thakar , Arun Risbud ,Robert Bollinger , Sanjay Mehendale. Incidence of common opportunistic infections in HIV-infected individuals in Pune, India: analysis by stages of immunosuppression represented by CD4 counts. International Journal of Infectious Diseases 13, 2009, e1—e8.
[26]. Mary B Cauldbeck, Catherine O'Connor et al. Adherence to anti-retroviral therapy among HIV patients in Bangalore, India. AIDS Res Ther. 2009, 6: 7.
[27]. Sheri D. Weiser, MD, MPH, Kimberly A. Fernandes, MSC, Eirikka K. Brandson, MPH,Viviane D. Lima, PhD, Aranka Anema, MSc, David R. Bangsberg, MD, MPH, Julio S.Montaner, MD, FRCPC, and Robert S. Hogg, PhD. The association between food insecurity and mortality among HIV-infected individuals on HAART, J Acquir Immune Defic Syndr. 52(3), 2009, 342–349.
Divya Y et al / Int. J. of Allied Med. Sci. and Clin. Research Vol-6(1) 2018 [165-174]
174
[28]. Ruth Joy, MSc, Eric F. Druyts, MSc, Eirikka K. Brandson, MSc, Viviane D. Lima, PhD,Clare A. Rustad, MPhil, Wendy Zhang, MSc, Evan Wood, MD, PhD, Julio S. G. Montaner, MD, FRCPC, FCCP, and Robert S. Hogg, PhD.Impact of Neighborhood-Level Socioeconomic Status on HIV Disease Progression in a Universal Health Care Setting, J Acquir Immune Defic Syndr 47, 2008, 500–505.
[29]. Ledergerber B, Egger M, Erard V, Weber R, Hirschel B, et al. AIDS related opportunistic illnesses occurring after initiation of potent antiretroviral therapy: the Swiss HIV Cohort Study. JAMA. 282, 1999, 2220-2226.
[30]. Srirangaraj S, Venkatesha D Opportunistic infections in relation to antiretroviral status among AIDS patients from south India. Indian J Med Microbiol 29, 2011, 395-400.
[31]. Kaplan JE, Hanson D, Dworkin MS, Frederick T, Bertolli J, et al. Epidemiology of human immunodeficiency virus–associated opportunistic infections in the United States in the era of highly active antiretroviral therapy. Clin Infect Dis 30, 2000, 5-14.
[32]. Lawn SD, Badri M, Wood R Tuberculosis among HIV-infected patients receiving HAART: long term incidence and risk factors in a South African cohort. AIDS. 19, 2005, 2109-2116.
[33]. Yazdanpanah Y, Chêne G, Losina E, Goldie SJ, Merchadou LD, et al. Incidence of primary opportunistic infections in two human immunodeficiency virus-infected French clinical cohorts. Int J Epidemiol.30, 2001, 864-871. How
References
Longo, Kasper, Fauci, Hauser, Jameson, Loascalzo. Infections due to Human Immunodeficency Virus. Harrison’s Principles of Internal Medicine 2(2), 2012, 2138-2159.
[2]. National AIDS Control Organisation. Annual report 2015-16.NACO 24, 2016, 335-395.
[3]. Maria Cheng. AIDS to be third leading cause of death. Associated Press/USA Today. 28, 2006, 2-4.
[4]. Lindsay C. Bacik, B.S, Dr. Futou Seck, Dr. Rhonda BeLue1.Spectrum of Comorbid Conditions and Their Relationship to CD4 T-lymphocyte Counts in HIV-Infected Patients in Mbour, Senegal. J Glob Health 2017.
[5]. Kumar A, Singh S, Sahu NP. Evaluation of CD4 count and correlation with development of opportunistic infection among HIV seropositives. Eastern J Med Sci 1(1), 2016, 12-16.
[6]. Bhusal KR, Devkota S, Shrestha M, Khadga P. Profile of Anaemia in HIV Positive Patients. JCMS Nepal; 12(2), 2016, 70-3.
[7]. John Rubaihayo, Nazarius M Tumwesigye1 and Joseph Konde-Lule1. Trends in prevalence of selected opportunistic infections associated with HIV/AIDS in Uganda. BMC Infectious Diseases 2015, 15:187.
[8]. Aishwarya. R. Assessment of Nutritional Status of people living with HIV/AIDS (PLWHA) in the age group of 18-55 years. IOSR-JNHS 4(2), 2015, 17-28.
