Displaying publications 1 - 20 of 60 in total

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  1. Lubis R, Bulgiba AM
    JUMMEC, 2014;17(1):18-22.
    MyJurnal
    Initiation of Highly Active Anti-Retroviral Therapy (HAART) depends on clinical or immunological criteria. Clinical criteria include the presence of opportunistic infections, categorized by the WHO as stage 3 and 4. Immunological criteria are based on CD4 cell count. The WHO guidelines have changed frequently. All patients with CD4 cell count less than 200 cells/µl and symptomatic HIV or late disease or severe recurrent HIV illnesses or patients with AIDS or tumor at any CD4 count, should start therapy. WHO guidelines in 2013 recommended initiating HAART at CD4 counts less than 500 cells/µl. HAART is usually initiated when CD4 is less than 200 cell/µl because HIV infected patients present at a late stage. Research on factors responsible for this is sorely needed so that interventions can be targeted at this group.
    Matched MeSH terms: CD4 Lymphocyte Count
  2. Wan Yusuf WN, Wan Mohammad WMZ, Gan SH, Mustafa M, Abd Aziz CB, Sulaiman SA
    J Tradit Complement Med, 2019 Oct;9(4):249-256.
    PMID: 31453119 DOI: 10.1016/j.jtcme.2018.05.003
    This is the first study to report on the effects of honey in asymptomatic HIV positive subjects in ameliorating CD4 count, viral load (VL) and quality of life (QOL). It is a randomized, controlled, open labelled study, comparing the effects of Tualang honey (TH) administration for six months at three different doses: 20 g (THL), 40 g (THI) or 60 g (THH) daily compared with control (no administered treatment, THC). Only asymptomatic HIV positive subjects (n=95) having CD4 count 250-600 cell/ml, not on antiretrovirals were enrolled. Blood, (together with QOL questionnaires administration) were investigated at baseline, three and six months (CD4 cell count) while VL was determined only at baseline and six months. Significant reductions in CD4 counts in THL and THC groups (p= 0.003 for both) were seen with no significant reductions in the CD4 counts in THI and THH groups (p=0.447 and 0.053 respectively). There was improvement in VL in THC and THI (130% and 32% respectively) and reductions in THL and THH (26% and 8% respectively). Within and between group analyses for VL indicated significant differences between THL and THH compared to THC. In addition, significant improvement in QOL of groups which received TH was noted. TH has the potential to improve the QOL (physical and psychological) and CD4 counts. There was a trend of lower VL in asymptomatic HIV subjects following TH administration thus supporting the possible role of TH in boosting the immune system by improving CD4 counts, causing VL reductions in HIV positive subjects.
    Matched MeSH terms: CD4 Lymphocyte Count
  3. Tung, Mun Yee, Mary, Lee Hong Gee, John, Tan Jin Teong, Adeeba Kamarulzaman, Ng, Chong Guan
    ASEAN Journal of Psychiatry, 2009;10(2):135-147.
    MyJurnal
    Objective: The aim of this study was to identify depression among HIVinfected patients attending Infectious Disease Clinic in University Malaya Medical Centre (UMMC). Methods: This is a cross sectional study on HIVinfected patients attending Infectious Disease Clinic, UMMC. Those who fulfilled inclusion criteria were recruited and interviewed. Sociodemographic characteristics and clinical conditions such as mode of transmission, year of diagnosis, CD4+ counts, drug treatment and clinical stage were collected. The patients were then subjected to self-administered questionnaires, Patient Health Questionnaire, (PHQ-9) and Hospital Anxiety & Depression Scale (HADS). Results: 89 patients were recruited. Scores from PHQ9 showed 32% of depression rate while scores from HADS showed 19% of depression rate among the respondents. Non-self financial supporter, nonalcoholic drinkers and females were more likely to be depressed (P
    Matched MeSH terms: CD4 Lymphocyte Count
  4. Ong, C.K., Tan, W.C., Leong, K.N., Muttalif, A.R.
    MyJurnal
