Measurement of Bone Mineral Density in HIV-Infected Individuals Who Are Not Considered as a Specific Risk Group for Bone Mineral Densitometry Screening

Objective: As HIV-infected individuals continue to live longer with antiretroviral therapy (ART), systemic metabolic complications are also becoming more frequent. HIV-infected patients who have ART have a 2-6% reduction in bone mineral density (BMD) over the first two years. This reduction in BMD is thought to be due to the complex relationship between the virus itself, ART and the usual risk factors of osteoporosis. We aimed to investigate the possibility that the decrease in BMD occurred at younger ages in HIV-infected individuals, and to show the factors that affect it

aluation of HIV Infected Elderly Patients

Introduction: HIV/AIDS (Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome) has become one of the most studied infectious diseases since it was defined. As a result of the differences in life expectancy, aging has recently become an important point. Through the use of highly active antiretroviral therapy (HAART), life expectancy of HIV infected cases has prolonged. The studies have emphasized that providing an appropriate and multi-disciplined therapy to the patients with HIV is essential as the ages of the patients increased. In this study, our purpose was to compare elderlyand young HIV infected cases followed-up by our policlinic in terms of demographic features, CD4 count, and opportunistic infections. Materials and Methods: In our study, HIV infected cases followed-up by Istanbul Training and Research Hospital Infectious Diseases and Clinical Microbiology Policlinic between 2002 and 2012 were evaluated retrospectively. The cases included into the study were recorded in terms of their age, gender, mode of transmission, CD4 levels at application, and opportunistic infections. The cases included into the study were categorized into two groups constituting the cases aged 50 and over and cases aged between 18 and 49. The differences between these two groups were attempted to be determined (Group 1: aged 50 and over, Group 2: aged between 18 and 49). Results: In our study, totally two hundred and fifty-nine cases over the age of 18 with anti-HIV positivity confirmed through Western Blot method were included. It was noticed that the number of cases at and over 50 years of age was 44 (17%) and the number of cases between 18 and 49 years of age was 215 (83%). CD4 count of Group 1 and Group 2 during the application was 309.5 ± 301.9 and 335.0 ± 259.8, respectively; the presence of opportunistic infection was determined as 17/44 (38.63%) in Group 1, and as 90/215 (41.86%) in Group 2; and no statistically significant difference was determined between the two groups in terms of mean CD4 and presence of opportunistic infection at application (p>0.05). Discussion: Consequently, we considered that sharing the experiences of centers will be beneficial for the follow-up and treatment of this patient group in our country though the number of cases is limited; and especially considering the recent increase in the number of elderly HIV infected cases, the studies carried out upon these cases will successfully provide an increase in the management of these cases and better understanding of findings particular to HIV infected geriatric population

Comparison Of Risk Category Predictions Of Framingham Risk Score (Frs), Atherosclerotic Cardiovascular Disease Risk Score (Ascvd), Systematic Coronary Risk Evaluation (Score) And Data Collection On Adverse Events Of Anti-Hiv Drugs (D:A:D) In Hiv Infected Patients

Background Cardiovascular disease (CVD) is a major cause of mortality in HIV infected patients. Agreement between commonly used risk prediction equations for classification of high-risk individuals is varied in different populations. We aimed to compare the degree of agreement of four CVD risk calculators in a multicenter cohort. Methods A cross-sectional study was conducted among adult HIV patients who are followed in five tertiary centers between July 2016 and February 2017. Inclusion criteria were: age 40–74 years, without known CVD and not receiving statins. All necessary information to calculate risk scores were collected during follow-up visits with a standardized form. Web-based tools for each score were used for calculations. Persons were considered at higher risk if 10-year CVD risks ≥20% with FRS-CVD, >10% with SCORE for high-risk countries, >7.5% for ASCVD, and 5 year risk ≥5% with DAD or if they had additional risk factors defined for each score for automatic high-risk stratification. Based on the interpretation of CVD risk, the patients were placed in two categories: low/medium and high/very high. Agreement between scores was assessed by Cohen’s kappa (κ) statistics. Results Of 667 patients who were active during the study period, CVD scores of 527 HIV-infected patients (82% male) were assessed. Median (interquartile range) age was 48 (43–54) years. Prevalence of CVD risk factors were: 11% family history of early-onset CVD, 50% current smokers, 57% overweight or obese, 22% hypertension, and 8% diabetes mellitus. The prevalence of high CVD scores or risk equivalents was high ranging from 20.3% to 36.3%. The DAD-full, DAD-reduced, ASCVD and SCORE had 83.9%, 85%, 83.5% and 93.2% agreement compared with the FRS-CVD (κ = 0.55, 0.59, 0.61 and 0.80), respectively. European AIDS Clinical Society, European Society of Cardiology, Adult Treatment Panel-III and 2013 American College of Cardiology/American Heart Association guidelines would recommend statin therapy for 35.1%, 21.8%, 31.9% and 36.4% of patients, respectively. Conclusion We found moderate/substantial agreement among risk prediction tools evaluated in this study. Agreement was high for lower scores and at higher ages. Whether those scores accurately estimate risk at population level needs further evaluation. Disclosures All authors: No reported disclosures.PubMe

