Quality of Life among Persons with HIV/AIDS in Iran: Internal Reliability and Validity of an International Instrument and Associated Factors

The purpose of this cross-sectional study on 191 HIV/AIDS patient was to prepare the first Persian translation of complete WHOQOL-HIV instrument, evaluate its reliability and validity, and apply it to determine quality of life and its associated factors in Tehran, Iran. Student's t-test was used to compare quality of life between groups. Mean Cronbach's α of facets in all six domains of instrument were more than 0.6 indicating good reliability. Item/total corrected correlations coefficients had a lower limit of more than 0.5 in all facets except for association between energy and fatigue facet and physical domain. Compared to younger participants, patients older than 35 years had significantly lower scores in overall quality of life (P = 0.003), social relationships (P = 0.021), and spirituality/religion/personal beliefs (P = 0.024). Unemployed patients had significantly lower scores in overall quality of life (P = 0.01), level of independence (P = 0.004), and environment (P = 0.001) compared to employed participants. This study demonstrated that the standard, complete WHOQOL-HIV 120 instrument translated into Farsi and evaluated among Iranian participants provides a reliable and valid basis for future research on quality of life for HIV and other patients in Iran

Seroprevalence of Epstein-Barr virus among HIV Positive Patients Moreover and its Association with CD4 Positive Lymphocyte Count

Opportunistic infections are the leading cause of hospitalization and morbidity in human immunodeficiency virus (HIV) positive patients and are the most common cause of death between them. We aimed to measure IgG antibody against EBV viral capsid antigen (EBV-VCA IgG) to determine the seroprevalence of this infection in HIV-positive population. A case-control study between September 2011 and October 2012 was conducted in a teaching hospital enrolling 114 HIV-positive patients as case group and 114 healthy individuals as control with similar age and sex. Enzyme-linked immunosurbant assay (ELISA) technique was used for determination of EBV-VAC IgG in obtained samples. Of 114 serum samples obtained from HIV-positive patients, 103 (90.4%) samples were found positive for EBV-VCA IgG antibody. There was no significant difference in seroprevalence of EBV VCA IgG antibody between patients received antiretroviral therapy and naive patients (91.5% vs. 87.5%, P>0.05). There was no statistically significant difference in EBV-VCA IgG seroprevalence between three groups of CD4+ in HIV positive group. In conclusion current study showed that seroprevalence of EBV in HIV-positive patients is higher than HIV-negative healthy participants; however, administration of HAART and CD4+ lymphocyte count did not reveal a significant effect in seroprevalence of EBV. Due to the significance of this virus in mortality and morbidity and causing certain malignancies in patients with AIDS, these patients are strongly recommended to be tested for this virus

The issue of fine needle aspiration cytology in the diagnosis of tuberculous cervical lymphadenitis

BackgroundDue to different reports about the value of fine needle aspiration cytology (FNAC) as a simple and minimal invasive diagnostic tool for extra-pulmonary tuberculosis, we attempted to demonstrate the sensitivity of FNAC in patients with cervical tuberculous lymphadenitis in Iran. We wanted to know if fine needle aspiration (FNA) is an accurate method as a first step in diagnosis or not.Methods This study covered a 14 year period identifying 137 patients with a pathological report of granulomatosis in excisional biopsy of lymphadenopathy in two tertiary referral hospitals of Tehran, Iran. The results of fine needle aspiration cytology (FNAC) in 67 patients with tuberculosis cervical lymphadenitis were evaluated. Results The FNA cytology showed granuloma with background necrosis in five patients (7.46 per cent) and granuloma with or without necrosis in 13 patients (19.40 per cent). Patients with positive results of FNAC had a longer duration of lymphadenopathy compared to other patients.ConclusionIn this study, sensitivity of FNAC was reported to be low. The sensitivity of this method was 7.46 per cent (including pathology granuloma with background necrosis) and 19.40 per cent (total cases of granuloma with or without necrosis). It seems that the sensitivity of FNAC is significantly lower in patients with early cervical tuberculosis (TB) lymphadenitis. Combining acid-fast bacillus (AFB) staining and non-culture methods like polymerase chain reaction (PCR) could increase FNA sensitivity in these patients