    The incidence of tuberculosis (TB) is currently increasing. HIV induced immuno-suppression modifies the clinical presentation of TB. Our aim is to determine the differences in clinical presentation of HIV-TB co-infection based on their CD4 counts. This retrospective study looked at cases of adult active TB and HIV-1 co-infection treated in Penang Hospital from January 2004 to December 2005. Of the 820 patients treated for active TB, HIV-1 seropositivity rate was 12.6% (103 patients). Majority of HIV-1 co-infected patients presented with prolonged insidious and non-specific symptoms like weight loss, fever and night sweats. The clinical presentation of TB depended on the stage of HIV-1 infection and associated degree of immunodeficiency. Compared to the less immuno-compromised HIV-1 and TB co-infected population (CD4 > 200/mm3 ), patients with CD4 counts ≤ 200 are more likely to have atypical chest radiographs (P = 0.009). During active TB, the Mantoux test was positive in 12 (14.5%) HIV-1 infected patients with a CD4 counts ≤ 200/mm3 and in 16 (80%) of those with CD4 counts > 200/mm3 (P = 0.0001). In our series, the AFB smear / AFB culture and type of TB did not show obvious correlation with CD4 counts. Therefore to diagnose TB in severely immuno-compromised HIV patients, we need to have a high index of suspicion.
    Matched MeSH terms: CD4 Lymphocyte Count
  5. Yoong KY, Cheong I
    Int J STD AIDS, 1997 Feb;8(2):118-23.
    PMID: 9061411
    A cross-sectional study was undertaken to determine the clinical profile, haematological and biochemical changes, seroprevalence of common opportunistic pathogens, and AIDS-defining events in 49 Malaysian male drug addicts with HIV infection. Their mean age was 33.2 years, the majority had been injecting drugs for more than 5 years and 88% reporting sharing needles. Fatigue, weight loss and night sweats were common presenting symptoms and the most frequent physical findings were hepatomegaly (57%), lymphadenopathy (35%) and thrush (29%). Pulmonary infections were the commonest complications seen (61%) and of these, 13 had septic pulmonary emboli, 7 had bacterial pneumonias, 7 had pulmonary tuberculosis, and 4 had Pneumocystis carinii pneumonia. Eight patients had infective endocarditis and 5 had infected pseudoaneurysm in the groin. Anaemia (82%), leucocytosis (53%), hypoalbuminaemia (43%), hyperglobulinaemia (88%), elevated liver enzymes and hyponatraemia (57%) were frequent laboratory findings. The prevalence of HCV, HBV, cytomegalovirus and toxoplasma infection (by serology) were 100%, 12.2%, 72.7% and 59% respectively. All 7 patients with AIDS (4 P. carinii pneumonia, 2 extrapulmonary tuberculosis, and one oesophageal candidiasis) presented with their AIDS-defining illness, suggesting that HIV-infected intravenous drug user (IVDU) patients present late in the course of the disease.
    Matched MeSH terms: CD4 Lymphocyte Count
  6. Tang ASO, Teh YC, Chea CY, Yeo ST, Chua HH
    Oxf Med Case Reports, 2018 Dec;2018(12):omy107.
    PMID: 30487992 DOI: 10.1093/omcr/omy107
    We present a case of disseminated Kaposi's sarcoma with both cutaneous and extracutaneous involvement in an HIV-infected patient with a relatively high CD4 count of 369 cell/mm3. He developed chronic diarrhea, constitutional symptoms, worsening bilateral pleural effusion with respiratory distress, and progression of skin lesions distributed over his chest and extremities. The temporal relationship between rapid clinical progression and initiation of HAART suggested the possibility of Kaposi's sarcoma-associated immune reconstitution inflammatory syndrome, which eventually resulted in the death of this patient.
    Matched MeSH terms: CD4 Lymphocyte Count
  7. Pasayan MKU, S Mationg ML, Boettiger D, Lam W, Zhang F, Ku SW, et al.
    J. Acquir. Immune Defic. Syndr., 2019 Apr 01;80(4):436-443.
    PMID: 30550488 DOI: 10.1097/QAI.0000000000001933
    BACKGROUND: Mycobacterium avium complex prophylaxis is recommended for patients with advanced HIV infection. With the decrease in incidence of disseminated Mycobacterium avium complex infection and the availability of antiretroviral therapy (ART), the benefits of macrolide prophylaxis were investigated. This study examined the impact of macrolide prophylaxis on AIDS-defining conditions and HIV-associated mortality in a cohort of HIV-infected patients on ART.

