Nutritional status in patients with HIV infection and AIDS

The aim of this study was to evaluate the nutritional status of adults with HIV infection or with AIDS through the use of biochemical parameters. The study was performed on 43 patients (19 HIV+ and 24 AIDS patients), between 26 and 44 years of age, from low and medium socioeconomic status, with access to health care services; 35 patients were under highly active antiretroviral therapy (HAART) treatment. Body weight and height were determined, and the Body Mass Index calculated (kg/m2). Blood samples were collected from fasting patients. Plasma cholesterol (total, HDL and LDL), triacylglycerol, total protein, apolipoproteins A-I and B, albumin, transthyretin, retinol binding protein, and ceruloplasmin concentrations were determined. Plasma levels of zinc, copper, and selenium were determined in a haemolysis-free sample by flame atomic absorption spectrometry. Statistical analyses were performed with the Student's t-test. AIDS patients showed changes in biochemical parameters, particularly an increase in fibrinogen and a trend to decreased transthyretin levels. These findings stress the importance of the inclusion of functional biochemical parameters in the periodic evaluation of these patients. This would allow an early assessment of the need for appropriate nutritional support, implemented along with the specific retroviral treatment. This would aim at delaying the progression of the disease, and might improve the prospects of survival and quality of life.     

Nutritional support in the patient with HIV infection

Weight loss and malnutrition are the most common symptoms associated with active infection with human immunodeficiency virus. The origin of the malnutrition is considered multifactorial and broadly includes decreased nutrient intake, nutrient malabsorption, and metabolic alterations. Steady advances have been made in understanding the mechanisms underlying weight loss in these patients. The utility and optimal modes of nutrition support have not yet been fully established.     

AIDS and HIV infection in 1998

Last years number of notified and registered AIDS cases was quite stable. Some increasing of HIV infections number was observed. Quality of collected epidemiological data will depend--among other things--on: easy access to HIV testing, completeness of data and diagnosis of AIDS indicator diseases by definitive methods.     

Nutritional support in HIV infection: the use of enteral feeding to achieve weight gain and meet nutritional requirements in a patient with AIDS

This case study reports the progress of a 23-year-old woman with AIDS with inadequate food intake due to painful swallowing. Enteral nutritional support was provided for 118 days and a weight gain of 23.3 kg was achieved in 133 days. This demonstrates that enteral nutritional support can help to maintain nutritional status and facilitate weight gain in people with AIDS.     

Nutritional and metabolic abnormalities in pre-AIDS HIV infection

Since the earliest reports of human immunodeficiency virus (HIV) disease, undernutrition has been associated with HIV infection, typically with the late stages of the disease (namely acquired immunodeficiency syndrome), and may advance to severe wasting and cachexia. Specific micronutrient deficiencies are also recognized to occur with HIV infection, but their actual effect on the clinical course of the disease is hard to assess. The studies reviewed provide more insight into the complex interface between undernutrition and, in some cases, obesity and HIV/acquired immunodeficiency syndrome and highlight the possibility of alleviating or curing undernutrition by means of simple and comparatively inexpensive dietary adjustments.     

Rethinking about HIV infection and AIDS

There is growing interest in the theory that HIV is only a co-factor in the epidemiology of AIDS--a perspective with profound implications for models designed to forecast the future of the AIDS epidemic. Potential input variables for such models include age distribution, initial HIV prevalence, mortality, fertility, work status, migration, intravenous drug users, professional blood donors, transfused blood receivers, homosexuals, commercial sex workers, infected asymptomatic stage duration, number of partners, and state of pregnancy. Models would be of more use to policy makers if they went beyond estimations of eventual epidemic size to evaluate the magnitude of direct and indirect costs to the economy, health sector, and families. An important function of any model should be to assist countries to decide how to spend limited resources. Needed are both standard models to produce simple extrapolations for policy makers and decision makers and more complex models for pinpointing appropriate HIV/AIDS preventive interventions.     

AIDS and HIV infection in Poland in 1999

After gradual increasing in the number of annually diagnosed AIDS cases in the last years these numbers remained relatively stable (nearly 120). The biggest number of newly discovered HIV infections (809) was reported in 1990. Next years these numbers ranged from 384 in 1993 to 637 in 1998. Majority of AIDS cases and HIV-infected persons in Poland were drug users, respectively 50% and 60%. Between 1985 and 1999 some important changes have been observed in Polish data collection system concerning for example: anonimity of reported HIV infections, data completeness and reporting of AIDS indicator diseases. Quality of collected epidemiological data will depend--among others things--on: easy access to HIV testing, data completeness and diagnosis of AIDS indicator diseases by definitive methods.     

