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Journal articles on the topic 'AIDS (Disease) Patients Australia'

Author: Grafiati

Published: 4 June 2021

Last updated: 4 February 2022

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1

Murray, John M., Ann M. McDonald, and Matthew G. Law. "Rapidly ageing HIV epidemic among men who have sex with men in Australia." Sexual Health 6, no. 1 (2009): 83. http://dx.doi.org/10.1071/sh08063.

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Background: Antiretroviral therapy has increased survival for individuals living with HIV and has led to an ageing of this population in developed countries. To date the rate of ageing has been unquantified, giving rise to uncertainty in the treatment emphasis and burden in this population. Methods: A mathematical model was used in conjunction with HIV/AIDS data from the Australian National HIV/AIDS Registry to estimate numbers and ages of Australian men who have sex with men (MSM) living with HIV infection from 1980 to 2005. Results: The average age of HIV-infected Australian MSM is estimated to exceed 44 years of age by the year 2010 and has increased by 1 year of age for each two calendar years since the mid-1980s. HIV-infected MSM over 60 years of age have been increasing in number by 12% per year since 1995. A consequence of successful therapy with subsequent ageing of those infected has meant that from 2001 estimated deaths from other causes exceed AIDS deaths in Australia. Conclusions: In summary, our analyses indicate an increasing and rapidly ageing population living with HIV in Australia. This will inevitably lead to more serious non-AIDS conditions in ageing patients living with HIV, and to increased treatment complexity.

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2

Edmiston, Natalie, Erin Passmore, David J. Smith, and Kathy Petoumenos. "Multimorbidity among people with HIV in regional New South Wales, Australia." Sexual Health 12, no. 5 (2015): 425. http://dx.doi.org/10.1071/sh14070.

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Background Multimorbidity is the co-occurrence of more than one chronic health condition in addition to HIV. Higher multimorbidity increases mortality, complexity of care and healthcare costs while decreasing quality of life. The prevalence of and factors associated with multimorbidity among HIV positive patients attending a regional sexual health service are described. Methods: A record review of all HIV positive patients attending the service between 1 July 2011 and 30 June 2012 was conducted. Two medical officers reviewed records for chronic health conditions and to rate multimorbidity using the Cumulative Illness Rating Scale (CIRS). Univariate and multivariate linear regression analyses were used to determine factors associated with a higher CIRS score. Results: One hundred and eighty-nine individuals were included in the study; the mean age was 51.8 years and 92.6% were men. One-quarter (25.4%) had ever been diagnosed with AIDS. Multimorbidity was extremely common, with 54.5% of individuals having two or more chronic health conditions in addition to HIV; the most common being a mental health diagnosis, followed by vascular disease. In multivariate analysis, older age, having ever been diagnosed with AIDS and being on an antiretroviral regimen other than two nucleosides and a non-nucleoside reverse transcriptase inhibitor or protease inhibitor were associated with a higher CIRS score. Conclusion: To the best of our knowledge, this is the first study looking at associations with multimorbidity in the Australian setting. Care models for HIV positive patients should include assessing and managing multimorbidity, particularly in older people and those that have ever been diagnosed with AIDS.

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McMahon, Catherine M., Bamini Gopinath, Julie Schneider, Jennifer Reath, Louise Hickson, Stephen R. Leeder, Paul Mitchell, and Robert Cowan. "The Need for Improved Detection and Management of Adult-Onset Hearing Loss in Australia." International Journal of Otolaryngology 2013 (2013): 1–7. http://dx.doi.org/10.1155/2013/308509.

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Adult-onset hearing loss is insidious and typically diagnosed and managed several years after onset. Often, this is after the loss having led to multiple negative consequences including effects on employment, depressive symptoms, and increased risk of mortality. In contrast, the use of hearing aids is associated with reduced depression, longer life expectancy, and retention in the workplace. Despite this, several studies indicate high levels of unmet need for hearing health services in older adults and poor use of prescribed hearing aids, often leading to their abandonment. In Australia, the largest component of financial cost of hearing loss (excluding the loss of well-being) is due to lost workplace productivity. Nonetheless, the Australian public health system does not have an effective and sustainable hearing screening strategy to tackle the problem of poor detection of adult-onset hearing loss. Given the increasing prevalence and disease burden of hearing impairment in adults, two key areas are not adequately met in the Australian healthcare system: (1) early identification of persons with chronic hearing impairment; (2) appropriate and targeted referral of these patients to hearing health service providers. This paper reviews the current literature, including population-based data from the Blue Mountains Hearing Study, and suggests different models for early detection of adult-onset hearing loss.

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Swanson, Cheryl E., and David A. Cooper. "Factors influencing outcome of treatment with zidovudine of patients with AIDS in Australia." AIDS 4, no. 8 (August 1990): 749–58. http://dx.doi.org/10.1097/00002030-199008000-00006.

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5

Russell, J. "6. DYADIC PERSPECTIVES ON SUPPORT FOR WOMEN LIVING WITH HIV/AIDS IN AUSTRALIA: AN EXPLORATORY STUDY." Sexual Health 4, no. 4 (2007): 286. http://dx.doi.org/10.1071/shv4n4ab6.

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There are more women than ever living with HIV/AIDS in Australia and this relatively small heterogenous population has received scant research attention. Women living with HIV/AIDS, face many complex and compelling challenges in managing this stigmatised illness in their everyday lives. This study sought to gain an understanding of these women's support needs. Semi-structured, in-depth interviews were conducted with two groups: women living with HIV/AIDS (Sydney and Melbourne, involved and not in advocacy); and HIV specialists (Sydney and Melbourne) treating women living with HIV/AIDS. There was a consensus view among both specialists and women that women: have limited knowledge of HIV/AIDS; have no collective or historical understanding of HIV/AIDS; are more likely to present late with HIV; experience diagnosis as extremely distressing; are not aware of the resources available including medical treatments; and are more likely to experience social isolation. Both groups recognised the need for psychological and social support. HIV specialists questioned the effectiveness of community based peer support, while women identified this as one of the most important forms of support. HIV specialists differed in their knowledge and views of CBOs, and this influenced their decisions on recommending these to their female patients. The unique nature of this stigmatised illness calls for the recognition of the contributions of all parties in efforts to address these support needs; the women living with HIV/AIDS, HIV specialists and community based organisations. Particularly in light of the potential for social isolation, inquiries into social structures that provide the opportunity to access social resources are arguably a future direction to advance knowledge in this area.