    METHODS: Patients from TREAT Asia HIV Observational Database (September 2015 data transfer) aged 18 years and older with a CD4 count <50 cells/mm at ART initiation were included. The effect of macrolide prophylaxis on HIV-associated mortality or AIDS-defining conditions (as a combined outcome) and HIV-associated mortality alone were evaluated using competing risk regression. Sensitivity analysis was conducted in patients with a CD4 <100 cells/mm at ART initiation.

    RESULTS: Of 1345 eligible patients, 10.6% received macrolide prophylaxis. The rate of the combined outcome was 7.35 [95% confidence interval (CI): 6.04 to 8.95] per 100 patient-years, whereas the rate of HIV-associated mortality was 3.14 (95% CI: 2.35 to 4.19) per 100 patient-years. Macrolide use was associated with a significantly decreased risk of HIV-associated mortality (hazard ratio 0.10, 95% CI: 0.01 to 0.80, P = 0.031) but not with the combined outcome (hazard ratio 0.86, 95% CI: 0.32 to 2.229, P = 0.764). Sensitivity analyses showed consistent results among patients with a CD4 <100 cells/mm at ART initiation.

    CONCLUSIONS: Macrolide prophylaxis is associated with improved survival among Asian HIV-infected patients with low CD4 cell counts and on ART. This study suggests the increased usage and coverage of macrolide prophylaxis among people living with HIV in Asia.

    Matched MeSH terms: CD4 Lymphocyte Count
  8. Bartlett AW, Lumbiganon P, Kurniati N, Sudjaritruk T, Mohamed TJ, Hansudewechakul R, et al.
    J Adolesc Health, 2019 Aug 05.
    PMID: 31395514 DOI: 10.1016/j.jadohealth.2019.05.025
    PURPOSE: Antiretroviral monotherapy and treatment interruption are potential strategies for perinatally HIV-infected adolescents (PHIVA) who face challenges maintaining effective combination antiretroviral therapy (ART). We assessed the use and outcomes for adolescents receiving monotherapy or undergoing treatment interruption in a regional Asian cohort.

    METHODS: Regional Asian data (2001-2016) were analyzed to describe PHIVA who experienced ≥2 weeks of lamivudine or emtricitabine monotherapy or treatment interruption and trends in CD4 count and HIV viral load during and after episodes. Survival analyses were used for World Health Organization (WHO) stage III/IV clinical and immunologic event-free survival during monotherapy or treatment interruption, and a Poisson regression to determine factors associated with monotherapy or treatment interruption.

    RESULTS: Of 3,448 PHIVA, 84 (2.4%) experienced 94 monotherapy episodes, and 147 (4.3%) experienced 174 treatment interruptions. Monotherapy was associated with older age, HIV RNA >400 copies/mL, younger age at ART initiation, and exposure to ≥2 combination ART regimens. Treatment interruption was associated with CD4 count <350 cells/μL, HIV RNA ≥1,000 copies/mL, ART adverse event, and commencing ART age ≥10 years compared with age <3 years. WHO clinical stage III/IV 1-year event-free survival was 96% and 85% for monotherapy and treatment interruption cohorts, respectively. WHO immunologic stage III/IV 1-year event-free survival was 52% for both cohorts. Those who experienced monotherapy or treatment interruption for more than 6 months had worse immunologic and virologic outcomes.

