The evaluation of risk factors related to reduced bone mineral density in young people living with HIV

Background: Low bone mineral density (BMD) is one of the comorbidities that develop in people living with HIV (PLWHIV). Objective: This study was conducted to review the frequency and risk factors of reduced BMD according to age in HIV-infected patients in Turkey. Material and Method: This retrospective cohort study included HIV-infected patients aged 18-50. Bone density was analysed using dual-energy X-ray absorptiometry (DXA) according to the Z-score in three different regions including the lumbar, total-hip and femoral-neck. Results: The study included 224 PLWHIV with a mean age of 35.84-7.54, and 59.8% were ART naive. Of the patients, 40.6% had lower BMD than expected at least in one of the three examined regions including the lumbar, total hip and femoral neck. The low BMD ratios were found respectively as 11.6%, 11.6% and 28.6% in the femoral neck, total hip and lumbar regions. According to the logistic regression model, a high body mass index (p=0.003) and HIV-RNA level of ≥100.000IU/ml during the diagnosis in the ART-naive group (p=0.008) were associated with reduced bone demineralization. The low BMD frequency was high in the group that received ART for <24 months (p=0.001). Conclusion: Performing bone demineralization screening in the naive and young patient group, independently from ART status prior to making the diagnosis of HIV is important for organizing the bone health improvement methods. Keywords: HIV infection; bone density; antiretroviral therapy

Clinical follow-up of patients with HBeAg positive chronic hepatitis B infection: A long-term observational study

Background and Aim: We aimed to analyze the demographic, laboratory, and clinical characteristics of patients with HBeAg positive chronic hepatitis B infection in tertiary care centers in Istanbul. Materials and Methods: We conducted an observational cohort with >= 18-year-old patients with HBeAg positive chronic hepatitis B infection, who were followed up in three tertiary care centers in Istanbul between January 2000 and August 2018, were evaluated by reviewing electronic and recorded files. The Ethical Committee of Istanbul Medipol University approved this study (Protocol no: 10840098-604.01.01-E.44136). During the polyclinic interview, consent was obtained from patients for analysis and publication. Results: The mean age of the 64 patients was 30 (range 18-39) years, and 50% (32) of them were males. The mean follow-up period of the patients was 67 (18-180) months. Twenty-four patients were treated with at least one antiviral in their follow-up, and only 2 (3.1%) of these patients developed HBeAg seroconversion without antiviral treatment. HBeAg (+) chronic hepatitis B developed in 4 of the patients after the immune-active period. None of the patients and first-degree relatives had hepatocellular carcinoma (HCC). Conclusion: The rationality of antiviral treatment and HCC development risk in these patients still remains elusive

ANXIETY AND DEPRESSION AMONG PEOPLE LIVING WITH HIV DURING THE COVID-19 PANDEMIC: A FACE-TO-FACE SURVEY FROM TURKEY

Background: During the COVID-19 pandemic, there have been some difficulties in the routine care of people living with HIV (PLWH). Subjects and methods: We aimed to evaluate the impact of COVID-19 on mental health of PLWH and their use of health services. This study was conducted using the face-to-face interview method in the outpatient clinic of a university hospital, between 01.09.2020 and 30.11.2020. Hospital Anxiety and Depression Scale and survey instrument designed by the researchers investigating socio-demographic data and access to health services were used. Results: The study included 217 patients, 91.7% (n=199) of whom were male. All of the patients were postponed their hospital appointments, 60.8% were concerned about not being able to contact their physician and 53% had concerned about being stigmatized if they went to the hospital. Of the participants, 27.6% had depression, 12.9% had anxiety and 8.3% had both depression and anxiety. Low income, job loss, and fear of being stigmatized were associated with depression and anxiety. Lower level of education, discontinuation of medications and lack of opportunity to work remotely were associated with depression, while history of psychiatric illness, worry about not being able to contact their physician and cessation of antiretroviral therapy were associated with higher anxiety levels. Conclusion: It is important to develop strategies ensuring the continuity of care for PWLH and identify and support those with a higher mental health impact