Academic literature on the topic 'HIV/AIDS clients-Clinical characteristics'

Background: HIV / AIDS has become a global public health problem like Indonesia, with a fairly large percentage of 80% by 2020. The increase in cases is due to the absence of symptoms or special characteristics that mark the physical characteristics of ODHA and the absence of typical health complaints related to HIV. / AIDS. Anxiety is one of the things that will arise for clients in the form of feelings of fear and caution and unclear and unpleasant vigilance. The emergence of discrimination and classification will affect the quality of life and the level of welfare. Therefore, this study is important to determine the level of effectiveness of counseling interventions on clients' anxiety level with HIV / AIDS. The purpose of this study was to evaluate the effectiveness of the counseling intervention on the anxiety level of high-risk clients with HIV / AIDS. Method: Pre-experimental method with a one-group pre-test approach was developed in this study. HARS is an instrument and purposive sampling for data processing with a sample size of 21 people. Results: The results showed that the respondents had different characteristics, 70% male respondents, 30% of respondents aged 25-30 years, 50% had a high school education, and most worked as hotel employees. Conclusion: Counseling interventions can reduce clients' anxiety levels with a high risk of HIV / AIDS from 100% to 62%; in other words, counseling interventions affect clients' anxiety levels with a high risk of HIV / AIDS.

HIV has disproportionately affected economically vulnerable populations. HIV medical care, including antiretroviral therapy, successfully restores physical health but can be insufficient to achieve social and economic health. It may therefore be necessary to offer innovative economic support programs such as providing business training and microcredit tailored to people living with HIV/AIDS. However, microfinance institutions have shown reluctance to reach out to HIV-infected individuals, resulting in nongovernment and HIV care organizations providing these services. The authors investigate the baseline characteristics of a sample of medically stable clients in HIV care who are eligible for microcredit loans and evaluate their business and financial needs; the authors also analyze their repayment pattern and how their socioeconomic status changes after receipt of the program. The authors find that there is a significant unmet need for business capital for the sample under investigation, pointing toward the potentially beneficial role of providing microfinance and business training for clients in HIV care. HIV clients participating in the loans show high rates of repayment, and significant increases in (disposable) income, as well as profits and savings. The authors therefore encourage other HIV care providers to consider providing their clients with such loans.

Background: Deaths in productive age group due to HIV/AIDS have damaging impact on families and communities, skills are lost, workforce shrinks & children's are orphaned. Our study reports the socio-demographic characteristics of HIV/ AIDS clients from one of the Integrated Counselling & Testing Centre (ICTC) situated at Amtala, West Bengal. This will give us an insight on the distribution of various epidemiological characteristics of the HIV positive clients in this region thus help in formulating strategies for effective implementation of its prevention. The objective was to study socio-demographic profile and risk behavior pattern of HIV positive clients attending ICTC.Methods: It was an observational study cross sectional in design. Records of last eight years of HIV positive clients were accessed from ICTC centre at Amtala hospital, rural training centre, Department of community medicine, ESI PGIMSR medical college, Joka, Kolkata. Data was entered in SPSS for Windows version 20 software. Data was presented in percentages, mean with standard deviation etc.Results: Retrospective record of 62 HIV positive clients was studied, of them 37 were males (5 pediatric cases) and 25 females (7 ANC).Excluding pediatric clients, mean age of clients was 32 years. It was observed that majority of clients were illiterate and were on daily wages. Except one male client who was homosexual rest were heterosexual. Majority of clients 71.9% males and 92% females were married, of them 45.3% males and 34.7% females were sero concordant with their spouse. Seventeen subjects were co infected with TB.Conclusions: HIV sero prevalence rate has inverse relation with literacy level. Majority of male clients were daily wagers who act as link between high risk populations to general population i.e. their spouse, which in turn can pass on the infection to her baby. Lack of knowledge on mode of spread and preventive measures against HIV infection devastate the families making many children orphaned. There is need to carry out intense IEC activities for behavior change at grass root level.