AIDS and HIV infection in Poland in 2003

The cumulative number of AIDS cases diagnosed in Poland from 1986 through 2003 reached 1421, and 676 AIDS deaths were registered during this time. Compared to previous years there was a slight increase in number of diagnosed AIDS cases (139 in 2003, incidence 0.36 per 100,000, comparing to 116 in 2002). Moreover the upward trend in AIDS mortality, which began in 2002, continued in 2003, with 61 reported deaths (a 27% increase as compared to 2002 and 45% increase as compared to 2001). Additionally, taking into account the official life statistics data, AIDS deaths might be underreported. In 2003, 610 newly detected HIV infections were reported (incidence 1.5 per 100,000), which is within the range observed in the past years. Injecting drug users constituted the most numerous risk group both among the AIDS cases (59.7%) and the HIV infection cases (35.6%). The proportion of reports of HIV infections with missing information on the risk group, however, remained very high (55% of all reports). In order to monitor the epidemiological situation better quality of data will need to be assured.     

AIDS and HIV infection in Poland in 2002

The cumulative number of AIDS cases diagnosed in Poland from 1986 up to the end of 2002 reached 1273, and 618 AIDS deaths were registered during this time. The yearly number of newly diagnosed cases remained stable (113 in 2002, incidence 0.3 per 100,000), but with 48 reported deaths the downward trend in AIDS mortality, experienced since 1996, was not sustained. Additionally, taking into account the official life statistics data, AIDS deaths might be underreported. In 2002, 574 newly detected HIV infections were reported (incidence 1.5 per 100,000), which is within the range observed in the past years. Injecting drug users constituted the most numerous risk group both among the AIDS cases (56.5%) and the HIV infection cases (31.1%). The proportion of reports of HIV infections with missing information regarding the risk group further increased in 2002, coming up to 55%. In order to monitor the epidemiological situation better quality of data will need to be assured.     

Epidemiology of HIV infection and AIDS in Navarra

The incidence of AIDS in the countries of Western Europe has been declining since 1996. The new antiretrovirals delay the progression of AIDS. Navarra has a double system for the information of HIV infections and of AIDS cases. Up until December 1997, 605 cases of AIDS were notified in Navarra, 40 of which corresponded to the final year, 1997. The annual rate of incidence was 76.4 cases per million inhabitants in 1997, and Navarra occupied the tenth place by autonomous community. In 1996 and 1997, the incidence of AIDS cases diminished in Navarra with respect to previous years. At the European level, the rates of Navarra, as is the case with the rates for Spain, are higher than those observed in all of the countries of the European Union. The most frequent category of transmission is the use of intravenous drugs in 73.2% of the cases. 13.4% are due to transmission by heterosexual contact and 6.1% to homosexual practices between males. Between 1985 and December 1997, 2,239 people were diagnosed with HIV infection in Navarra. HIV infection presents two high points in the years 1987 (249 cases) and 1991 (236 cases). Starting from the year 1992 the diagnoses diminish: 210, 173, 146, 137, 95 and 82 cases in the year 1997. We have observed a decline in the number of cases amongst users of intravenous drugs and an increase of the cases of sexual transmission, especially amongst women.     

Epidemiology of HIV and AIDS infection in Navarra

The incidence of AIDS has been declining in the European Union since 1996 as a result, at least in part, of the use of more efficient treatments for HIV infection. The same tendency can be observed in Navarra, where the average has dropped from 70 annual cases in the first five years of the 1990s to 30 cases in the year 1999. In Navarra, the most frequent category of transmission was the consumption of intravenous drugs, a practice referred to by 72% of those diagnosed with AIDS between 1985 and 1999. 21% were attributed to sexual transmission (7% to homosexual practices and 14% to heterosexual), 2.5% to other mechanisms (mother-child, hemoderivates, etc.) and in the remaining 4.6% information was unavailable on the probable mechanism of transmission. With respect to the incidence of HIV infection, between 1985 and December 1999, 2,379 cases were diagnosed in Navarra. The annual number of new diagnoses of HIV infection showed two maximum peaks in the years 1987 and 1991, with over 200 annual cases. A progressive decline can be observed from 1993 onwards, falling to 40 cases in 1999. The figure of over 2,000 cases of HIV infection contrasts with the 672 cases of AIDS registered in this autonomous community up until the year 2000, and resituates the epidemic in more certain terms. Although the cases of AIDS and HIV have fallen in Navarra in recent years, the data from the microbiology laboratories and the hospital services that treat persons with HIV infection indicate that a considerable number of new cases of infection will continue to occur, which justifies the need for maintaining the prevention programs.     