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Martin, J., and J. Brimacombe. "Chromobacterium Violaceum Septicaemia: The Intensive Care Management of Two Cases." Anaesthesia and Intensive Care 20, no. 1 (February 1992): 88–90. http://dx.doi.org/10.1177/0310057x9202000120.

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The first human infection with Chromobacterium violaceum was recorded in 1927,1 but since men mere have been about 33 cases reported worldwide, including two from Australia.2,3 Chr. violaceum occurs in the tropics and subtropics and is generally considered to be nonpathogenic, but infection can occur in patients who are immunosuppressed4 and it has a high mortality rate.3 This paper presents the intensive care management of two cases of Chr. violaceum infection occurring in Far North Queensland. The patients’ predisposition appears to have been malnourishment and alcohol abuse. The increased use of immunosuppressive drugs and the appearance of diseases such as acquired immune deficiency syndrome (AIDS) make it possible that we will see more of this condition in Australian intensive care units.

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7

Franceschi, Silvia, and Marco Geddes. "Epidemiology of Classic Kaposi's Sarcoma, with Special Reference to Mediterranean Population." Tumori Journal 81, no. 5 (September 1995): 308–14. http://dx.doi.org/10.1177/030089169508100502.

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An excess of classic Kaposi's sarcoma (KS) in individuals of southern European ancestry has long been suspected and recently quantified in terms of age-standardized rates. In Italy and most notably in southern Italy for the period 1976-84, prior to the AIDS epidemic, KS incidence rates were two-to-three-fold higher than in the United States and Sweden and many ten-fold higher than in England and Wales and Australia. A high frequency of classic KS has also been documented in Israel and, in low-risk countries, in individuals born in southern Europe and the Middle East. Many infections have been suspected to play a role in the etiology of KS, including cytomegalovirus, malaria and, most recently, a new virus of the herpes family, identified in AIDS-associated and classic KS. The present review deals with epidemiologic data concerning KS in the Mediterranean and stresses the opportunity to combine the study of KS in AIDS as well as non-AIDS patients in order to shed light on this no longer rare disease.

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8

Foster, Rosalind, Sian Morris, Nathan Ryder, Lynne Wray, and Anna McNulty. "Screening of HIV-infected patients for non-AIDS-related morbidity: an evidence-based model of practice." Sexual Health 8, no. 1 (2011): 30. http://dx.doi.org/10.1071/sh10021.

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Objective: To develop guidelines to facilitate management of HIV infection as a chronic disease within the setting of a sexual health or other HIV outpatient clinic. Methods: We undertook a literature search to identify published guidelines and expert panel commentaries on screening and managing non-AIDS comorbidities in the general and HIV-infected population. We developed evidence-based guidelines for screening and management of non-AIDS comorbidities in HIV-positive clients attending the Sydney Sexual Health Centre (SSHC) that could be used in other HIV outpatient settings. Results: Guidelines have been developed that describe the recommended tests and an interpretation of results, and outline actions to take if abnormal. A summary document can be placed in the medical notes to record completed tests, and resources such as lifestyle modification pamphlets and cardiovascular risk assessment tools made easily available in clinics. Conclusions: These guidelines are being used by nurses and doctors to facilitate the management of HIV as a chronic disease in the SSHC. This represents a significant shift in practice from the traditional role of a sexual health clinic, and is likely to become increasingly important in resource-rich countries such as Australia where individuals with HIV are expected to live beyond their seventh decade. This model could be used in other HIV outpatient settings including general practice.

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Thomas, S. L., K. Lam, L. Piterman, A. Mijch, and P. A. Komesaroff. "Complementary medicine use among people living with HIV/AIDS in Victoria, Australia: practices, attitudes and perceptions." International Journal of STD & AIDS 18, no. 7 (July 1, 2007): 453–57. http://dx.doi.org/10.1258/095646207781147292.

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There is limited evidence suggesting the underlying reasons for the use of complementary and alternative medicines (CAMs) by people with HIV/AIDS, or individual attitudes and beliefs about the use of CAMs. Using focus groups and a survey with 151 individuals attending the HIV Clinics at The Alfred Hospital, Melbourne, we aimed to provide insights into factors that influence the use of CAMs among people living with HIV/AIDS. Roughly half (49%) of the participants had used CAMs to manage their HIV/AIDs. Users of CAMs utilized a wide range of treatments in managing their condition, but costs of the CAMs meant that users were not necessarily able to use them as much as they might have liked. Use of CAMs was based on a desire to find something beneficial rather than on being dissatisfied with conventional medicine. Further research is needed into (a) the effects of CAMs and (b) the enhancement of communication and collaboration between patients, doctors and complementary medicine practitioners.

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Chiang, Yung-Chih, Anna Collins, Prem Chopra, Ti Lu, Eng-Seong Tan, and Jeremy W. Couper. "Understanding the experiences of Mandarin-speaking patients diagnosed with life-threatening cancer in Australia." Palliative and Supportive Care 13, no. 5 (November 10, 2014): 1317–23. http://dx.doi.org/10.1017/s1478951514001175.

