14th ICID - Poster Abstracts - International Society for Infectious ...

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When citing these abstracts please use the following reference: Author(s) of abstract. Title of abstract [abstract]. Int J Infect Dis 2010;14S1: Abstract number. Please note that the official publication of the International Journal of Infectious Diseases 2010, Volume 14, Supplement 1 is available electronically on http://www.sciencedirect.com Final Abstract Number: 78.008 Session: HIV: Opportunistic Infections & Malignancies Date: Friday, March 12, 2010 Time: 12:30-13:30 Room: Poster & Exhibition Area/Ground Level Type: Poster Presentation HIV and opportunistic infections in a western hospital of Venezuela, 2007-2009 A. Herrera-Martínez 1 , Y. Herrera 1 , A. M. Pineda 2 1 Hospital Central Antonio María Pineda, Barquisimeto, Lara, Venezuela, 2 Hospital Central Antonio María Pineda, Barquisimeto, Venezuela Background: Numerous opportunistic infections occur in HIV infected patients, particularly in those without access to antiretroviral therapy. In Venezuela it is known a high relationship between TB, PJP and candidiasis in HIV infected patients. Methods: We describe epidemiology, diagnosis and clinical features in HIV infected patients admitted to the Central Hospital of Barquisimeto, Western Venezuela, from January 2007 to September 2009. Monthly records of confirmed HIV cases from the epidemiological archives were collected. Only patients with opportunistic infections were selected. All the clinical relevant variables were considered in this analysis. Results: A total of 228 patients with HIV infection were treated in this medical center during the study period; Forty three (84%) were male; mean age was 36 years 51 (22%) had associated opportunistic infections.; Most cases due to sexual transmission (96%), 56% were heterosexual, 75% promiscuous, with a mean of four couples, beginning sexual relations at 17 years old. Fourteen (27%) patients had previous HIV diagnosis, with a mean of 25 months, just 8 (15%) were receiving treatment; 2/51 (4%) also had other sexual transmission diseases. Most common presented symptoms were fever 21/51 (41%), cough 19/51 (37%), weight loss, vomits and dyspnea had also an important incidence among others. Half patients had anemia. Pneumonia was the most common diagnosis 23/51 (45%), 65% caused by Pneumocystis jirovecii; followed by wasting syndrome 18/51 (35%), candidiasis (mucocutaneous, tracheal, esophagic), pancytopenia 14/51 (27%), and chronic diarrhea 11/51 (21%) among other diagnosis. TB had a low incidence during the study period (11%). Patients, in which lymphocytic count was available, had a CD4 count mean of 168 cells/mm3 and CD8 count of 813 cells/mm3 and a viral load of 62,913 copies/mm3 log 3.06. CFR was 15%. Conclusion: A significant incidence of pneumonia due to Pneumocystis jirovecii was observed. Since the introduction of HAART in Venezuela, a considerable reduction of opportunistic infections was observed but HIV diagnosis usually occurs after opportunistic infections presentation, then, proper diagnosis and prevention campaigns are for outmost important not only in Venezuela, also in other developing countries in order to reduce the incidence of complications and to increase the quality of life of HIV infected patients.
When citing these abstracts please use the following reference: Author(s) of abstract. Title of abstract [abstract]. Int J Infect Dis 2010;14S1: Abstract number. Please note that the official publication of the International Journal of Infectious Diseases 2010, Volume 14, Supplement 1 is available electronically on http://www.sciencedirect.com Final Abstract Number: 78.009 Session: HIV: Opportunistic Infections & Malignancies Date: Friday, March 12, 2010 Time: 12:30-13:30 Room: Poster & Exhibition Area/Ground Level Type: Poster Presentation Prevalence of occult hepatitis B infection among HIV infected patients at an inner city clinic R. Nog, K. Singaravelu, A. Haider, V. Sivapalan, S. Mannheimer Columbia University College Of Physicians and Surgeons affiliation at Harlem Hospital Center, New York, NY, USA Background: Morbidity and mortality is higher in HIV/HBV coinfected than HIV monoinfected patients. Occult HBV infection i.e. isolated positive Hepatitis B core antibody (anti HBc) but Hepatitis B surface antigen (HBs Ag) and surface antibody (HBsAb) negative with HBV DNA is a form of chronic HBV infection that impacts HIV management. Objective: To determine the prevalence and patient characteristics of occult hepatitis B infection in HIV infected patients attending an outpatient HIV clinic in New York. Methods: An electronic database of 630 HIV positive patients at NYC Harlem Hospital Center’s Infectious Diseases clinic between June 2007 and January 2009 was reviewed. Total of 82 patients with HBV serology showing HBsAg-, HBsAb -, anti HBc+ were identified. Of these 57 (69.5 %) had HBV DNA testing information. Information on Demographic variables, Hepatitis C antibody (HCV Ab), antiretroviral therapy (ARV), CD4 and HIV viral load were collected. Results: Among the final study population, majority were males (n=36, 63.2%), African American (n=34, 59.6%), mean age of 48.7 ± 6.2yrs, on ARV (n=39, 70.2%), had CD4 > 200 (n=44, 77.2%), VL < 50 (n=30, 52.6%) and 47.4% (n=27) tested positive for HCV. Approximately 7% (n=4) of study population met the definition of occult HBV infection. 22% of patients not on ARV (n=18) had positive HBV DNA, whereas none of patients on ARV (0%, n=39) had detectable HBV DNA (p=0.007). All patients on ARV (n=39) were on a regimen with anti HBV activity. Of those with occult HBV infection, 50% (n=2) were males, 100% (n=4) were African American, mean CD4 count was 408± 280, 75% (n=3) had HIV viral load > 50, 100% were not on ARV and 75 % tested positive for HCV. Prevalence of HCV by Occult HBV status Conclusion: Though the overall prevalence of occult HBV (7%) in our community clinic is lower than historical prevalence of 11%, among those not on ARV the prevelance was much higher (22%). Further, high proportion of patients with isolated anti HBc also tested positive for HCV ab (47.4%). Therefore clinicians should have a high index of suspicion for occult HBV among HIV infected patients whose hepatitis panel is positive only for core antibody.Clinicians should have a high index of suspicion for occult HBV among HIV infected patients whose hepatitis panel is positive only for core antibody particularly those not on ARV and with HCV coinfection.
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