Objective:The study aimed to correlate the status of hepatitis C (HCV) and hepatitis B virus (HBV) co-infection in patients with human immunodeficiency virus (HIV) infection with clinical and demographic data prior to starting highly active antiretroviral therapy (HAART) and assess the impact of HCV and HBV co-infection on the natural history of HIV infection.Patients and Methods:The study involved a total of 836 treatment-naive patients with available serological status for HBV and HCV at the point of therapy initiation. Patients were stratified into four groups: HIV mono-infection, HIV/HCV, HIV/HBV, and HIV/HCV/HBV co-infection. Demographic, epidemiological, immunological and clinical characteristics were analyzed in order to assess the possible impact of HCV and HBV co-infection on HIV - related immunodeficiency and progression to AIDS.Results:The prevalence of HCV and HBV co-infection in our cohort was 25.7% and 6.3%, respectively. Triple HIV/HCV/HBV infection was recorded in 1.7% of the patients. In comparison with those co-infected with HCV, patients with HIV mono-infection had lower levels of serum liver enzymes activity and higher CD4 cell counts, and were less likely to have CD4 cell counts below100 cells/µL and clinical AIDS, with OR 0.556 and 0.561, respectively. No difference in the development of advanced immunodeficiency and/or AIDS was recorded between patients with HIV monoinfection and those co-infected with HBV, or both HCV/HBV.Conclusion:HIV/HCV co-infection was found to be more prevalent than HIV/HBV co-infection in a Serbian cohort. Co-infection with HCV was related to more profound immunodeficiency prior to therapy initiation, reflecting a possible unfavorable impact of HCV on the natural history of HIV infection.

This study is to analyze clinical features of 97 AIDS patients received and treated in our hospital. Clinical data of 97 HIV-infected patients who were admitted between September 2004 and September 2018 were analyzed retrospectively. We found that all patients were in AIDS stage, CD4+ T lymphocytes counts were (210.56 ± 79.31)/µL. After the highly active antiretroviral therapy (HAART) regimens, CD4+ cell number is 315.21 ± 187.90, most patients before clinical symptoms are significantly improved. HIV infections were mainly through intravenous drug injection (51 cases, 52.58%) and sex contact (29 cases, 29.90%). In conclusion, the clinical manifestations of AIDS patients are various, and the main infection route is intravenous drug injection. Multiple measures should be taken to prevent and control HIV transmission, patients should undergo effective antiviral treatment, monitor and follow-up, so as to control opportunistic infection and virus replication.

ObjectiveThis article provides an overview and interpretation of the performance of the US President’s Emergency Plan for AIDS Relief’s (PEPFAR’s) male circumcision programme which has supported the majority of voluntary medical male circumcisions (VMMCs) performed for HIV prevention, from its 2007 inception to 2017, and client characteristics in 2017.DesignLongitudinal collection of routine programme data and disaggregations.Setting14 countries in sub-Saharan Africa with low baseline male circumcision coverage, high HIV prevalence and PEPFAR-supported VMMC programmes.ParticipantsClients of PEPFAR-supported VMMC programmes directed at males aged 10 years and above.Main outcome measuresNumbers of circumcisions performed and disaggregations by age band, result of HIV test offer, procedure technique and follow-up visit attendance.ResultsPEPFAR supported a total of 15 269 720 circumcisions in 14 countries in Southern and Eastern Africa. In 2017, 45% of clients were under 15 years of age, 8% had unknown HIV status, 1% of those tested were HIV+ and 84% returned for a follow-up visit within 14 days of circumcision.ConclusionsOver 15 million VMMCs have been supported by PEPFAR since 2007. VMMC continues to attract primarily young clients. The non-trivial proportion of clients not testing for HIV is expected, and may be reassuring that testing is not being presented as mandatory for access to circumcision, or in some cases reflect test kit stockouts or recent testing elsewhere. While VMMC is extremely safe, achieving the highest possible follow-up rates for early diagnosis and intervention on complications is crucial, and programmes continue to work to raise follow-up rates. The VMMC programme has achieved rapid scale-up but continues to face challenges, and new approaches may be needed to achieve the new Joint United Nations Programme on HIV/AIDS goal of 27 million additional circumcisions through 2020.