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AbstractObjective:People from ethnic minority groups who receive cancer care outside their country of origin may experience poor survival and psychological outcomes relative to that nation's majority groups. This exploratory qualitative study aimed to understand the experience of a large minority group of Mandarin-speaking cancer patients (MSCPs) after diagnosis and treatment of their cancer in Australia, with a view to delineate if cultural or linguistic factors affected the quality of care provided.Method:We employed an exploratory qualitative design involving interviews with 22 MSCPs who were treated during 2009 at the Peter MacCallum Cancer Centre (PMCC) in Melbourne, Australia. Participants were interviewed by a bilingual psychiatrist, audiotaped, transcribed in Mandarin, and then translated into English before being subjected to thematic analysis by two independent researchers.Results:MSCPs experienced notable challenges as a result of both language difficulties and differing cultural approaches, which often limited their understanding of their disease and impeded their ability to access quality care and adequate support. The results call for Australia and other Western nations with increasingly diverse populations to consider how cancer care can be modified to better support people from minority groups to effectively cope with their diagnosis and treatment.Significance of results:This study raises several suggestions for service improvement, including the development of bilingual communication aids, improved educational opportunities for clinical staff to aid their mastery of cultural issues and effective interpreter consultations, and improved access to supportive services offering culturally specific strategies.

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Chen, Sharon C. A. "Cryptococcosis in Australasia and the treatment of cryptococcal and other fungal infections with liposomal amphotericin B." Journal of Antimicrobial Chemotherapy 49, suppl_1 (January 1, 2002): 57–61. http://dx.doi.org/10.1093/jac/49.suppl_1.57.

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Abstract Cryptococcus neoformans is an important fungal pathogen in both immunocompromised and immunocompetent hosts. The mean annual incidence during 1994–1997 was 6.6 cases per million people per year in Australia, and 2.2 cases per million people per year in New Zealand. C. neoformans var. neoformans caused 85% of 312 episodes (98% of episodes in immunocompromised hosts) and C. neoformans var. gattii caused 15% (44% in immunocompetent hosts). The AIDS-specific incidence declined significantly over the 3 years. Mortality from cryptococcosis remains substantial. In trials involving small numbers of AIDS patients, liposomal amphotericin B (AmBisome) was found to be active against C. neoformans, with mycological response rates of 67–85%; however, maintenance therapy with an oral antifungal agent is required indefinitely. In a randomized study of patients with cryptococcal meningitis, AmBisome (4 mg/kg/day) produced mycological eradication in 73% of patients compared with 38% with conventional amphotericin. AmBisome resulted in significantly earlier sterilization of cerebrospinal fluid than conventional amphotericin (7–14 days versus 21 days) and was less nephrotoxic. The benefit of this reduced toxicity is denied to many patients because of an enormous cost barrier. In a survey of the practices of clinical mycologists in Australia, 11 experts responded to a questionnaire survey regarding the use of available lipid preparations. Their indications for use as initial therapy were mucormycosis (7/10), renal failure (7/10), Fusarium infection (2/10) and aspergillosis (2/10). Cryptococcosis, candidosis and febrile neutropenia were rarely regarded as an indication; failed therapy with conventional amphotericin was an indication to use AmBisome for 8/11 respondents. The majority believed that AmBisome was equivalent to conventional amphotericin, with amphotericin B lipid complex and AmBisome equivalent to each other in terms of efficacy. The main barrier to replacement of conventional amphotericin with lipid preparations was seen as an issue of cost.

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12

Wang, G., N. Karimi, J. Descallar, K. O’Connor, J. Pipicella, L. Willmann, A. Williams, and V. W. Huang. "A170 A NOVEL DECISION AID IMPROVES KNOWLEDGE AND QUALITY OF PREGNANCY-RELATED DECISION-MAKING IN IBD." Journal of the Canadian Association of Gastroenterology 4, Supplement_1 (March 1, 2021): 180–82. http://dx.doi.org/10.1093/jcag/gwab002.168.

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Abstract Background Women with inflammatory bowel disease (IBD) with poor IBD-specific reproductive knowledge experience more voluntary childlessness. Poor knowledge is associated with fear of IBD medications in pregnancy; this must be addressed as active IBD at preconception (PC) correlates with worse intrapartum disease and poor fetal outcomes. The Pregnancy IBD Decision Aid (PIDA), developed by an international multidisciplinary team following International Patient Decision Aids Standards, is an interactive online tool that offers personalised decision support on fertility, pregnancy, and medications in IBD (Fig). Aims To assess PIDA’s impact on knowledge and quality of decision-making among PC and pregnant patients with IBD, and to evaluate its feasibility as a tool for patients and clinicians. Methods PC and pregnant women aged 18–45 with IBD, recruited in Canada and Australia, completed questionnaires pre and post PIDA to assess quality of decision-making (Decisional Conflict Scale, DCS; Self-Efficacy Score, SES) and IBD in pregnancy knowledge (Crohn’s and Colitis Pregnancy Knowledge Score, CCPKnow). DCS assesses if a decision is informed, aligned with personal values, and would be implemented. SES measures belief in one’s ability to make informed decisions. Patients and clinicians (gastroenterology, obstetrics, primary care) also completed feasibility surveys. Paired t-test assessed for differences pre and post PIDA. Results DCS and SES were completed by 74 patients (42 Crohn’s disease, 32 ulcerative colitis); 41 PC and 33 pregnant. DCS improved significantly post PIDA (effect size 0.44, p<0.0001); this was observed in PC patients regarding pregnancy planning with IBD, and in pregnant patients regarding peripartum IBD medication management. SES of PC but not pregnant patients improved significantly post PIDA (effect size 0.32 vs 0.24, p=0.0001 vs 0.0525). In both cohorts, CCPKnow improved significantly post PIDA (n=76, effect size 0.66, p<0.0001). Patients (n=73) assessed PIDA feasibility. Mean scores for length (3.05±0.44), readability (3.09±0.5), and content amount (2.91±0.81) were perceived as appropriate (1=limited, 5=excessive). Perceived usefulness of PIDA was high among all patients (4.09±0.93; 5=most useful). Clinicians (n=14) believed PIDA had appropriate length, readability, and content amount, and deemed PIDA useful to patients (4.6±0.8) and themselves (4.8±0.8) for clinical practice. Conclusions PIDA improved knowledge and quality of decision-making in PC and pregnant patients with IBD. Patients developed a strengthened belief in their ability to make informed, effective decisions, and both patients and clinicians found PIDA feasible. PIDA is an accessible tool that can empower women with IBD to make evidence-based decisions about pregnancy and may ultimately reduce voluntary childlessness. Funding Agencies Mount Sinai Hospital Resident Research Grant; Gastroenterological Society of Australia Rose Amarant Grant; Women and Children’s Health Research Institute (WCHRI); Clinical/Community Research Integration Support Program (CRISP); Merck Better Care, Healthy Communities Funding Program

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Siefried, Krista J., Stephen Kerr, Robyn Richardson, Limin Mao, John Rule, John McAllister, John de Wit, and Andrew Carr. "Socioeconomic and psychosocial factors are associated with poor treatment outcomes in Australian adults living with HIV: a case-control study." Sexual Health 16, no. 6 (2019): 548. http://dx.doi.org/10.1071/sh18138.

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Background A substantial minority of patients living with HIV refuse or cease antiretroviral therapy (ART), have virological failure (VF) or develop an AIDS-defining condition (ADC) or serious non-AIDS event (SNAE). It is not understood which socioeconomic and psychosocial factors may be associated with these poor outcomes. Methods: Thirty-nine patients with poor HIV treatment outcomes, defined as those who refused or ceased ART, had VF or were hospitalised with an ADC or SNAE (cases), were compared with 120 controls on suppressive ART. A self-report survey recorded demographics, physical health, life stressors, social supports, HIV disclosure, stigma or discrimination, health care access, treatment adherence, side effects, health and treatment perceptions and financial and employment status. Socioeconomic and psychosocial covariates significant in bivariate analyses were assessed with conditional multivariable logistic regression, adjusted for year of HIV diagnosis. Results: Cases and controls did not differ significantly with regard to sex (96.2% (n = 153) male) or age (mean (± s.d.) 51 ± 11 years). Twenty cases (51%) had refused or ceased ART, 35 (90%) had an HIV viral load >50 copies mL–1, 12 (31%) were hospitalised with an ADC and five (13%) were hospitalised with a new SNAE. Three covariates were independently associated with poor outcomes: foregoing necessities for financial reasons (adjusted odds ratio (aOR) 3.1, 95% confidence interval (95% CI) 1.3–7.6, P = 0.014), cost barriers to accessing HIV care (aOR 3.1, 95% CI 1.0–9.6, P = 0.049) and lower quality of life (aOR 3.8, 95% CI 1.5–9.7, P = 0.004). Conclusions: Despite universal health care, socioeconomic and psychosocial factors are associated with poor HIV outcomes in adults in Australia. These factors should be addressed through targeted interventions to improve long-term successful treatment.

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Williams, A., Y. Leung, and V. Huang. "A237 SHARED DECISION MAKING: DESIGN OF A PREGNANCY IN IBD DECISION AID (PIDA)." Journal of the Canadian Association of Gastroenterology 3, Supplement_1 (February 2020): 113–15. http://dx.doi.org/10.1093/jcag/gwz047.236.

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Abstract Background Given a significant proportion of women with inflammatory bowel disease (IBD) are of child-bearing age, the development of a pregnancy IBD decision aid would benefit patients and clinicians. Lack of IBD-specific reproductive knowledge has been associated with increased “voluntary childlessness” and may contribute to inappropriate medication changes during or after pregnancy. Decision aids support decision making in pregnancy in general, as well as in multiple other chronic diseases. However existing literature has not identified such a resource for women with IBD. Aims To develop a decision aid to improve decision making regarding preconception and pregnancy in IBD among women with IBD. Methods We followed the International Patient Decision Aids Standards (IPDAS). A steering committee of Canadian and Australian health care professionals with an interest in IBD management in pregnancy, in addition to patient representatives, was established. Themes chosen for discussion included inheritance, fertility, nutrition, medications, mode of delivery, breastfeeding, infant health. Initial patient and clinician focus groups were conducted and responses recorded with written/audio mediums. We developed an electronic PIDA draft that incorporates individualised information (type of IBD, pre-conception or pregnant, surgical history, medications) in personalized decision making. Further patient focus groups and interviews were conducted to obtain user opinion of the PIDA draft. Results In July 2017, patient and clinician focus groups were conducted at a Canadian site. Three patients (pre-conception) attended the focus group. Patient concerns - impact of disease and surgery on fertility and preterm delivery; impact of drug therapies on the fetus/ infant; impact of active disease on maternal and fetal/infant health. The clinician focus group included 3 IBD specialists, 2 IBD fellows, 2 IBD nurses, an obstetrician and a neonatal intensivist. Clinician concerns - absence of pre-conception counselling and lack of patient understanding about the impact of disease activity and IBD medication use in pregnancy. Additional patient feedback obtained through interviews (n=15) at two Canadian sites since March 2019 regarding the current electronic PIDA was positive, with comments about content, personalization, readability and unbiased presentation. Suggestions were made for inclusion of additional content such as impact of IBD on sexual function, laboratory changes during pregnancy, and timing of medications post-partum. Conclusions The pre and post PIDA design patient and clinician focus groups and interviews affirmed the role for PIDA. Main decisions considered necessary to address included ideal timing of conception pending disease activity, management of medications, and delivery methods. Ongoing user feedback will be obtained at Australian and Canadian sites during planned alpha testing. Funding Agencies WCHRI, Sinai Health System, UBC

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Petoumenos, Kathy, Matthew G. Law, and on behalf of the Australian HIV Observational Database. "Risk factors and causes of death in the Australian HIV Observational Database." Sexual Health 3, no. 2 (2006): 103. http://dx.doi.org/10.1071/sh05045.

