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Fulltext Endocrinopathies in HIV infected patients

Rosdina Zamrud Ahmad Akbar, Sharifah Faradila Wan Muhammad Hatta, Rosnida Mohd Noh, Fatimah Zaherah Mohd Shah, Thuhairah Abdul Rahman, Rohana Abdul Ghani, et al.

Journal of Clinical and Health Sciences, 2020;5(2):39-45.
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Introduction: Hormonal abnormality is one of many clinical manifestations of HIV infections
that is not well understood. However, the consequences could affect quality of life and are
potentially treatable. Thus, this study aimed to determine the prevalence and associated
factors of thyroid, adrenal and gonadal dysfunctions among HIV-infected patients. Methods:
This is a single centre cross-sectional study involving 150 HIV-infected patients attending the
HIV clinic. Each subject was required to answer specific symptoms questionnaire and their
medical records were reviewed for relevant clinical and biochemical data. Blood for was
collected and thyroid hormones, cortisol, ACTH, FSH, LH, testosterone and estradiol were
analysed using electrochemiluminescent immunoassay. Thyroid, adrenal and gonadal axes
abnormalities were identified. Results: Hypogonadism had the highest prevalence amongst
the endocrine abnormalities, which was detected in 23 patients (15.3%), followed by thyroid
dysfunction in 18 patients (12%) and hypocortisolism in 2 patients (1.3%). There was
significant correlation between CD4 count, BMI and age with the hormone levels. Conclusion:
Prevalence of endocrine abnormalities was low in these well-treated HIV-positive patients,
with hypogonadism being the most common. However, significant correlations between CD4
count, age and BMI with the hormonal levels were detected. Clinical symptoms in relation to
endocrinopathy are not specific as a screening tool thus underscoring the need for
biochemical tests to identify these treatable conditions.

Matched MeSH terms: CD4 Lymphocyte Count
Fulltext Determining standardized causes of death of infants, children, and adolescents living with HIV in Asia

Sohn AH, Lumbiganon P, Kurniati N, Lapphra K, Law M, Do VC, et al.

AIDS, 2020 08 01;34(10):1527-1537.
PMID: 32443064 DOI: 10.1097/QAD.0000000000002583

OBJECTIVE: To implement a standardized cause of death reporting and review process to systematically disaggregate causes of HIV-related deaths in a cohort of Asian children and adolescents.
DESIGN: Death-related data were retrospectively and prospectively assessed in a longitudinal regional cohort study.
METHODS: Children under routine HIV care at sites in Cambodia, India, Indonesia, Malaysia, Thailand, and Vietnam between 2008 and 2017 were followed. Causes of death were reported and then independently and centrally reviewed. Predictors were compared using competing risks survival regression analyses.
RESULTS: Among 5918 children, 5523 (93%; 52% male) had ever been on combination antiretroviral therapy. Of 371 (6.3%) deaths, 312 (84%) occurred in those with a history of combination antiretroviral therapy (crude all-cause mortality 9.6 per 1000 person-years; total follow-up time 32 361 person-years). In this group, median age at death was 7.0 (2.9-13) years; median CD4 cell count was 73 (16-325) cells/μl. The most common underlying causes of death were pneumonia due to unspecified pathogens (17%), tuberculosis (16%), sepsis (8.0%), and AIDS (6.7%); 12% of causes were unknown. These clinical diagnoses were further grouped into AIDS-related infections (22%) and noninfections (5.8%), and non-AIDS-related infections (47%) and noninfections (11%); with 12% unknown, 2.2% not reviewed. Higher CD4 cell count and better weight-for-age z-score were protective against death.
CONCLUSION: Our standardized cause of death assessment provides robust data to inform regional resource allocation for pediatric diagnostic evaluations and prioritization of clinical interventions, and highlight the continued importance of opportunistic and nonopportunistic infections as causes of death in our cohort.

Matched MeSH terms: CD4 Lymphocyte Count

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