Status of immunity against PVB19 in HIV-infected patients according to CD4 + cell count, and antiretroviral therapy regimen groups

Background: Human Parvovirus B19 (PVB19) is among the aetiology of aplastic crisis in human immunodeficiency virus (HIV)-infected patients. Several studies have indicated the importance of an infection agent in bringing about complications in immuno-compromised patients. The current study aims to determine the seroprevalence of IgM and IgG antibodies to PVB19 among HIV-positive patients and its association with clinical and epidemiological factors. Materials and Methods: In a case control study, 90 HIV-positive patients were compared with 90 sex and age matched healthy controls in terms of anti-PVB19 IgG and IgM along with other primary clinical and laboratory features. Results: The overall prevalence of positive anti-PVB19 IgG among HIV patients and controls were 81.1% and 28.9%, respectively (P < 0.001). None of the subjects showed positive results for anti-PVB19 IgM. Patients with CD4 + cell count <200 showed higher seroprevalence of positive anti-PVB19 IgG which did not reach statistically significant. However, anti-PVB19 IgG seropositivity differed significantly between HIV patients on different regimens of antiretroviral therapy (ART) (P < 0.05). Conclusion: Immunity against PVB19 is more prevalent among HIV-positive patients compared to healthy controls. However, positive HIV status is not associated with acute PVB19 infection. The presence of anti-PVB19 IgG does not necessarily protect the body from further complications like anaemia. Given the results of the study, AIDS patients are recommended to undergo screening for parvovirus antibody in order to prevent complications like aplastic anaemia

Is the Evaluation of Entamoeba Histolytica Infection in HIV-Positive Patients of any Clinical Significance?

Amoebiasis caused by Entamoeba histolytica (E. histolytica) is one of the most problematic parasitic infections worldwide. Data regarding the effect of HIV-induced immunodeficiency on the status of E. histolytica infection are sparse in Iran. This study aimed to assess the seroprevalence of anti-E. histolytica IgG among Iranian HIV patients. Further, it determined whether the advancement of immunodeficiency accompanies an increased risk of amoebiasis. A total of 91 HIV-infected patients and 91 controls were enrolled in this case-control study. Controls were matched to cases with respect to age, gender, and where possible socioeconomic status. Patients with a history of treatment for intestinal parasitism within last two weeks were not included in the study. Blood samples were obtained from all participants. Serum IgG against E. histolytica measured using a commercial enzyme-linked immunosorbent assay (ELISA). The mean serum anti-E. histolytica IgG was significantly higher in HIV patients than controls (9.34 ± 4.18 vs. 2.07 ± 0.60, P<0.001). HIV-infected patients showed a significantly higher positive serology for E. histolytica IgG comparing healthy controls (30.8% vs. 0% P<0.001). There was no statistical difference in the serology of E. histolytica among AIDS stage and non-AIDS HIV patients. This study demonstrated that HIV is significantly associated with higher prevalence of E. histolytica infection. Early evaluation and treatment of E. histolytica in this population is recommended to prevent and control this infection

Retinitis Due to Opportunistic Infections in Iranian HIV Infected Patients

We tried to evaluate prevalence and characteristics of Iranian HIV infected patients with retinitis due to opportunistic infections. In this cross sectional study, we evaluated 106 HIV infected patients via indirect ophthalmoscopy and slit lamp examination by 90 lens to find retinitis cases. General information and results of ophthalmologic examination were analyzed. Prevalence of retinitis due to opportunistic infections was 6.6%: cytomegalovirus (CMV) retinitis 1.88%, toxoplasmosis retinochoroiditis 1.88% and tuberculosis chorioretinitis 2.83%. CD4 count was higher than 50 cell/µlit in both cases with CMV retinitis. Along with increasing survival in the HIV infected patients, the prevalence of complications such as ocular manifestation due to opportunistic infections are increasing and must be more considered