[9]. Muluken Assefa M, Abegaz W, Shewamare A, Medhin M, Belay M. Prevalence and correlates of Anaemia among HIV infected patients on highly active retroviral therapy. BMC Hematology, Ethiopia, 2015, 15: 6.
[10]. Moges NA, Kassa GM. Prevalence of Opportunistic Infections and Associated Factors among HIV Positive Patients taking Anti-Retroviral Therapy in DebreMarkos Referral Hospital, Northwest Ethiopia. J AIDS Clin Res 2014, 5: 301.
Divya Y et al / Int. J. of Allied Med. Sci. and Clin. Research Vol-6(1) 2018 [165-174]
173
[11]. Catherine Martin, Poudel-Tandukar K, Poudel KC. HIV Symptom Burden and Anemia among HIV-Positive Individuals: Cross-Sectional Results of a Community-Based Positive Living with HIV (POLH) Study in Nepal. PLoS ONE 9(12), 2014, e116263.
[12]. Woldesellassie M. Bezabhe, Leanne Chalmers, Luke R. Bereznicki, Gregory M. Peterson, Mekides A. Bimirew, Desalew M. Kassie. Barriers and Facilitators of Adherence to Antiretroviral Drug Therapy and Retention in Care among Adult HIV-Positive Patients: A Qualitative Study from Ethiopia. PLoS ONE 9(5), 2014, e97353.
[13]. Debasu Damtie, Gizachew Yismaw, Desalegn Woldeyohannes and Belay Anagaw. Common opportunistic infections and their CD4 cell correlates among HIV-infected patients attending at antiretroviral therapy clinic of Gondar University Hospital, Northwest Ethiopia. BMC Research Notes 2013, 6:534.
[14]. Bach Xuan Tran, Long Thanh Nguyen, Nga Hoang Nguyen, Quynh Van Hoang and Jongnam Hwang. Determinants of antiretroviral treatment adherence among HIV/AIDS patients: a multisite study. Glob Health Action 2013, 6: 19570.
[15]. Sandeep Rai, Bidhubhusan Mahapatra, Subhashish Sircar, Pinnamaneni Yujwal Raj, Srinivasan Venkatesh, Mohammed Shaukat, Bharat Bhusan Rewari. Adherence to Antiretroviral Therapy and Its Effect on Survival of HIV-Infected Individuals in Jharkhand, India. PLoS ONE 8(6), 2013, e66860.
[16]. Banwat ME, Yakubu NW, Olalude EO, Ogunsakin JA. An Assessment of the Nutritional Knowledge, Practice and Status of Adult HIV/Aids Patients Attending an Art Centre in Jos, North Central Nigeria. Health Care Current Reviews (1), 2013, 101.
[17]. Ana Célia Oliveira dos Santos and Ana Maria Rampeloti Almeida. Nutritional status and CD4 cell counts in patients with HIV/AIDS receiving antiretroviral therapy. Revista da Sociedade Brasileira de Medicina Tropical, 46(6), 2013, 698-703.
[18]. Iroezindu MO, Ofondu EO, Hausler H, Wyk BV. Prevalence and Risk Factors for Opportunistic Infections in HIV Patients Receiving Antiretroviral Therapy in a Resource-Limited Setting in Nigeria. J AIDS Clinic Res 2013, S3:002.
[19]. Shen Y, Wang Z, Lu H, Wang J, Chen J. Prevalence of Anemia among Adults with Newly Diagnosed HIV/AIDS in China. PLoS ONE 8(9), 2013, e73807.
[20]. Anant A. Takalkar, G.S. Saiprasad, V .G. Prasad, Narendra S. Madhekar. Study of Opportunistic Infections in HIV Seropositive Patients Admitted to Community Care centre (CCC), KIMS Narketpally. Biomedical Research 23(1), 2012, 139-142
[21]. Carolline de Araújo Mariz, Maria de Fátima P. Militão de Albuquerque, Ricardo Arraes de Alencar Ximenes, Heloísa Ramos Lacerda de Melo, Francisco Bandeira, Thaís Gelenske Braga e Oliveira, Érico Higino de Carvalho, Adriana Paula da Silva, Demócrito de Barros Miranda Filho . Body mass index in individuals with HIV infection and factors associated with thinness and overweight/obesity. Cad. Saúde Pública, Rio de Janeiro; 27(10), 2011, 1997-2008.