    CONCLUSIONS: Until challenges of treatment adherence, engagement in care, and combination ART durability/tolerability are met, monotherapy and treatment interruption will lead to poor long-term outcomes.

    Matched MeSH terms: CD4 Lymphocyte Count
  9. Ahn JY, Boettiger D, Law M, Kumarasamy N, Yunihastuti E, Chaiwarith R, et al.
    J. Acquir. Immune Defic. Syndr., 2015 Jul 1;69(3):e85-92.
    PMID: 25850606 DOI: 10.1097/QAI.0000000000000634
    Current treatment guidelines for HIV infection recommend routine CD4 lymphocyte (CD4) count monitoring in patients with viral suppression. This may have a limited impact on influencing care as clinically meaningful CD4 decline rarely occurs during viral suppression.
    Matched MeSH terms: CD4 Lymphocyte Count*
  10. Kiertiburanakul S, Boettiger D, Lee MP, Omar SF, Tanuma J, Ng OT, et al.
    J Int AIDS Soc, 2014;17:18804.
    PMID: 24598459 DOI: 10.7448/IAS.17.1.18804
    Although antiretroviral therapy (ART) has been rapidly scaled up in Asia, most HIV-positive patients in the region still present with late-stage HIV disease. We aimed to determine trends of pre-ART CD4 levels over time in Asian HIV-positive patients and to determine factors associated with late ART initiation.
    Matched MeSH terms: CD4 Lymphocyte Count/statistics & numerical data*
  11. Naftalin CM, Wong NS, Chan DP, Wong KH, Reidpath DD, Lee SS
    Int J STD AIDS, 2015 Oct;26(11):803-9.
    PMID: 25281539 DOI: 10.1177/0956462414553826
    To explore the heterogeneity of CD4 responses following highly active antiretroviral therapy, the patterns of CD4 recovery of HIV-1-infected Chinese patients who have been on their first antiretroviral regimen for ≥5 years were analysed. The CD4 trajectories were traced, smoothed and differentiated into three defined profiles. Half (56.3%) were 'satisfactory responders', with CD4 gain of >100 cells/μL and a peak of >350 cells/μL, plateauing before the end of Year 5. Thirty-three (24.4%) were 'continuing responders' whose CD4 rise persisted at Year 4-5. The remaining 26 (19.3%) were 'poor responders'. Presentation with AIDS before therapy was common not just among 'poor' but also paradoxically the 'continuing' responders. While a majority had responded well to antiretroviral therapy, older patients and those with AIDS diagnosis before initiation of therapy may never achieve a satisfactory level even with effective treatment. Categorization of HIV patients by their CD4 trajectory may support the prediction of immunological outcome over time, and ultimately inform treatment choices.
    Matched MeSH terms: CD4 Lymphocyte Count*
  12. Chow WZ, Lim SH, Ong LY, Yong YK, Takebe Y, Kamarulzaman A, et al.
    PLoS ONE, 2015;10(9):e0137281.
    PMID: 26335136 DOI: 10.1371/journal.pone.0137281
    Human immunodeficiency virus type 1 (HIV-1) subtypes have been shown to differ in the rate of clinical progression. We studied the association between HIV-1 subtypes and the rate of CD4+ T-cell recovery in a longitudinal cohort of patients on combination antiretroviral therapy (cART). We studied 103 patients infected with CRF01_AE (69%) and subtype B (31%) who initiated cART between 2006 and 2013. Demographic data, CD4+ T-cell counts and HIV-1 viral load were abstracted from patient medical charts. Kaplan-Meier was used to estimate the time to CD4+ T-cell count increase to ≥350 between subtypes and effects of covariates were analysed using Cox proportional hazards. An 87% of the study population were male adults (mean age of 38.7 years old). Baseline CD4+ T-cell counts and viral loads, age at cART initiation, sex, ethnicity and co-infection did not differ significantly between subtypes. A shorter median time for CD4+ T-cell count increase to ≥350 cells/μL was observed for CRF01_AE (546 days; 95% confidence interval [CI], 186-906 days; P = .502) compared to subtype B (987 days; 95% CI, 894-1079 days). In multivariate analysis, female sex was significantly associated with a 2.7 times higher chance of achieving CD4+ T-cell recovery (adjusted hazard ratio [HR], 2.75; 95% CI, 1.21-6.22; P = .025) and both baseline CD4+ T-cell count (P = .001) and viral load (P = .001) were important predictors for CD4+ T-cell recovery. Immunological recovery correlated significantly with female sex, baseline CD4+ T-cell counts and viral load but not subtype.
    Matched MeSH terms: CD4 Lymphocyte Count*
  13. Asmal HS, Mustafa M, Abdullah S, Zaidah AR, Nurhaslindawati AR, Sarimah A, et al.
    PMID: 20578464
    Pneumocystis pneumonia (PCP) has become the most common opportunistic infection in HIV/AIDS patients with a CD4 count < or = 200. The incidence of PCP has declined as a result of prophylaxis and better highly active antiretroviral therapy (HAART). The objective of this study was to review the demographic data of HIV patients diagnosed clinically as having PCP at the Hospital Raja Perempuan Zainab II (HRPZ II) in Malaysia. This was a prospective study. All HIV patients admitted to HRPZ II with respiratory symptoms were enrolled in this study after giving informed consent. Their demographic data were collected. The total number of HIV patients reviewed in this study was 107. Nearly 60% of patients were clinically diagnosed as having pneumocystis pneumonia based on their signs, symptoms and chest x-ray findings. A CD4 count was available in 83 out of 107 patients. The fifty-three percent of patients(44) had a CD4 < 200 and were clinically diagnosed as having pneumocystis pneumonia. Thirty percent had a CD4 < 200 but did not have clinical pneumocystis pneumonia. Sixteen point nine percent had a CD4 > 200 and had clinical pneumocystis pneumonia, three of whom had received HAART, four patients had received prophylaxis. Overall, 94 patients (87.8%) received prophylaxis for pneumocystis pneumonia. Thirty-three patients (30.8%) received HAART. The occurrence of pneumocystis pneumonia was common before full implementation of HAART. Pneumocystis pneumonia can occur in patients with a CD4 >200.
    Matched MeSH terms: CD4 Lymphocyte Count
  14. Hamid MZ, Aziz NA, Zulkifli ZS, Norlijah O, Azhar RK
    PMID: 18564712
    A prospective cohort study was conducted to determine the incidence of progressive encephalopathy (PE) and its associated clinical manifestations amongst a cohort of HIV infected children attending the HIV/AIDS clinic of the Pediatric Institute, Kuala Lumpur Hospital, Malaysia. Neurological and neurobehavioral assessments were performed in 55 children with HIV over a 24-month study period. Parameters assessed were physical and neurological assessments, CD4 counts, CD4 percentages, RNA viral loads and an IQ assessment at four monthly intervals. PE was diagnosed when patient developed at least one of the definitive criteria for PE based on the Consensus of Pediatric Neurology/Psychology Working Group, AIDS Clinical Trial 1996. The incidence of encephalopathy was 18.2% (n = 10) in 2002. All the patients had hepatosplenomegaly, lymphadenopathy, abnormal deep tendon reflexes and five had impairment in brain growth. The CD4 counts and CD4 percentages were more likely to be associated with PE compared to the non-PE group.
    Matched MeSH terms: CD4 Lymphocyte Count
  15. Hong HC, Koh KC
    Malays Fam Physician, 2013;8(3):43-45.
    PMID: 25893059 MyJurnal