Plasmablastic lymphoma is a rare and aggressive B cell lymphoma that is considered to be strongly associated with HIV infection. This article explores the histological morphology and immunohistochemical characteristics of HIV/AIDS-related plasmablastic lymphoma with the goal of improving the diagnosis and treatment of this rare tumor. According to criteria of the World Health Organization Classification of Tumors of Hematopoietic and Lymphoid Tissues (2008), six plasmablastic lymphoma cases admitted to the Shanghai Public Health Clinical Center were comprehensively analyzed with conventional hematoxylin-eosin staining, immunohistochemical staining and in situ hybridization. The morphological features of six tumors were consistent with PBL. Immunohistochemical staining showed that all six cases were negative for CD19, CD20, and CD79a, and positive for OCT-2, BOB-1, VS38c, and melanoma ubiquitous mutated 1. The Ki67 proliferation index was higher than 90% in all six cases. In situ hybridization indicated that four cases were EBER-positive. In addition, three cases had C-MYC translocation rearrangement. Our results showed that the immunophenotypes of PBL vary, which makes PBL diagnosis difficult. Therefore, morphological characteristics, immunophenotypic markers, and clinical data should be used in combination to enable an accurate diagnosis, especially in the presence of immunophenotypic variation, as this approach will facilitate timely treatment.

Introduction Patients with HIV are commonly coinfected with hepatitis C virus (HCV) mostly due to similar routes of transmission, especially in areas with high prevalence of intravenous drug use. In the era of highly active antiretroviral therapy (HAART), life expectancy of these patients has increased and end-stage liver disease is a common cause of death. Material and methods This study included 387 HIV-positive patients treated at the Institute of Infectious and Tropical Diseases "Dr. Kosta Todorovic" in Belgrade. We investigated epidemiological and clinical features of patients who underwent biochemical liver tests, ultrasonography and some of them blind liver biopsies. Results The prevalence of HCV infection among these patients was 58.13% with' 225/387 ELISA anti-HCV-antibody positive patients. HCV coinfection was statistically more significant among male patients aged between 30 and 34, and among intravenous drug users. None of the biochemical parameters were statistically significant among coinfected patients, except aminotraspherase levels which were significantly higher among patients with chronic hepatitis C and HIV. 44 patients underwent biopsy and pathohistological findings showed that every 4th patient (25%) had chronic hepatitis C infection. The average survival rate in coinfected patients in the pre HAART era was the same as in AIDS patients. Conclusions Liver biopsy, elevated aminotraspherase and positive serology can help in making the diagnosis of chronic hepatitis C, and possible future treatment options.

Community nurses have a critical role in caring for people and families affected by HIV/AIDS in the home setting. Despite this, there is a dearth of Australian literature describing the health needs of these clients who are referred to them. This study identified the demographic, clinical and psychoemotional aspects of adult clients with HIV/AIDS in Sydney, Australia, who were referred to community nurses and died between 1993 and 1995. Retrospective data from the records of 73 clients identified on 171 Community Nursing Referral Forms completed within the study period from an inpatient HIV/AIDS Unit was analysed using descriptive statistics and content analysis. The sample was demographically similar to the general population of people with HIV/AIDS during the study period. The most commonly identified clinical aspects of clients included oral candida, mycobacterium avium complex, anaemia, drug intolerance, cytomegalovirus, pain, fever, diarrhoea, weight loss and cough. The most commonly identified psychoemotional variables were depressed mood, anxiety, grief and nonadherence to suggested interventions, with the most common emergent theme being the physical effects of HIV/AIDS illness. Emotional support, symptom monitoring and home assessments were the most common requests made of community nurses. The study sample represented 14% of people who died following AIDS in New South Wales during this known peak period of AIDS diagnoses and deaths following AIDS. As a result of this study, documentation exists describing the characteristics of clients with advanced HIV/AIDS referred to community nurses. Current and future clients with advanced HIV/AIDS referred to community nurses may experience a similar clinical picture to that identified in this study. The findings can be used to reveal relationships amongst the key variables; lay the foundation for further comparative, theory or hypothesis driven studies; and demonstrate how this influences the community nursing role, strategies, interventions and outcomes.