[22]. N. Joglekar, R. Paranjape, R. Jain, G. Rahane, R. Potdar, K.S. Reddy & S. Sahay. Barriers to ART adherence & follow ups among patients attending ART centres in Maharashtra, India. Indian J Med Res 134, 2011, 954-959.
[23]. Samuel N. Obi, Ngozi A. Ifebunandu, Azubuike K. Onyebuchi. Nutritional status of HIV-positive individuals on free HAART treatment in a developing nation. J Infect Dev Ctries 4(11), 2010, 745-749.
[24]. Crum-Cianflone N, Roediger MP, Eberly L, Headd M, Marconi V, et al. Increasing Rates of Obesity among HIV-Infected Persons during the HIV Epidemic. PLoS ONE; 5(4), 2010, e10106.
[25]. Manisha Ghate , Swapna Deshpande , Srikanth Tripathy , Madhura Nene ,Preeti Gedam , Sheela Godbole , Madhuri Thakar , Arun Risbud ,Robert Bollinger , Sanjay Mehendale. Incidence of common opportunistic infections in HIV-infected individuals in Pune, India: analysis by stages of immunosuppression represented by CD4 counts. International Journal of Infectious Diseases 13, 2009, e1—e8.
[26]. Mary B Cauldbeck, Catherine O'Connor et al. Adherence to anti-retroviral therapy among HIV patients in Bangalore, India. AIDS Res Ther. 2009, 6: 7.
[27]. Sheri D. Weiser, MD, MPH, Kimberly A. Fernandes, MSC, Eirikka K. Brandson, MPH,Viviane D. Lima, PhD, Aranka Anema, MSc, David R. Bangsberg, MD, MPH, Julio S.Montaner, MD, FRCPC, and Robert S. Hogg, PhD. The association between food insecurity and mortality among HIV-infected individuals on HAART, J Acquir Immune Defic Syndr. 52(3), 2009, 342–349.
Divya Y et al / Int. J. of Allied Med. Sci. and Clin. Research Vol-6(1) 2018 [165-174]
174
[28]. Ruth Joy, MSc, Eric F. Druyts, MSc, Eirikka K. Brandson, MSc, Viviane D. Lima, PhD,Clare A. Rustad, MPhil, Wendy Zhang, MSc, Evan Wood, MD, PhD, Julio S. G. Montaner, MD, FRCPC, FCCP, and Robert S. Hogg, PhD.Impact of Neighborhood-Level Socioeconomic Status on HIV Disease Progression in a Universal Health Care Setting, J Acquir Immune Defic Syndr 47, 2008, 500–505.
[29]. Ledergerber B, Egger M, Erard V, Weber R, Hirschel B, et al. AIDS related opportunistic illnesses occurring after initiation of potent antiretroviral therapy: the Swiss HIV Cohort Study. JAMA. 282, 1999, 2220-2226.
[30]. Srirangaraj S, Venkatesha D Opportunistic infections in relation to antiretroviral status among AIDS patients from south India. Indian J Med Microbiol 29, 2011, 395-400.
[31]. Kaplan JE, Hanson D, Dworkin MS, Frederick T, Bertolli J, et al. Epidemiology of human immunodeficiency virus–associated opportunistic infections in the United States in the era of highly active antiretroviral therapy. Clin Infect Dis 30, 2000, 5-14.
[32]. Lawn SD, Badri M, Wood R Tuberculosis among HIV-infected patients receiving HAART: long term incidence and risk factors in a South African cohort. AIDS. 19, 2005, 2109-2116.
[33]. Yazdanpanah Y, Chêne G, Losina E, Goldie SJ, Merchadou LD, et al. Incidence of primary opportunistic infections in two human immunodeficiency virus-infected French clinical cohorts. Int J Epidemiol.30, 2001, 864-871. How
[2]. National AIDS Control Organisation. Annual report 2015-16.NACO 24, 2016, 335-395.
[3]. Maria Cheng. AIDS to be third leading cause of death. Associated Press/USA Today. 28, 2006, 2-4.
[4]. Lindsay C. Bacik, B.S, Dr. Futou Seck, Dr. Rhonda BeLue1.Spectrum of Comorbid Conditions and Their Relationship to CD4 T-lymphocyte Counts in HIV-Infected Patients in Mbour, Senegal. J Glob Health 2017.
[5]. Kumar A, Singh S, Sahu NP. Evaluation of CD4 count and correlation with development of opportunistic infection among HIV seropositives. Eastern J Med Sci 1(1), 2016, 12-16.