HIV and AIDS, stigma and AIDS support groups: Perspectives from women living with HIV and AIDS in central Thailand

In this paper, community attitudes toward women living with HIV and AIDS at the present time from the perspectives of women in Thailand are examined. We also look at strategies women use in order to deal with any stigma and discrimination that they may feel or experience in the community. The paper is based on our larger study of the experiences of women living with HIV and AIDS and their participation in clinical trials. In late 2007 and early 2008 we carried out a number of in-depth interviews with women living with HIV and AIDS in central Thailand. We find that women living with HIV and AIDS still deal with stigma and discrimination in their everyday life. However, from the women's narratives, we also find more positive attitudes from local communities. Some women deal with stigma and discrimination by joining and participating in HIV and AIDS support groups that have emerged in response to the AIDS epidemic in Thailand. We argue that women are not passive victims, but that they act in their own agencies to counteract any negativity they might encounter.     

Social support and support groups among people with HIV/AIDS in Ghana

HIV/AIDS, a chronic burden in Ghana, poses social and health outcome concerns to those infected. Examining the Medical Outcome Study Social Support Survey (MOS-SSS) instrument among 300 Ghanaians from a cross-sectional design, Principal Component Analysis yielded four factors (positive interaction, trust building, information giving, and essential support), which accounted for 85.73% of the total variance in the MOS-SSS. A logistic regression analysis showed that essential support was the strongest predictor of the length of time an individual stayed in the support group, whereas positive interaction indicated negative association. The study’s implications for policy, research, and practice were discussed.     

Social support,medication compliance and HIV/AIDS

Social work practitioners and researchers have greatly understudied the idea of how social support correlates with combination therapy medication compliance, in people living with HIV disease. Meanwhile, such data could help health social workers better assist HIV-infected people who want to cope well, live long, and avoid drug resistance. Therefore, this article presents findings from a three-stage empirical secondary data analysis that examined seven specific types of social support, psychological history and stage of illness variables, and sociodemographics and their connection to medication compliance ratings. A sub-sample of 179 HIV-infected clinical trial study participants enrolled in a federally funded combination therapy treatment study and a nested compliance study were analyzed. Analysis of 14 bivariate hypotheses and 20 predictor variables at the multivariate level revealed that having emotional support and being employed seemed to be predictive of being a "Good Complier." Also, having higher levels of HIV symptoms appeared to be associated with being a "Poor Complier."     

Patient attitudes and knowledge about HIV infection and AIDS

BACKGROUND. Family physicians are caring for an increasing number of those with human immunodeficiency virus (HIV) infection, those at risk, and those concerned about HIV disease. METHODS. A questionnaire survey of attitudes and knowledge about HIV infection was conducted in 430 patients in three family practices in Monroe County, NY. RESULTS. The majority of those surveyed had worried about catching HIV and had spoken with friends or relatives about HIV. Approximately 7.5% had had the HIV test. Approximately half of all the respondents expressed a desire to discuss HIV-related issues with their family doctor; however, less than 8% had actually done so. The majority of the respondents believed their family doctor was competent to answer questions about HIV disease. Furthermore, the majority were well informed about the modes of transmission of HIV. Many of the respondents were unsure of the lack of risk from casual contact, however, and whether acquired immune deficiency syndrome (AIDS) is incurable at the present time. CONCLUSIONS. Family physicians need to take a more active role in educating and counseling patients about HIV disease.     

河南省HIV感染者/AIDS患者社会支持现状分析

目的了解河南省艾滋病(AIDS)高发区艾滋病病毒(HIV)感染者/AIDS患者社会支持状况及其影响因素,为进一步制定政策提供依据。方法采用一般调查问卷和社会支持量表(SSRS)对146例HIV感染者/AIDS患者进行调查。结果HIV感染者/AIDS患者社会支持各领域评分及总评分均低于国内常模,差异有统计学意义(P<0.05),AIDS患者社会支持得分为(32.93±5.74)分,低于HIV感染者的(35.90±7.27)分,差异有统计学意义(t=2.412,P=0.017);多元线性回归分析结果表明,未婚、离婚和丧偶(t=-3.513,P=0.002)、AIDS患者(t=-3.516,P=0.001),抑郁状况较重(t=-4.184,P=0.000)是社会支持的不利因素,不受歧视(t=4.279,P=0.000)、家庭经济收入>10 000元(t=4.918,P=0.000)、身体状况好(t=3.006,P=0.003)是社会支持的有利因素。结论河南省AIDS高发区HIV感染者/AIDS患者社会支持状况低于健康人群,社会支持的影响因素包括婚姻状况、疾病阶段、抑郁状况、歧视状况、家庭经济收入状况和健康状况。