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Hailu Tilahun Sarah J. Masyuko Jerusha N. Mogaka Tecla Temu John Kinuthia Alfred O. Osoti Damalie Nakanjako Carey Farquhar Stephanie T. Page 《Medicine》2021,100(10)
There is increasing morbidity and mortality from cardiovascular diseases (CVD) in sub-Saharan Africa (SSA). Dyslipidemia is a well-known CVD risk factor which has been associated with human immunodeficiency virus (HIV) infection and its treatment in high-income countries. Studies in SSA that have examined the relationship between HIV and dyslipidemia have reported mixed results. In this study, we sought to determine the prevalence of dyslipidemia in HIV positive and negative adults (>=30 years old) and evaluate for association in Western Kenya with a higher prevalence expected among HIV positive individuals.HIV positive adults receiving antiretroviral therapy (ART) and HIV negative individuals seeking HIV testing and counseling services were recruited into a cross-sectional study. Demographic and behavioral data and fasting blood samples were collected. Dyslipidemia was defined according to the National Cholesterol Education Program Adult Treatment Panel III. Associations between baseline demographic and clinical variables and dyslipidemia were analyzed using logistic regression.A total of 598 participants, 300 HIV positive and 298 HIV negative adults were enrolled. Dyslipidemia data was available for 564 (94%) participants. In total, 267 (47%) had dyslipidemia. This was not significantly different between HIV positive and HIV negative individuals (46% vs 49%, P = .4). In a multivariate analysis including both HIV positive and negative individuals, adults 50 to 59 years of age had a 2-fold increased risk of dyslipidemia (Odds ratio [OR] 2.1, 95% confidence interval (1.2–3.5) when compared to 30 to 39-years-old participants. Abdominal obesity (OR 2.5), being overweight (OR 1.9), and low fruit and vegetable intake (OR 2.2) were significantly associated with dyslipidemia. Among HIV positive participants, time since HIV diagnosis, ART duration, use of (PI) protease inhibitor-based ART, viral load suppression, current cluster of differentiation (CD4) count and nadir CD4 did not have significant associations with dyslipidemia.The prevalence of dyslipidemia is high in Western Kenya, with nearly half of all participants with lipid abnormalities. Dyslipidemia was not significantly associated with HIV status, or with HIV-specific factors. Older age, being overweight, abdominal obesity, and low fruit and vegetable intake were associated with dyslipidemia and may be targets for public health interventions to lower the prevalence of dyslipidemia and CVD risk in sub-Saharan Africa. 相似文献
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Damalie Nakanjako Isaac Ssewanyana Harriet Mayanja-Kizza Agnes Kiragga Robert Colebunders Yukari C Manabe Rose Nabatanzi Moses R Kamya Huyen Cao 《BMC infectious diseases》2011,11(1):43
Background
Antiretroviral therapy (ART) partially corrects immune dysfunction associated with HIV infection. The levels of T-cell immune activation and exhaustion after long-term, suppressive ART and their correlation with CD4 T-cell count reconstitution among ART-treated patients in African cohorts have not been extensively evaluated. 相似文献6.
Nakanjako D Kamya M Daniel K Mayanja-Kizza H Freers J Whalen C Katabira E 《AIDS and behavior》2007,11(5):753-758
HIV testing is an entry point to comprehensive HIV/AIDS prevention and care. In Uganda, Routine Testing and Counseling for
HIV (RTC) is not widely offered as part of standard medical care in acute care settings. This study determined the acceptance
of RTC in a medical emergency setting at Mulago national referral hospital. We interviewed 233 adult patients who were offered
HIV testing. Overall, 83% were unaware of their HIV serostatus and 88% of these had been to a health unit in the previous
six months. Of the 208 eligible for HIV testing, 95% accepted to test. Half the patients were HIV infected and 77% of these
were diagnosed during the study. HIV testing was highly acceptable and detected a significant number of undiagnosed HIV infections.