    Figure 1 is a picture of a 48-year-old male patient who presents with progressive painful enlargement of the areolae of 10 months’ duration. There was no bleeding or nipple discharge. He was diagnosed with human immunodeficiency virus (HIV) infection 16 months ago and was initiated on antiretroviral therapy (ARV), which consisted of zidovudine, lamivudine and efavirenz. As his CD4 cell count at diagnosis was less than 200 cells/mm3, he was prescribed trimethoprim-sulphamethoxazole (Bactrim) for prophylaxis against pneumonia due to pneumocystis jirovecii. Physical examination was unremarkable except for bilateral breast enlargement and right-sided old shingles scar in the T4 dermatome distribution.
    Matched MeSH terms: CD4 Lymphocyte Count
  16. Abiola, Abdulrahman Surajudeen, Lekhraj Rampal, Norlijah Othman, Faisal Ibrahim, Hayati Kadir@Shahar, Anuradha P. Radhakrishnan
    MyJurnal
    Adherence to antiretroviral therapy (ART) prevents disease progression, and the emergence of resistant mutations. It also reduces morbidity, and the necessity for more frequent, complicated regimens which are also relatively more expensive. Minimum adherence levels of 95% are required for treatment success. Poor adherence to treatment remains a stumbling block to the success of treatment programs. This generates major concerns about possible resistance of the human immunodeficiency virus (HIV) to the currently available ARVs. This paper aims to describe baseline results from a cohort of 242 Malaysian patients receiving ART within the context of an intervention aimed to improve adherence and treatment outcomes among patients initiating ART. A single-blinded Randomized Controlled Clinical Trial was conducted between January and December, 2014 in Hospital Sungai Buloh. Data on socio-demographic factors, clinical symptoms and adherence behavior of respondents was collected using modified, pre-validated Adult AIDS Clinical Trials Group (AACTG) adherence questionnaires. Baseline CD4 count, viral load, weight, full blood count, blood pressure, Liver function and renal profile tests were also conducted and recorded. Data was analyzed using SPSS version 22 and R software. Patients consisted of 215 (89%) males and 27 (11%) females. 117 (48%) were Malays, 98 (40%) were Chinese, 22 (9%) were Indians while 5 (2%) were of other ethnic minorities. The mean age for the intervention group was 32.1 ± 8.7 years while the mean age for the control group was 34.7 ± 9.5 years. Mean baseline adherence was 80.1 ± 19.6 and 85.1 ± 15.8 for the intervention and control groups respectively. Overall mean baseline CD4 count of patients was 222.97 ± 143.7 cells/mm³ while overall mean viral load was 255237.85 ± 470618.9. Patients had a mean weight of 61.55 ± 11.0 kg and 61.47 ± 12.3 kg in the intervention and control groups, respectively. Males account for about 90% of those initiating ART in the HIV clinic, at a relatively low CD4 count, high viral load and sub-optimal medication adherence levels at baseline.
    Matched MeSH terms: CD4 Lymphocyte Count
  17. Jing W, Ismail R
    Int. J. Dermatol., 1999 Jun;38(6):457-63.
    PMID: 10397587
    BACKGROUND: Mucocutaneous lesions directly related to human immunodeficiency virus (HIV) infection usually present as initial manifestations of immune deficiency. The most common mucocutaneous lesions are Kaposi's sarcoma, histoplasmosis, oro-esophageal candidiasis, oral hairy leukoplakia, and, in Asia, Penicillium marneffei infection. Non-HIV-related skin lesions, such as psoriasis, seborrheic dermatitis, and nodular prurigo, may be the initial presentation among HIV infected patients attending outpatient clinics.