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Objective: To analyze the epidemiological, clinical and behavioral characteristics of patients with AIDS accompanied by the Hospital for Tropical Diseases in Tocantins, from 2007 to 2013. Methods: A descriptive, retrospective and cross. Data were collected from 592 reporting forms and records of adult AIDS cases and child, the period under study, through adapted SINAN record, according to the inclusion and exclusion criteria. We used the chi-square test to see if there were significant differences (p <0.05) between the observed and expected frequencies and in all analyzes, adopting a significance level of 0.05. Results: excelled males (57.4%); aged 20-59 years (93.9%); the brown skin color (82.4%); Singles (65%); with occupancy type employees, self-employed or retired (75.8%); studied the elementary school (44.6%); resided in Tocantins (71.05%). Except gender (p = 0.0001), the other variables showed significant differences (p <0.0001); the cases were reported by the criteria Rio de Janeiro - Caracas: cachexia (16.8%) and asthenia (16.5%), CDC adapted: CD4 T lymphocyte count (51.3%), toxoplasmosis (11.7%) and pneumonia (11%) and 2.4% for criterion death; were alive until the end of data collection (72.5%); AIDS was reported in less than 1 year of HIV diagnosis (80.7%); the year 2013 had a higher incidence of AIDS notifications; exposure to HIV through sexual contact occurred (92.9%); were diagnosed by conventional tests (62.7%); in the notification: CD4 <350 cells - mm3 (79.9%) and viral load> 40 viral copies (77.2%); and last record: CD4> 500 cells - mm3 (49.5%) and viral load <40 copies to undetectable (57.1%); examination performed genotyping (2.4%); visceral leishmaniasis (35%) and pulmonary tuberculosis (21%) were the most prevalent and co-infections, toxoplasmosis (23%) and pneumocystosis (22%) were the major opportunistic infections; in relations: regular - irregular attendance to health services versus coinfection - IO, 56.7% of patients without regularity developed coinfection - IO (p <0.0001); regular - irregular attendance to health services versus death, 85.9% died without those regularly employed (p <0.0001); hospitalization versus coinfection - IO, 63.5% had coinfection - IO but not hospitalized (p <0.0001); coinfection - IO versus death, 71.7% of patients died with some coinfection (p <0.0001); 57.6% of patients used ART with AZT + 3TC + EFV at baseline and at the final on 42.3% used other combinations; the behavior of patients, 41.1% of men reported using or have used any legal or illegal drug (p = 0.0006); 85.7% of men reported not use or never used condoms during sexual intercourse (p = 0.4574); on the type of sexual partner, 93.3% of women and 69.1% of men reported having heterosexual relationship. Conclusion: The analysis of all variables and their results corroborate to achieve the objectives proposed in this study and to understand how it presents the profile of the AIDS epidemic at the local level, contributing to the management in control measures for the spread of AIDS in state and the region.
