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

Noninvasive Models to Predict Liver Fibrosis in Patients with Chronic Hepatitis B: A Study from Turkey

WOS: 000429311600004Background: Manynoninvasive methods, including aspartateaminotransaminase (AST)/alanineaminotransaminase (ALT) ratio (AAR), AST-to-platelet ratio index (APRI), Bonacini cirrhosis discriminant score (CDS), fibrosis-4 (FIB4) index, and age-platelet index (API), have been described to determine the stage of hepatic fibrosis. However, thesemethodsare developed for patients with chronic hepatitisC(CHC) andproduce conflicting results in the prediction of liver fibrosis in patients with chronic hepatitis B (CHB). Objectives: The aim of this study was to evaluate the relationship between 7 noninvasive models, including AAR, APRI, CDS, API, FIB-4, neutrophil-to-lymphocyte ratio (NLR), and red cell distribution width (RDW)-to-platelet ratio (RPR) in patients with CHB. Methods: The study population included all patients with CHB, undergoing liver biopsy to determine HBsAg and HBV DNA positivity in more than 6 months. Results: A total of 2520 treatment-naive CHB patients from 40 different centers were included in the study. In total, 62.6% of the patients were male, and the mean age was 40.60 +/- 12.34 years (minimum, 18 years; maximum, 77 years). The Ishak fibrosis score was >= 3 in 29.8% of the patients, indicating significant fibrosis. The mean API, APRI, CDS, NLR, FIB4, and RPR scores in the noninvasive models were significantly different between the groups with significant and low fibrosis (P < 0.05). All the noninvave models (API, APRI, AAR, CDS, NLR, RPR, and FIB4) were found to be significant in the discrimination of cirrhosis (P < 0.05). In the multiple logistic regression analysis, CDS, albumin, alkaline phosphatase (ALP), total bilirubin, neutrophil count, NLR, mean platelet volume (MPV), and FIB4 were independent indices for cirrhosis. Conclusions: In the present study, the role of noninvasive tests in the prediction of liver fibrosis stage and cirrhosis was evaluated in a large cohort of CHB patients. Overall, noninvasive models are gradually becoming more promising. Accordingly, the need for liver biopsy can be reduced with a combination of noninvasive methods in the future