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BİLEK HC, DEVECİ A, TANYEL E. Pneumocystis Jirovecii Pneumonia In HIV-Infected Patients: A Single Center Experience. MUSTAFA KEMAL ÜNIVERSITESI TIP DERGISI 2021. [DOI: 10.17944/mkutfd.911354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Abstract
Employment is a social determinant of health that is important for understanding health behaviors, health outcomes and HIV transmission among people living with HIV. This study is a scoping review of the literature that addresses (a) the relationship between employment and the HIV continuum of care, (b) determinants of employment among PLWH and (c) experiences with employment. We searched two databases, PubMed and Embase, and identified a total of 5622 articles that were subjected to title and abstract review. Of these, 5387 were excluded, leaving 235 articles for full-text review. A total of 66 articles met inclusion criteria and were included in the study. The literature suggests that employment status is positively associated with HIV testing, linkage to HIV care, retention in HIV care, and HIV medication adherence. Guided by a social-ecological framework, we identified determinants of employment at the individual, interpersonal, organizational, community, and policy levels that are amenable to public health intervention. Experiences with employment, including barriers, facilitators, advantages, disadvantages, and needs, provide additional insight for future research and programs.
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Affiliation(s)
- Catherine H Maulsby
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
- Department of Health Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Rm. 904C, Baltimore, MD, 21205, USA.
| | - Aneeka Ratnayake
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Donna Hesson
- Welch Medical Library, Johns Hopkins University, Baltimore, MD, USA
| | | | - Carl A Latkin
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Leadebal ODCP, Medeiros LBD, Nascimento JAD, Monroe AA, Nogueira JDA. Classification of clinical risk in people with AIDS followed up in specialized care. Rev Bras Enferm 2019; 72:1235-1242. [PMID: 31531646 DOI: 10.1590/0034-7167-2017-0559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 12/19/2017] [Indexed: 11/21/2022] Open
Abstract
AIM To develop a clinical risk stratification score for people living with AIDS and to analyze its association with clinical and sociodemographic aspects. METHOD Cross-sectional study involving 150 adults with AIDS, in outpatient follow-up. A structured instrument was applied and, sequentially, inferential statistical techniques on the developed score. RESULTS 45.3% of the participants were classified as in high clinical risk. TL-CD4+ <500cel/mm3 count, detectable viral load, presence of opportunistic diseases, chronic diseases and clinical manifestations were associated with high clinical risk. There was a significant difference in the mean risk between the categories of variables employment status (p = 0.003) and economic class (p = 0.035). There was a higher risk for brown people (OR = 5.55), unemployed status (OR = 16,51) and belonging to classes C (OR = 20.07) and D (OR = 53,32), and a lower risk for individuals with higher schooling (OR = 0.02). CONCLUSION The proposed score quantifies clinical situations and points out sociodemographic aspects that predispose to instability and aggravation of AIDS, supporting the qualification of care.
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Affiliation(s)
| | | | | | - Aline Aparecida Monroe
- Universidade de São Paulo, Escola de Enfermagem. de Ribeirão Preto. Ribeirão Preto, São Paulo, Brazil
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Nyamathi A, Ekstrand M, Heylen E, Ramakrishna P, Yadav K, Sinha S, Hudson A, Carpenter CL, Arab L. Relationships Among Adherence and Physical and Mental Health Among Women Living with HIV in Rural India. AIDS Behav 2018; 22:867-876. [PMID: 27990577 PMCID: PMC5476510 DOI: 10.1007/s10461-016-1631-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
We conducted a cross-sectional examination of the physical and psychological factors related to ART adherence among a sample of 400 women living with HIV/AIDS in rural India. Interviewer-administered measures assessed adherence, internalized stigma, depressive symptoms, quality of life, food insecurity, health history and sociodemographic information. CD4 counts were measured using blood collected at screening. Findings revealed that adherence to ART was generally low, with 94% of women taking 50% or less of prescribed medication in past month. Multivariate analyses showed a non-linear association between numbers of self-reported opportunistic infections (OIs) in past 6 months (p = 0.016) and adherence, with adherence decreasing with each additional OI for 0-5 OIs. For those reporting more than 5 OIs, the association reversed direction, with increasing OIs beyond 5 associated with greater adherence.