[6]. Bhusal KR, Devkota S, Shrestha M, Khadga P. Profile of Anaemia in HIV Positive Patients. JCMS Nepal; 12(2), 2016, 70-3.
[7]. John Rubaihayo, Nazarius M Tumwesigye1 and Joseph Konde-Lule1. Trends in prevalence of selected opportunistic infections associated with HIV/AIDS in Uganda. BMC Infectious Diseases 2015, 15:187.
[8]. Aishwarya. R. Assessment of Nutritional Status of people living with HIV/AIDS (PLWHA) in the age group of 18-55 years. IOSR-JNHS 4(2), 2015, 17-28.
[9]. Muluken Assefa M, Abegaz W, Shewamare A, Medhin M, Belay M. Prevalence and correlates of Anaemia among HIV infected patients on highly active retroviral therapy. BMC Hematology, Ethiopia, 2015, 15: 6.
[10]. Moges NA, Kassa GM. Prevalence of Opportunistic Infections and Associated Factors among HIV Positive Patients taking Anti-Retroviral Therapy in DebreMarkos Referral Hospital, Northwest Ethiopia. J AIDS Clin Res 2014, 5: 301.
Divya Y et al / Int. J. of Allied Med. Sci. and Clin. Research Vol-6(1) 2018 [165-174]
173
[11]. Catherine Martin, Poudel-Tandukar K, Poudel KC. HIV Symptom Burden and Anemia among HIV-Positive Individuals: Cross-Sectional Results of a Community-Based Positive Living with HIV (POLH) Study in Nepal. PLoS ONE 9(12), 2014, e116263.
[12]. Woldesellassie M. Bezabhe, Leanne Chalmers, Luke R. Bereznicki, Gregory M. Peterson, Mekides A. Bimirew, Desalew M. Kassie. Barriers and Facilitators of Adherence to Antiretroviral Drug Therapy and Retention in Care among Adult HIV-Positive Patients: A Qualitative Study from Ethiopia. PLoS ONE 9(5), 2014, e97353.
[13]. Debasu Damtie, Gizachew Yismaw, Desalegn Woldeyohannes and Belay Anagaw. Common opportunistic infections and their CD4 cell correlates among HIV-infected patients attending at antiretroviral therapy clinic of Gondar University Hospital, Northwest Ethiopia. BMC Research Notes 2013, 6:534.
[14]. Bach Xuan Tran, Long Thanh Nguyen, Nga Hoang Nguyen, Quynh Van Hoang and Jongnam Hwang. Determinants of antiretroviral treatment adherence among HIV/AIDS patients: a multisite study. Glob Health Action 2013, 6: 19570.
[15]. Sandeep Rai, Bidhubhusan Mahapatra, Subhashish Sircar, Pinnamaneni Yujwal Raj, Srinivasan Venkatesh, Mohammed Shaukat, Bharat Bhusan Rewari. Adherence to Antiretroviral Therapy and Its Effect on Survival of HIV-Infected Individuals in Jharkhand, India. PLoS ONE 8(6), 2013, e66860.
[16]. Banwat ME, Yakubu NW, Olalude EO, Ogunsakin JA. An Assessment of the Nutritional Knowledge, Practice and Status of Adult HIV/Aids Patients Attending an Art Centre in Jos, North Central Nigeria. Health Care Current Reviews (1), 2013, 101.
[17]. Ana Célia Oliveira dos Santos and Ana Maria Rampeloti Almeida. Nutritional status and CD4 cell counts in patients with HIV/AIDS receiving antiretroviral therapy. Revista da Sociedade Brasileira de Medicina Tropical, 46(6), 2013, 698-703.
[18]. Iroezindu MO, Ofondu EO, Hausler H, Wyk BV. Prevalence and Risk Factors for Opportunistic Infections in HIV Patients Receiving Antiretroviral Therapy in a Resource-Limited Setting in Nigeria. J AIDS Clinic Res 2013, S3:002.
[19]. Shen Y, Wang Z, Lu H, Wang J, Chen J. Prevalence of Anemia among Adults with Newly Diagnosed HIV/AIDS in China. PLoS ONE 8(9), 2013, e73807.