Objetivo: analisar as características epidemiológicas, clínicas e comportamentais dos pacientes com AIDS acompanhados pelo Hospital de Doenças Tropicais no Tocantins, no período de 2007 a 2013. Métodos: estudo descritivo, retrospectivo e transversal. Foram coletados dados de 592 fichas de notificação e prontuários de casos de AIDS adultos e criança, do período em estudo, através de ficha adaptada do SINAN, obedecendo aos critérios de inclusão e de exclusão. Foi aplicado o teste do Quiquadrado para verificar se havia diferenças significativas (p < 0,05) entre as frequências observadas e esperadas e em todas as análises, sendo adotado um nível de significância igual a 0,05. Resultados: sobressaiu o gênero masculino (57,4%); faixa etária entre 20 a 59 anos (93,9%); a cor parda da pele (82,4%); solteiros (65%); com ocupação tipo empregados, autônomos ou aposentados (75,8%); estudaram o ensino fundamental incompleto (44,6%); residiam no Tocantins (71,05%). Com exceção ao gênero (p = 0,0001), as demais variáveis apresentaram diferenças significativas (p < 0,0001); os casos foram notificados pelos critérios Rio de Janeiro-Caracas: caquexia (16,8%) e astenia (16,5%), CDC adaptado: contagem de linfócitos T CD4 (51,3%), neurotoxoplasmose (11,7%) e pneumonia (11%) e 2,4% por critério óbito; encontravam-se vivos até o final da coleta de dados (72,5%); foi notificado AIDS com menos de 1 ano do diagnóstico de HIV (80,7%); o ano de 2013 teve maior ocorrência de notificações de Aids; a exposição ao HIV ocorreu por via sexual (92,9%); foram diagnosticados por exames convencionais (62,7%); na notificação: CD4 < 350 cels-mm3 (79,9%) e carga viral > 40 cópias virais (77,2%); e último registro: CD4 > 500 cels-mm3 (49,5%) e carga viral < 40 cópias à indetectável (57,1%); realizaram exame de genotipagem (2,4%); a leishmaniose visceral (35%) e a tuberculose pulmonar (21%) foram as coinfecções mais prevalentes e, a toxoplasmose (23%) e a pneumocistose (22%) foram as principais infecções oportunistas; nas relações: comparecimento regular-irregular ao serviço de saúde versus coinfecção-IO, 56,7% dos pacientes sem regularidade desenvolveram coinfecção-IO (p < 0,0001); comparecimento regular-irregular ao serviço de saúde versus óbito, 85,9% faleceram aqueles sem regularidade ao serviço (p < 0,0001); hospitalização versus coinfecção-IO, 63,5% tiveram coinfecção-IO mas não hospitalizaram (p < 0,0001); coinfecção-IO versus óbito, 71,7% dos pacientes faleceram com alguma coinfecção (p < 0,0001); 57,6% dos pacientes utilizaram a TARV com EFZ + AZT + 3TC no início do tratamento e, na última consulta 42,3% utilizou outras combinações; quanto ao comportamento dos pacientes, 41,1% dos homens referiu usar ou já ter usado alguma droga lícita ou ilícita (p = 0,0006); 85,7% dos homens referiu não usar ou nunca ter usado preservativo nas relações sexuais (p = 0,4574); sobre o tipo de parceria sexual, 93,3% das mulheres e 69,1% dos homens informaram ter relacionamento heterossexual. Conclusão: A análise do conjunto de variáveis e seus resultados corroboraram para o alcance dos objetivos propostos neste estudo e para compreender como se apresenta o perfil da epidemia de Aids em âmbito local, contribuindo com a gestão nas medidas de controle para o avanço da Aids no estado e na região.