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Introduction: Mortality rates in HIV-infected people remain high in the era of highly active antiretroviral treatment (HAART). The objective of this paper was to examine causes of deaths in the Australian HIV Observational Database (AHOD) and compare risk factors for HIV-related and HIV-unrelated deaths. Methods: Data from AHOD, an observational study of people with HIV attending medical sites between 1999 and 2004, were analysed. Primary and underlying causes of death were ascertained by sites completing a standardised cause of death form. Causes of death were then coded as HIV-related or HIV-unrelated. Risk factors for HIV-related and unrelated deaths were assessed using survival analysis among patients who had a baseline and at least one follow-up CD4 and RNA measure. Results: The AHOD had enrolled 2329 patients between 1999 and 2004. During this time, a total of 105 patients died, with a crude mortality rate of 1.58 per 100 person years. Forty-two (40%) deaths were HIV-related (directly attributable to an AIDS event), 55 (52%) HIV-unrelated (all other causes), and eight had unknown cause of death. Independent risk factors for HIV-related deaths were low CD4 count and receipt of a larger number of antiretroviral treatment combinations. Among HIV-unrelated deaths, low CD4 count and older age were independent risk factors. Conclusions: In AHOD in the HAART era, mortality in people with HIV remains around 10-fold higher than in the general population. In our analyses, HIV-unrelated deaths were associated with more advanced HIV disease in a similar way to HIV-related deaths.

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Di Ciaccio, Pietro R., Fengyi Jin, Matthew Law, Marina Van Leeuwen, Andrew Grulich, Janaki Amin, Claire Vajdic, Skye McGregor, and Mark N. Polizzotto. "The Role of Lymphomas in Subsequent Primary Cancers in People with HIV/AIDS: An Australian National Population-Based Data Linkage Study." Blood 136, Supplement 1 (November 5, 2020): 32. http://dx.doi.org/10.1182/blood-2020-139012.

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Background Despite combination antiretroviral therapy (cART), the incidence of lymphomas remains elevated in persons with HIV/AIDS (PWHA). While the risk of subsequent primary cancers (SPCs) in the general population is well understood, these data are lacking for PWHA. Underlying aetiologic factors in PWHA, including oncogenic viruses and immunodeficiency, may have a differential impact on SPCs. We conducted a nationwide data linkage study in order to examine the role of lymphoma in SPCs in PWHA in two ways. First, we determined the incidence of and risk factors for Hodgkin lymphoma (HL) or non-Hodgkin lymphoma (NHL) (including chronic lymphocytic leukaemia) in PWHA previously diagnosed with an initial cancer of any type. Second, we assessed the incidence and features of SPCs of any type in PWHA after a primary HL or NHL. Methods Since 1982 Australia has had compulsory disease notification of all new HIV infections and all invasive cancers. We conducted a probabilistic data linkage study between the Australian National HIV Registry, the Australian Cancer Database and National Death Index to identify PWHA diagnosed with an initial cancer, followed by at least one SPC between 1982 and 2012. Follow up commenced from 90 days post the date of first cancer diagnosis at or following HIV diagnosis, and ended on 31 December 2012 or death, whichever came earlier. A SPC was defined as a cancer of diverse site and histology to the first cancer and diagnosed more than 90 days later (in order to mitigate ascertainment bias). The incidence of SPC was compared using Poisson regression. Risk factors considered included: age, sex, HIV exposure modality (such as male-to-male, intravenous drug, etc.) and CD4+ cell count at HIV diagnosis (<50, 50-199, 200-499, >500 cells/µL). Incidence was also compared across various eras corresponding to HIV treatment advances: 1982-1995 (pre-cART); 1996-1999 (early-cART); 2000-2004 (availability of protease inhibitors for HIV); and, 2005-2012 (availability of fusion inhibitors for HIV and rituximab for CD20-positive lymphomas). Results Out of 28,696 PWHA, 3,548 were identified with a first cancer. Among them, 229 SPCs were identified over 27,398 person-years (PY) of follow-up. The crude incidence of SPCs was 8.36 per 1000 PY (95% CI 7.34-9.51). Of 229 SPCs, 88 were lymphomas, comprising 42 diffuse large B cell, 4 Burkitt, 3 T cell, 2 primary effusion, 3 low grade lymphomas and 5 HLs; 29 NHLs were not sub-classified in the Database. The majority of first cancers in the group with SPCs were Kaposi sarcoma (KS) (55%). The incidence of lymphoma as an SPC decreased from 8.10 to 0.79 per 1000 PY from 1982-1995 to 2005-2012 (p=0.003). Median time from first cancer diagnosis to the diagnosis of a lymphoma SPC was 2.0 years (interquartile range (IQR): 0.8-4.0). Median age at diagnosis of a lymphoma SPC was 39 years (IQR: 34-49). The risk of a lymphoma SPC decreased with older age, from 10.68 per 1000 PY in those under 35 to 1.28 per 1000 PY in those above 55 (p=0.003). CD4 count at HIV diagnosis and HIV exposure modality were not associated with the risk of a lymphoma SPC. The incidence of a SPC after lymphoma as a first cancer (n=39) was 5.60 per 1000 PY, versus 9.30 per 1000 PY when the first cancer was not lymphoma (n=190, p=0.004). KS was the most common SPC after an initial lymphoma (49% of cases). Only two myeloid SPCs occurred. Median time to diagnosis of SPC after an initial lymphoma was 2.6 years (IQR: 1.1-6.7). Risk of a SPC after a first lymphoma increased significantly from 4.12 per 1000 person-years in those diagnosed with HIV in the 1982-1995 pre-cART era, to 33.15 per 1000 person-years in patients diagnosed with HIV between 2009-2012 (p=0.005). Conclusion The incidence and spectrum of SPC in PWHA is increasingly important as overall and cancer-specific survival of these patients continues to improve. The incidence of lymphomas as SPC in PWHA has decreased over time, which may be a function of improved HIV treatment and reduced susceptibility to immunosuppression-related lymphoma. However, PWHA diagnosed with lymphoma as a first cancer are experiencing increasing incidence of SPCs, occurring after relatively short intervals. Longer survival is likely contributing to this effect. Importantly, therapy-related cancers do not appear prominent, suggesting HIV-specific factors may play a role. These findings emphasise the importance of SPC surveillance tailored to this special population. Disclosures Di Ciaccio: Janssen: Honoraria.

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Kohan, Darius, Paul E. Hammerschlag, and Roy A. Holliday. "Otologic Disease in AIDS Patients." Laryngoscope 100, no. 12 (December 1990): 1326???1330. http://dx.doi.org/10.1288/00005537-199012000-00016.