[20]. Anant A. Takalkar, G.S. Saiprasad, V .G. Prasad, Narendra S. Madhekar. Study of Opportunistic Infections in HIV Seropositive Patients Admitted to Community Care centre (CCC), KIMS Narketpally. Biomedical Research 23(1), 2012, 139-142
[21]. Carolline de Araújo Mariz, Maria de Fátima P. Militão de Albuquerque, Ricardo Arraes de Alencar Ximenes, Heloísa Ramos Lacerda de Melo, Francisco Bandeira, Thaís Gelenske Braga e Oliveira, Érico Higino de Carvalho, Adriana Paula da Silva, Demócrito de Barros Miranda Filho . Body mass index in individuals with HIV infection and factors associated with thinness and overweight/obesity. Cad. Saúde Pública, Rio de Janeiro; 27(10), 2011, 1997-2008.
[22]. N. Joglekar, R. Paranjape, R. Jain, G. Rahane, R. Potdar, K.S. Reddy & S. Sahay. Barriers to ART adherence & follow ups among patients attending ART centres in Maharashtra, India. Indian J Med Res 134, 2011, 954-959.
[23]. Samuel N. Obi, Ngozi A. Ifebunandu, Azubuike K. Onyebuchi. Nutritional status of HIV-positive individuals on free HAART treatment in a developing nation. J Infect Dev Ctries 4(11), 2010, 745-749.
[24]. Crum-Cianflone N, Roediger MP, Eberly L, Headd M, Marconi V, et al. Increasing Rates of Obesity among HIV-Infected Persons during the HIV Epidemic. PLoS ONE; 5(4), 2010, e10106.
[25]. Manisha Ghate , Swapna Deshpande , Srikanth Tripathy , Madhura Nene ,Preeti Gedam , Sheela Godbole , Madhuri Thakar , Arun Risbud ,Robert Bollinger , Sanjay Mehendale. Incidence of common opportunistic infections in HIV-infected individuals in Pune, India: analysis by stages of immunosuppression represented by CD4 counts. International Journal of Infectious Diseases 13, 2009, e1—e8.
[26]. Mary B Cauldbeck, Catherine O'Connor et al. Adherence to anti-retroviral therapy among HIV patients in Bangalore, India. AIDS Res Ther. 2009, 6: 7.
[27]. Sheri D. Weiser, MD, MPH, Kimberly A. Fernandes, MSC, Eirikka K. Brandson, MPH,Viviane D. Lima, PhD, Aranka Anema, MSc, David R. Bangsberg, MD, MPH, Julio S.Montaner, MD, FRCPC, and Robert S. Hogg, PhD. The association between food insecurity and mortality among HIV-infected individuals on HAART, J Acquir Immune Defic Syndr. 52(3), 2009, 342–349.
Divya Y et al / Int. J. of Allied Med. Sci. and Clin. Research Vol-6(1) 2018 [165-174]
174
[28]. Ruth Joy, MSc, Eric F. Druyts, MSc, Eirikka K. Brandson, MSc, Viviane D. Lima, PhD,Clare A. Rustad, MPhil, Wendy Zhang, MSc, Evan Wood, MD, PhD, Julio S. G. Montaner, MD, FRCPC, FCCP, and Robert S. Hogg, PhD.Impact of Neighborhood-Level Socioeconomic Status on HIV Disease Progression in a Universal Health Care Setting, J Acquir Immune Defic Syndr 47, 2008, 500–505.
[29]. Ledergerber B, Egger M, Erard V, Weber R, Hirschel B, et al. AIDS related opportunistic illnesses occurring after initiation of potent antiretroviral therapy: the Swiss HIV Cohort Study. JAMA. 282, 1999, 2220-2226.
[30]. Srirangaraj S, Venkatesha D Opportunistic infections in relation to antiretroviral status among AIDS patients from south India. Indian J Med Microbiol 29, 2011, 395-400.
[31]. Kaplan JE, Hanson D, Dworkin MS, Frederick T, Bertolli J, et al. Epidemiology of human immunodeficiency virus–associated opportunistic infections in the United States in the era of highly active antiretroviral therapy. Clin Infect Dis 30, 2000, 5-14.
[32]. Lawn SD, Badri M, Wood R Tuberculosis among HIV-infected patients receiving HAART: long term incidence and risk factors in a South African cohort. AIDS. 19, 2005, 2109-2116.
[33]. Yazdanpanah Y, Chêne G, Losina E, Goldie SJ, Merchadou LD, et al. Incidence of primary opportunistic infections in two human immunodeficiency virus-infected French clinical cohorts. Int J Epidemiol.30, 2001, 864-871. How