The research objectives were to describe the age and gender of adult HIV positive clients on ART who received IPT; the incidence of tuberculosis among clients that received IPT and the defaulter rate among those that were commenced on IPT. Quantitative non-experimental descriptive retrospective cohort study was undertaken to ascertain the incidence of tuberculosis among adult HIV positive clients who received IPT. 104 clinic records of HIV positive adult clients accessing care at Isithebe Clinic, iLembe-South Africa who were commenced on IPT between 01 July 2010 and 30 November 2011 were analysed. The study found that 66 of 104 (63.5%) study respondents completed the course of IPT and the majority of those that defaulted were due to poor quality of care. Gender was statistically found to have played a role on whether a patient completes IPT. None of the study respondents that completed IPT was diagnosed with TB disease.
Health Studies
M.A. (Public Health)

M.A.
The researcher has undertaken a social constructionist research project that aims to explore the narratives of therapists who work with HIV-positive clients in the South African context. The researcher hoped to generate information regarding the: difficulties or challenges that are peculiar to this type of therapy and the impact of this therapy on the professional and personal lives of the therapist. The initial part of the dissertation covers an investigation of the literature regarding HIV/AIDS and HIV-related therapy. This literature reveals that mental health workers and psychologists experience considerable stress and 'burn-out' related to the many difficult issues provoked by HIV-positive clients. The theoretical foundations of postmodernism and social constructionist research are also described. In line with the researcher's epistemology, the methodology was qualitative in nature and made use of unstructured interviews. The narratives of the participants were then subjected to a qualitative or thematic analysis. The results of the study are presented in terms of the significant themes in the participants' accounts. It is evident in the narratives of the research participants that there are peculiar difficulties in therapy with HIV-positive clients. Also evident are the significant effects that this work has on the therapists' professional and personal beliefs, attitudes, philosophies and behaviour. Finally the results are discussed and a critical evaluation of the study is offered. The objective of the research is not to generalise the findings to all Clinical Psychologists who work with HIV-positive clients. A recommendation based on the findings is that therapists considering working with HIV-positive clients familiarise themselves with the issues that this therapy raises.

This collection of images of Histopathology is the fruit of the authors' thirty years' experience in the performance of practical exercises in General Pathology. It is aimed at students attending lessons of General Pathology on the Degree Courses in Medical Surgery and Biological Sciences. It does not aspire either to be complete from the point of view of the various organic pathologies, or to replace direct and personal observation of the histological preparations through the microscope, but is rather intended as an aid to students preparing for the exam. It does not include the rudiments of cytology and microscopic anatomy, which it is assumed have already been mastered by those approaching General Histopathology, nor are histopathological phenomena systematically addressed, for which the reader is referred to textbooks on General Pathology. The 44 preparations presented here have been grouped in line with the main arguments of General Pathology: Cellular Degeneration, Inflammation, Neoplasia both benign and malign, and Vascular Pathology. They have been selected for their didactic significance and the simplicity and clarity of the lesions present, without taking into account the information to be derived from the clinical case history. The images of the preparations, in which the best possible quality of reproduction has been sought, are presented in progressive enlargements and are accompanied by brief descriptions comprising the explanations essential for identification of the characteristic aspects of the elementary lesion, as well as any eventual defects in the preparations themselves. Effectively, the objective of the work is to enable the student to exercise his understanding of the images. For this reason the casuistics included is as essential as possible, and the method of presentation utilised is designed to avoid mere visual memorisation, stimulating first analysis and then synthesis, and the development of individual logical skills so as to indicate whether aspects of cellular pathology, inflammation or neoplasia are present.

Effective treatment of clients with co-occurring disorders (CODs) requires the practitioner to be familiar with the continuum of care so that clients become engaged in services needed to address their disorders and related problems. Evidence suggests that clients receiving integrated treatment have higher rates of treatment adherence and improved clinical outcomes, particularly those with more persistent and chronic forms of psychiatric disorders. Therefore, it is best to provide integrated care that focuses on both types of disorders, regardless of whether the client is in an inpatient, residential, or ambulatory treatment setting. Given that clients with CODs have higher rates of problems with treatment adherence compared to those with a single type of disorder, this chapter reviews strategies to improve adherence. It also delineates recovery issues in the domains of physical/lifestyle, psychological, behavioral/cognitive, family/interpersonal/social, and personal growth/maintenance. The authors stress the potential helpfulness of mutual support programs and discuss clinical challenges such as suicide, violence, HIV/AIDS, and hepatitis C.

Chapter 16 describes the clinical case of an adult male who meets diagnostic criteria for pedophilia and who has acted on his pedophilic interests on several known occasions. It addresses important historical and clinical characteristics of the case, as well as treatment efforts and indicators of risk. It also discusses the application of empirically supported practices and clinical science to the assessment, treatment, and risk management of this client, highlighting what is known from the scientific literature, and future directions that will aid in the clinical care of individuals with pedophilic diagnoses.