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Weissler, Jonathan C., and Ann R. Mootz. "Pulmonary Disease in AIDS Patients." American Journal of the Medical Sciences 300, no. 5 (November 1990): 330–43. http://dx.doi.org/10.1097/00000441-199011000-00010.

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Gao, Y., Z. Z. Lu, R. Shi, X. Y. Sun, and Y. Cai. "AIDS and sex education for young people in China." Reproduction, Fertility and Development 13, no. 8 (2001): 729. http://dx.doi.org/10.1071/rd01082.

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Although China has had a rich sexual culture for thousands of years, Chinese people are usually unwilling to openly discuss issues of sex. Some parents are quite ignorant of the change in their children’s sexual attitude and behaviour. In China today, adolescents are becoming much more sexually liberated. Premarital sex and unplanned pregnancies among teenagers are increasing. Sexually transmitted diseases (STD) including HIV/AIDS are also spreading rapidly. However, young people lack basic information on AIDS/STD and do not know how to protect themselves from these diseases or how to avoid unintended pregnancies. Several major youth peer education programmes in China are mentioned in this paper. Among them, a four-year programme entitled the Australian–Chinese AIDS/STD/Safer Sex Peer Education Programme for Youth, is discussed in some detail. The programme has so far reached over 40000 university and school students. Evaluation results show that the programme is effective in both significantly increasing students’ knowledge about AIDS/STDs and changing their attitude towards AIDS patients. In addition, the programme is highly praised by the students.

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Hamm, Hinrich, and Heinrich Matthys. "Pleural disease in patients with AIDS." Current Opinion in Pulmonary Medicine 3, no. 4 (July 1997): 315–18. http://dx.doi.org/10.1097/00063198-199707000-00014.

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Bini, Edmund J., and David L. Diehl. "Colonic disease in patients with AIDS." Techniques in Gastrointestinal Endoscopy 4, no. 2 (April 2002): 77–85. http://dx.doi.org/10.1053/tgie.2002.33010.

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22

Zonta, Marise Bueno, Sérgio Monteiro de Almeida, Mirian T. M. de Carvalho, and Lineu César Werneck. "Functional assesment of patients with AIDS disease." Brazilian Journal of Infectious Diseases 7, no. 5 (October 2003): 301–6. http://dx.doi.org/10.1590/s1413-86702003000500004.

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Oelemann, Walter, Jorge N. Velásquez, Silvana Carnevale, Horacio Besasso, Maria G. M. Teixeira, and José M. Peralta. "Intestinal Chagas' disease in patients with AIDS." AIDS 14, no. 8 (May 2000): 1072. http://dx.doi.org/10.1097/00002030-200005260-00027.

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24

Volberding, Paul. "Treatment of malignant disease in AIDS patients." AIDS 2 (1988): S169–176. http://dx.doi.org/10.1097/00002030-198800001-00025.

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25

Solomon, Patricia J., Susan R. Wilson, Cheryl E. Swanson, and David A. Cooper. "Effect of zidovudine on survival of patients with AIDS in Australia." Medical Journal of Australia 153, no. 5 (September 1990): 254–57. http://dx.doi.org/10.5694/j.1326-5377.1990.tb136895.x.

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26

Navarro, Willis H., and Lawrence D. Kaplan. "AIDS-related lymphoproliferative disease." Blood 107, no. 1 (January 1, 2006): 13–20. http://dx.doi.org/10.1182/blood-2004-11-4278.

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Abstract Not long after the recognition of HIV as the causative agent of AIDS, it was evident that individuals infected with HIV developed lymphoma at a greater rate than the population at large. Approximately two thirds of AIDS-related lymphoma (ARL) cases are categorized as diffuse large B-cell type, with Burkitt lymphomas comprising 25% and other histologies a much smaller proportion. Typically, these individuals have presented with advanced extranodal disease and CD4+ lymphocyte counts of less than 200/mm3. Recent clinical trials have demonstrated a better outcome with chemotherapy for ARL since the introduction of combination antiretroviral treatment, termed highly active antiretroviral therapy (HAART). For patients with relapses, solid evidence points to the safety and utility of hematopoietic-cell transplantation as a salvage modality. Coinfection with other viruses such as Epstein-Barr virus and Kaposi sarcoma-associated herpesvirus have led to the genesis of previously rare or unrecognized lymphoma subtypes such as plasmablastic and primary effusion lymphomas. The immunosuppressive impact of treatment for patients with ARL receiving chemotherapy with HAART appears transient and opportunistic infections have become less problematic than prior to HAART. Significant progress has been made in the understanding and management of ARL but outcomes still remain inferior compared to those achieved in HIV- individuals.

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Santos, Edwiges, Andre Japiassu, Marcia Lazera, and Fernando Bozza. "Fungal disease in AIDS patients in intensive care." Critical Care 17, Suppl 4 (2013): P41. http://dx.doi.org/10.1186/cc12941.

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28

Burke, Don G., Steven N. Emancipator, Michael C. Smith, and Robert A. Salata. "Histoplasmosis and Kidney Disease in Patients with AIDS." Clinical Infectious Diseases 25, no. 2 (August 1997): 281–84. http://dx.doi.org/10.1086/514556.

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29

Benson, Constance A. "Mycobacterium avium Complex Disease in Patients With AIDS." Infectious Diseases in Clinical Practice 4, no. 1 (January 1995): 1–10. http://dx.doi.org/10.1097/00019048-199501000-00001.

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30

Mhiri, Chokri, Laurent Bélec, Bernard Di Costanzo, Alain Georges, and Romain Gherardi. "The slim disease in African patients with AIDS." Transactions of the Royal Society of Tropical Medicine and Hygiene 86, no. 3 (May 1992): 303–6. http://dx.doi.org/10.1016/0035-9203(92)90323-5.

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31

Ezzy, D., R. De Visser, and M. Bartos. "Poverty, disease progression and employment among people living with HIV/AIDS in Australia." AIDS Care 11, no. 4 (August 1999): 405–14. http://dx.doi.org/10.1080/09540129947785.