Transmission route and reasons for HIV testing among recently diagnosed HIV patients in HIV-TR cohort, 2011-2012

Introduction: Routes of transmission and reasons for HIV testing are important epidemiologic data to analyze the epidemic and to tailor the response to AIDS. The aim of this study was to analyze reasons for testing and transmission ways of HIV among recently diagnosed HIV patients registered in the multicenter HIV-TR cohort in Turkey. Methods: Transmission ways and reasons for testing of all patients diagnosed in 2011 and 2012 were recorded on a web-based data collection system and were analyzed retrospectively. Results: The study included 693 patients (561 male, 132 female) from 24 sites. Reason for HIV testing was available in 640 patients (92%). The most common reason for HIV testing was diagnostic workout for other conditions or illness followed by patient-initiated testing. The reasons for testing were listed in Table 1. The most common routes of HIV transmission were heterosexual intercourse (62.7%) and sex among men who have sex with men (MSM) (22.6%). At the time of HIV diagnosis, the mean CD4 lymphocyte cell count was 355/mm3 (3–1433/mm3). Primary HIV infection was determined in 42/693 (6%) patients and 9/693 (% 1, 2) cases were considered “probable primary HIV infection.” The majority of the cases presented to a clinic for follow-up right after the diagnosis. On the other hand 32/616 (5.2%) patients delayed their presentation for more than 3 months. The longest delay was 11 months. Conclusions: The results of the database suggest that targeted testing is lacking in the country. The shift toward homosexual transmission during the last 2 years emphasizes the need for targeted interventions. Patients present relatively late and HIV infection could only be diagnosed when immunosuppression related findings appeared. Patient-initiated testing,an indicator of awareness, was very low suggesting a need to scale-up awareness raising interventions

Outcomes of initial antiretroviral treatment (ART) among recently diagnosed HIV patients in HIV-TR cohort, 2011-2012

WOS: 000344961700197PubMed ID: 2539742

A new model using platelet indices to predict liver fibrosis in patients with chronic hepatitis B infection

We aimed to investigate whether mean platelet volume (MPV) and platelet distribution width (PDW) are variables determining the severity of liver fibrosis in patients with chronic HBV infection

The Effect of Mupirocin- and Fusidic Acid-nasal Packings, Placed after Septoplasty, on the Nasal Bacterial Profile

Aim To examine the effects, after septoplasty, of local antibiotic pomades as an alternative to prophylactic antibiotic use, which is a controversial matter among the otolaryngologists, on nasal flora and bacterial growth. Material and Method Nasal packings placed after septoplasty surgery to provide septal stabilization and bleeding control pose a risk in terms of infection. In this study, 106 patients, who were examined by comparing mupirocin- and fusidic acid-soaked packings and antibiotic-free packings, were divided into three groups. Nasal cultures were obtained from each patient twice, before the surgery and on the second day immediately after the packings were removed, and the culture results were statistically compared. Results In the mupirocin group (group 2), postoperative normal flora growth rate was significantly higher than in the fusidic acid group (group 3) and the antibiotic-free group (group 1) (p < 0.024). In the mupirocin group (group 2), the gram-positive growth rate in the postoperative period showed a significant decrease when compared when the preoperative period (p < 0.05) (5.7%). In the fusidic acid group (group 3), the postoperative gram-positive rate showed a significant decrease compared with the preoperative period (p < 0.05). In group 2, the postoperative methicillin-resistant Staphylococcus aureus rate showed a significant decrease than in the preoperative period (2.9%) (p < 0.05). Similarly, in group 3, the postoperative methicillin-resistant S. aureus rate showed a significant decrease compared with that of the preoperative period (11.1%) (p < 0.05). Conclusion Use of mupirocin- and fusidic acid-soaked nasal packings after septoplasty significantly decreased, especially, postoperative gram-positive bacterial growth in nasal cultures. Although systemic antibiotherapy was not administered, the lack of local and systemic infection findings was an important result that we obtained in terms of clinical use. Usage advantages of mupirocin and fusidic acid soaked packings are an easily applicable, cost-effective, and safe method