Epidemiological, clinical, laboratory findings, and outcomes of disseminated tuberculosis in Tehran, Iran

Background: Disseminated tuberculosis (TB) accounts for 1 to 3% of all TB cases. This retrospective study reviews the clinical, radiological, laboratory findings and Outcome in patients with disseminated tuberculosis in an endemic area. Methods: Medical records were reviewed for patients with disseminated TB admitted to two tertiary centers in Tehran, Iran between 1999 and 2006. Results: Fifty patients were found to have disseminated TB. A miliary pattern was documented in the chest x-ray of 34 patients. Hematologic abnormalities including anemia, leukopenia, and thrombocytopenia were frequently observed. Death Occurred in nine of the cases. The mortality rate was significantly higher in diabetic patients, injection drug users, and patients with hematologic abnormalities; however, steroid usage and human immunodeficiency virus infection were not significantly associated with a higher mortality rate. Clinical improvement occurred in 41 patients following treatment. Conclusion: Disseminated TB could have different manifestations. Hematologic abnormalities are common and are considered poor prognostic signs in these patients

Oral candidiasis in Human Immunodeficiency Virus (HIV) infected individuals in Iran

&quot;n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Oropharyngeal candidiasis is the most frequent fungal infection in HIV patients. The aims of this study were to appraise prevalence of oropharyngeal candidiasis and to determine factors associated with oropharyngeal candidiasis and oral yeast colonization among Iranian HIV patients.&quot;n&quot;nMethods: The patients were composed 150 Iranian HIV positive individuals referred to Iranian Research Center for HIV &amp;amp; Aids (IRCHA), Imam Khomeini Hospital complex in Tehran, Iran. Oral samples were obtained and cultured on mycological media. TCD4 lymphocyte count/percentage was measured and patients were categorized. Patients evaluated for some risk factors for oropharyngeal candidiasis and oral candida colonization.&quot;n&quot;nResults: Fifty nine percent of patients were presented with oropharyngeal candidiasis and the carriage rate of yeasts was 116 (77.2%). The most frequent isolated candida species were Candida albicans (102) 50.2% and Candida glabrata (45) 22%. Thrush in 57(38%), perleche in 30(20%) and erythematous lesions in 7(4.7%) of patients were observed. Significant differences in TCD4 count (p=0.01), gender (p=0.02), antifungal therapy (p=0.001), smoking (p=0.02), and intravenous drug use (p=0.03), between asymptomatic and symptomatic patients were observed.&quot;n&quot;nConclusion: Oral candidiasis is a frequent complication among Iranian HIV individuals. C. albicans and C. glabrata are most important etiologic agents of oral candidiasis. In Iranian HIV individuals; TCD4 count, antifungal therapy, gender, smoking and intravenous drug use are important risk factors for oropharyngeal candidiasis. Denture wearing and age are predisposing factors for oral colonization

Quality of Life among Persons with HIV/AIDS in Iran: Internal Reliability and Validity of an International Instrument and Associated Factors

The purpose of this cross-sectional study on 191 HIV/AIDS patient was to prepare the first Persian translation of complete WHOQOL-HIV instrument, evaluate its reliability and validity, and apply it to determine quality of life and its associated factors in Tehran, Iran. Student&apos;s t-test was used to compare quality of life between groups. Mean Cronbach&apos;s α of facets in all six domains of instrument were more than 0.6 indicating good reliability. Item/total corrected correlations coefficients had a lower limit of more than 0.5 in all facets except for association between energy and fatigue facet and physical domain. Compared to younger participants, patients older than 35 years had significantly lower scores in overall quality of life (P = 0.003), social relationships (P = 0.021), and spirituality/religion/personal beliefs (P = 0.024). Unemployed patients had significantly lower scores in overall quality of life (P = 0.01), level of independence (P = 0.004), and environment (P = 0.001) compared to employed participants. This study demonstrated that the standard, complete WHOQOL-HIV 120 instrument translated into Farsi and evaluated among Iranian participants provides a reliable and valid basis for future research on quality of life for HIV and other patients in Iran