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32

Petros Kelkile, Desalegn. "Statistical Analysis of Adult HIV/AIDS Patients and Modelling of AIDS Disease Progression." Science Journal of Applied Mathematics and Statistics 4, no. 5 (2016): 189. http://dx.doi.org/10.11648/j.sjams.20160405.12.

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33

Wilcox, C. Mel, and Klaus E. Mönkemüller. "Hepatobiliary Diseases in Patients with AIDS: Focus on AIDS Cholangiopathy and Gallbladder Disease." Digestive Diseases 16, no. 4 (1998): 205–13. http://dx.doi.org/10.1159/000016868.

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34

Kohan, Darius, Stephen G. Rothstein, and Noel L. Cohen. "Otologic Disease in Patients with Acquired Immunodeficiency Syndrome." Annals of Otology, Rhinology & Laryngology 97, no. 6 (November 1988): 636–40. http://dx.doi.org/10.1177/000348948809700611.

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A 5-year retrospective study evaluating otologic disease in patients with acquired immunodeficiency syndrome (AIDS) was conducted at the New York University Medical Center-Bellevue Hospital Center. Twenty-six patients with documented otologic disease who met the Centers for Disease Control criteria for AIDS were identified and their charts were analyzed according to presenting complaints, physical examination, diagnostic modalities, pathologic condition, management, and outcome. A marked diversity of otologic diseases of varying severity was noted. The majority of patients complained of hearing loss and otalgia during their hospitalization for treatment of AIDS-related opportunistic infections. The most frequent diagnoses were otitis externa, acute otitis media, and otitis media with effusion. Sensorineural hearing loss frequently appeared to be related to ototoxic medications and neurologic infections.

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35

&NA;. "Clarithromycin treats M. avium disease in patients with AIDS." Inpharma Weekly &NA;, no. 969 (January 1995): 15. http://dx.doi.org/10.2165/00128413-199509690-00026.

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36

Bonacini, Maurizio, and Loren A. Laine. "Esophageal Disease in Patients with AIDS: Diagnosis and Treatment." Gastrointestinal Endoscopy Clinics of North America 8, no. 4 (October 1998): 811–23. http://dx.doi.org/10.1016/s1052-5157(18)30233-2.

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JACOBSON, MARK A. "Current Management of Cytomegalovirus Disease in Patients with AIDS." AIDS Research and Human Retroviruses 10, no. 8 (August 1994): 917–23. http://dx.doi.org/10.1089/aid.1994.10.917.

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38

Sargent, Juliet, and Eileen Nixon. "IV access options for AIDS patients with cytomegalovirus disease." British Journal of Nursing 6, no. 10 (May 22, 1997): 543–53. http://dx.doi.org/10.12968/bjon.1997.6.10.543.

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39

Corr, Peter D. "Imaging of Cerebrovascular and Cardiovascular Disease in AIDS Patients." American Journal of Roentgenology 187, no. 1 (July 2006): 236–41. http://dx.doi.org/10.2214/ajr.05.0190.

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40

Winston, Jonathan, Gilbert Deray, Trevor Hawkins, Lynda Szczech, Christina Wyatt, and Benjamin Young. "Kidney Disease in Patients with HIV Infection and AIDS." Clinical Infectious Diseases 47, no. 11 (December 2008): 1449–57. http://dx.doi.org/10.1086/593099.

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41

Jacobson, Mark A. "Current Management of Cytomegalovirus Disease in Patients with AIDS." AIDS Patient Care 9, no. 1 (February 1995): 10–17. http://dx.doi.org/10.1089/apc.1995.9.10.

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42

BENSON, CONSTANCE. "Disseminated Mycobacterium avium Complex Disease in Patients with AIDS." AIDS Research and Human Retroviruses 10, no. 8 (August 1994): 913–16. http://dx.doi.org/10.1089/aid.1994.10.913.

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43

., V. Nissapatorn, C. K. C. Lee ., Y. A. L. Lim ., K. S. Tan ., I. Jamaiah ., M. Rohela ., B. L. H. Sim ., et al. "Toxoplasmosis: A Silent Opportunistic Disease in HIV/AIDS Patients." Research Journal of Parasitology 2, no. 1 (January 1, 2007): 23–31. http://dx.doi.org/10.3923/jp.2007.23.31.

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44

Stuart, Rhonda L., Margaret E. Hellard, Damien Jolley, Denis Spelman, Jennifer Hoy, Elaine M. Stevenson, Maria T. Yates, Norbert J. Ryan, and Christopher K. Fairley. "Cryptosporidiosis in patients with AIDS." International Journal of STD & AIDS 8, no. 5 (May 1, 1997): 339–41. http://dx.doi.org/10.1258/0956462971920064.

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Cases of cryptosporidiosis in patients with the acquired immunodeficiency syndrome (AIDS) residing in Melbourne over a 6-year period (1990-1995) are described. During this period 85 cases occurred, while 979 new AIDS diagnoses were notified. Over this period temporal clustering in cryptosporidial detection was evident ( P =0.007), but the pattern was not statistically associated with the season, rainfall ( P =0.88), mean average maximal temperature ( P =0.15) or mean average minimal temperature. Further studies should identify these risk factors and provide an opportunity to prevent this devastating disease.

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45

Khondker, Lubna. "Dermatological Manifestations of HIV/AIDS Patients." Journal of Enam Medical College 9, no. 3 (September 22, 2019): 185–88. http://dx.doi.org/10.3329/jemc.v9i3.43249.