    METHODS: A retrospective analysis was performed on 145 HIV-positive Malaysians of Chinese descent from two centers at the University Hospital Kuala Lumpur (UHKL) and the General Hospital Kuala Lumpur (GHKL) from March 1997 to February 1998. Demographic data and clinical data were analyzed.

    RESULTS: The analysis showed that 104 out of 145 patients had mucocutaneous disorders (71.7%). In the study, there were 100 men (96.2%) and four women (3.8%). The majority of patients were in the age group 20-50 years. The patients who presented with mucocutaneous disease also had low CD4+ T-lymphocyte counts and most had acquired immunodeficiency syndrome (AIDS) defining illness. The number of cases with generalized hyperpigmentation was very high in the group (35.9%), followed by nodular prurigo (29.7%) and xerosis (27.6%). Seborrheic dermatitis was seen in 20.7% of cases, with psoriasis in 8.3%. The most common infections were oral candidiasis (35.9%), tinea corporis and onychomycosis (9.7%), and herpes infection (5.5%); however, mucocutaneous manifestations of Kaposi's sarcoma were rare.

    CONCLUSIONS: The results suggest that mucocutaneous findings are useful clinical predictors of HIV infection or signs of the presence of advanced HIV infection.

    Matched MeSH terms: CD4 Lymphocyte Count
  18. Wood E, Cheong I, Lee C
    Int. J. Clin. Pract., 1998 Jan-Feb;52(1):23-6.
    PMID: 9536563
    A retrospective study of 144 adults with HIV infection was conducted to investigate the prevalence of upper and lower respiratory tract infections (URTIs and LRTIs). The patients were divided into two groups: those with acquired HIV through intravenous drug abuse (IVDA), and those who had acquired HIV through 'other' risk behaviours. LRTIs were more prevalent than URTIs overall, and LRTIs were significantly more common (p < 0.001) in IVDAs than in the other-risk group. Tuberculosis (40%) and bacterial pneumonias (33%) comprised the majority of LRTIs among IVDAs, while Pneumocystis carinii pneumonia (40%) was the commonest LRTI in the other-risk group. Analysis of CD4 T-lymphocyte counts indicated that HIV-seropositive IVDAs are at greater risk of developing chest infections at higher CD4 counts than other-risk patients. The IVDAs were also found to have a much higher rate of co-infection with hepatitis C and B, which may be a factor accelerating the progression from HIV infection to AIDS. The mean time averaged for the two groups from known seroconversion to development of respiratory tract infection is only 1.37 years, which suggests HIV-infected patients are presenting late for treatment in Malaysia.
    Matched MeSH terms: CD4 Lymphocyte Count
  19. Jiamsakul A, Lee MP, Nguyen KV, Merati TP, Cuong DD, Ditangco R, et al.
    Int. J. Tuberc. Lung Dis., 2018 02 01;22(2):179-186.
    PMID: 29506614 DOI: 10.5588/ijtld.17.0348
    SETTING: Tuberculosis (TB) is the most common human immunodeficiency virus (HIV) related opportunistic infection and cause of acquired immune-deficiency syndrome related death. TB often affects those from a low socio-economic background.

    OBJECTIVE: To assess the socio-economic determinants of TB in HIV-infected patients in Asia.

    DESIGN: This was a matched case-control study. HIV-positive, TB-positive cases were matched to HIV-positive, TB-negative controls according to age, sex and CD4 cell count. A socio-economic questionnaire comprising 23 questions, including education level, employment, housing and substance use, was distributed. Socio-economic risk factors for TB were analysed using conditional logistic regression analysis.

    RESULTS: A total of 340 patients (170 matched pairs) were recruited, with 262 (77.1%) matched for all three criteria. Pulmonary TB was the predominant type (n = 115, 67.6%). The main risk factor for TB was not having a university level education (OR 4.45, 95%CI 1.50-13.17, P = 0.007). Burning wood or coal regularly inside the house and living in the same place of origin were weakly associated with TB diagnosis.

    CONCLUSIONS: These data suggest that lower socio-economic status is associated with an increased risk of TB in Asia. Integrating clinical and socio-economic factors into HIV treatment may help in the prevention of opportunistic infections and disease progression.

    Matched MeSH terms: CD4 Lymphocyte Count
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