We recommend adoption of RTC as standard of care in the medical emergency unit in order to scale HIV diagnosis and linkage
to HIV/AIDS care. 相似文献
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Katherine Buhikire Joachim Voss Joanita Kigozi Patience Nyakato Nickson Ankunda Brenda Kalebbo Michael Musiitwa Alex Muganzi Nelson K. Sewankambo Damalie Nakanjako 《AIDS and behavior》2018,22(8):2458-2467
Assisted partner notification programs represent one strategy for targeted HIV testing and treatment of exposed individuals in high-risk populations. This study of a pilot Partner Services program in rural Uganda describes predictors of successful contact tracings and testing of partners of HIV+ individuals and possible barriers to contact. Partner contact tracing data was extracted from registers at seven Ministry of Health facilities between May and October 2016, to inform program implementation and scale up. A total of 464 HIV+ index clients named 660 sexual partners; 334/660 (51%) were contacted, 193/334 (58%) tested for HIV, and 61/193 (32%) tested HIV+. Current relationship status predicted contact [AOR?=?0.23; (95% CI 0.15, 0.37), p?<?0.0001] and testing [AOR?=?0.19; (95% CI 0.09, 0.36), p?<?0.0001]. Partner contact information type was associated with contact (p?<?0.0001), and assisted disclosure with testing (p?<?0.0001). Partner contact tracing is an effective means of identifying undiagnosed HIV infections. 相似文献
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Atorvastatin reduces T‐cell activation and exhaustion among HIV‐infected cART‐treated suboptimal immune responders in Uganda: a randomised crossover placebo‐controlled trial 下载免费PDF全文
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Damalie Nakanjako Juliet Otiti-Sengeri Isaac Ssewanyana Rose Nabatanzi Lois Bayigga Samuel Kirimunda Moses Joloba Yukari C. Manabe Andrew Kambugu Robert Colebunders Harriet Mayanja-Kizza 《Immunology letters》2014
Background
Cataracts contribute 12% of visual loss among HIV-infected adults in Uganda. Immuno-pathogenesis of cataracts may differ among HIV-infected individuals; thus the need for innovative therapeutic interventions among HIV-infected adults.Methods
In a laboratory based case-control study, nested in a clinical/surgical community outreach camp, 50 adults with cataracts eligible for surgery were selected consecutively. HIV testing was done for individuals with unknown HIV sero-status. Peripheral Blood Mononuclear Cells (PBMC) were collected from all HIV-positive-adults-with-cataracts (cases) and HIV-negative-adults-with-cataracts (comparative group) and age-matched HIV-negative and HIV-positive-adults-without-cataracts (comparative group). Treg were measured as CD3 + CD4 + FoxP3 + CD25+Bright and immune activation as CD3 + CD4 + CD38 + HALDR+ using a Facs Canto II flowcytometer. Mann Whitney test was used to compare expression among the four groups.Results
Of 50 adults operated for cataracts, 24 (48%) were female, 25 (50%) were HIV-positive. HIV-positive-individuals had cataracts earlier [median; Inter-quartile Range (IQR); 49 (44–53) years] than HIV-negative [70 (IQR 59–75) years]; p = 0.0005. Treg were lower among individuals with cataracts irrespective of HIV status; p = 0.001; but comparable among younger HIV-positive and elderly HIV-negative with cataracts; p = 0.301. Immune activation levels were comparable among HIV-positive and HIV-negative individuals with cataracts. However, HIV-positive-individuals with cataracts expressed higher levels of immune activation than HIV-positive-individuals without cataracts; p = 0.012 and HIV-negative-individuals-with-cataracts expressed higher levels of immune activation that HIV-negative-without-cataracts; p < 0.0001.Conclusion
CD4 T-cell activation and reduced regulatory T-cell populations were associated with cataracts among adults aging with HIV. We recommend studies on clinical relevance of immune modulation in the prevention of early development of cataracts among adults aging with HIV in Africa. 相似文献10.