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Human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/ AIDS) is a global pandemic. According to Global HIV & AIDS statistics 2018, approximately 36.9 million people are living with HIV globally, 77.3 million [59.9 million–100 million] people have become infected with HIV since the start of the epidemic, 35.4 million [25.0–49.9 million] people died from AIDS-related illnesses since the start of the epidemic and 940000 [670000–1.3 million] people died from AIDS-related illnesses in 2017. It weakens a person’s immune system by destroying important cells that fight disease and infection. Dermatologic diseases are common in the HIV-infected population. Skin disease can be uniquely associated with HIV disease and many of the cutaneous diseases are not unique to this group, but the presentation can be more severe and recalcitrant to treatment. The spectrum of skin conditions includes skin findings associated with primary HIV infection and a broad range of skin problems related to the immune deficiency of advanced AIDS. Recognition of characteristic eruptions can facilitate early diagnosis of HIV. A broad variety of neoplastic, infectious and non-infectious diseases can manifest in the skin and may alert the clinician of declining of the immune system. This article reviews the current spectrum of HIV-associated skin conditions, focusing on common complaints, infections, drugassociated toxicity and malignancies based on recently published literature relevant to this area. J Enam Med Col 2019; 9(3): 185-188

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46

Flexman, James. "Cat scratch disease in Australia." Microbiology Australia 33, no. 4 (2012): 174. http://dx.doi.org/10.1071/ma12174.

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Companion animals such as cats are important for their health benefits. However, one of the risks of bringing cats into the household is cat scratch disease (CSD), with kittens or stray cats posing the highest risk. CSD is a clinical syndrome caused mainly by Bartonella henselae and is characterised by regional lymphadenopathy in patients with a history of close cat contact within three months of onset of symptoms. In most cases, CSD is a benign, self-limited infection, with more severe infections occurring only rarely in immunocompetent people. However, in immunocompromised patients, including those post-organ transplantation or with advanced HIV infection, the disease can be more severe and avoiding exposure needs to be considered. Improving flea control is also important, as transmission among cats occurs via the cat flea Ctenocephalides felis. To add to the data on B. henselae in Australia, I will report on some previously unpublished data on the seroprevalence and percentage of culture positives in WA domestic cats.

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47

Cheong, I., P. J. Flegg, R. P. Brettle, P. D. Welsby, S. M. Burns, B. Dhillon, C. L. S. Leen, and J. A. Gray. "Cytomegalovirus Disease in AIDS: The Edinburgh Experience." International Journal of STD & AIDS 3, no. 5 (September 1992): 324–28. http://dx.doi.org/10.1177/095646249200300504.

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Retrospective analysis of medical records of 557 HIV positive patients (including 113 with AIDS) revealed 17 patients with an antemortem clinical diagnosis of cytomegalovirus (CMV) disease. This group comprised 7 injection drug users (2 male and 5 female) and 10 homosexual men. Males were significantly older than females, and homosexual men were significantly older than drug users at the time of diagnosis of CMV. All 17 patients had evidence of retinitis, and 6 also had evidence of extraocular disease. CMV retinitis was the AIDS defining diagnosis in two patients, and the attack rate of CMV in all AIDS patients progressively increased with time, with a 3-year CMV-free survival of 57%. Fifteen patients with CMV disease had evidence of previous CMV infection (CMV IgG positive), with 7 also having a positive CMV IgM and 10 a positive viral culture. The mean CD4+ lymphocyte count at diagnosis of CMV was 17 cells/mm3, compared with 68 cells/mm3 at diagnosis of AIDS. Therapy was unsatisfactory, often being complicated by marrow suppression. Relapse occurred in 11 patients after initial improvement but despite this only 3 patients died with severe visual impairment. The mean survival after a diagnosis of CMV was 10.5 months. This study confirms that disease caused by CMV is usually a late manifestation of AIDS, and the increasing prevalence among patients with AIDS implies that, the longer the survival, the greater the risk of disease. Frequent fundoscopy in HIV positive patients is of paramount importance particularly in patients who have a CD4+ lymphocyte count of less than 100 cells/mm3.

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48

White, M., C. Cirrincione, A. Blevins, and D. Armstrong. "Cryptococcal Meningitis: Outcome in Patients with AIDS and Patients with Neoplastic Disease." Journal of Infectious Diseases 165, no. 5 (May 1, 1992): 960–63. http://dx.doi.org/10.1093/infdis/165.5.960.

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49

Thomsen, Hauke, Xinjun Li, Kristina Sundquist, Jan Sundquist, Asta Försti, and Kari Hemminki. "Familial associations for Addison’s disease and between Addison’s disease and other autoimmune diseases." Endocrine Connections 9, no. 11 (November 2020): 1114–20. http://dx.doi.org/10.1530/ec-20-0328.

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Design Addison’s disease (AD) is a rare autoimmune disease (AID) of the adrenal cortex, present as an isolated AD or part of autoimmune polyendocrine syndromes (APSs) 1 and 2. Although AD patients present with a number of AID co-morbidities, population-based family studies are scarce, and we aimed to carry out an unbiased study on AD and related AIDs. Methods We collected data on patients diagnosed with AIDs in Swedish hospitals and calculated standardized incidence ratios (SIRs) in families for concordant AD and for other AIDs, the latter as discordant relative risks. Results The number of AD patients was 2852, which accounted for 0.4% of all hospitalized AIDs. A total of 62 persons (3.6%) were diagnosed with familial AD. The SIR for siblings was remarkably high, reaching 909 for singleton siblings diagnosed before age 10 years. It was 32 in those diagnosed past age 29 years and the risk for twins was 323. SIR was 9.44 for offspring of affected parents. AD was associated with 11 other AIDs, including thyroid AIDs and type 1 diabetes and some rarer AIDs such as Guillain–Barre syndrome, myasthenia gravis, polymyalgia rheumatica and Sjögren’s syndrome. Conclusions The familial risk for AD was very high implicating genetic etiology, which for juvenile siblings may be ascribed to APS-1. The adult part of sibling risk was probably contributed by recessive polygenic inheritance. AD was associated with many common AIDs; some of these were known co-morbidities in AD patients while some other appeared to more specific for a familial setting.

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Goodman, David S., Ellen D. Teplitz, Amy Wishner, Robert S. Klein, Peter G. Burk, and Esther Hershenbaum. "Prevalence of cutaneous disease in patients with acquired immunodeficiency syndrome (AIDS) or AIDS-related complex." Journal of the American Academy of Dermatology 17, no. 2 (August 1987): 210–20. http://dx.doi.org/10.1016/s0190-9622(87)70193-5.

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