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Affiliation(s)
- Adeline Nyamathi
- School of Nursing, University of California, Room 2-250, Factor Building, Los Angeles, CA, 90095-1702, USA.
| | - Maria Ekstrand
- Center for AIDS Prevention Studies, University of California, San Francisco, USA
| | - Elsa Heylen
- Center for AIDS Prevention Studies, University of California, San Francisco, USA
| | | | - Kartik Yadav
- School of Nursing, University of California, Room 2-250, Factor Building, Los Angeles, CA, 90095-1702, USA
| | - Sanjeev Sinha
- Department of Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Angela Hudson
- School of Medicine, Cal State University, Los Angeles, USA
| | - Catherine L Carpenter
- School of Nursing, University of California, Room 2-250, Factor Building, Los Angeles, CA, 90095-1702, USA
| | - Lenore Arab
- School of Medicine, University of California, Los Angeles, USA
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Huang YS, Yang JJ, Lee NY, Chen GJ, Ko WC, Sun HY, Hung CC. Treatment of Pneumocystis jirovecii pneumonia in HIV-infected patients: a review. Expert Rev Anti Infect Ther 2017; 15:873-892. [PMID: 28782390 DOI: 10.1080/14787210.2017.1364991] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Pneumocystis pneumonia is a potentially life-threatening pulmonary infection that occurs in immunocompromised individuals and HIV-infected patients with a low CD4 cell count. Trimethoprim-sulfamethoxazole has been used as the first-line agent for treatment, but mutations within dihydropteroate synthase gene render potential resistance to sulfamide. Despite advances of combination antiretroviral therapy (cART), Pneumocystis pneumonia continues to occur in HIV-infected patients with late presentation for cART or virological and immunological failure after receiving cART. Areas covered: This review summarizes the diagnosis and first-line and alternative treatment and prophylaxis for Pneumocystis pneumonia in HIV-infected patients. Articles for this review were identified through searching PubMed. Search terms included: 'Pneumocystis pneumonia', 'Pneumocystis jirovecii pneumonia', 'Pneumocystis carinii pneumonia', 'trimethoprim-sulfamethoxazole', 'primaquine', 'trimetrexate', 'dapsone', 'pentamidine', 'atovaquone', 'echinocandins', 'human immunodeficiency virus infection', 'acquired immunodeficiency syndrome', 'resistance to sulfamide' and combinations of these terms. We limited the search to English language papers that were published between 1981 and March 2017. We screened all identified articles and cross-referenced studies from retrieved articles. Expert commentary: Trimethoprim-sulfamethoxazole will continue to be the first-line agent for Pneumocystis pneumonia given its cost, availability of both oral and parenteral formulations, and effectiveness or efficacy in both treatment and prophylaxis. Whether resistance due to mutations within dihydropteroate synthase gene compromises treatment effectiveness remains controversial. Continued search for effective alternatives with better safety profiles for Pneumocystis pneumonia is warranted.
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Affiliation(s)
- Yu-Shan Huang
- a Department of Internal Medicine , National Taiwan University Hospital Hsin-Chu Branch , Hsin-Chu , Taiwan
| | - Jen-Jia Yang
- b Department of Internal Medicine , Po Jen General Hospital , Taipei , Taiwan
| | - Nan-Yao Lee
- c Department of Internal Medicine , National Cheng Kung University Hospital , Tainan , Taiwan.,d Department of Medicine , College of Medicine, National Cheng Kung University , Tainan , Taiwan
| | - Guan-Jhou Chen
- e Department of Internal Medicine , National Taiwan University Hospital and National Taiwan University College of Medicine , Taipei , Taiwan
| | - Wen-Chien Ko
- c Department of Internal Medicine , National Cheng Kung University Hospital , Tainan , Taiwan.,d Department of Medicine , College of Medicine, National Cheng Kung University , Tainan , Taiwan
| | - Hsin-Yun Sun
- e Department of Internal Medicine , National Taiwan University Hospital and National Taiwan University College of Medicine , Taipei , Taiwan
| | - Chien-Ching Hung
- e Department of Internal Medicine , National Taiwan University Hospital and National Taiwan University College of Medicine , Taipei , Taiwan.,f Department of Parasitology , National Taiwan University College of Medicine , Taipei , Taiwan.,g Department of Medical Research , China Medical University Hospital , Taichung , Taiwan.,h China Medical University , Taichung , Taiwan
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